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        <OtherCompensation>753</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>HELEN VAFAIE</NamePerson>
        <Title>MENTAL HEALTH MD</Title>
        <AverageHoursPerWeek>40.0</AverageHoursPerWeek>
        <AverageHoursPerWeekRelated>0.0</AverageHoursPerWeekRelated>
        <HighestCompensatedEmployee>X</HighestCompensatedEmployee>
        <ReportableCompFromOrganization>124800</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>1347</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>CYNTHIA KATZAN</NamePerson>
        <Title>HOSPICE MD</Title>
        <AverageHoursPerWeek>0.0</AverageHoursPerWeek>
        <AverageHoursPerWeekRelated>40.0</AverageHoursPerWeekRelated>
        <HighestCompensatedEmployee>X</HighestCompensatedEmployee>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>147902</ReportableCompFromRelatedOrgs>
        <OtherCompensation>504</OtherCompensation>
      </Form990PartVIISectionA>
      <TotalReportableCompFromOrg>124800</TotalReportableCompFromOrg>
      <TotalReportableCompFrmRltdOrgs>940607</TotalReportableCompFrmRltdOrgs>
      <TotalOtherCompensation>42636</TotalOtherCompensation>
      <NumberIndividualsGT100K>1</NumberIndividualsGT100K>
      <FormersListed>false</FormersListed>
      <TotalCompGT150K>true</TotalCompGT150K>
      <CompensationFromOtherSources>false</CompensationFromOtherSources>
      <ContractorCompensation>
        <NameOfContractor>
          <NamePerson>DEULEY HOME REHABILITATION</NamePerson>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>35104 EUCLID AVE STE 311</AddressLine1>
            <City>WILLOUGHBY</City>
            <State>OH</State>
            <ZIPCode>44094</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>THERAPY SERVICES</DescriptionOfServices>
        <Compensation>155770</Compensation>
      </ContractorCompensation>
      <NumberOfContractorsGT100K>1</NumberOfContractorsGT100K>
      <FederatedCampaigns>104843</FederatedCampaigns>
      <GovernmentGrants>250419</GovernmentGrants>
      <AllOtherContributions>388643</AllOtherContributions>
      <TotalContributions>743905</TotalContributions>
      <ProgramServiceRevenue>
        <Description>MEDICARE</Description>
        <BusinessCode>621610</BusinessCode>
        <TotalRevenueColumn>14827331</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>14827331</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
        <Description>MEDICAID</Description>
        <BusinessCode>621610</BusinessCode>
        <TotalRevenueColumn>1152442</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>1152442</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
        <Description>THIRD PARTY PAYORS</Description>
        <BusinessCode>621610</BusinessCode>
        <TotalRevenueColumn>354628</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>354628</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
        <Description>SELF PAY</Description>
        <BusinessCode>621610</BusinessCode>
        <TotalRevenueColumn>4174</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>4174</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <TotalProgramServiceRevenue>16338575</TotalProgramServiceRevenue>
      <InvestmentIncome>
        <TotalRevenueColumn>925425</TotalRevenueColumn>
        <ExclusionAmount>925425</ExclusionAmount>
      </InvestmentIncome>
      <IncomeFromInvestBondProceeds>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </IncomeFromInvestBondProceeds>
      <RoyaltiesRevenue>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </RoyaltiesRevenue>
      <RentalIncomeOrLoss>
        <Real>0</Real>
        <Personal>0</Personal>
      </RentalIncomeOrLoss>
      <NetRentalIncomeOrLoss>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetRentalIncomeOrLoss>
      <NetGainOrLossInvestments>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetGainOrLossInvestments>
      <NetIncomeFromFundraisingEvents>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetIncomeFromFundraisingEvents>
      <NetIncomeFromGaming>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetIncomeFromGaming>
      <NetIncomeOrLoss>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetIncomeOrLoss>
      <OtherRevenueMisc>
        <Description>MANAGEMENT SERVICES</Description>
        <BusinessCode>900099</BusinessCode>
        <TotalRevenueColumn>136548</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>136548</RelatedOrExemptFunctionIncome>
