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      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
        <Description>OTHER OPERATING REVENUE</Description>
        <BusinessCode>621610</BusinessCode>
        <TotalRevenueColumn>237000</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>237000</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <TotalProgramServiceRevenue>20482404</TotalProgramServiceRevenue>
      <InvestmentIncome>
        <TotalRevenueColumn>1140299</TotalRevenueColumn>
        <ExclusionAmount>1140299</ExclusionAmount>
      </InvestmentIncome>
      <IncomeFromInvestBondProceeds>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </IncomeFromInvestBondProceeds>
      <RoyaltiesRevenue>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </RoyaltiesRevenue>
      <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>516159</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>516159</RelatedOrExemptFunctionIncome>
      </OtherRevenueMisc>
      <OtherRevenueMisc>
        <Description>MISCELLANEOUS</Description>
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        <TotalRevenueColumn>112524</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>112524</RelatedOrExemptFunctionIncome>
      </OtherRevenueMisc>
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      <TotalRevenue>
        <TotalRevenueColumn>23212622</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>21111087</RelatedOrExemptFunctionIncome>
        <ExclusionAmount>1140299</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>12582017</Total>
        <ProgramServices>9562333</ProgramServices>
        <ManagementAndGeneral>3019684</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </OtherSalariesAndWages>
      <PensionPlanContributions>
        <Total>0</Total>
      </PensionPlanContributions>
      <OtherEmployeeBenefits>
        <Total>1425714</Total>
        <ProgramServices>1083543</ProgramServices>
        <ManagementAndGeneral>342171</ManagementAndGeneral>
      </OtherEmployeeBenefits>
      <PayrollTaxes>
        <Total>1268634</Total>
        <ProgramServices>964162</ProgramServices>
        <ManagementAndGeneral>304472</ManagementAndGeneral>
      </PayrollTaxes>
      <FeesForServicesManagement>
        <Total>2833776</Total>
        <ProgramServices>1749844</ProgramServices>
        <ManagementAndGeneral>1083932</ManagementAndGeneral>
      </FeesForServicesManagement>
      <FeesForServicesLegal>
        <Total>171194</Total>
        <ProgramServices>167623</ProgramServices>
        <ManagementAndGeneral>3571</ManagementAndGeneral>
      </FeesForServicesLegal>
      <FeesForServicesAccounting>
        <Total>25312</Total>
        <ProgramServices>19237</ProgramServices>
        <ManagementAndGeneral>6075</ManagementAndGeneral>
      </FeesForServicesAccounting>
      <FeesForServicesLobbying>
        <Total>0</Total>
      </FeesForServicesLobbying>
      <FeesForServicesProfFundraising>
        <Total>0</Total>
      </FeesForServicesProfFundraising>
      <FeesForServicesInvstMgmntFees>
        <Total>71894</Total>
        <ProgramServices>54639</ProgramServices>
        <ManagementAndGeneral>17255</ManagementAndGeneral>
      </FeesForServicesInvstMgmntFees>
      <FeesForServicesOther>
        <Total>1790427</Total>
        <ProgramServices>1509083</ProgramServices>
        <ManagementAndGeneral>281344</ManagementAndGeneral>
      </FeesForServicesOther>
      <Advertising>
        <Total>31550</Total>
        <ProgramServices>31550</ProgramServices>
      </Advertising>
      <OfficeExpenses>
        <Total>603599</Total>
        <ProgramServices>458735</ProgramServices>
        <ManagementAndGeneral>144864</ManagementAndGeneral>
      </OfficeExpenses>
      <InformationTechnology>
        <Total>0</Total>
      </InformationTechnology>
      <Royalties>
        <Total>0</Total>
      </Royalties>
      <Occupancy>
        <Total>677079</Total>
        <ProgramServices>514580</ProgramServices>
        <ManagementAndGeneral>162499</ManagementAndGeneral>
      </Occupancy>
      <Travel>
        <Total>642809</Total>
        <ProgramServices>576547</ProgramServices>
        <ManagementAndGeneral>66262</ManagementAndGeneral>
      </Travel>
      <TravelEntrtnmntPublicOfficials>
        <Total>0</Total>
      </TravelEntrtnmntPublicOfficials>
      <ConferencesMeetings>
        <Total>31300</Total>
        <ProgramServices>23788</ProgramServices>
        <ManagementAndGeneral>7512</ManagementAndGeneral>
      </ConferencesMeetings>
      <Interest>
        <Total>209453</Total>
        <ProgramServices>159184</ProgramServices>
        <ManagementAndGeneral>50269</ManagementAndGeneral>
      </Interest>
      <PaymentsToAffiliates>
        <Total>0</Total>
      </PaymentsToAffiliates>
      <DepreciationDepletion>
        <Total>700809</Total>
        <ProgramServices>532615</ProgramServices>
        <ManagementAndGeneral>168194</ManagementAndGeneral>
      </DepreciationDepletion>
      <Insurance>
        <Total>0</Total>
      </Insurance>
      <OtherExpenses>
        <Description>MEDICAL SUPPLIES</Description>
        <Total>432590</Total>
        <ProgramServices>432590</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>BAD DEBTS</Description>
        <Total>83030</Total>
