﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2018v3.1">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2019-11-14T08:38:51-06:00</ReturnTs>
    <TaxPeriodEndDt>2018-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>010523282</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>Berry Dunn McNeil &amp; Parker LLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>1000 Elm Street 4th Floor</AddressLine1Txt>
        <CityNm>Manchester</CityNm>
        <StateAbbreviationCd>NH</StateAbbreviationCd>
        <ZIPCd>03101</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2018-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>042880108</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>Visiting Nurse Association of Boston</BusinessNameLine1Txt>
        <BusinessNameLine2Txt>Management Resources Inc</BusinessNameLine2Txt>
      </BusinessName>
      <BusinessNameControlTxt>VISI</BusinessNameControlTxt>
      <PhoneNum>6178866812</PhoneNum>
      <USAddress>
        <AddressLine1Txt>120 Thomas Street</AddressLine1Txt>
        <CityNm>Worcester</CityNm>
        <StateAbbreviationCd>MA</StateAbbreviationCd>
        <ZIPCd>016081280</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>Todd Rose</PersonNm>
      <PersonTitleTxt>CFO</PersonTitleTxt>
      <PhoneNum>6178866500</PhoneNum>
      <SignatureDt>2019-11-11</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>Dimitrios Panacopoulos CPA</PreparerPersonNm>
      <PTIN>P01603705</PTIN>
      <PhoneNum>6036697337</PhoneNum>
      <PreparationDt>2019-11-11</PreparationDt>
    </PreparerPersonGrp>
    <FilingSecurityInformation>
      <IPAddress>
        <IPv4AddressTxt>69.49.157.66</IPv4AddressTxt>
      </IPAddress>
      <IPDt>2019-11-11</IPDt>
      <IPTm>14:19:54</IPTm>
      <IPTimezoneCd>ES</IPTimezoneCd>
      <FilingLicenseTypeCd>P</FilingLicenseTypeCd>
      <AtSubmissionCreationDeviceId>E86B87CE19A618452E7D988FD4F1BB89485416DA</AtSubmissionCreationDeviceId>
      <AtSubmissionFilingDeviceId>C4707E3AC495039012926C06CAF0FE7A77282DC5</AtSubmissionFilingDeviceId>
    </FilingSecurityInformation>
    <TaxYr>2018</TaxYr>
    <BuildTS>2020-03-31 21:24:44Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="6">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <AddressChangeInd>X</AddressChangeInd>
      <PrincipalOfficerNm>Todd Rose</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>120 Thomas Street</AddressLine1Txt>
        <CityNm>Worcester</CityNm>
        <StateAbbreviationCd>MA</StateAbbreviationCd>
        <ZIPCd>016081280</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>26406444</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>www.bostonvna.org</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1984</FormationYr>
      <LegalDomicileStateCd>MA</LegalDomicileStateCd>
      <ActivityOrMissionDesc>Providing management services to related tax-exempt 501(c)(3) and non-exempt organizations.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>15</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>13</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>385</TotalEmployeeCnt>
      <TotalVolunteersCnt>13</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>2366</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>0</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>0</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>27545203</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>26406444</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>0</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>0</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>0</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>0</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>27545203</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>26406444</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>23812522</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>18985185</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>3732681</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>7421260</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>27545203</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>26406445</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>0</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-1</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>36647637</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>70032316</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>36839719</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>70224399</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>-192082</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>-192083</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>Providing management services to related tax-exempt 501(c)(3) and non-exempt organizations.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <RevenueAmt>26406444</RevenueAmt>
      <Desc>Providing administrative management services to related tax-exempt and non-exempt organizations.</Desc>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd>0</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">0</CreditCounselingInd>
      <TempOrPermanentEndowmentsInd referenceDocumentId="RetDoc1040000001">0</TempOrPermanentEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">1</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">1</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd>0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>0</PYExcessBenefitTransInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWithOfficerEntInd>0</BusinessRlnWithOfficerEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc1043400001">0</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043400001">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc1043400001">0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>34</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>385</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>15</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>13</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>1</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>1</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>1</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>1</LocalChaptersInd>
      <PoliciesReferenceChaptersInd>1</PoliciesReferenceChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>1</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>1</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>MA</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>Stephen Gut</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>5087860693</PhoneNum>
        <USAddress>
          <AddressLine1Txt>120 Thomas Street</AddressLine1Txt>
          <CityNm>Worcester</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>016081280</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>Rita Advani</PersonNm>
        <TitleTxt>Chairman</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Stephanie Jackman-Havey</PersonNm>
        <TitleTxt>Treasurer/CFO</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>39.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>304198</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>13203</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Robin F Spaulding</PersonNm>
        <TitleTxt>Clerk</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Mary Ann O'Connor</PersonNm>