      </OtherRevenueMisc>
      <OtherRevenueMisc>
        <Description>MISCELLANEOUS</Description>
        <BusinessCode>621610</BusinessCode>
        <TotalRevenueColumn>23692</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>23692</RelatedOrExemptFunctionIncome>
      </OtherRevenueMisc>
      <TotalOtherRevenue>160240</TotalOtherRevenue>
      <TotalRevenue>
        <TotalRevenueColumn>18168145</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>16498815</RelatedOrExemptFunctionIncome>
        <ExclusionAmount>925425</ExclusionAmount>
      </TotalRevenue>
      <GrantsToDomesticOrgs>
        <Total>0</Total>
      </GrantsToDomesticOrgs>
      <GrantsToDomesticIndividuals>
        <Total>0</Total>
      </GrantsToDomesticIndividuals>
      <ForeignGrants>
        <Total>0</Total>
      </ForeignGrants>
      <BenefitsToMembers>
        <Total>0</Total>
      </BenefitsToMembers>
      <CompCurrentOfficersDirectors>
        <Total>0</Total>
      </CompCurrentOfficersDirectors>
      <CompDisqualPersons>
        <Total>0</Total>
      </CompDisqualPersons>
      <OtherSalariesAndWages>
        <Total>9273288</Total>
        <ProgramServices>7047699</ProgramServices>
        <ManagementAndGeneral>2225589</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </OtherSalariesAndWages>
      <PensionPlanContributions>
        <Total>0</Total>
      </PensionPlanContributions>
      <OtherEmployeeBenefits>
        <Total>892900</Total>
        <ProgramServices>678604</ProgramServices>
        <ManagementAndGeneral>214296</ManagementAndGeneral>
      </OtherEmployeeBenefits>
      <PayrollTaxes>
        <Total>868016</Total>
        <ProgramServices>659692</ProgramServices>
        <ManagementAndGeneral>208324</ManagementAndGeneral>
      </PayrollTaxes>
      <FeesForServicesManagement>
        <Total>3977799</Total>
        <ProgramServices>2999077</ProgramServices>
        <ManagementAndGeneral>978722</ManagementAndGeneral>
      </FeesForServicesManagement>
      <FeesForServicesLegal>
        <Total>2988</Total>
        <ProgramServices>2533</ProgramServices>
        <ManagementAndGeneral>455</ManagementAndGeneral>
      </FeesForServicesLegal>
      <FeesForServicesAccounting>
        <Total>8575</Total>
        <ProgramServices>6517</ProgramServices>
        <ManagementAndGeneral>2058</ManagementAndGeneral>
      </FeesForServicesAccounting>
      <FeesForServicesLobbying>
        <Total>0</Total>
      </FeesForServicesLobbying>
      <FeesForServicesProfFundraising>
        <Total>0</Total>
      </FeesForServicesProfFundraising>
      <FeesForServicesInvstMgmntFees>
        <Total>63345</Total>
        <ProgramServices>48142</ProgramServices>
        <ManagementAndGeneral>15203</ManagementAndGeneral>
      </FeesForServicesInvstMgmntFees>
      <FeesForServicesOther>
        <Total>637366</Total>
        <ProgramServices>484398</ProgramServices>
        <ManagementAndGeneral>152968</ManagementAndGeneral>
      </FeesForServicesOther>
      <Advertising>
        <Total>79214</Total>
        <ProgramServices>79214</ProgramServices>
      </Advertising>
      <OfficeExpenses>
        <Total>429709</Total>
        <ProgramServices>326579</ProgramServices>
        <ManagementAndGeneral>103130</ManagementAndGeneral>
      </OfficeExpenses>
      <InformationTechnology>
        <Total>0</Total>
      </InformationTechnology>
      <Royalties>
        <Total>0</Total>
      </Royalties>
      <Occupancy>
        <Total>433078</Total>
        <ProgramServices>329139</ProgramServices>
        <ManagementAndGeneral>103939</ManagementAndGeneral>
      </Occupancy>
      <Travel>
        <Total>521040</Total>
        <ProgramServices>508540</ProgramServices>
        <ManagementAndGeneral>12500</ManagementAndGeneral>
      </Travel>
      <TravelEntrtnmntPublicOfficials>
        <Total>0</Total>
      </TravelEntrtnmntPublicOfficials>
      <ConferencesMeetings>
        <Total>89021</Total>
        <ProgramServices>67656</ProgramServices>
        <ManagementAndGeneral>21365</ManagementAndGeneral>
      </ConferencesMeetings>
      <Interest>
        <Total>-2083</Total>
        <ProgramServices>-1583</ProgramServices>
        <ManagementAndGeneral>-500</ManagementAndGeneral>
      </Interest>
      <PaymentsToAffiliates>
        <Total>0</Total>
      </PaymentsToAffiliates>
      <DepreciationDepletion>
        <Total>342566</Total>
        <ProgramServices>260350</ProgramServices>
        <ManagementAndGeneral>82216</ManagementAndGeneral>
