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        <ExplanationTxt>FIN 48 DISCLOSURE VNSNY CHOICE WAS INCLUDED IN THE VNS CHOICE AND SUBSIDIARY FINANCIAL STATEMENT AUDIT WITH VNSNY CHOICE COMMUNITY CARE AND THE FOLLOWING STATEMENT IS FROM THE VNS CHOICE AND SUBSIDIARY AUDITED FINANCIAL STATEMENTS: VNSNY CHOICE AND ITS SUBSIDIARY HAVE BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE ORGANIZATIONS DESCRIBED IN INTERNAL REVENUE CODE (THE CODE) SECTION 501(C)(3), AND THEREFORE ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. VNSNY CHOICE RECOGNIZES INCOME TAX POSITIONS WHEN IT IS MORE-LIKELY THAN-NOT THAT THE POSITION WILL BE SUSTAINABLE BASED ON THE MERITS OF THE POSITION. MANAGEMENT HAS CONCLUDED THAT THERE ARE NO MATERIAL TAX LIABILITIES THAT NEED TO BE RECORDED AS OF DECEMBER 31, 2018 AND 2017. H.R. 1, ORIGINALLY KNOWN AS THE TAX CUTS AND JOBS ACT (THE ACT), WAS SIGNED INTO LAW ON DECEMBER 22, 2017. THE ACT CONTAINS VARIOUS PROVISIONS AFFECTING NOT-FOR-PROFIT ENTITIES. TAX-EXEMPT ENTITIES ARE IMPACTED IN PART BY THE INCLUSION OF A NEW EXCISE TAX ON EXCESS COMPENSATION FOR COVERED EMPLOYEES AND CHANGES TO UNRELATED BUSINESS INCOME. THE ACT'S PROVISIONS MAY ALSO IMPACT DONOR INCENTIVES FOR CHARITABLE GIVING. MANAGEMENT OF VNSNY CHOICE HAS DETERMINED THAT THERE IS NO MATERIAL IMPACT ON THE CONSOLIDATED FINANCIAL STATEMENTS AS OF DECEMBER 31, 2018.</ExplanationTxt>
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        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>184038</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>John Caralyus</PersonNm>
        <TitleTxt>Dir., NtkCnt/PrvRel,SH,MA,FIDA</TitleTxt>
        <BaseCompensationFilingOrgAmt>205068</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>15422</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>220490</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Nancy Vitale</PersonNm>
        <TitleTxt>VP, Contact Ctr Svcs&amp;Admin Ops</TitleTxt>
        <BaseCompensationFilingOrgAmt>196643</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>60400</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>863</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>2060</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>19724</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>279690</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Mazin Farraj</PersonNm>
        <TitleTxt>VP, M'care Mkt De (END 09/18)</TitleTxt>
        <BaseCompensationFilingOrgAmt>168520</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>45275</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>97545</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>7493</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>19057</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>337890</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Robert Rieger</PersonNm>
        <TitleTxt>CAO, CHOICE (END 03/18)</TitleTxt>
        <BaseCompensationFilingOrgAmt>69406</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>256429</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>1967</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>327802</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>James Sweeney</PersonNm>
        <TitleTxt>VP, Ops &amp; Exec (END 09/18)</TitleTxt>
        <BaseCompensationFilingOrgAmt>176014</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>70759</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>84193</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>3716</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>5371</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>340053</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 4A</FormAndLineReferenceDesc>
