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        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>GINNY RYAN</NamePerson>
        <Title>DIRECTOR</Title>
        <AverageHoursPerWeek>1.0</AverageHoursPerWeek>
        <AverageHoursPerWeekRelated>2.0</AverageHoursPerWeekRelated>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>JOHN HORVATH</NamePerson>
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        <AverageHoursPerWeek>1.0</AverageHoursPerWeek>
        <AverageHoursPerWeekRelated>2.0</AverageHoursPerWeekRelated>
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        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>BARRY M PALATAS</NamePerson>
        <Title>VICE PRESIDENT AND CFO</Title>
        <AverageHoursPerWeek>35.0</AverageHoursPerWeek>
        <AverageHoursPerWeekRelated>10.0</AverageHoursPerWeekRelated>
        <Officer>X</Officer>
        <ReportableCompFromOrganization>137922</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>6252</OtherCompensation>
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      <Form990PartVIISectionA>
        <NamePerson>MIYEON OH</NamePerson>
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        <AverageHoursPerWeekRelated>0.0</AverageHoursPerWeekRelated>
        <HighestCompensatedEmployee>X</HighestCompensatedEmployee>
        <ReportableCompFromOrganization>184625</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>1844</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>THERESA KAISER</NamePerson>
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        <HighestCompensatedEmployee>X</HighestCompensatedEmployee>
        <ReportableCompFromOrganization>117699</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>1109</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>MONIQUE BERG SPLINDELMAN</NamePerson>
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        <OtherCompensation>970</OtherCompensation>
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        <NamePerson>BETH DORSCHEID</NamePerson>
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        <NamePerson>SANDRA COLBURN</NamePerson>
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      <TotalReportableCompFrmRltdOrgs>2797541</TotalReportableCompFrmRltdOrgs>
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      <NumberIndividualsGT100K>6</NumberIndividualsGT100K>
      <FormersListed>false</FormersListed>
      <TotalCompGT150K>true</TotalCompGT150K>
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          <AddressUS>
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        </AddressOfContractor>
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      </ContractorCompensation>
      <ContractorCompensation>
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          <NamePerson>AMERICAN RED CROSS</NamePerson>
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          <AddressUS>
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        <Compensation>851407</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
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        <AddressOfContractor>
          <AddressUS>
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        </AddressOfContractor>
        <DescriptionOfServices>HEALTHCARE SERVICES</DescriptionOfServices>
        <Compensation>423859</Compensation>
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      <ContractorCompensation>
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          <NamePerson>MCKESSON</NamePerson>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
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        <Compensation>368031</Compensation>
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      <ContractorCompensation>
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          <NamePerson>FAZZI ASSOCIATES INC</NamePerson>
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        <AddressOfContractor>
          <AddressUS>
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          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>CODING SERVICES</DescriptionOfServices>
        <Compensation>349585</Compensation>
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      <FederatedCampaigns>298095</FederatedCampaigns>
      <RelatedOrganizations>813448</RelatedOrganizations>
      <GovernmentGrants>933922</GovernmentGrants>
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      <TotalContributions>2290133</TotalContributions>
      <ProgramServiceRevenue>
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      <ProgramServiceRevenue>
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        <RelatedOrExemptFunctionIncome>116766</RelatedOrExemptFunctionIncome>