      </DepreciationDepletion>
      <Insurance>
        <Total>0</Total>
      </Insurance>
      <OtherExpenses>
        <Description>MEDICAL SUPPLIES</Description>
        <Total>278254</Total>
        <ProgramServices>278254</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>BAD DEBTS</Description>
        <Total>188956</Total>
        <ProgramServices>188956</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>RECRUITMENT</Description>
        <Total>3991</Total>
        <ProgramServices>3033</ProgramServices>
        <ManagementAndGeneral>958</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>MISCELLANEOUS</Description>
        <Total>32603</Total>
        <ProgramServices>29225</ProgramServices>
        <ManagementAndGeneral>3378</ManagementAndGeneral>
      </OtherExpenses>
      <TotalFunctionalExpenses>
        <Total>18120626</Total>
        <ProgramServices>13996025</ProgramServices>
        <ManagementAndGeneral>4124601</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </TotalFunctionalExpenses>
      <CashNonInterestBearing>
        <BOY>72602</BOY>
        <EOY>12166</EOY>
      </CashNonInterestBearing>
      <SavingsAndTempCashInvestments>
        <BOY>2421827</BOY>
        <EOY>2883024</EOY>
      </SavingsAndTempCashInvestments>
      <PledgesAndGrantsReceivable>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </PledgesAndGrantsReceivable>
      <AccountsReceivable>
        <BOY>2861967</BOY>
        <EOY>2883889</EOY>
      </AccountsReceivable>
      <ReceivablesFromOfficersEtc>
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        <EOY>0</EOY>
      </ReceivablesFromOfficersEtc>
      <ReceivablesFromDisqualPersons>
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        <EOY>0</EOY>
      </ReceivablesFromDisqualPersons>
      <OtherNotesLoansReceivableNet>
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        <EOY>0</EOY>
      </OtherNotesLoansReceivableNet>
      <InventoriesForSaleOrUse>
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        <EOY>0</EOY>
      </InventoriesForSaleOrUse>
      <PrepaidExpensesDeferredCharges>
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        <EOY>341856</EOY>
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      <LandBuildingsEquipmentBasis>6259576</LandBuildingsEquipmentBasis>
      <LandBldgEquipmentAccumDeprec>6018568</LandBldgEquipmentAccumDeprec>
      <LandBuildingsEquipmentBasisNet>
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      </LandBuildingsEquipmentBasisNet>
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      </InvestmentsPubTradedSecurities>
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        <EOY>101250</EOY>
      </InvestmentsOtherSecurities>
      <InvestmentsProgramRelated>
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        <EOY>0</EOY>
      </InvestmentsProgramRelated>
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        <EOY>0</EOY>
      </IntangibleAssets>
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      <GrantsPayable>
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      </GrantsPayable>
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      </TaxExemptBondLiabilities>
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      </LoansFromOfficersDirectors>
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      <UnsecuredNotesLoansPayable>
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      </UnsecuredNotesLoansPayable>
      <OtherLiabilities>
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        <EOY>0</EOY>
      </OtherLiabilities>
      <TotalLiabilities>
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        <EOY>8289052</EOY>
      </TotalLiabilities>
      <FollowSFAS117>X</FollowSFAS117>
      <UnrestrictedNetAssets>
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        <EOY>13805211</EOY>
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      <TemporarilyRestrictedNetAssets>
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        <EOY>14000</EOY>
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      <PermanentlyRestrictedNetAssets>
        <BOY>5064136</BOY>
        <EOY>5444436</EOY>
      </PermanentlyRestrictedNetAssets>
      <TotalNetAssetsFundBalances>
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        <EOY>19263647</EOY>
      </TotalNetAssetsFundBalances>
      <TotalLiabNetAssetsFundBalances>
        <BOY>27253905</BOY>
        <EOY>27552699</EOY>
      </TotalLiabNetAssetsFundBalances>