        <ExplanationTxt>SEVERANCE PAYMENT JOHN MURTHA - VNS CHOICE AGREED TO PAY JOHN MURTHA 52 WEEKS OF SALARY AT THE TIME OF SEPARATION FROM VNSNY IN JULY 2017. THE TOTAL AMOUNT PAID IN 2018 WAS $184,038.49. ROBERT RIEGER - VNS CHOICE AGREED TO PAY ROBERT RIEGER 52 WEEKS OF SALARY AT THE TIME OF SEPARATION FROM VNSNY IN MARCH 2018. THE TOTAL AMOUNT PAID IN 2018 WAS $234,461.58. THE BALANCE WILL BE PAID IN 2019. JAMES SWEENEY - VNS CHOICE AGREED TO PAY JAMES SWEENEY 26 WEEKS OF SALARY AT THE TIME OF SEPARATION FROM VNSNY IN SEPTEMBER 2018. THE TOTAL AMOUNT PAID IN 2018 WAS $60,585. THE BALANCE WILL BE PAID IN 2019. MAZIN FARRAJ - VNS CHOICE AGREED TO PAY MAZIN FARRAJ 26 WEEKS OF SALARY AT THE TIME OF SEPARATION FROM VNSNY IN SEPTEMBER 2018. THE TOTAL AMOUNT PAID IN 2018 WAS $64,368.78. THE BALANCE WILL BE PAID IN 2019. MARKI FLANNERY - $166,142.29 (PAID FOR BY RELATED ORGANIZATION - VISITING NURSE SERVICE OF NEW YORK AND INCLUDED IN PART II, COLUMN B(III)). CHRISTOPHER OLIVIA - $866,215.35 (PAID FOR BY RELATED ORGANIZATION - VISITING NURSE SERVICE OF NEW YORK AND INCLUDED IN PART II, COLUMN B(III)). B(III)).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART 1, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>SUPPLEMENTAL RETIREMENT PLAN HANY ABDELAAL - $66,025.38 (INCLUDED IN PART II, COLUMN B(III)) MARKI FLANNERY - $58,775.53 (PAID FOR BY RELATED ORGANIZATION - VISITING NURSE SERVICE OF NEW YORK AND INCLUDED IN PART II, COLUMN B(III)). CHRISTOPHER OLIVIA - $231,863.49 PAID FOR BY RELATED ORGANIZATION - VISITING NURSE SERVICE OF NEW YORK AND INCLUDED IN PART II, COLUMN B(III)). DANIEL SAVITT - $73,200.00 (PAID BY RELATED ORGANIZATION - VISITING NURSE SERVICE OF NEW YORK. THIS AMOUNT WAS ACCRUED IN 2017, BUT HAS NOT YET VESTED AND IS PROPERLY DISCLOSED ON SCHEDULE J, PART II, COLUMN (C)).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART 1, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>DURING THE TAX YEAR, EMPLOYEES OF THE ORGANIZATION WERE PAID NON-FIXED BONUSES BASED ON PERFORMANCE. THESE BONUSES ARE PROPERLY DISCLOSED ON SCHEDULE J, PART II, COLUMN (B)(II)</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="IRS990ScheduleL">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>SUSAN UNDERWOOD</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>DAUGHTER of B.M. GROSS</RelationshipDescriptionTxt>
        <TransactionAmt>202582</TransactionAmt>
        <TransactionDesc>EMPLOYMENT</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS:</FormAndLineReferenceDesc>
        <ExplanationTxt>(A) NAME OF PERSON: SUSAN UNDERWOOD (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: SUSAN UNDERWOOD IS A FAMILY MEMBER OF BETTY M. GROSS - DIRECTOR. (C) DESCRIPTION OF TRANSACTION: SUSAN UNDERWOOD'S EMPLOYMENT WITH VNS CHOICE COMMUNITY CARE PREDATES BETTY M. GROSS' SERVICES AS A DIRECTOR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part I, Line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MISSION OF VNS CHOICE, AS AN AFFILIATE, IS TO HELP ENROLLEES CONTINUE TO LIVE INDEPENDENTLY IN THEIR OWN HOMES AND COMMUNITIES; PROMOTE CHOICE IN HEALTH AND LONG TERM CARE AND TO PROVIDE INNOVATIVE HEALTH AND LONG TERM CARE SOLUTIONS THAT ARE BENEFICIAL, COST EFFECTIVE, AND SERVE EACH ENROLLEE'S NEEDS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION OF ORGANIZATION'S MISSION: HELP MEMBERS CONTINUE TO LIVE INDEPENDENTLY IN THEIR OWN HOME AND COMMUNITIES FOR AS LONG AS POSSIBLE; PROMOTE CHOICE IN