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      <ProgramServiceRevenue>
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      <ProgramServiceRevenue>
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        <Personal>0</Personal>
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      <TotalRevenue>
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        <RelatedOrExemptFunctionIncome>38170643</RelatedOrExemptFunctionIncome>
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      <InfoInScheduleOPartIX>X</InfoInScheduleOPartIX>
      <GrantsToDomesticOrgs>
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      </GrantsToDomesticOrgs>
      <GrantsToDomesticIndividuals>
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      </GrantsToDomesticIndividuals>
      <ForeignGrants>
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      </ForeignGrants>
      <BenefitsToMembers>
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      </BenefitsToMembers>
      <CompCurrentOfficersDirectors>
        <Total>137922</Total>
        <ProgramServices>0</ProgramServices>
        <ManagementAndGeneral>137922</ManagementAndGeneral>
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      <CompDisqualPersons>
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        <Total>17289105</Total>
        <ProgramServices>12719797</ProgramServices>
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      <PensionPlanContributions>
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        <ProgramServices>490466</ProgramServices>
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      <OtherEmployeeBenefits>
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        <ProgramServices>0</ProgramServices>
        <ManagementAndGeneral>38225</ManagementAndGeneral>
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      <FeesForServicesLegal>
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        <ProgramServices>0</ProgramServices>
        <ManagementAndGeneral>51234</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </FeesForServicesLegal>
      <FeesForServicesAccounting>
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      </FeesForServicesAccounting>
      <FeesForServicesLobbying>
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        <Fundraising>0</Fundraising>
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        <ProgramServices>30626</ProgramServices>
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      <TravelEntrtnmntPublicOfficials>
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        <ProgramServices>0</ProgramServices>
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        <ProgramServices>31642</ProgramServices>
        <ManagementAndGeneral>38615</ManagementAndGeneral>
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        <ProgramServices>0</ProgramServices>
        <ManagementAndGeneral>204407</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
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      <PaymentsToAffiliates>
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        <ProgramServices>0</ProgramServices>
        <ManagementAndGeneral>0</ManagementAndGeneral>
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      <DepreciationDepletion>
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        <ManagementAndGeneral>255527</ManagementAndGeneral>
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      <Insurance>
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        <ProgramServices>9233</ProgramServices>
        <ManagementAndGeneral>125857</ManagementAndGeneral>
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      </Insurance>
      <OtherExpenses>
        <Description>PATIENT RELATED SUPPLIES</Description>
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        <ProgramServices>2414021</ProgramServices>
        <ManagementAndGeneral>752</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </OtherExpenses>
      <OtherExpenses>
        <Description>OTHER</Description>
        <Total>1342496</Total>
        <ProgramServices>777865</ProgramServices>
        <ManagementAndGeneral>564631</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
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      <TotalFunctionalExpenses>
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        <ProgramServices>32047706</ProgramServices>
        <ManagementAndGeneral>8973278</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </TotalFunctionalExpenses>
      <InfoInScheduleOPartX>X</InfoInScheduleOPartX>
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        <EOY>0</EOY>
