﻿<?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="2023v6.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2025-04-18T08:16:34-05:00</ReturnTs>
    <TaxPeriodEndDt>2024-06-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>010523282</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>Berry Dunn McNeil &amp; Parker LLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>1000 Elm Street 4th Floor</AddressLine1Txt>
        <CityNm>Manchester</CityNm>
        <StateAbbreviationCd>NH</StateAbbreviationCd>
        <ZIPCd>03101</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2023-07-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>020360640</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>VNA at HCS Inc</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>VNAA</BusinessNameControlTxt>
      <PhoneNum>6033522253</PhoneNum>
      <USAddress>
        <AddressLine1Txt>312 Marlboro Street</AddressLine1Txt>
        <CityNm>Keene</CityNm>
        <StateAbbreviationCd>NH</StateAbbreviationCd>
        <ZIPCd>03431</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>Geraldine Holmes</PersonNm>
      <PersonTitleTxt>CFO</PersonTitleTxt>
      <PhoneNum>6033522253</PhoneNum>
      <SignatureDt>2025-04-16</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>1</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>Melissa Magoon CPA</PreparerPersonNm>
      <PTIN>P01712842</PTIN>
      <PhoneNum>6036697337</PhoneNum>
      <PreparationDt>2025-04-16</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2023</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="9">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>Maura McQueeney</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>312 Marlboro Street</AddressLine1Txt>
        <CityNm>Keene</CityNm>
        <StateAbbreviationCd>NH</StateAbbreviationCd>
        <ZIPCd>03431</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>18641393</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>www.hcsservices.org</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1981</FormationYr>
      <LegalDomicileStateCd>NH</LegalDomicileStateCd>
      <ActivityOrMissionDesc>To provide services which will enable people to function throughout life at their optimal level of health, well-being, and independence according to their personal beliefs and choices.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>12</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>11</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>228</TotalEmployeeCnt>
      <TotalVolunteersCnt>12</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>987418</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>891182</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>17496268</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>17731262</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>2178</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>2993</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>-379</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>-517</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>18485485</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>18624920</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>13913</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>11508526</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>11843317</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>7532410</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>8205945</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>19054849</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>20049262</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-569364</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-1424342</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>8609592</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>7369109</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>3168449</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>3349997</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>5441143</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>4019112</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>To provide services which will enable people to function throughout life at their optimal level of health, well-being, and independence according to their personal beliefs and choices.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>8324410</ExpenseAmt>
      <RevenueAmt>8777858</RevenueAmt>
      <Desc>Homecare Service - Objective is to help residents of southwestern New Hampshire to recover at home after a hospitalization or rehabilitation stay in a facility. Skilled care provided by nurses, rehabilitation therapists are available to residents of all ages with the goal of comfort, care and support at home. Private duty services are also offered to customize care to individual needs.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>5870815</ExpenseAmt>
        <RevenueAmt>6190611</RevenueAmt>
        <Desc>Hospice Care - Is offered to those who would like to remain in the comfort and dignity of their own home at the end of life. A care team of nurses, social workers, chaplain and volunteers provide comfort measures to the patient and support for their family members. Bereavement support is also offered to families and to the community at no charge.</Desc>
      </ProgSrvcAccomActy2Grp>
      <ProgSrvcAccomActy3Grp>
        <ExpenseAmt>2620072</ExpenseAmt>
        <RevenueAmt>2762793</RevenueAmt>
        <Desc>Community Service - Conduct events such as Meals on Wheels, adult day care, and door to door transportation. Provide additional help for those who need short- or long-term supportive services to remain safely at home. Other community services, such as the healthy starts maternal and child health program, nurse is in clinics, and age in motion promote the health and well-being of the communities we serve.</Desc>
      </ProgSrvcAccomActy3Grp>