HEALTH AND LONG TERM CARE BY DIRECTLY INVOLVING MEMBERS IN THEIR CARE, AND BY OFFERING A WIDE RANGE OF FLEXIBLE SERVICES TO MEET MEMBERS' NEEDS; AND PROVIDE INNOVATIVE HEALTH AND LONG TERM CARE SOLUTIONS THAT ARE BENEFICIAL, COST EFFECTIVE, AND SERVE EACH MEMBER'S NEEDS. VNS CHOICE SHARES THE EMBEDDED VALUES OF MAINTAINING INDEPENDENCE AND DIGNITY THROUGH CHOICE WITH VNSNY AND ITS RELATED 501(C)(3) CORPORATIONS AND RECEIVES SIGNIFICANT ASSISTANCE FROM VNSNY FOR ITS PROGRAMS. THIS ASSISTANCE INCLUDES GRANTS OF PHILANTHROPIC DOLLARS (MONIES FROM DONORS AND FROM VNSNY'S OWN RESERVES) FOR ITS CHARITABLE INITIATIVES. IN 2018, VNSNY CHOICE, A MANAGED CARE ORGANIZATION LICENSED UNDER ARTICLE 44 OF THE NEW YORK STATE HEALTH LAWS, OPERATED AN INTEGRATED MEDICARE ADVANTAGE/MEDICAID MANAGED LONG-TERM CARE PLAN ALSO KNOWN AS "FULLY INTEGRATED DUAL ADVANTAGE" (FIDA), WHICH PROVIDED HEALTH COVERAGE TO INDIVIDUALS WHO ARE ELIGIBLE FOR BOTH MEDICARE AND MLTC BENEFITS. FIDA SERVES ALL 5 BOROUGHS OF NYC AND HAS OVER 1,233 ENROLLEES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III - PROGRAM SERVICE, LINE 4A</FormAndLineReferenceDesc>
        <ExplanationTxt>VNSNY CHOICE, A MANAGED CARE ORGANIZATION LICENSED UNDER ARTICLE 44 OF THE NEW YORK STATE HEALTH LAWS, OPERATES MANAGED LONG-TERM CARE ("MLTC") AND "MLTC PLUS" PROGRAMS. IT IS A CAPITATED MEDICAID PROGRAM THAT ARRANGES FOR AND MANAGES INDIVIDUALLY TAILORED CARE FOR MEDICAID-ELIGIBLES WHO WISH TO LIVE AT HOME BUT BECAUSE OF MULTIPLE CLINICAL DIAGNOSES NEED DAY-TO-DAY ASSISTANCE. ONE OF THE LARGEST MLTC PROGRAM IN NEW YORK STATE, VNSNY CHOICE HAS OVER 14,701 MEMBERS AND SERVES ALL BOROUGHS OF NEW YORK CITY PLUS NASSAU, SUFFOLK, WESTCHESTER, DUTCHESS, ORANGE, ROCKLAND, SULLIVAN, ULSTER AND PUTNAM COUNTIES. VNSNY CHOICE MLTC EXPANDED ITS SERVICE AREA IN 2013 TO UPSTATE NEW YORK AND NOW HAS ENROLLMENT IN MULTIPLE COUNTIES, INCLUDING: ALBANY, COLUMBIA, ERIE, GREENE, MONROE, MONTGOMERY, RENSSELAER, SARATOGA, SCHNECTADY, SCHOHARIE, WARREN, WASHINGTON, ONEIDA, AND ONONDAGA COUNTIES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>MATTHEW BOX SERVED AS INTERIM CFO OF THE ORGANIZATION FROM JUNE 11, 2017 TO JANUARY 28, 2018. MATTHEW BOX IS A MANAGING DIRECTOR WITH ALVAREZ &amp; MARSAL, AND HIS SERVICES AS INTERIM CFO WERE PROVIDED PURSUANT TO A CONTRACT WITH ALVAREZ &amp; MARSAL. VNSNY HAD A PRIOR BUSINESS RELATIONSHIP WITH ALVAREZ &amp; MARSAL THAT PRECEDED MATTHEW BOX'S APPOINTMENT AS INTERIM CFO. MATTHEW BOX RECUSED HIMSELF FROM ANY DISCUSSIONS THAT THE MANAGEMENT OF VNSNY HAD REGARDING CONTRACTS WITH ALVAREZ &amp; MARSAL. FOR THE PERIOD OF 1/1/2018 - 1/28/2018, ALVAREZ &amp; MARSAL WAS PAID $73,600 FOR THE SERVICES PROVIDED BY MATTHEW BOX AS INTERM CFO OF VNSNY. FORM 990, PART VI, SECTION A, LINE 6 VNS CONTINUING CARE DEVELOPMENT CORPORATION IS THE SOLE CORPORATE MEMBER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MEMBER MAY ELECT THE DIRECTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>VNS CONTINUING CARE DEVELOPMENT CORPORATION IS THE SOLE CORPORATE MEMBER. THE MEMBER HOLDS ANNUAL MEETINGS TO ELECT THE DIRECTORS, AND THE MEMBER MAY TAKE ACTION AS REQUIRED OR PERMITTED UNDER THE ORGANIZATION'S BYLAWS OR UNDER ANY PROVISION OF LAW.