        <TitleTxt>(Past) President &amp; CEO</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>39.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>87338</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>546</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Katharine Bolland Eshghi</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Holly Chaffee</PersonNm>
        <TitleTxt>President/CEO</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>39.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>376542</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>25201</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Stephanne Clark</PersonNm>
        <TitleTxt>Assistant Clerk</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>3.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Renee L Harper</PersonNm>
        <TitleTxt>Vice Chair</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Kathleen T Gardner</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Linda Hope-Springer</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Lenore Monahan</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Michael E Morris</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>John Murphy</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Guy Spinelli MD</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>49.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>449294</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>65678</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Steven Strongwater MD</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>49.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>1173059</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>347440</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Stephen E Tosi MD</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dr Richard Lopez</PersonNm>
        <TitleTxt>CMO</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>49.50</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>328979</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>42052</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Bryan Kaplan</PersonNm>
        <TitleTxt>Director/Predictive Modeling</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>147748</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>George Richardson</PersonNm>
        <TitleTxt>Director/Clinical Systems Application</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>157648</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jennifer Casper</PersonNm>
        <TitleTxt>Director Buisness Operatio</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>170645</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>35075</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Alysia DeMartino</PersonNm>
        <TitleTxt>Nurse Practitioner</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>129332</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>12934</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Theresa Bison</PersonNm>
        <TitleTxt>Director/Managed Care</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>124313</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>23444</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>729686</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>2719410</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>565573</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>7</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Daymarck LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>6405 Metcalf Ave Suite 108</AddressLine1Txt>
            <CityNm>Overland Park</CityNm>
            <StateAbbreviationCd>KS</StateAbbreviationCd>
            <ZIPCd>66202</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Contract Services</ServicesDesc>
        <CompensationAmt>1367986</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>BerryDunn</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1000 Elm St 4th Floor</AddressLine1Txt>
            <CityNm>Manchester</CityNm>
            <StateAbbreviationCd>NH</StateAbbreviationCd>
            <ZIPCd>03101</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Consulting/Audit</ServicesDesc>
        <CompensationAmt>337258</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>The Allied Group</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>25 Amflex Drive</AddressLine1Txt>
            <CityNm>Cranston</CityNm>
            <StateAbbreviationCd>RI</StateAbbreviationCd>
            <ZIPCd>02921</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Printing</ServicesDesc>
        <CompensationAmt>212730</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Language Line Services</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 202564</AddressLine1Txt>
            <CityNm>Dallas</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>75320</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Contract Services</ServicesDesc>
        <CompensationAmt>175463</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Clinlogica</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>58 Lawrence Road</AddressLine1Txt>
            <CityNm>Weston</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>02493</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Data Analytics</ServicesDesc>
        <CompensationAmt>172884</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>6</CntrctRcvdGreaterThan100KCnt>
      <ProgramServiceRevenueGrp>
        <Desc>Management Fees</Desc>
        <BusinessCd>561000</BusinessCd>
        <TotalRevenueColumnAmt>26406444</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>26406444</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>26406444</TotalProgramServiceRevenueAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>26406444</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>26406444</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>14346257</TotalAmt>
        <ManagementAndGeneralAmt>14346257</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>3491227</TotalAmt>
        <ManagementAndGeneralAmt>3491227</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>1147701</TotalAmt>
        <ManagementAndGeneralAmt>1147701</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>3121186</TotalAmt>
        <ManagementAndGeneralAmt>3121186</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>58970</TotalAmt>
        <ManagementAndGeneralAmt>58970</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>389488</TotalAmt>
        <ManagementAndGeneralAmt>389488</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>2364407</TotalAmt>
        <ManagementAndGeneralAmt>2364407</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>123816</TotalAmt>
        <ManagementAndGeneralAmt>123816</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>209530</TotalAmt>
        <ManagementAndGeneralAmt>209530</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>5802</TotalAmt>
        <ManagementAndGeneralAmt>5802</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>524353</TotalAmt>
        <ManagementAndGeneralAmt>524353</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <OtherExpensesGrp>
        <Desc>Printing &amp; Publications</Desc>
        <TotalAmt>230881</TotalAmt>
        <ManagementAndGeneralAmt>230881</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Telephone</Desc>
        <TotalAmt>151443</TotalAmt>
        <ManagementAndGeneralAmt>151443</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Other expenses</Desc>