      <TotalProgramServiceExpensesAmt>16815297</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd referenceDocumentId="RetDoc1039700001">0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd referenceDocumentId="RetDoc1039700001">1</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd referenceDocumentId="RetDoc1039700001">0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">0</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>1</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">1</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">0</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">1</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd referenceDocumentId="RetDoc1041300001">0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd referenceDocumentId="RetDoc1041300001">1</FundraisingActivitiesInd>
      <GamingActivitiesInd referenceDocumentId="RetDoc1041300001">1</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd>0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>0</PYExcessBenefitTransInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc1043400001">0</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043400001">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc1043400001">0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>18</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>228</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>12</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>11</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>1</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>1</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>1</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>1</LocalChaptersInd>
      <PoliciesReferenceChaptersInd>1</PoliciesReferenceChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>1</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>1</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>NH</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>Geraldine Holmes</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>6033522253</PhoneNum>
        <USAddress>
          <AddressLine1Txt>312 Marlboro Street</AddressLine1Txt>
          <CityNm>Keene</CityNm>
          <StateAbbreviationCd>NH</StateAbbreviationCd>
          <ZIPCd>03431</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>Virginia Jordan</PersonNm>
        <TitleTxt>Chair</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Eric Horne</PersonNm>
        <TitleTxt>Treasurer</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Julie Green</PersonNm>
        <TitleTxt>Secretary</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Paul Berch</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Mary Ann Davis</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Ann Heffernon</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Donald Mazanowski</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Will Pearson</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>David Stinson</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Julie Tweksbury</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Andrew Trembley</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Maura McQueeney</PersonNm>
        <TitleTxt>President &amp; CEO</TitleTxt>
        <AverageHoursPerWeekRt>8.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>32.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>226481</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>14085</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>David Therrien</PersonNm>
        <TitleTxt>Past Chair</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Michael Chelstowski</PersonNm>
        <TitleTxt>Past Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Julie Greenwood</PersonNm>
        <TitleTxt>Past Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Judy Sadoski</PersonNm>
        <TitleTxt>Past Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dawn Michelizzi</PersonNm>
        <TitleTxt>Past CFO</TitleTxt>
        <AverageHoursPerWeekRt>8.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>37.50</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>175988</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10154</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Stephen Pullman</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <AverageHoursPerWeekRt>5.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>25.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>89787</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Laura Brow</PersonNm>
        <TitleTxt>Director - Clinical Operations</TitleTxt>
        <AverageHoursPerWeekRt>37.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>154884</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>7943</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Christine White</PersonNm>
        <TitleTxt>Rehab Leader/PT</TitleTxt>
        <AverageHoursPerWeekRt>37.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>113558</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>15477</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Lana Moore</PersonNm>
        <TitleTxt>Hospice RN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>156174</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>12685</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Christopher Persson</PersonNm>
        <TitleTxt>Rehab Team Lead OT</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>152482</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>11615</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Roberta Heinonen</PersonNm>
        <TitleTxt>Hospice RN</TitleTxt>
        <AverageHoursPerWeekRt>37.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>135256</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>13928</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>712354</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>492256</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>85887</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>6</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>1</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Home HealthCare Hospice &amp; Community Ser</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>312 Marlboro Street</AddressLine1Txt>
            <CityNm>Keene</CityNm>
            <StateAbbreviationCd>NH</StateAbbreviationCd>