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AUDIT COMMITTEE OF VNSNY AND ITS AFFILIATED ORGANIZATIONS REVIEWED THE FORM 990. A COMPLETE COPY OF THE ORGANIZATION'S FINAL FORM 990, INCLUDING ALL REQUIRED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, WAS PROVIDED TO EACH VOTING MEMBER OF VNS CHOICE'S BOARD BEFORE ITS FILING WITH THE IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE TAXPAYER DOES NOT HAVE A SEPERATE POLICY BUT HAS ADOPTED THE POLICIES AND PROCEDURES OF VNSNY. THE PROCEDURES UNDERTAKEN AT THE VNSNY LEVEL ARE DESCRIBED BELOW: THE CHIEF AND PRIVACY COMPLIANCE OFFICER REVIEWS THE DISCLOSURE STATEMENTS COMPLETED ANNUALLY BY EACH OFFICER, DIRECTOR, AND KEY EMPLOYEE, AND CONSULTS WITH THE EXECUTIVE VICE PRESIDENT, GENERAL COUNSEL &amp; CHIEF RISK OFFICER AS APPROPRIATE. ANY POTENTIAL CONFLICTS ARE VETTED WITH THE CEO, EXECUTIVE VICE PRESIDENT, GENERAL COUNSEL &amp; CHIEF RISK OFFICER AND, AS APPROPRIATE, THE CHAIR OF THE BOARD. SPECIFIC FOLLOW-UP ACTION IS TAKEN ON A CASE-BY-CASE BASIS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Lines 13 &amp; 14</FormAndLineReferenceDesc>
        <ExplanationTxt>THE TAXPAYER DOES NOT HAVE A SEPARATE WHISTLEBLOWER OR DOCUMENT RETENTION AND DESTRUCTION POLICY, BUT HAS ADOPTED THE POLICIES AND PROCEDURES OF VNSNY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15A &amp; 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE TAXPAYER DOES NOT HAVE A SEPARATE POLICY BUT HAS ADOPTED THE POLICIES AND PROCEDURES OF VNSNY. THE PROCEDURES UNDERTAKEN AT THE VNSNY LEVEL ARE DESCRIBED BELOW: VNSNY REVIEWS ITS OVERALL EXECUTIVE COMPENSATION PROGRAM ON A PERIODIC BASIS. EXECUTIVE COMPENSATION REVIEWS WERE DONE IN PART IN 2017 AND IN 2018. THE PROCESS FOR DETERMINING THE INDIVIDUAL COMPENSATION LEVELS OF VNSNY'S TOP MANAGEMENT, INCLUDING THE CEO, AND ALL OFFICERS MEETS THE THREE REQUIREMENTS OF THE REBUTTABLE PRESUMPTION UNDER TREAS. REG. 53.4958-6. A COMPENSATION COMMITTEE IS APPOINTED BY THE BOARD OF DIRECTORS FOR THE PURPOSE OF ASSISTING THE BOARD TO FULFILL ITS RESPONSIBILITY TO VNSNY AND THE COMMUNITY TO ENSURE THE COMPENSATION IS IN ACCORDANCE WITH VNSNY'S POLICIES. THE COMMITTEE IS COMPRISED OF FOUR DIRECTORS WHO ARE INDEPENDENT OF MANAGEMENT AND VNSNY AND FREE OF ANY CONFLICTS OF INTEREST THAT WOULD INTERFERE WITH THEIR EXERCISE OF INDEPENDENT JUDGMENT. PRIOR TO MAKING COMPENSATION DECISIONS, THE COMMITTEE OBTAINS AND RELIES UPON APPROPRIATE DATA AS TO COMPARABILITY. THE COMMITTEE RETAINS AN INDEPENDENT COMPENSATION CONSULTANT AND UTILIZES LOCAL AND NATIONAL COMPENSATION SURVEYS TO ASSIST IN SETTING COMPENSATION LEVELS. THE COMPENSATION COMMITTEE ADEQUATELY AND ON A TIMELY BASIS DOCUMENTS THE BASIS FOR SETTING COMPENSATION WITH THE MAKING OF THE DETERMINATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>DOCUMENTS ARE AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:CONTRACTED HHA/HA PROVIDERS TOTAL FEES:XXX-XX-XXXX</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:CONTRACTED HEALTH PROVIDERS TOTAL FEES:XXX-XX-XXXX</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:OTHER PROFESSIONAL SERVICES TOTAL FEES:47519210</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:TEMPORARY HELP TOTAL FEES:812102</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VISITING NURSE SERVICE OF NEW YORK</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>220 EAST 42ND STREET 6TH FL</AddressLine1Txt>
          <CityNm>NEW YORK</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>10017</ZIPCd>
        </USAddress>
        <EIN>133189926</EIN>
        <PrimaryActivitiesTxt>HOME HEALTH</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12,III-FI</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VISITING NURSE SVC OF NY HOME CARE II</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>220 EAST 42ND STREET 6TH FL</AddressLine1Txt>
          <CityNm>NEW YORK</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>10017</ZIPCd>
        </USAddress>