        <TotalAmt>114825</TotalAmt>
        <ManagementAndGeneralAmt>114825</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Postage and Shipping</Desc>
        <TotalAmt>94001</TotalAmt>
        <ManagementAndGeneralAmt>94001</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>32558</TotalAmt>
        <ManagementAndGeneralAmt>32558</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>26406445</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>26406445</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>-87271</BOYAmt>
        <EOYAmt>-33864</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>291104</BOYAmt>
        <EOYAmt>1056460</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>6749978</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>2366016</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>943139</BOYAmt>
        <EOYAmt>4383962</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>35500665</BOYAmt>
        <EOYAmt>64625758</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>36647637</BOYAmt>
        <EOYAmt>70032316</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>4357460</BOYAmt>
        <EOYAmt>7480131</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>32482259</BOYAmt>
        <EOYAmt>62744268</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>36839719</BOYAmt>
        <EOYAmt>70224399</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
      <UnrestrictedNetAssetsGrp>
        <BOYAmt>-192082</BOYAmt>
        <EOYAmt>-192083</EOYAmt>
      </UnrestrictedNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>-192082</BOYAmt>
        <EOYAmt>-192083</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>36647637</BOYAmt>
        <EOYAmt>70032316</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-1</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>4428427</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4251305</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4392843</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>27545203</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>26406444</CurrentTaxYearAmt>
        <TotalAmt>67024222</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>4428427</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4251305</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4392843</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>27545203</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>26406444</CurrentTaxYearAmt>
        <TotalAmt>67024222</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>67024222</PublicSupportTotal509Amt>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>4428427</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4251305</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4392843</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>27545203</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>26406444</CurrentTaxYearAmt>
        <TotalAmt>67024222</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>1.00000</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>1.00000</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00000</InvestmentIncomeCYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>129371</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>83165</DepreciationAmt>
        <BookValueAmt>46206</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>6620607</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2282851</DepreciationAmt>
        <BookValueAmt>4337756</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>4383962</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>Due From Affiliates</Desc>
        <BookValueAmt>64605758</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Other Assets</Desc>
        <BookValueAmt>20000</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>64625758</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Due To Affiliates</Desc>
        <Amt>62744268</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>62744268</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>26406444</TotalRevEtcAuditedFinclStmtAmt>
      <RevenueNotReportedAmt>0</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>26406444</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>26406444</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>26406445</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>26406445</ExpensesSubtotalAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>26406445</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>The organizations included in these consolidated financial statements, excluding VNA Private Care, Inc. are qualified as public charities under Section 501 (c)(3) of the Internal Revenue Code. As public charities, the Association is exempt from state and federal income taxes on income earned in accordance with its tax exempt purpose. Unrelated business income is subject to state and federal income tax. Management has evaluated the Association's tax position and concluded that the Association has no unrelated business income or uncertain tax positions that require adjustment to the consolidated financial statements.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <Form990OfOtherOrganizationsInd>X</Form990OfOtherOrganizationsInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>1</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Stephanie Jackman-Havey</PersonNm>
        <TitleTxt>Treasurer/CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>304198</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>13203</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>317401</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Holly Chaffee</PersonNm>
        <TitleTxt>President/CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>376542</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>25201</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>401743</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Guy Spinelli MD</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>400476</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>22050</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>26768</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>27500</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>38178</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>514972</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Steven Strongwater MD</PersonNm>
        <TitleTxt>Board Member</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>945616</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>192640</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>34803</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>318654</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>28786</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>1520499</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>272203</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Dr Richard Lopez</PersonNm>
        <TitleTxt>CMO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>227656</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>78743</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>22580</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>27500</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>14552</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>371031</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>97631</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>George Richardson</PersonNm>