      <ReconcilationRevenueExpenses>47519</ReconcilationRevenueExpenses>
      <ReconciliationUnrealizedInvest>883538</ReconciliationUnrealizedInvest>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>false</AccountantCompileOrReview>
      <FSAudited>true</FSAudited>
      <FSAuditedBasis>
        <FinancialStatementConsolidated>X</FinancialStatementConsolidated>
      </FSAuditedBasis>
      <AuditCommittee>true</AuditCommittee>
      <FederalGrantAuditRequired>false</FederalGrantAuditRequired>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA">
      <PubliclySupportedOrg170b1Avi>X</PubliclySupportedOrg170b1Avi>
      <GiftsGrantsContribReceived170>
        <CurrentTaxYearMinus4Years>1766568</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>1294549</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>961236</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>1068812</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>743905</CurrentTaxYear>
        <Total>5835070</Total>
      </GiftsGrantsContribReceived170>
      <TaxRevLeviedForOrgBenefit170>
        <Total>0</Total>
      </TaxRevLeviedForOrgBenefit170>
      <ValueSrvcFcltsFurnishedByGovt>
        <Total>0</Total>
      </ValueSrvcFcltsFurnishedByGovt>
      <Total170>
        <CurrentTaxYearMinus4Years>1766568</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>1294549</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>961236</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>1068812</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>743905</CurrentTaxYear>
        <Total>5835070</Total>
      </Total170>
      <AmountsSubstContributorsTotal>0</AmountsSubstContributorsTotal>
      <PublicSupportTotal170>5835070</PublicSupportTotal170>
      <GrossInvestmentIncome170>
        <CurrentTaxYearMinus4Years>145289</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>328883</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>1140299</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>1737613</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>925425</CurrentTaxYear>
        <Total>4277509</Total>
      </GrossInvestmentIncome170>
      <NetUBI>
        <Total>0</Total>
      </NetUBI>
      <OtherIncome170>
        <CurrentTaxYearMinus4Years>297020</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>627553</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>628683</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>294700</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>160240</CurrentTaxYear>
        <Total>2008196</Total>
      </OtherIncome170>
      <TotalSupport>12120775</TotalSupport>
      <GrossReceiptsFromAdmissionsEtc>101404473</GrossReceiptsFromAdmissionsEtc>
      <PublicSupportPertcentage170>0.48141</PublicSupportPertcentage170>
      <PublicSupportPertcentPriorYear>0.50940</PublicSupportPertcentPriorYear>
      <ThirtyThreePercntTestsCY170>X</ThirtyThreePercntTestsCY170>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB">
      <ContributorInfo>
        <ContributorNumber>RESTRICTED</ContributorNumber>
        <ContributorNameBusiness>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorNameBusiness>
        <ContributorAddressUS>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorAddressUS>
        <AggregateContributions>RESTRICTED</AggregateContributions>
      </ContributorInfo>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
      <ArtPublicExhibitionAmts />
      <HeldWorksOfArtAmts />
      <CurrentYearMinus3Years />
      <CurrentYearMinus4Years />
      <Land />
      <Buildings />
      <LeaseholdImprovements>
        <OtherCostOrOtherBasis>69364</OtherCostOrOtherBasis>
        <Depreciation>37826</Depreciation>
        <BookValue>31538</BookValue>
      </LeaseholdImprovements>
      <Equipment>
        <OtherCostOrOtherBasis>5750381</OtherCostOrOtherBasis>
        <Depreciation>5540911</Depreciation>
        <BookValue>209470</BookValue>
      </Equipment>
      <OtherLandBuildings>
        <OtherCostOrOtherBasis>439831</OtherCostOrOtherBasis>
        <Depreciation>439831</Depreciation>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>241008</TotalOfBookValueLandBuildings>
      <OtherAssets>
        <Description>INTERCOMPANY RECEIVABLES</Description>
        <BookValue>3870491</BookValue>
      </OtherAssets>
      <TotalBookValueOtherAssets>3870491</TotalBookValueOtherAssets>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ">
      <IndependentConsultant>X</IndependentConsultant>