        <ProgramServices>83030</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>RECRUITMENT</Description>
        <Total>24676</Total>
        <ProgramServices>18754</ProgramServices>
        <ManagementAndGeneral>5922</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>MISCELLANEOUS</Description>
        <Total>41852</Total>
        <ProgramServices>33038</ProgramServices>
        <ManagementAndGeneral>8814</ManagementAndGeneral>
      </OtherExpenses>
      <TotalFunctionalExpenses>
        <Total>23647715</Total>
        <ProgramServices>17974875</ProgramServices>
        <ManagementAndGeneral>5672840</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </TotalFunctionalExpenses>
      <CashNonInterestBearing>
        <BOY>7369</BOY>
        <EOY>27263</EOY>
      </CashNonInterestBearing>
      <SavingsAndTempCashInvestments>
        <BOY>1752762</BOY>
        <EOY>773740</EOY>
      </SavingsAndTempCashInvestments>
      <AccountsReceivable>
        <BOY>2982722</BOY>
        <EOY>3417717</EOY>
      </AccountsReceivable>
      <PrepaidExpensesDeferredCharges>
        <BOY>376254</BOY>
        <EOY>369425</EOY>
      </PrepaidExpensesDeferredCharges>
      <LandBuildingsEquipmentBasis>13109531</LandBuildingsEquipmentBasis>
      <LandBldgEquipmentAccumDeprec>10017075</LandBldgEquipmentAccumDeprec>
      <LandBuildingsEquipmentBasisNet>
        <BOY>3575212</BOY>
        <EOY>3092456</EOY>
      </LandBuildingsEquipmentBasisNet>
      <InvestmentsPubTradedSecurities>
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        <EOY>20962328</EOY>
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        <EOY>101250</EOY>
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        <BOY>26902751</BOY>
        <EOY>28744179</EOY>
      </TotalAssets>
      <AccountsPayableAccruedExpenses>
        <BOY>6897574</BOY>
        <EOY>10301417</EOY>
      </AccountsPayableAccruedExpenses>
      <DeferredRevenue>
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        <EOY>2953</EOY>
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      <MortNotesPyblSecuredInvestProp>
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        <EOY>55000</EOY>
      </MortNotesPyblSecuredInvestProp>
      <OtherLiabilities>
        <BOY>1474132</BOY>
        <EOY>588403</EOY>
      </OtherLiabilities>
      <TotalLiabilities>
        <BOY>9804659</BOY>
        <EOY>10947773</EOY>
      </TotalLiabilities>
      <FollowSFAS117>X</FollowSFAS117>
      <UnrestrictedNetAssets>
        <BOY>11981464</BOY>
        <EOY>12153008</EOY>
      </UnrestrictedNetAssets>
      <TemporarilyRestrictedNetAssets>
        <BOY>4167</BOY>
        <EOY>102580</EOY>
      </TemporarilyRestrictedNetAssets>
      <PermanentlyRestrictedNetAssets>
        <BOY>5112461</BOY>
        <EOY>5540818</EOY>
      </PermanentlyRestrictedNetAssets>
      <TotalNetAssetsFundBalances>
        <BOY>17098092</BOY>
        <EOY>17796406</EOY>
      </TotalNetAssetsFundBalances>
      <TotalLiabNetAssetsFundBalances>
        <BOY>26902751</BOY>
        <EOY>28744179</EOY>
      </TotalLiabNetAssetsFundBalances>
      <InfoInScheduleOPartXI>X</InfoInScheduleOPartXI>
      <ReconcilationRevenueExpenses>-435093</ReconcilationRevenueExpenses>
      <ReconcilationOtherChanges>1133407</ReconcilationOtherChanges>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>false</AccountantCompileOrReview>
      <FSAudited>true</FSAudited>
      <AuditCommittee>true</AuditCommittee>
      <FinancialStatementConsolidated>X</FinancialStatementConsolidated>
      <FederalGrantAuditRequired>false</FederalGrantAuditRequired>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA">
      <PubliclySupportedOrg170b1Avi>X</PubliclySupportedOrg170b1Avi>
      <GiftsGrantsContribReceived170>
        <CurrentTaxYearMinus4Years>1568154</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>1544891</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>1766568</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>1294549</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>961236</CurrentTaxYear>
        <Total>7135398</Total>
      </GiftsGrantsContribReceived170>
      <Total170>
        <CurrentTaxYearMinus4Years>1568154</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>1544891</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>1766568</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>1294549</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>961236</CurrentTaxYear>
        <Total>7135398</Total>
      </Total170>
      <PublicSupportTotal170>7135398</PublicSupportTotal170>
      <GrossInvestmentIncome170>
        <CurrentTaxYearMinus4Years>312696</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>519537</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>145289</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>328883</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>1140299</CurrentTaxYear>
        <Total>2446704</Total>
      </GrossInvestmentIncome170>
      <OtherIncome170>
        <CurrentTaxYearMinus4Years>574934</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>671551</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>297020</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>627553</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>628683</CurrentTaxYear>
        <Total>2799741</Total>
      </OtherIncome170>