        <EIN>131624211</EIN>
        <PrimaryActivitiesTxt>HOME HEALTH</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VNSNY</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VNS CONTINUING CARE DEVELOPMENT CORP</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>220 EAST 42ND STREET 6TH FL</AddressLine1Txt>
          <CityNm>new york</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>10017</ZIPCd>
        </USAddress>
        <EIN>133974198</EIN>
        <PrimaryActivitiesTxt>LT CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12,III-FI</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VNSNY</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VNS CHOICE COMMUNITY CARE</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>220 EAST 42ND STREET 6TH FL</AddressLine1Txt>
          <CityNm>NEW YORK</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>10017</ZIPCd>
        </USAddress>
        <EIN>320053323</EIN>
        <PrimaryActivitiesTxt>HOME &amp; COMMU.</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VNS CHOICE</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VISITING NURSE SVC OF NY HOSPICE CARE</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>220 EAST 42ND STREET 6TH FL</AddressLine1Txt>
          <CityNm>NEW YORK</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>10017</ZIPCd>
        </USAddress>
        <EIN>300006817</EIN>
        <PrimaryActivitiesTxt>HOSPICE CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VNSNY</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>NEW PARTNERS INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>220 EAST 42ND STREET 6TH FL</AddressLine1Txt>
          <CityNm>NEW YORK</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>10017</ZIPCd>
        </USAddress>
        <EIN>133885148</EIN>
        <PrimaryActivitiesTxt>HOME HEALTH</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VNSNY</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>FAMILY CARE SERVICES INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>220 EAST 42ND STREET 6TH FL</AddressLine1Txt>
          <CityNm>NEW YORK</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>10017</ZIPCd>
        </USAddress>
        <EIN>133213081</EIN>
        <PrimaryActivitiesTxt>HOME HEALTH</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VNSNY</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MEDICAL CARE AT HOME PC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>220 EAST 42ND STREET 6TH FLOOR</AddressLine1Txt>
          <CityNm>NEW YORK</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>10017</ZIPCd>
        </USAddress>
        <EIN>264175570</EIN>
        <PrimaryActivitiesTxt>HOME HEALTH</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VNSNY</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C CORP</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>0</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>0</ShareOfEOYAssetsAmt>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>true</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>true</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>true</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>true</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>true</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>VNS CHOICE COMMUNITY CARE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>467097</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>VNS CHOICE COMMUNITY CARE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>1061143</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