      </CashNonInterestBearing>
      <SavingsAndTempCashInvestments>
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      </SavingsAndTempCashInvestments>
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        <EOY>0</EOY>
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      </InvestmentsPubTradedSecurities>
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      <InvestmentsProgramRelated>
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      <AccountantCompileOrReview>false</AccountantCompileOrReview>
      <FSAudited>true</FSAudited>
      <FSAuditedBasis>
        <FinancialStatementBoth>X</FinancialStatementBoth>
      </FSAuditedBasis>
      <AuditCommittee>true</AuditCommittee>
      <FederalGrantAuditRequired>false</FederalGrantAuditRequired>
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        <CurrentTaxYearMinus1Year>2112708</CurrentTaxYearMinus1Year>
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        <CurrentTaxYearMinus1Year>36941937</CurrentTaxYearMinus1Year>
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      <SupportFromDQPsEtc>
        <Total>0</Total>
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        <CurrentTaxYearMinus1Year>0</CurrentTaxYearMinus1Year>
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        <Total>0</Total>
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        <CurrentTaxYearMinus1Year>1710598</CurrentTaxYearMinus1Year>
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        <Total>6964032</Total>
      </OtherIncome509>
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        <CurrentTaxYearMinus3Years>43916705</CurrentTaxYearMinus3Years>
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        <CurrentTaxYearMinus1Year>38652535</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>40460776</CurrentTaxYear>
        <Total>201705944</Total>
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      <PublicSupportPercentage509>0.96547</PublicSupportPercentage509>
      <PriorYearSupportPercentage>0.95943</PriorYearSupportPercentage>
      <InvestmentIncomePercentage>0.00000</InvestmentIncomePercentage>
      <PriorYrInvestIncomePercentage>0.00000</PriorYrInvestIncomePercentage>
      <ThirtyThreePercntTestsCY509>X</ThirtyThreePercntTestsCY509>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB">
      <ContributorInfo>
        <ContributorNumber>RESTRICTED</ContributorNumber>
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          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
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        <ContributorAddressUS>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorAddressUS>
        <AggregateContributions>RESTRICTED</AggregateContributions>
      </ContributorInfo>
    </IRS990ScheduleB>
    <IRS990ScheduleC documentId="IRS990ScheduleC">
      <TotalGrassrootsLobbying />
      <TotalDirectLobbying />
      <TotalLobbyingExpenditures />
      <OtherExemptPurposeExpenditures />
      <TotalExemptPurposeExpenditures />
      <LobbyingNontaxableAmount />
      <GrassrootsNontaxableAmount />
      <TotLobbyingGrassrootMinusNonTx />
      <TotLobbyExpendMnsLobbyingNontx />
      <Volunteers>false</Volunteers>
      <PaidStaffOrManagement>true</PaidStaffOrManagement>
      <MediaAdvertisements>false</MediaAdvertisements>
      <MailingsMembers>true</MailingsMembers>
      <MailingsMembersAmount>100</MailingsMembersAmount>
      <PublicationsOrBroadcast>false</PublicationsOrBroadcast>
      <GrantsOtherOrganizations>false</GrantsOtherOrganizations>
      <DirectContactLegislators>true</DirectContactLegislators>
      <DirectContactLegislatorsAmount>3000</DirectContactLegislatorsAmount>
      <RalliesDemonstrations>false</RalliesDemonstrations>
      <OtherActivities>true</OtherActivities>
      <OtherActivitiesAmount>3000</OtherActivitiesAmount>
      <TotalLobbyingExpendituresIIB>6100</TotalLobbyingExpendituresIIB>
      <NotDescribedIn501c3>false</NotDescribedIn501c3>
      <Form990ScheduleCPartIV>
        <Identifier>DETAIL OF LOBBYING ACTIVITIES</Identifier>
        <ReturnReference>FORM 990, SCHEDULE C, PART II-B, LINE 1</ReturnReference>
        <Explanation>VISITING NURSE SERVICE OF ROCHESTER AND MONROE COUNTY, INC. ADVOCATES LOCAL, STATE AND FEDERAL OFFICIALS ON REGULATORY AND FISCAL ISSUES AFFECTING THE HOME CARE INDUSTRY.</Explanation>
      </Form990ScheduleCPartIV>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
      <ArtPublicExhibitionAmts />
      <HeldWorksOfArtAmts />
      <CurrentYearMinus3Years />
      <CurrentYearMinus4Years />
      <Land>
        <OtherCostOrOtherBasis>420000</OtherCostOrOtherBasis>
        <BookValue>420000</BookValue>