            <ZIPCd>03431</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Management Services</ServicesDesc>
        <CompensationAmt>4381997</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Core Medical Group</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>655 South Willow Street Suite 125</AddressLine1Txt>
            <CityNm>Manchester</CityNm>
            <StateAbbreviationCd>NH</StateAbbreviationCd>
            <ZIPCd>03103</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Contracted Nursing</ServicesDesc>
        <CompensationAmt>392250</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Brightree Home Health &amp; Hospice LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 101233</AddressLine1Txt>
            <CityNm>Atlanta</CityNm>
            <StateAbbreviationCd>GA</StateAbbreviationCd>
            <ZIPCd>303921233</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>EMR Software Services</ServicesDesc>
        <CompensationAmt>208237</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>SimiTree Healthcare Consulting</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>4130 Whitney Avenue</AddressLine1Txt>
            <CityNm>Hamden</CityNm>
            <StateAbbreviationCd>CT</StateAbbreviationCd>
            <ZIPCd>065180248</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Contracted Staffing (Director, Coding, B</ServicesDesc>
        <CompensationAmt>200617</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Dartmouth-Hitchcock</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>One Medical Center Drive</AddressLine1Txt>
            <CityNm>Lebanon</CityNm>
            <StateAbbreviationCd>NH</StateAbbreviationCd>
            <ZIPCd>03756</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Physician Services</ServicesDesc>
        <CompensationAmt>150759</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>5</CntrctRcvdGreaterThan100KCnt>
      <FundraisingAmt>21368</FundraisingAmt>
      <GovernmentGrantsAmt>401488</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>468326</AllOtherContributionsAmt>
      <TotalContributionsAmt>891182</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Net Patient Service Revenue</Desc>
        <BusinessCd>621610</BusinessCd>
        <TotalRevenueColumnAmt>15402339</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>15402339</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Other Operating Revenue</Desc>
        <BusinessCd>621610</BusinessCd>
        <TotalRevenueColumnAmt>2328923</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2328923</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>17731262</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>1760</TotalRevenueColumnAmt>
        <ExclusionAmt>1760</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>1233</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>0</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>1233</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>1233</TotalRevenueColumnAmt>
        <ExclusionAmt>1233</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <FundraisingGrossIncomeAmt>0</FundraisingGrossIncomeAmt>
      <ContriRptFundraisingEventAmt>21368</ContriRptFundraisingEventAmt>
      <FundraisingDirectExpensesAmt>12723</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>-12723</TotalRevenueColumnAmt>
        <ExclusionAmt>-12723</ExclusionAmt>
      </NetIncmFromFundraisingEvtGrp>
      <GamingGrossIncomeAmt>15956</GamingGrossIncomeAmt>
      <GamingDirectExpensesAmt>3750</GamingDirectExpensesAmt>
      <NetIncomeFromGamingGrp>
        <TotalRevenueColumnAmt>12206</TotalRevenueColumnAmt>
        <ExclusionAmt>12206</ExclusionAmt>
      </NetIncomeFromGamingGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>18624920</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>17731262</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>2476</ExclusionAmt>
      </TotalRevenueGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>9658738</TotalAmt>
        <ProgramServicesAmt>8438839</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1219899</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>158503</TotalAmt>
        <ProgramServicesAmt>138484</ProgramServicesAmt>
        <ManagementAndGeneralAmt>20019</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1332773</TotalAmt>
        <ProgramServicesAmt>1164444</ProgramServicesAmt>
        <ManagementAndGeneralAmt>168329</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>693303</TotalAmt>
        <ProgramServicesAmt>605739</ProgramServicesAmt>
        <ManagementAndGeneralAmt>87564</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>4381997</TotalAmt>
        <ProgramServicesAmt>3828551</ProgramServicesAmt>
        <ManagementAndGeneralAmt>553446</ManagementAndGeneralAmt>
      </FeesForServicesManagementGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>149</TotalAmt>
        <ManagementAndGeneralAmt>149</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>1624851</TotalAmt>
        <ProgramServicesAmt>635054</ProgramServicesAmt>
        <ManagementAndGeneralAmt>989797</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>26291</TotalAmt>
        <ProgramServicesAmt>22970</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3321</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>263828</TotalAmt>
        <ProgramServicesAmt>230507</ProgramServicesAmt>
        <ManagementAndGeneralAmt>33321</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>315414</TotalAmt>
        <ProgramServicesAmt>275577</ProgramServicesAmt>
        <ManagementAndGeneralAmt>39837</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>52250</TotalAmt>
        <ProgramServicesAmt>45651</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6599</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>418857</TotalAmt>
        <ProgramServicesAmt>365955</ProgramServicesAmt>
        <ManagementAndGeneralAmt>52902</ManagementAndGeneralAmt>
      </TravelGrp>
      <InterestGrp>
        <TotalAmt>258</TotalAmt>
        <ProgramServicesAmt>225</ProgramServicesAmt>
