﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2023v5.1">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2024-11-14T19:34:57-06:00</ReturnTs>
    <TaxPeriodEndDt>2023-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>873231666</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>PKF O'CONNOR DAVIES ADVISORY LLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>500 MAMARONECK AVENUE SUITE 301</AddressLine1Txt>
        <CityNm>HARRISON</CityNm>
        <StateAbbreviationCd>NY</StateAbbreviationCd>
        <ZIPCd>105281633</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990EZ</ReturnTypeCd>
    <TaxPeriodBeginDt>2023-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>141513989</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>ULSTER HOME HEALTH SERVICES INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>ULST</BusinessNameControlTxt>
      <PhoneNum>6466334700</PhoneNum>
      <USAddress>
        <AddressLine1Txt>205 LEXINGTON AVENUE 2ND FLOOR</AddressLine1Txt>
        <CityNm>NEW YORK</CityNm>
        <StateAbbreviationCd>NY</StateAbbreviationCd>
        <ZIPCd>10016</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>ANNMARIE COVONE</PersonNm>
      <PersonTitleTxt>EXECUTIVE VP &amp; CFO</PersonTitleTxt>
      <PhoneNum>6466334700</PhoneNum>
      <SignatureDt>2024-11-14</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>1</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>MELISSA MODELSON</PreparerPersonNm>
      <PTIN>P01603524</PTIN>
      <PhoneNum>9143818900</PhoneNum>
      <PreparationDt>2024-11-05</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2023</TaxYr>
    <BuildTS>2024-10-15 13:58:12Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="4">
    <IRS990EZ documentId="RetDoc1234200001" referenceDocumentId="RetDoc1051800001 RetDoc2278000001">
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <ScheduleBNotRequiredInd>X</ScheduleBNotRequiredInd>
      <WebsiteAddressTxt>N/A</WebsiteAddressTxt>
      <Organization501c3Ind referenceDocumentId="RetDoc1039100001">X</Organization501c3Ind>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <GrossReceiptsAmt>0</GrossReceiptsAmt>
      <InfoInScheduleOPartIInd>X</InfoInScheduleOPartIInd>
      <TotalRevenueAmt>0</TotalRevenueAmt>
      <TotalExpensesAmt>0</TotalExpensesAmt>
      <ExcessOrDeficitForYearAmt>0</ExcessOrDeficitForYearAmt>
      <NetAssetsOrFundBalancesBOYAmt>959</NetAssetsOrFundBalancesBOYAmt>
      <OtherChangesInNetAssetsAmt>-4</OtherChangesInNetAssetsAmt>
      <NetAssetsOrFundBalancesEOYAmt>955</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIInd>X</InfoInScheduleOPartIIInd>
      <CashSavingsAndInvestmentsGrp>
        <BOYAmt>5430</BOYAmt>
        <EOYAmt>5429</EOYAmt>
      </CashSavingsAndInvestmentsGrp>
      <OtherAssetsTotalDetail>
        <BOYAmt>11343</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </OtherAssetsTotalDetail>
      <Form990TotalAssetsGrp>
        <BOYAmt>16773</BOYAmt>
        <EOYAmt>5429</EOYAmt>
      </Form990TotalAssetsGrp>
      <SumOfTotalLiabilitiesGrp>
        <BOYAmt>15814</BOYAmt>
        <EOYAmt>4474</EOYAmt>
      </SumOfTotalLiabilitiesGrp>
      <NetAssetsOrFundBalancesGrp>
        <BOYAmt>959</BOYAmt>
        <EOYAmt>955</EOYAmt>
      </NetAssetsOrFundBalancesGrp>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <PrimaryExemptPurposeTxt>TO ASSIST RESIDENTS OF ALL AGES OF THE MID-HUDSON VALLEY TO REGAIN AND/OR MAINTAIN OPTIMUM HEALTH, TO REMAIN AT HOME AND TO PREVENT PREMATURE OR RECURRING INSTITUTIONALIZATION BY PROVIDING HOME CARE, HEALTHCARE AND INDIVIDUAL QUALITY OF LIFE SERVICES.</PrimaryExemptPurposeTxt>
      <ProgramSrvcAccomplishmentGrp>
        <DescriptionProgramSrvcAccomTxt>THE ORGANIZATION PROVIDED HOME HEALTHCARE TO RESIDENTS IN THE MID-HUDSON VALLEY REGION. THE ORGANIZATION CEASED OPERATION AND IS IN THE PROCESS OF BEING DISSOLVED.</DescriptionProgramSrvcAccomTxt>
        <GrantsAndAllocationsAmt>0</GrantsAndAllocationsAmt>
        <ProgramServiceExpensesAmt>0</ProgramServiceExpensesAmt>
      </ProgramSrvcAccomplishmentGrp>
      <TotalProgramServiceExpensesAmt>0</TotalProgramServiceExpensesAmt>
      <OfficerDirectorTrusteeEmplGrp>
        <PersonNm>SCOTT P LA RUE</PersonNm>
        <TitleTxt>PRESIDENT/CEO</TitleTxt>
        <AverageHrsPerWkDevotedToPosRt>0.10</AverageHrsPerWkDevotedToPosRt>
        <CompensationAmt>0</CompensationAmt>
        <EmployeeBenefitProgramAmt>0</EmployeeBenefitProgramAmt>
        <ExpenseAccountOtherAllwncAmt>0</ExpenseAccountOtherAllwncAmt>
      </OfficerDirectorTrusteeEmplGrp>
      <OfficerDirectorTrusteeEmplGrp>
        <PersonNm>ANNMARIE COVONE</PersonNm>
        <TitleTxt>EXECUTIVE VP/CFO</TitleTxt>
        <AverageHrsPerWkDevotedToPosRt>0.10</AverageHrsPerWkDevotedToPosRt>
        <CompensationAmt>0</CompensationAmt>
        <EmployeeBenefitProgramAmt>0</EmployeeBenefitProgramAmt>
        <ExpenseAccountOtherAllwncAmt>0</ExpenseAccountOtherAllwncAmt>
      </OfficerDirectorTrusteeEmplGrp>
      <InfoInScheduleOPartVInd>X</InfoInScheduleOPartVInd>
      <ActivitiesNotPreviouslyRptInd>0</ActivitiesNotPreviouslyRptInd>
      <ChgMadeToOrgnzngDocNotRptInd>0</ChgMadeToOrgnzngDocNotRptInd>
      <OrganizationHadUBIInd>0</OrganizationHadUBIInd>