      </Land>
      <Buildings>
        <OtherCostOrOtherBasis>3580216</OtherCostOrOtherBasis>
        <Depreciation>2786982</Depreciation>
        <BookValue>793234</BookValue>
      </Buildings>
      <LeaseholdImprovements />
      <Equipment>
        <OtherCostOrOtherBasis>4515705</OtherCostOrOtherBasis>
        <Depreciation>3752910</Depreciation>
        <BookValue>762795</BookValue>
      </Equipment>
      <OtherLandBuildings>
        <OtherCostOrOtherBasis>98882</OtherCostOrOtherBasis>
        <Depreciation>78749</Depreciation>
        <BookValue>20133</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>1996162</TotalOfBookValueLandBuildings>
      <OtherAssets>
        <Description>ASSISTED HOUSING</Description>
        <BookValue>1</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>DUE FROM STRONG HOME CARE GRP</Description>
        <BookValue>319343</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>ROCHESTER</Description>
        <BookValue>134973</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>DUE FROM UNIV OF ROCHESTER</Description>
        <BookValue>116188</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>INSURANCE CLAIMS RECEIVABLE</Description>
        <BookValue>3486547</BookValue>
      </OtherAssets>
      <TotalBookValueOtherAssets>4057052</TotalBookValueOtherAssets>
      <FederalIncomeTaxLiability>0</FederalIncomeTaxLiability>
      <OtherLiabilities>
        <Description>ESTIMATED 3RD PARTY SETTLEMENT</Description>
        <Amount>2104445</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>ACCRUED PENSION LIABILITY</Description>
        <Amount>4517217</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>ACCRUED POSTRETIREMENT LIABILI</Description>
        <Amount>320441</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>DUE TO STRONG HOME CARE GROUP</Description>
        <Amount>655</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>DUE TO COMMUNITY CARE OF ROCH</Description>
        <Amount>297795</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>DUE TO UNIVERSITY OF ROCHESTER</Description>
        <Amount>5046746</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>DUE TO HIGHLAND HOSPITAL</Description>
        <Amount>635949</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>ACCRUED WORKERS COMPENSATION</Description>
        <Amount>3486547</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>16409795</TotalOfAmounts>
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      <RevenueSubtotal>40460776</RevenueSubtotal>
      <TotalRevenuePerForm990>40460776</TotalRevenuePerForm990>
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      <TotalExpensesPerForm990>41020984</TotalExpensesPerForm990>
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        <Identifier>DETAIL OF OTHER CHANGES IN NET ASSETS PER BOOK NOT INCLUDED ON RETURN</Identifier>
        <ReturnReference>FORM 990, SCHEDULE D, PART XII, LINE 2D</ReturnReference>
        <Explanation>PENSION AND POSTRETIREMENT RELATED CHARGES $175,007</Explanation>
      </Form990ScheduleDPartXIII>
    </IRS990ScheduleD>
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      <SeverancePayment>false</SeverancePayment>
      <SupplementalNonqualRetirePlan>true</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
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      <CompBasedNetEarningsRelateOrgs>false</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>false</AnyNonFixedPayments>
      <InitialContractException>false</InitialContractException>
      <Form990ScheduleJPartII>
        <NamePerson>STEVEN I GOLDSTEIN</NamePerson>
        <Title>DIRECTOR</Title>
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        <CompBasedOnRelatedOrgs>867354</CompBasedOnRelatedOrgs>
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        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>DR WALLACE JOHNSON</NamePerson>
        <Title>DIRECTOR</Title>
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        <CompBasedOnRelatedOrgs>351822</CompBasedOnRelatedOrgs>
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        <OtherCompensationRelatedOrgs>17058</OtherCompensationRelatedOrgs>
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        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>PETER G ROBINSON</NamePerson>
        <Title>DIRECTOR EX-OFFICIO</Title>
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        <CompBasedOnRelatedOrgs>576029</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
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        <OtherCompensationRelatedOrgs>31613</OtherCompensationRelatedOrgs>