        <TitleTxt>Director/Clinical Systems Applicatio</TitleTxt>
        <BaseCompensationFilingOrgAmt>157648</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>157648</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Jennifer Casper</PersonNm>
        <TitleTxt>Director Buisness Operatio</TitleTxt>
        <BaseCompensationFilingOrgAmt>170645</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>35075</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>205720</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>Richard Lopez</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>The sole corporate member shall be The Visiting Nurse Association of Boston Foundation, Inc. acting through its board of directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>The Visiting Nurse Association of Boston Foundation, Inc. shall elect or appoint, and may remove or suspend, directors in accordance with Article III, shall have all rights to vote with respect to the affairs of the Corporation, and shall have such other powers as provided by law, the Articles of Organization or the By-Laws.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Visiting Nurse Association of Boston Foundation, Inc. shall elect or appoint, and may remove or suspend, directors in accordance with Article III, shall have all rights to vote with respect to the affairs of the Corporation, and shall have such other powers as provided by law, the Articles of Organization or the By-Laws.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>990 compiled and reviewed by the CEO and CFO and sent to the Finance Committee for review. The Finance Committee presents to the board for approval. Board members offered a copy of the 990 at that time.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>All board members are required to read and sign a conflict of interest policy annually at the company's annual board meeting. All managers are required to read and sign a conflict of interest policy annually. Also, at the beginning of all Board meetings the Board Chair asks if there are any conflicts with any of the agenda items.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>The VNA of Boston engaged an outside executive compensation consultant to conduct an executive compensation survey for the positions of CEO, CFO, Vice President of Operations, Executive Director of VNA Hospice, Executive Director of VNA Private Care, Inc., Chief Information Officer, Director of Develop/Communications, Director of Provider Relations, Director of Risk, Quality and Regulatory Affairs.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Financial statements are attached to the MA Form PC filed with the attorney general's office, which is open to public inspection. The articles of organization are available at the Massachusetts Secretary of State's office, including on-line. Other governing documents and the conflicts of interest policy are not generally available to the public. Requests for copies of such documents are considered on a case by case basis.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Other Contract Services: Program service expenses 0. Management and general expenses 1,471,554. Fundraising expenses 0. Total expenses 1,471,554. Coding: Program service expenses 0. Management and general expenses 1,649,632. Fundraising expenses 0. Total expenses 1,649,632.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Visiting Nurse Association of Boston Foundation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>500 Rutherford Avenue Suite 200</AddressLine1Txt>
          <CityNm>Charlestown</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02129</ZIPCd>
        </USAddress>
        <EIN>042880614</EIN>
        <PrimaryActivitiesTxt>Fundraising</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VNA Care Network Foundation Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Visiting Nurse Association of Boston Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>500 Rutherford Avenue Suite 200</AddressLine1Txt>
          <CityNm>Charlestown</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02129</ZIPCd>
        </USAddress>
        <EIN>042105800</EIN>
        <PrimaryActivitiesTxt>Home Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VNAB Foundation Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Atrius Health Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>275 Grove Street Suite 3-300</AddressLine1Txt>
          <CityNm>Newton</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02466</ZIPCd>
        </USAddress>
        <EIN>043397450</EIN>
        <PrimaryActivitiesTxt>Provide Medical Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 10</PublicCharityStatusTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Atrius Health Foundation Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>275 Grove Street Suite 3-300</AddressLine1Txt>
          <CityNm>Newton</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02466</ZIPCd>
        </USAddress>
        <EIN>264517944</EIN>
        <PrimaryActivitiesTxt>Support Atrius Health and Its Supporting Organizations</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 12b, II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Atrius Health Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VNA Care Hospice Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>120 Thomas Street</AddressLine1Txt>
          <CityNm>Worcester</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01608</ZIPCd>
        </USAddress>
        <EIN>043217872</EIN>
        <PrimaryActivitiesTxt>Hospice Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VNA Care Network Foundation Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VNA Care Network Foundation Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>120 Thomas Street</AddressLine1Txt>
          <CityNm>Worcester</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01608</ZIPCd>
        </USAddress>
        <EIN>042794849</EIN>
        <PrimaryActivitiesTxt>Management Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Atrius Health Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VNA Care Network Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>120 Thomas Street</AddressLine1Txt>
          <CityNm>Worcester</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01608</ZIPCd>
        </USAddress>
        <EIN>042103825</EIN>
        <PrimaryActivitiesTxt>Home Health Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VNA Care Network Foundation Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VNA Care Advantage Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>120 Thomas Street</AddressLine1Txt>
          <CityNm>Worcester</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01608</ZIPCd>
        </USAddress>
        <EIN>042953171</EIN>
        <PrimaryActivitiesTxt>Day Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VNA Care Network Foundation Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VNA First Choice</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>120 Thomas Street</AddressLine1Txt>
          <CityNm>Worcester</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01608</ZIPCd>
        </USAddress>
        <EIN>812016808</EIN>
        <PrimaryActivitiesTxt>Provide Temporary Staffing</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>vna Care Network Foundation Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>1</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>