      <WrittenEmploymentContract>X</WrittenEmploymentContract>
      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>false</SeverancePayment>
      <SupplementalNonqualRetirePlan>true</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>false</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>false</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>false</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>false</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>false</AnyNonFixedPayments>
      <InitialContractException>false</InitialContractException>
      <Form990ScheduleJPartII>
        <NamePerson>Claire M Zangerle</NamePerson>
        <Title>BOARD AT LARGE (President/CEO)</Title>
        <BaseCompensationFilingOrg>0</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>280001</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>0</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>753</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>0</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>280754</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Mario M Danese</NamePerson>
        <Title>CHIEF FINANCIAL OFFICER</Title>
        <BaseCompensationFilingOrg>0</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>139947</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>0</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>22442</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>0</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>162389</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <Identifier>NONQUALIFIED DEFERRED COMPENSATION PLAN,</Identifier>
        <ReturnReference>PART I, LINE 4B:</ReturnReference>
        <Explanation>ONE EMPLOYEE OF A RELATED ORGANIZATION CONTRIBUTED TO A NONQUALIFIED SECTION 457(b) DEFERRED COMPENSATION PLAN OF THAT ORGANIZATION. MARIO DANESE CONTRIBUTED $5,200 DURING 2012 TO THAT PLAN.</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <GeneralExplanation>
        <Identifier>Members of the Organization,</Identifier>
        <ReturnReference>Form 990, Part VI, Line 6:</ReturnReference>
        <Explanation>The organization has one member. The Visiting Nurse Association Healthcare Partners of Ohio is the sole owner/member. This organization's board reports in a professional/advisory role to the Visiting Nurse Association Healthcare Partners of Ohio's governance board.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990 Review,</Identifier>
        <ReturnReference>Form 990, Part VI, Line 11b:</ReturnReference>
        <Explanation>Form 990 is reviewed by the Chief Financial Officer with the assistance of the outside public accounting firm. Form 990 is made available to the Board after it is filed with the Internal Revenue Service.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Monitoring and Enforcement of Conflict Policy,</Identifier>
        <ReturnReference>Form 990, Part VI, Line 12c:</ReturnReference>
        <Explanation>Annual completion of the conflict of interest forms for officers and directors provides regular review of potential conflicts which may arise.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Compensation Review and Approval,</Identifier>
        <ReturnReference>Form 990, Part VI, Line 15:</ReturnReference>
        <Explanation>THE CHIEF HUMAN RESOURCE OFFICER CONDUCTS A MARKET COMPENSATION STUDY TO ESTABLISH SALARY RANGES FOR ALL AGENCY EMPLOYEES. FINDINGS ARE REVIEWED WITH TOP MANAGEMENT TO DETERMINE IF COMPENSATION STRUCTURES NEED REVISION. IF REVISIONS ARE NEEDED, THEY ARE PRESENTED FOR APPROVAL TO THE HUMAN RESOURCE COMMITTEE OF THE BOARD FOR APPROVAL. IF APPROVED, THE SALARY STRUCTURE IS MODIFIED TO KEEP THE ORGANIZATIION COMPETITIVE IN THE ECONOMIC MARKET. THE LAST SALARY REVIEW WAS IN 2010.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Availability of documents,</Identifier>
        <ReturnReference>Form 990, Part VI, Line 19:</ReturnReference>
        <Explanation>Certain agencies receive the audited financial statements as required by our business relationship with them. All others are able to obtain the audited financial statements via written request. The governing documents and conflict of interest policy are available upon request.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR">
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>VISITING NURSE ASSOCOF MID-OHIO</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>2500 EAST 22ND STREET</AddressLine1>