      <SubjectToProxyTaxInd>0</SubjectToProxyTaxInd>
      <OrganizationDissolvedEtcInd>0</OrganizationDissolvedEtcInd>
      <DirectIndirectPltclExpendAmt>0</DirectIndirectPltclExpendAmt>
      <MadeLoansToFromOfficersInd>0</MadeLoansToFromOfficersInd>
      <TaxImposedUnderIRC4911Amt>0</TaxImposedUnderIRC4911Amt>
      <TaxImposedUnderIRC4912Amt>0</TaxImposedUnderIRC4912Amt>
      <TaxImposedUnderIRC4955Amt>0</TaxImposedUnderIRC4955Amt>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <TaxImposedOnOrganizationMgrAmt>0</TaxImposedOnOrganizationMgrAmt>
      <TaxReimbursedByOrganizationAmt>0</TaxReimbursedByOrganizationAmt>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <StatesWhereCopyOfReturnIsFldCd>NY</StatesWhereCopyOfReturnIsFldCd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>ANNMARIE COVONE</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>205 LEXINGTON AVENUE - 2ND FLR</AddressLine1Txt>
          <CityNm>NEW YORK</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>10016</ZIPCd>
        </USAddress>
        <PhoneNum>2126334700</PhoneNum>
      </BooksInCareOfDetail>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <DonorAdvisedFndsInd>0</DonorAdvisedFndsInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <TanningServicesProvidedInd>0</TanningServicesProvidedInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>0</TrnsfrExmptNonChrtblRltdOrgInd>
      <PartVIOfCompOfHghstPdEmplTxt>NONE</PartVIOfCompOfHghstPdEmplTxt>
      <PartVIHghstPdCntrctProfSrvcTxt>NONE</PartVIHghstPdCntrctProfSrvcTxt>
      <FiledScheduleAInd>1</FiledScheduleAInd>
    </IRS990EZ>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>3902</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>912</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>141</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>219</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>5174</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>3290621</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>634019</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2000</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>61019</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>3987659</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>3294523</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>634931</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2141</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>61238</CurrentTaxYearMinus1YearAmt>
        <TotalAmt>3992833</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>3992833</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>31</CurrentTaxYearMinus4YearsAmt>
        <TotalAmt>31</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>31</CurrentTaxYearMinus4YearsAmt>
        <TotalAmt>31</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <OtherIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>9989</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>126</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>164827</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>43278</CurrentTaxYearMinus1YearAmt>
        <TotalAmt>218220</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>3304543</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>635057</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>166968</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>104516</CurrentTaxYearMinus1YearAmt>
        <TotalAmt>4211084</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.94820</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.94290</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00000</InvestmentIncomeCYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:</FormAndLineReferenceDesc>
        <ExplanationTxt>MISCELLANEOUS REVENUE - 2019 AMOUNT: $ 9,183. 2020 AMOUNT: $ 126. 2023 AMOUNT: $ 0. FORGIVENESS OF INTERCOMPANY DEBT - 2021 AMOUNT: $ 164,827. 2022 AMOUNT: $ 43,278. 2023 AMOUNT: $ 0. MEDICAL RECORD ABSTRACT - 2019 AMOUNT: $ 806. 2023 AMOUNT: $ 0.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleO documentId="RetDoc1051800001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990-EZ, PART I, LINE 20 - OTHER CHANGES IN NET ASSETS</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION: ROUNDING. AMOUNT: -4.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990-EZ, PART II, LINE 24 - OTHER ASSETS</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION: ACCOUNTS RECEIVABLE. BEG. OF YEAR AMOUNT: 4,693. END OF YEAR AMOUNT: 0. DESCRIPTION: INSURANCE RECOVERIES RECEIVABLE. BEG. OF YEAR AMOUNT: 6,650. END OF YEAR AMOUNT: 0.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990-EZ, PART II, LINE 26 - OTHER LIABILITIES</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION: OTHER LIABILITIES. BEG. OF YEAR AMOUNT: 4,690. END OF YEAR AMOUNT: 0. DESCRIPTION: PROFESSIONAL LIABILITIES. BEG. OF YEAR AMOUNT: 6,650. END OF YEAR AMOUNT: 0. DESCRIPTION: DUE TO ARCHCARE AT HOME. BEG. OF YEAR AMOUNT: 4,474. END OF YEAR AMOUNT: 4,474.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <TransferPrsnlBnftContractsDecl documentId="RetDoc2278000001">
      <DeclarationDesc>THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.</DeclarationDesc>
    </TransferPrsnlBnftContractsDecl>
  </ReturnData>
</Return>