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          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
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    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="RetDoc1040000001">
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        <OtherCostOrOtherBasisAmt>4413436</OtherCostOrOtherBasisAmt>
        <BookValueAmt>4413436</BookValueAmt>
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      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>25017686</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>6527100</DepreciationAmt>
        <BookValueAmt>18490586</BookValueAmt>
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      <LeaseholdImprovementsGrp>
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      <EquipmentGrp>
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        <DepreciationAmt>6393448</DepreciationAmt>
        <BookValueAmt>1269342</BookValueAmt>
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      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>2703130</OtherCostOrOtherBasisAmt>
        <BookValueAmt>2703130</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>26901066</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>REFUNDABLE ADVANCE</Desc>
        <Amt>1669995</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>OTHER LONG-TERM LIABILITY</Desc>
        <Amt>63178</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>1733173</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>52120700</TotalRevEtcAuditedFinclStmtAmt>
      <OtherRevenueAmt>23526</OtherRevenueAmt>
      <RevenueNotReportedAmt>23526</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>52097174</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>52097174</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>49525487</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>49525487</ExpensesSubtotalAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>49525487</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>VNA IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). IN ADDITION, VNA QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER IRC SECTION 170(B)(1)(A)(III) AND HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION UNDER IRC SECTION 509(A). VNA WAS NOT REQUIRED TO RECORD A LIABILITY FOR UNRECOGNIZED TAX BENEFITS AT YEAR-END.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>IN-KIND 23,526.</ExplanationTxt>
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      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>1</SupplementalNonqualRtrPlanInd>
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      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
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        <BonusFilingOrganizationAmount>68345</BonusFilingOrganizationAmount>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CLAIRE DOBBINS</PersonNm>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MIRIAM KIROLLOS</PersonNm>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>VASANTHA ANNE</PersonNm>
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        <PersonNm>SONNY DE RAMA</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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        <FormAndLineReferenceDesc>PART I, LINE 4B</FormAndLineReferenceDesc>
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    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 1A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS OF VNA HAS AN EXECUTIVE COMMITTEE COMPRISED OF THE CHAIRMAN, 1ST VICE-CHAIRMAN, 2ND VICE-CHAIRMAN, SECRETARY, AND TREASURER. THE PRESIDENT/CEO PARTICIPATES IN AN EX OFFICIO, NON-VOTING CAPACITY. THE EXECUTIVE COMMITTEE SHALL CONVENE AS NECESSARY AND SHALL ACT FOR THE BOARD OF DIRECTORS IN ALL MATTERS REQUIRING IMMEDIATE ATTENTION DURING THE INTERIM PERIODS BETWEEN MEETINGS OF THE BOARD OF DIRECTORS; PROVIDED THAT THE EXECUTIVE COMMITTEE SHALL NOT (1) ADOPT A PLAN FOR THE DISTRIBUTION OF THE ASSETS OF THE CORPORATION, OR FOR DISSOLUTION; (2) FILL VACANCIES ON THE BOARD OR ON ANY OF ITS COMMITTEES; (3) ELECT, APPOINT OR REMOVE ANY OFFICER, DIRECTOR OR COMMITTEE MEMBER, OR FIX THE COMPENSATION OF ANY COMMITTEE MEMBER; (4) ADOPT, AMEND OR REPEAL THE BYLAWS OR THE ARTICLES OF INCORPORATION; (5) ADOPT A PLAN OF MERGER OR ADOPT A PLAN OF CONSOLIDATION WITH ANOTHER CORPORATION, OR AUTHORIZE THE SALE, LEASE, EXCHANGE, OR MORTGAGE OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OR ASSETS OF THE CORPORATION; OR (6) AMEND, ALTER, REPEAL OR TAKE ACTION INCONSISTENT WITH ANY RESOLUTION OR ACTION OF THE BOARD OF DIRECTORS WHEN THE RESOLUTION OR ACTION OF THE BOARD PROVIDES BY ITS TERMS THAT IT SHALL NOT BE AMENDED, ALTERED OR REPEALED BY ACTION OF A COMMITTEE. THE EXECUTIVE COMMITTEE SHALL MAKE A REPORT FOR THE BOARD OF DIRECTORS, AND SHALL OBTAIN THE BOARD'S RATIFICATION AT THE NEXT BOARD MEETING, WHENEVER IT TAKES ANY ACTIONS ON THE BOARD'S BEHALF. IN ADDITION, THE EXECUTIVE COMMITTEE SHALL: (1) DEVELOP THE BOARD PLAN FOR THE YEAR, INCLUDING TRAINING AND DEVELOPMENT FOR THE BOARD AND APPROPRIATE TRAVEL FOR BOARD MEMBERS; (2) COMPRISE THE SEARCH COMMITTEE RESPONSIBLE FOR RECOMMENDING CANDIDATES FOR PRESIDENT/CEO; AND (3) CONDUCT THE EVALUATION OF THE PRESIDENT/CEO.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE VP OF FINANCE AND CHIEF FINANCIAL OFFICER INSPECTS FORM 990 AND REVIEWS IT WITH THE FINANCE COMMITTEE CHAIRMAN, COMPARING THE TAX RETURN WITH INTERNAL RECORDS. A DRAFT OF THE FORM 990 IS ALSO DISTRIBUTED TO ALL MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO FILING THE RETURN WITH THE IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>BOARD MEMBERS AND OFFICERS ARE REQUIRED TO ANNUALLY DISCLOSE IN WRITING ALL BUSINESS AND FAMILY RELATIONSHIPS THAT MIGHT POTENTIALLY CREATE A CONFLICT OF INTEREST. ALL POSSIBLE INDIRECT FINANCIAL INTERESTS IN A FEDERALLY FUNDED CONTRACT MUST ALSO BE DISCLOSED IN WRITING. BOARD MEMBERS MAY NOT VOTE ON ANY MATTER WHICH MAY DIRECTLY OR INDIRECTLY RESULT IN FINANCIAL GAIN TO THAT MEMBER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>IN DETERMINING THE COMPENSATION OF THE CEO, TOP MANAGEMENT, AND OTHER EMPLOYEES, THE ORGANIZATION PARTICIPATES IN INDUSTRY-WIDE COMPENSATION SURVEYS FOR HOMECARE AND HEALTH CENTERS. IN ADDITION, COMPENSATION PACKAGES DETAILED ON PUBLICLY AVAILABLE TAX FILINGS ARE TAKEN INTO CONSIDERATION WHEN DETERMINING SALARIES. THE BOARD EXECUTIVE COMMITTEE REVIEWS THE CEO'S PERFORMANCE ANNUALLY AND SETS GOALS AND OBJECTIVES TO ACHIEVE IN THE UPCOMING REVIEW PERIOD.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>MOST DOCUMENTS ARE AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AUDIT OVERSIGHT AND ACCOUNTANT SELECTION PROCESS HAS NOT CHANGED SIGNIFICANTLY FROM THE PRIOR YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