          <City>CLEVELAND</City>
          <State>OH</State>
          <ZIPCode>44115</ZIPCode>
        </AddressUS>
        <EIN>341913736</EIN>
        <PrimaryActivities>HOME HLTHCARE</PrimaryActivities>
        <LegalDomicileState>OH</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>7</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>VNA HPO</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>true</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>VNA HOUSECALLS</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>2500 EAST 22ND STREET</AddressLine1>
          <City>CLEVELAND</City>
          <State>OH</State>
          <ZIPCode>44115</ZIPCode>
        </AddressUS>
        <EIN>300240348</EIN>
        <PrimaryActivities>HOME HLTHCARE</PrimaryActivities>
        <LegalDomicileState>OH</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>7</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>VNA HPO</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>true</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>VISITING NURSE ASSOCOF CLEVEHOSPICE</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>2500 EAST 22ND STREET</AddressLine1>
          <City>CLEVELAND</City>
          <State>OH</State>
          <ZIPCode>44115</ZIPCode>
        </AddressUS>
        <EIN>341638790</EIN>
        <PrimaryActivities>HOME HLTHCARE</PrimaryActivities>
        <LegalDomicileState>OH</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>7</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>VNA HPO</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>true</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>VNA CARE PLUS</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>2500 EAST 22ND STREET</AddressLine1>
          <City>CLEVELAND</City>
          <State>OH</State>
          <ZIPCode>44115</ZIPCode>
        </AddressUS>
        <EIN>341622010</EIN>
        <PrimaryActivities>HOME HLTHCARE</PrimaryActivities>
        <LegalDomicileState>OH</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>7</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>VNA HPO</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>true</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>VISNURSE ASSOCHEALTHPARTNERS OF OHIO</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>2500 EAST 22ND STREET</AddressLine1>
          <City>CLEVELAND</City>
          <State>OH</State>
          <ZIPCode>44115</ZIPCode>
        </AddressUS>
        <EIN>341816401</EIN>
        <PrimaryActivities>HLTHCARE MGT</PrimaryActivities>
        <LegalDomicileState>OH</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>9</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>VNA ENTERPRISES</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>2500 EAST 22ND STREET</AddressLine1>
          <City>CLEVELAND</City>
          <State>OH</State>
          <ZIPCode>441153204</ZIPCode>
        </AddressUS>
        <EIN>341558796</EIN>
        <PrimaryActivity>HOME HEALTHCARE</PrimaryActivity>
        <LegalDomicileState>OH</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C-CORP</TypeOfEntity>
      </Form990ScheduleRPartIV>
      <ReceiptOfIntAnnRentsRoyalties>false</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>false</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>false</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>false</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
      <SaleOfAssetsToOtherOrg>false</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>false</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>false</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>false</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>true</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>true</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>true</SharingOfFacilities>
      <SharingOfPaidEmployees>true</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>false</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>false</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>false</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>false</OtherTransferFromOtherOrg>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>VNA HEALTHCARE PARTNERS OF OHIO</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>M</TransactionType>
        <AmountInvolved>4041775</AmountInvolved>
        <MethodOfAmtDetermination>BOOK VALUE</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
    </IRS990ScheduleR>
  </ReturnData>
</Return>