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      <Form990PartVIISectionAGrp>
        <PersonNm>EVELYN INGRAM 24-25</PersonNm>
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        <PersonNm>JANE HALBRITTER 24-25</PersonNm>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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        <PersonNm>MARY KATE ROLF</PersonNm>
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        <PersonNm>DR JOEL AMIDON</PersonNm>
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        <PersonNm>JOSEPH TWARDY</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>ANDREA LAZAREK-LAQUAY</PersonNm>
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        <PersonNm>CHERYL MANNA</PersonNm>
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        <PersonNm>RYAN BLEHAR</PersonNm>
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        <PersonNm>JANET BILLINGTON</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>JOSEPH CHEVRETTE</PersonNm>
        <TitleTxt>EVP, INFORMATION SECURITY</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>JESSICA NELSON</PersonNm>
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        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>AMANDA FREDERICK</PersonNm>
        <TitleTxt>VP, HEALTH PLAN OPERATIONS</TitleTxt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <TotReportableCompRltdOrgAmt>2031523</TotReportableCompRltdOrgAmt>
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      <ContractorCompensationGrp>
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          <BusinessName>
            <BusinessNameLine1Txt>RAM TECHNOLOGIES</BusinessNameLine1Txt>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>275 COMMERCE DR SUITE 100</AddressLine1Txt>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>HEALTHPRO MANAGEMENT SERVICES LLC</BusinessNameLine1Txt>
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        <ContractorAddress>
          <USAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
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          <USAddress>
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      <ContractorCompensationGrp>
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          <USAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ACC TECHNICAL SERVICES</BusinessNameLine1Txt>
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        <ContractorAddress>
          <USAddress>
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      <GovernmentGrantsAmt>530279</GovernmentGrantsAmt>
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      <TotalContributionsAmt>828871</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
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        <BusinessCd>623000</BusinessCd>
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        <ExclusionAmt>1224779</ExclusionAmt>
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        <ExclusionAmt>509224</ExclusionAmt>
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        <BusinessCd>900099</BusinessCd>
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      <OtherRevenueMiscGrp>
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        <RelatedOrExemptFuncIncomeAmt>48355</RelatedOrExemptFuncIncomeAmt>
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        <ProgramServicesAmt>869597</ProgramServicesAmt>
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        <ProgramServicesAmt>3272852</ProgramServicesAmt>
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        <ProgramServicesAmt>1922048</ProgramServicesAmt>
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        <ProgramServicesAmt>267797</ProgramServicesAmt>
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        <ProgramServicesAmt>216557</ProgramServicesAmt>
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        <ManagementAndGeneralAmt>140480</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>877086</ProgramServicesAmt>
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        <ManagementAndGeneralAmt>398987</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>6688259</ProgramServicesAmt>
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        <ProgramServicesAmt>1316415</ProgramServicesAmt>
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        <EOYAmt>23557516</EOYAmt>
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        <EOYAmt>705625</EOYAmt>
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        <EOYAmt>23543109</EOYAmt>
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        <EOYAmt>98207787</EOYAmt>
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        <EOYAmt>12492281</EOYAmt>
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        <EOYAmt>55242118</EOYAmt>
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      <DonorRestrictionNetAssetsGrp>
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        <EOYAmt>10330</EOYAmt>
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        <EOYAmt>42965669</EOYAmt>
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        <EOYAmt>98207787</EOYAmt>
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        <DeferredCompensationFlngOrgAmt>8422</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>11613</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>228518</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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        <FormAndLineReferenceDesc>PART I, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>NASCENTIA HEALTH, INC. IS THE EMPLOYER OF THE CEO. THE ORGANIZATION'S EXECUTIVE COMMITTEE IS THE COMPENSATION COMMITTEE AND THEY APPROVE THE COMPENSATION OF THE CEO. THE COMMITTEE USES THE ANNUAL BENCHMARK HOMECARE SALARY AND BENEFITS REPORT, AND ALSO LOOKS AT EXECUTIVE COMPENSATION OF SIMILAR SIZE ORGANIZATIONS AS WELL AND EVALUATES HER PERFORMANCE FOR THE YEAR. THE CEO USES THE SAME METHOD FOR THE COMPENSATION OF THE OTHER KEY EMPLOYEES.</ExplanationTxt>
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          <PersonNm>JENNAFER ROLF</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>DAUGHTER OF CEO</RelationshipDescriptionTxt>
        <TransactionAmt>118873</TransactionAmt>
        <TransactionDesc>EMPLOYEE-SALARY</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>BROOKE D'AMICO</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>DAUGHTER OF CFO</RelationshipDescriptionTxt>
        <TransactionAmt>94957</TransactionAmt>
        <TransactionDesc>EMPLOYEE-SALARY</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>BRIAN CAVANAGH</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>BROTHER OF CEO</RelationshipDescriptionTxt>
        <TransactionAmt>97164</TransactionAmt>
        <TransactionDesc>EMPLOYEE-SALARY</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>JANET SZILAGYI</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>DAUGHTER OF CEO</RelationshipDescriptionTxt>
        <TransactionAmt>28070</TransactionAmt>
        <TransactionDesc>EMPLOYEE-SALARY</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>JAMIE ROLF</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>DAUGHTER OF CEO</RelationshipDescriptionTxt>
        <TransactionAmt>48834</TransactionAmt>
        <TransactionDesc>EMPLOYEE-SALARY</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
    </IRS990ScheduleL>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>THE SOLE MEMBER OF VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK, INC. IS NASCENTIA HEALTH, INC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>NASCENTIA HEALTH, INC. MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>NASCENTIA HEALTH, INC. IS THE SOLE MEMBER OF VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK, INC. THE MEMBER RESERVES TO ITSELF ALL THE RIGHTS AND POWERS OF CORPORATE MEMBERSHIP CREATED BY THE LAWS OF THE STATE OF NEW YORK OR THE CERTIFICATE OF INCORPORATION OR THE BY-LAWS OF THE CORPORATION. SPECIFICALLY, THE MEMBER RESERVES THE AUTHORITY TO APPOINT DIRECTORS TO THE GOVERNING BODY, TO AMEND THE BY-LAWS OF THE CORPORATION, AND TO APPROVE THE SALE, TRANSFER, OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>MANAGEMENT REVIEWS FORM 990, THEN PROVIDES TO THE BOARD MEMBERS VIA A SECURE BOARD PLATFORM WHEREBY MEMBERS HAVE ACCESS TO THE RETURNS FOR REVIEW PRIOR TO THE FILING OF THE FORM.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE WRITTEN CONFLICT OF INTEREST POLICY IS REVIEWED ON AN ANNUAL BASIS. SIGNATURES FROM THE BOARD MEMBERS DISCLOSING CONFLICTS OF INTEREST ARE UPDATED ON AN ANNUAL BASIS AS WELL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S EXECUTIVE COMMITTEE IS THE COMPENSATION COMMITTEE AND THEY APPROVE THE COMPENSATION OF THE CEO. THE COMMITTEE USES THE ANNUAL BENCHMARK HOMECARE SALARY AND BENEFITS REPORT, AND ALSO LOOKS AT EXECUTIVE COMPENSATION OF SIMILAR SIZE ORGANIZATIONS AS WELL AND EVALUATES HER PERFORMANCE FOR THE YEAR. THE CEO USES THE SAME METHOD FOR THE COMPENSATION OF THE OTHER KEY EMPLOYEES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>PENSION/POST RETIREMENT 260,609. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 86,888. OTHER COMPONENTS OF NET PERIODIC BENEFIT COST -320,443.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 12, PART XII, LINE 2C:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR.</ExplanationTxt>
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</Return>