        <ManagementAndGeneralAmt>33</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>40855</TotalAmt>
        <ProgramServicesAmt>35695</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5160</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>19456</TotalAmt>
        <ProgramServicesAmt>16999</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2457</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Program supplies</Desc>
        <TotalAmt>656891</TotalAmt>
        <ProgramServicesAmt>656891</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Equipment Rental</Desc>
        <TotalAmt>393220</TotalAmt>
        <ProgramServicesAmt>343556</ProgramServicesAmt>
        <ManagementAndGeneralAmt>49664</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Other expenses</Desc>
        <TotalAmt>11628</TotalAmt>
        <ProgramServicesAmt>10160</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1468</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>20049262</TotalAmt>
        <ProgramServicesAmt>16815297</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3233965</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <InfoInScheduleOPartXInd>X</InfoInScheduleOPartXInd>
      <CashNonInterestBearingGrp>
        <BOYAmt>208</BOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>977518</BOYAmt>
        <EOYAmt>56</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>1956656</BOYAmt>
        <EOYAmt>1443488</EOYAmt>
      </AccountsReceivableGrp>
      <LandBldgEquipCostOrOtherBssAmt>1463434</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>1294274</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>185804</BOYAmt>
        <EOYAmt>169160</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>162079</BOYAmt>
        <EOYAmt>125214</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>5327327</BOYAmt>
        <EOYAmt>5631191</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>8609592</BOYAmt>
        <EOYAmt>7369109</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>3093707</BOYAmt>
        <EOYAmt>3273132</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>74742</BOYAmt>
        <EOYAmt>76865</EOYAmt>
      </DeferredRevenueGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>3168449</BOYAmt>
        <EOYAmt>3349997</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>5293130</BOYAmt>
        <EOYAmt>3862264</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>148013</BOYAmt>
        <EOYAmt>156848</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>5441143</BOYAmt>
        <EOYAmt>4019112</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>8609592</BOYAmt>
        <EOYAmt>7369109</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-1424342</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>2311</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>875265</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>2972211</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>827747</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>987418</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>891182</CurrentTaxYearAmt>
        <TotalAmt>6553823</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>13876665</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>15125898</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>15442380</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>17496268</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>17731262</CurrentTaxYearAmt>
        <TotalAmt>79672473</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>14751930</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>18098109</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>16270127</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>18483686</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>18622444</CurrentTaxYearAmt>
        <TotalAmt>86226296</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <CurrentTaxYearMinus4YearsAmt>12140</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>9865</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>8487</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>875</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>12569</CurrentTaxYearAmt>
        <TotalAmt>43936</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <CurrentTaxYearMinus4YearsAmt>12140</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>9865</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>8487</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>875</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>12569</CurrentTaxYearAmt>
        <TotalAmt>43936</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>86182360</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>1307</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>563</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>974</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1546</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1760</CurrentTaxYearAmt>
        <TotalAmt>6150</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>1307</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>563</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>974</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1546</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1760</CurrentTaxYearAmt>
        <TotalAmt>6150</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <NetIncomeFromOtherUBIGrp>
        <CurrentTaxYearMinus4YearsAmt>4771</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>22661</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>3988</CurrentTaxYearMinus2YearsAmt>
        <TotalAmt>31420</TotalAmt>
      </NetIncomeFromOtherUBIGrp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>14758008</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>18121333</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>16275089</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>18485232</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>18624204</CurrentTaxYearAmt>
        <TotalAmt>86263866</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.99910</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99910</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00010</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00010</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleC documentId="RetDoc1039700001">
