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        <ProgramServicesAmt>168094</ProgramServicesAmt>
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        <ProgramServicesAmt>98914</ProgramServicesAmt>
        <ManagementAndGeneralAmt>155103</ManagementAndGeneralAmt>
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      <FeesForServicesLegalGrp>
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        <ManagementAndGeneralAmt>28369</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>76213</ProgramServicesAmt>
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      <OtherExpensesGrp>
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        <ProgramServicesAmt>9359</ProgramServicesAmt>
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        <EOYAmt>3703536</EOYAmt>
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      <ReconcilationRevenueExpnssAmt>7251</ReconcilationRevenueExpnssAmt>
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      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
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        <CurrentTaxYearMinus3YearsAmt>1142175</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>695623</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>320</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>125</CurrentTaxYearAmt>
        <TotalAmt>2910763</TotalAmt>
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        <CurrentTaxYearMinus1YearAmt>4900021</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>5056888</CurrentTaxYearAmt>
        <TotalAmt>23701471</TotalAmt>
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      <Total509Grp>
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        <CurrentTaxYearMinus3YearsAmt>5710144</CurrentTaxYearMinus3YearsAmt>
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        <CurrentTaxYearMinus1YearAmt>4900341</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>5057013</CurrentTaxYearAmt>
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      <AmountsRcvdDsqlfyPersonGrp>
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      <SubstantialContributorsAmtGrp>
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        <CurrentTaxYearAmt>963213</CurrentTaxYearAmt>
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      <InvestmentIncomeAndUBTIGrp>
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        <CurrentTaxYearAmt>1645</CurrentTaxYearAmt>
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        <TotalAmt>20271</TotalAmt>
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      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Schedule A, Part III, Line 12, Explanation of Other Income:</FormAndLineReferenceDesc>
        <ExplanationTxt>Investment in Subsidiary - 2021 Amount: $ 20,271.</ExplanationTxt>
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        <Desc>Lease obligation</Desc>
        <Amt>364852</Amt>
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      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization primarily consists of public charities under Section 501(c)(3) of the Internal Revenue Code (IRC). As public charities, the Organization is exempt from state and federal income taxes on income earned in accordance with its tax-exempt purpose. Unrelated business income is subject to state and federal income tax. Management has evaluated the Organization's tax positions and concluded that there is no unrelated business income or uncertain tax positions that require adjustment to the combined financial statements.</ExplanationTxt>
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    </IRS990ScheduleD>
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      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
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      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsFilingOrgAmt>34805</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>244365</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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    <IRS990ScheduleL documentId="RetDoc1042800001">
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        <NameOfInterested>
          <PersonNm>Dr Patricia Yoder</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>Family member to Board Officer, Charles Yoder</RelationshipDescriptionTxt>
        <TransactionAmt>132021</TransactionAmt>
        <TransactionDesc>Employee Compensation</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>Nicole Bland</PersonNm>
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        <RelationshipDescriptionTxt>Family Member of CEO/President</RelationshipDescriptionTxt>
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        <TransactionDesc>Employee Compensation</TransactionDesc>
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    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Form 990 is provided to all board members for review before filing.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Board members sign a conflict of interest disclosure form annually.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>Compensation for top official - the organization utilizes the regional section of the national homecare salaries and benefits annual report to compare CEO compensation with regional peers. Organizational quality and fiscal performance is compared to home health organizations serving the same geographical area. The CEO performance report is prepared by all board members individually, and then compiled into an aggregated evaluation. The CEO compensation is then reviewed and approved during a board of directors meeting without the CEO present. Senior executive compensation is also benchmarked against the national homecare salaries and benefits annual report for propriety. The CEO determines the compensation of senior management within parameters established and voted upon by the board of directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Governing documents, conflict of interest statement and financial statements are available to the public upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part X, Line 10: Land, Buildings, and Equipment:</FormAndLineReferenceDesc>
        <ExplanationTxt>Section 1.263(a)-3(n) Election: VNA Health System 21 West Independence Street Shamokin, PA 17872 EIN: 24-0833353 VNA Health System is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n).</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>Visiting Nurse Association of Central PA Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>3315 Derry Street</AddressLine1Txt>
          <CityNm>Harrisburg</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>17111</ZIPCd>
        </USAddress>
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        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Centre HomeCare Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
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          <CityNm>State College</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
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        </USAddress>
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          <CityNm>Lock Haven</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>17745</ZIPCd>
        </USAddress>
        <EIN>240798641</EIN>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
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        <PublicCharityStatusTxt>Line 10</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>VNA Health System</BusinessNameLine1Txt>
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          <BusinessNameLine1Txt>VNA Private Duty Inc</BusinessNameLine1Txt>
        </RelatedOrganizationName>
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          <StateAbbreviationCd>PA</StateAbbreviationCd>
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        </USAddress>
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        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
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        </DirectControllingEntityName>
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        <ShareOfEOYAssetsAmt>173218</ShareOfEOYAssetsAmt>
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