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        <NontaxableBenefitsRelatedOrgs>22140</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>0</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>819459</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>VICTORIA G HINES</NamePerson>
        <Title>PRESIDENT AND CEO, EX-OFFICIO</Title>
        <BaseCompensationFilingOrg>0</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>233088</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>23287</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>0</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>20247</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>0</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>276622</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>MIYEON OH</NamePerson>
        <Title>MEDICAL DIRECTOR</Title>
        <BaseCompensationFilingOrg>184625</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>1844</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>0</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>186469</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>DANIEL MENDELSON MD</NamePerson>
        <Title>DIRECTOR</Title>
        <BaseCompensationFilingOrg>0</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>243947</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>67447</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
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        <NontaxableBenefitsRelatedOrgs>41472</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>0</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>377271</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>TOMMYE HINTON</NamePerson>
        <Title>DIRECTOR</Title>
        <BaseCompensationFilingOrg>0</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>210861</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>11305</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>0</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>16483</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>0</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>238649</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <Identifier>TOP MANAGEMENT COMPENSATION</Identifier>
        <ReturnReference>FORM 990,SCHEDULE J, LINE 3</ReturnReference>
        <Explanation>AS PROVIDED IN THE FORM 990, SCHEDULE J INSTRUCTIONS, SINCE THE ORGANIZATION RELIES ON A RELATED ORGANIZATION WHICH USES ONE OR MORE OF THE METHODS DESCRIBED IN LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIALS' COMPENSATION, THIS QUESTION HAS BEEN LEFT UNANSWERED. REFER TO SCHEDULE O, DESCRIPTION OF COMPENSATION REVIEW AND APPROVAL PROCESS.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>PARTICIPATION IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN</Identifier>
        <ReturnReference>FORM 990, SCHEDULE J, LINE 4B</ReturnReference>
        <Explanation>CERTAIN OFFICERS AND DIRECTORS OF VISITING NURSE SERVICE OF ROCHESTER AND MONROE COUNTY, INC. PARTICIPATE IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PROVIDED BY THE UNIVERSITY OF ROCHESTER, A RELATED IRC SECTION 501(C)(3) ORGANIZATION. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN AND RECEIVED EMPLOYER-PAID AMOUNTS THAT ARE INCLUDED IN DEFERRED COMPENSATION: STEVEN I. GOLDSTEIN SERP PLAN $159,400 STEVEN I. GOLDSTEIN 457(F) PLAN 37,500 DR. WALLACE JOHNSON SERP PLAN 6,000 PETER G. ROBINSON SERP PLAN 45,000 PETER G. ROBINSON 457(F) PLAN 120,600</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <GeneralExplanation>
        <Identifier>FORM 990 REVIEW PROCESS</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 11</ReturnReference>
        <Explanation>THE FORM 990 OF VISITING NURSE SERVICE OF ROCHESTER AND MONROE COUNTY, INC. ("VNS") IS PREPARED BY FINANCE STAFF AND PROVIDED TO PRICEWATERHOUSECOOPERS LLP AND SENIOR MANAGEMENT FOR REVIEW PRIOR TO FILING. THE FORM 990 WAS ALSO PROVIDED TO VNS'S FINANCE COMMITTEE PRIOR TO FILING. THE COMMITTEE'S QUESTIONS AND COMMENTS WERE ADDRESSED PRIOR TO FILING. THE FORM 990 WAS ALSO PROVIDED TO THE ENTIRE BOARD OF DIRECTORS PRIOR TO FILING.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>CONFLICT OF INTEREST POLICY</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 12C</ReturnReference>