      <VolunteersInd>0</VolunteersInd>
      <PaidStaffOrManagementInd>0</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>0</MediaAdvertisementsInd>
      <MailingsMembersInd>0</MailingsMembersInd>
      <PublicationsOrBroadcastInd>0</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>0</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>0</DirectContactLegislatorsInd>
      <RalliesDemonstrationsInd>0</RalliesDemonstrationsInd>
      <OtherActivitiesInd>1</OtherActivitiesInd>
      <OtherActivitiesAmt>3219</OtherActivitiesAmt>
      <TotalLobbyingExpendituresAmt>3219</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>0</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II-B, Line 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization pays dues to various organizations, a portion of which is attributable to lobbying expenses.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <CYEndwmtFundGrp>
        <BeginningYearBalanceAmt>18623</BeginningYearBalanceAmt>
        <EndYearBalanceAmt>18623</EndYearBalanceAmt>
      </CYEndwmtFundGrp>
      <CYMinus1YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>18623</BeginningYearBalanceAmt>
        <EndYearBalanceAmt>18623</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>18623</BeginningYearBalanceAmt>
        <EndYearBalanceAmt>18623</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>18623</BeginningYearBalanceAmt>
        <EndYearBalanceAmt>18623</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>18623</BeginningYearBalanceAmt>
        <EndYearBalanceAmt>18623</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <BoardDesignatedBalanceEOYPct>0.00000</BoardDesignatedBalanceEOYPct>
      <PrmnntEndowmentBalanceEOYPct>1.00000</PrmnntEndowmentBalanceEOYPct>
      <TermEndowmentBalanceEOYPct>0.00000</TermEndowmentBalanceEOYPct>
      <EndowmentsHeldUnrelatedOrgInd>0</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>0</EndowmentsHeldRelatedOrgInd>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>28312</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>22043</DepreciationAmt>
        <BookValueAmt>6269</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>1169951</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1030774</DepreciationAmt>
        <BookValueAmt>139177</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>265171</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>241457</DepreciationAmt>
        <BookValueAmt>23714</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>169160</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>Due From Affiliate</Desc>
        <BookValueAmt>5631191</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>5631191</TotalBookValueOtherAssetsAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part V, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>Income used for operations and to support hospice.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Association is a public charity under Section 501(c)(3) of the Internal Revenue Code (IRC). As a public charity, the Association 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 Association's tax positions and concluded that the Association has no unrelated business income or uncertain tax positions that require adjustment to the consolidated financial statements.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleG documentId="RetDoc1041300001">
      <FundraisingEventInformationGrp>
        <Event1Nm>Butterfly Event</Event1Nm>
        <GrossReceiptsEvent1Amt>21368</GrossReceiptsEvent1Amt>
        <CharitableContriEvent1Amt>21368</CharitableContriEvent1Amt>
        <OtherDirectExpensesEvent1Amt>12723</OtherDirectExpensesEvent1Amt>
        <GrossReceiptsTotalAmt>21368</GrossReceiptsTotalAmt>
        <CharitableContributionsTotAmt>21368</CharitableContributionsTotAmt>
        <OthDirectExpnssTotalEventsAmt>12723</OthDirectExpnssTotalEventsAmt>
        <DirectExpenseSummaryEventsAmt>12723</DirectExpenseSummaryEventsAmt>
        <NetIncomeSummaryAmt>-12723</NetIncomeSummaryAmt>
      </FundraisingEventInformationGrp>
      <GamingInformationGrp>
        <GrossRevenueOtherGamingAmt>15956</GrossRevenueOtherGamingAmt>
        <RentFcltyCostsOtherGamingAmt>3750</RentFcltyCostsOtherGamingAmt>
        <VolunteerLaborOtherGamingInd>0</VolunteerLaborOtherGamingInd>
        <GrossRevenueTotalGamingAmt>15956</GrossRevenueTotalGamingAmt>
        <RentFcltyCostsTotalGamingAmt>3750</RentFcltyCostsTotalGamingAmt>
        <DirectExpenseSummaryGamingAmt>3750</DirectExpenseSummaryGamingAmt>
        <NetGamingIncomeSummaryAmt>12206</NetGamingIncomeSummaryAmt>
      </GamingInformationGrp>
      <StatesWhereGamingConductedCd>NH</StatesWhereGamingConductedCd>
      <LicensedInd>1</LicensedInd>
      <LicenseSuspendedEtcInd>0</LicenseSuspendedEtcInd>
      <GamingWithNonmembersInd>1</GamingWithNonmembersInd>
      <MemberOfOtherEntityInd>0</MemberOfOtherEntityInd>
      <GamingOtherFacilityPct>1.00000</GamingOtherFacilityPct>
      <IndividualWithBooksNm>Sareen Sarna Director of Growth an</IndividualWithBooksNm>
      <PersonsWithBooksUSAddress>
        <AddressLine1Txt>VNA at HCS Inc 312 Marlboro St</AddressLine1Txt>
        <CityNm>Keene</CityNm>
        <StateAbbreviationCd>NH</StateAbbreviationCd>
        <ZIPCd>03431</ZIPCd>
      </PersonsWithBooksUSAddress>
      <CntrctWith3rdPrtyForGameRevInd>1</CntrctWith3rdPrtyForGameRevInd>
      <GamingRevenueReceivedByOrgAmt>15956</GamingRevenueReceivedByOrgAmt>
      <GamingRevenueRtnBy3PrtyAmt>3750</GamingRevenueRtnBy3PrtyAmt>
      <ThirdPartyBusinessName>
        <BusinessNameLine1Txt>Emerald Gaming LLC dba Wonder Casino</BusinessNameLine1Txt>
      </ThirdPartyBusinessName>
      <ThirdPartyUSAddress>
        <AddressLine1Txt>172 Emerald Street Suite 101</AddressLine1Txt>
        <CityNm>Keene</CityNm>
        <StateAbbreviationCd>NH</StateAbbreviationCd>
        <ZIPCd>03431</ZIPCd>
      </ThirdPartyUSAddress>
      <GamingManagerPersonNm>Sareen Sarna Director of Growth an</GamingManagerPersonNm>