      <TotalSupport>12381843</TotalSupport>
      <GrossReceiptsFromAdmissionsEtc>108445072</GrossReceiptsFromAdmissionsEtc>
      <PublicSupportPertcentage170>0.57628</PublicSupportPertcentage170>
      <PublicSupportPertcentPriorYear>0.51728</PublicSupportPertcentPriorYear>
      <ThirtyThreePercntTestsCY170>X</ThirtyThreePercntTestsCY170>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB">
      <ContributorInfo>
        <ContributorNumber>RESTRICTED</ContributorNumber>
        <ContributorNameBusiness>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorNameBusiness>
        <ContributorAddressUS>
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          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorAddressUS>
        <AggregateContributions>RESTRICTED</AggregateContributions>
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    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
      <ArtPublicExhibitionAmts />
      <HeldWorksOfArtAmts />
      <Land>
        <InvestmentCostOrOtherBasis>0</InvestmentCostOrOtherBasis>
        <OtherCostOrOtherBasis>453126</OtherCostOrOtherBasis>
        <BookValue>453126</BookValue>
      </Land>
      <Buildings>
        <InvestmentCostOrOtherBasis>0</InvestmentCostOrOtherBasis>
        <OtherCostOrOtherBasis>6154942</OtherCostOrOtherBasis>
        <Depreciation>4290826</Depreciation>
        <BookValue>1864116</BookValue>
      </Buildings>
      <LeaseholdImprovements>
        <InvestmentCostOrOtherBasis>0</InvestmentCostOrOtherBasis>
        <OtherCostOrOtherBasis>69364</OtherCostOrOtherBasis>
        <Depreciation>20131</Depreciation>
        <BookValue>49233</BookValue>
      </LeaseholdImprovements>
      <Equipment>
        <InvestmentCostOrOtherBasis>0</InvestmentCostOrOtherBasis>
        <OtherCostOrOtherBasis>5992268</OtherCostOrOtherBasis>
        <Depreciation>5313892</Depreciation>
        <BookValue>678376</BookValue>
      </Equipment>
      <OtherLandBuildings>
        <InvestmentCostOrOtherBasis>0</InvestmentCostOrOtherBasis>
        <OtherCostOrOtherBasis>439831</OtherCostOrOtherBasis>
        <Depreciation>392226</Depreciation>
        <BookValue>47605</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>3092456</TotalOfBookValueLandBuildings>
      <FederalIncomeTaxLiability>0</FederalIncomeTaxLiability>
      <OtherLiabilities>
        <Description>PAYABLES TO AFFILIATES</Description>
        <Amount>588403</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>588403</TotalOfAmounts>
    </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>
        <BaseCompensationFilingOrg>0</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>280361</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>0</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>0</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>280361</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Mario M Danese</NamePerson>
        <BaseCompensationFilingOrg>0</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>135474</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>0</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>25376</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>0</TotalCompensationFilingOrg>
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        <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 2010 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 reviewed by the Finance Committee and presented to the entire 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>Annually the Chief Human Resource Officer conducts a market compensation study to establish salary ranges, not only for officers and key employees, but all agency employees. Findings are reviewed with top management to determine if compensation structures need revision. If revisions are necessary, they are presented for approval to the Human Resource committee of the Board of Directors for approval. If approved, the revisions are enacted and all staff compensation is adjusted to reflect the new salary structure designed to keep the organization competitive in the economic market. The last salary review was in 2010, and because of the current economic conditions, a compensation freeze was implemented for 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>
      <GeneralExplanation>
        <Identifier>Other Changes in Net Assets,</Identifier>
        <ReturnReference>Form 990, Part VI, Line 5:</ReturnReference>
        <Explanation>Unrealized gains on investments: $1,133,407</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>
      </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>
      </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>
      </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>
      </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>
      </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 HEALTHCA</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>VISITING NURSE ASSOCOF CLEVEHOSPICE</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>K</TransactionType>
        <AmountInvolved>304405</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>VNA HEALTHCARE PARTNERS OF OHIO</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>L</TransactionType>
        <AmountInvolved>3189997</AmountInvolved>
      </TransactionsRelatedOrgsTable>
    </IRS990ScheduleR>
  </ReturnData>
</Return>