        <Explanation>DIRECTORS, COMMITTEE MEMBERS, OFFICERS AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE A CONFLICT OF INTEREST: (A) PRIOR TO VOTING ON OR OTHERWISE DISCHARGING THEIR DUTIES WITH RESPECT TO ANY MATTER INVOLVING THE CONFLICT WHICH COMES BEFORE THE BOARD OR ANY COMMITTEE; (B) PRIOR TO ENTERING INTO ANY CONTRACT OR TRANSACTION INVOLVING THE CONFLICT; (C) AS SOON AS POSSIBLE AFTER THE DIRECTOR, COMMITTEE MEMBER OR OFFICER LEARNS OF THE CONFLICT; AND (D) ON AN ANNUAL CONFLICT OF INTEREST DISCLOSURE FORM. THE FORM IS DISTRIBUTED ANNUALLY AND REQUIRES DISCLOSURE OF ALL CONFLICTS OF INTEREST, INCLUDING SPECIFIC INFORMATION CONCERNING THE TERMS OF ANY CONTRACT OR TRANSACTION WITH VISITING NURSE SERVICE OF ROCHESTER AND MONROE COUNTY, INC. ("VNS") THAT INVOLVES A POTENTIAL CONFLICT OF INTEREST FOR THE INDIVIDUAL. THE FORMS ARE REVIEWED BY THE BOARD CHAIR AND LEGAL COUNSEL, AND CONFLICTS DISCLOSED ON THE FORMS OR ON AN AD HOC BASIS ARE REVIEWED BY A BOARD COMMITTEE. THE COMMITTEE CONSIDERS THE MATERIAL FACTS CONCERNING ANY PROPOSED CONTRACT OR TRANSACTION, INCLUDING THE PROCESS BY WHICH THE DECISION WAS MADE TO APPROVE OR RECOMMEND ENTERING INTO THE ARRANGEMENT ON THE TERMS PROPOSED, AND APPROVES SUCH CONTRACTS OR TRANSACTIONS ONLY IF THE TERMS ARE FAIR AND REASONABLE TO VNS AND THE ARRANGEMENTS ARE CONSISTENT WITH THE BEST INTERESTS OF VNS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>COMPENSATION REVIEW AND APPROVAL</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 15</ReturnReference>
        <Explanation>WRITTEN SELF-EVALUATIONS AND PERFORMANCE EVALUATIONS FOR VISITING NURSE SERVICE OF ROCHESTER AND MONROE COUNTY, INC. ("VNS") OFFICERS ANNUALLY ARE REVIEWED BY THE COMMITTEE ON COMPLIANCE AND COMPENSATION OF THE UNIVERSITY OF ROCHESTER MEDICAL CENTER BOARD. THE COMMITTEE HAS AVAILABLE THE EVALUATIONS FROM VNS'S BOARD AND THE CEO OF URMC HEALTH SYSTEM FOR THE CFO. THE COMMITTEE REVIEWS AND APPROVES TOTAL COMPENSATION FOR OFFICERS AND CONSIDERS, IN ADDITION TO THE EVALUATIONS, THE SCOPE OF THE INDIVIDUAL'S JOB RESPONSIBILITIES, PREVIOUS COMPENSATION AND COMPARABLE COMPENSATION PAID TO PEOPLE WITH SIMILAR RESPONSIBILITIES AT COMPARABLE INSTITUTIONS. THE COMPARABLE INFORMATION IS PROVIDED BY AN INDEPENDENT CONSULTANT AND IS BASED ON LOCAL, REGIONAL AND NATIONAL COMPENSATION SURVEYS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>GOVERNING DOCUMENTS</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION C, LINE 19</ReturnReference>
        <Explanation>VISITING NURSE SERVICE OF ROCHESTER AND MONROE COUNTY, INC. ("VNS") FORM 1023 AND FORM 990 ARE AVAILABLE UPON REQUEST. VNS'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS ARE NOT ROUTINELY MADE AVAILABLE TO THE PUBLIC.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>MEMBERSHIP INFORMATION</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION A, LINES 6, 7A &amp; 7B</ReturnReference>
        <Explanation>THE SOLE MEMBER OF VISITING NURSE SERVICE OF ROCHESTER AND MONROE COUNTY, INC. ("VNS") IS STRONG HOME CARE GROUP ("SHCG"). SHCG, ACTING THROUGH ITS BOARD OF DIRECTORS, HAS THE AUTHORITY TO ELECT THE GOVERNING BODY OF VNS, AND CERTAIN DECISIONS OF THE VNS BOARD ARE SUBJECT TO THE APPROVAL OF THE SHCG BOARD. SUCH DECISIONS INCLUDE APPOINTMENT OF THE VNS PRESIDENT AND CEO, AMENDMENT OF THE CERTIFICATE OF INCORPORATION AND BYLAWS, APPROVAL OF EXTRAORDINARY CORPORATE ACTIONS SUCH AS MERGER OR DISSOLUTION, AND APPROVAL OF CAPITAL AND OPERATING BUDGETS, STRATEGIC PLANS, AND INCURRENCE OF CERTAIN DEBT.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>DIRECTOR COMPENSATION INFORMATION</Identifier>
        <ReturnReference>FORM 990, PART VII AND SCHEDULE J-2</ReturnReference>
        <Explanation>THE OFFICERS AND DIRECTORS OF VISITING NURSE SERVICE OF ROCHESTER AND MONROE COUNTY, INC. ("VNS") ARE ALSO OFFICERS AND DIRECTORS OF COMMUNITY CARE OF ROCHESTER AND STRONG HOME CARE GROUP, RELATED IRC SECTION 501(C)(3) ORGANIZATIONS. THE OFFICERS AND DIRECTORS DEVOTE TIME EACH WEEK TO EACH OF THESE RELATED ORGANIZATIONS. IN ADDITION, CERTAIN DIRECTORS OF VNS ALSO DEVOTE SIGNIFICANT TIME EACH WEEK TO OTHER RELATED ORGANIZATIONS. NONE OF THE BOARD MEMBERS OF VNS ARE COMPENSATED FOR THEIR BOARD SERVICE.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>DETAIL OF OTHER CHANGES IN NET ASSETS OR FUND BALANCES</Identifier>
        <ReturnReference>FORM 990, PART XI, LINE 5</ReturnReference>
        <Explanation>PENSION AND POSTRETIREMENT RELATED CHARGES ($175,007)</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>OTHER FEES FOR SERVICES FOR NON-EMPLOYEES</Identifier>
        <ReturnReference>FORM 990 PART IX LINE 11G</ReturnReference>
        <Explanation>DESCRIPTION:CONTRACT HHA, HOSPICE &amp; OTHER TOTAL FEES:13300639</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR">
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>UNIVERSITY OF ROCHESTER</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
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      <OtherTransferToOtherOrg>false</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>false</OtherTransferFromOtherOrg>
    </IRS990ScheduleR>
  </ReturnData>
</Return>