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      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section A, line 6</Identifier>
        <Explanation>VNA's parent corporation, suncoast health systems, inc. ("SHS") serves as the sole corporate member or sole corporate stockholder of each if its affilates.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section A, line 7a</Identifier>
        <Explanation>VNA's parent corporation, Southcoast Health Systems elects the trustees or directors of each affiliate and with respect to certain of the affilates, exercises specified reserve powers and is governed by a board of trustees.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section A, line 7b</Identifier>
        <Explanation>The role of the SHS board is to maintain a system perspective with a regional emphasis and a broad focus across all activities in the organziation. primary functions of the shs board include strategic planning, nnetwork growth and development, and overall fiscal responsibilities. Each affiliate board is expcted to focus on its own activities addressing community needs within its scope of service.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section B, line 11</Identifier>
        <Explanation>The 990 is reviewed by the CFO and the CEO/President.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section B, line 12c</Identifier>
        <Explanation>SHS has conflict of interest, legal compliance, and code of conduct policies that apply to all trustees, officers, employees and volunteers (referred to as "members"). The President of SHS is responsible for informing all members of this policy. The Chairman of SHS's Board is responsible for making an initial determination as to whether a potential conflict of interest exists with respect to any trustee, officer or director of SHS or any of its affiliates. The President of SHS is responsible for making an initial determination as to whether a potential conflict of interest exists as to any member other than a trustee or director. In the event of a potential conflict relating to the Chairman of SHS, the matter would be reported to the President of SHS and referred automatically to the System's Governance Committee for determination as to whether a potential conflict of interest exists. In the event the affected member disagrees with the initial determination of the Chairman or President, as applicable, then upon request, he or she may be afforded the opportunity to discuss the issue with the SHS Governance Committee which has final authority in its sole discretion to determine whether a potential conflict of interest exists. The affected member, if a member of the Governance Committee, must remove himself from the room during any discussion of the matter (after his initial presentation) and refrain from participating in any vote or other decision making in regard to the matter. The minutes of the meeting would reflect that a full and accurate disclosure was made, that the member abstained from voting or decision making and that a quorum was otherwise present. Violation of this policy may result in disciplinary action up to and including termination of employment or removal from office. The Conflict of interest policy is reviewed annually by the Board. The Board is advised of the policy prior to selection as a member and is required to file within 30 days thereafter the conflict of interest disclosure statement or questionnaire.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section B, line 15</Identifier>
        <Explanation>Compensation for all vice presidents and higher level executives is established using the following procedure: 1. Review and approval by the compensation committee of Southcoast Health System, without the involvement of persons with a conflict of interest with respect to the compensation arrangement at issue. 2. Use of data as to comparable compensation for similarly qualified persons in functionally comparable positions at similarly situated positions. The compensation committee engaged the services of an independent human resource consulting firm ("consultant") to provide updated compensation data and assess the reasonableness of the total compensation provided to SHS's executives. This included relevant competitive market practice information for the northeast region market obtained from two healthcare executive compensation surveys that were prepared by independent firms. The consultant also compiled national market data from three commercially-available healthcare executive compensation surveys prepared by independent firms, and 3. Contemporaneous documentation and recordkeeping with respect to deliberations and decisions regarding the compensation arrangements. 4. The consultant's reports were used by the compensation committee for the fiscal year ending September 30, 2009.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section C, line 19</Identifier>
        <Explanation>All documents are provided upon request.</Explanation>
      </GeneralExplanation>
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      </Form990ScheduleRPartIV>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>health management initiative inc</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>363 highland avenue</AddressLine1>
          <City>fall river</City>
          <State>MA</State>
          <ZIPCode>02702</ZIPCode>
        </AddressUS>
        <EIN>042998712</EIN>
        <PrimaryActivity>commercial rentals</PrimaryActivity>
        <LegalDomicileState>MA</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <TypeOfEntity>C</TypeOfEntity>
      </Form990ScheduleRPartIV>
      <ReceiptOfIntAnnRentsRoyalties>0</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>0</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>0</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>0</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>0</LoansOrGuaranteesFromOtherOrg>
      <SaleOfAssetsToOtherOrg>0</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>0</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>0</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>0</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>0</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>0</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>1</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>0</SharingOfFacilities>
      <SharingOfPaidEmployees>0</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>1</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>0</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>0</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>0</OtherTransferFromOtherOrg>
    </IRS990ScheduleR>
  </ReturnData>
</Return>