      <GamingManagerServicesProvTxt>Sareen Sarna, Director of Growth and Philanthropy supervises the event as part of her job responsibilities. Ms. Sarna oversees all fundraising event related activities, including organizing staff and volunteers and recordkeeping for the event. Total compensation paid to Ms. Sarna was in her capacity as an employee of Home Healthcare Hospice &amp; Community Services, a related organization. Services related to the event were a very small portion of the total services she provided to the Organization during the fiscal year, so no reasonable basis for the amount of her compensation related to the gaming activities can be established.</GamingManagerServicesProvTxt>
      <GamingManagerIsEmployeeInd>X</GamingManagerIsEmployeeInd>
      <CharitableDistributionRqrInd>0</CharitableDistributionRqrInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule G, Part III, Line 15a:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization had an agreement where Concord Bingo, LLC d/b/a Wonder Casino would provide VNA at HCS, Inc. a percentage of revenue from Concord Bingo, LLC's games of chance proceeds. VNA at HCS, Inc. never paid Concord Bingo, LLC directly and was not directly involved in administrating any of the games of chance. VNA at HCS, Inc. was charged $1875 a day for the ten-day event which was taken directly out of the proceeds earned by Concord Bingo, LLC which then donated the remaining $15,955.66 of proceeds to VNA at HCS, Inc. There was an additional deposit of $3,750 paid by VNA at HCS, Inc. event held in July 2023 and June 2024.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleG>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>1</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Maura McQueeney</PersonNm>
        <TitleTxt>President &amp; CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>202381</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>24100</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>9000</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>5085</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>240566</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Dawn Michelizzi</PersonNm>
        <TitleTxt>Past CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>175988</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>8100</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>2054</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>186142</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Lana Moore</PersonNm>
        <TitleTxt>Hospice RN</TitleTxt>
        <BaseCompensationFilingOrgAmt>156124</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>50</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>3900</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>8785</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>168859</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Christopher Persson</PersonNm>
        <TitleTxt>Rehab Team Lead OT</TitleTxt>
        <BaseCompensationFilingOrgAmt>151932</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>500</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>50</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>1950</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>9665</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>164097</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Laura Brow</PersonNm>
        <TitleTxt>Director - Clinical Operations</TitleTxt>
        <BaseCompensationFilingOrgAmt>154667</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>217</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>5850</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>2093</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>162827</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Stephen Pullman</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>89787</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>89787</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>The CEO and CFO are compensated by Home Health Care, Hospice &amp; Community Services, Inc., a related organization, for services rendered to VNA at HCS, Inc. The compensation for the CEO is determined through the use of: - Compensation committee - Form 990 of other organizations - Written employment contract - Compensation survey or study - Approval by the board or compensation committee</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>During 2023, employees received bonuses based on merit.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VII, line 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>Stephen Pullman, CFO, is paid by SimiTree, an unrelated organization via a professional services agreement. During calendar year 2023, Home HealthCare, Hospice &amp; Community Services, Inc. paid SimiTree $89,787 for services rendered to Home HealthCare, Hospice &amp; Community Services, Inc. The actual compensation paid to Mr. Pullman by SimiTree is not known to the Organization. As such, pursuant to the Form 990 instructions, the Organization is reporting the amount paid for services rendered as compensation to Mr. Pullman, and is reporting this amount on Form 990, Part VII, Column E.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>Home Healthcare, Hospice and Community Services, Inc. (HCS) shall be the sole member of the corporation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>The sole member of the corporation shall be entitled to vote.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Board of Directors shall have and exercise all of the powers of the corporation provided by law, subject to the reservation to Home HealthCare, Hospice and Community Services, the sole member of the corporation, of the right to approve certain matters set forth in these bylaws before they may become effective: (a) the annual operating and capital budgets of the corporation; (b) any amendment, repeal, replacement or additional to these bylaws or to the articles of agreement of the corporation; and (c) the employment of the CEO of the corporation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The CFO reviews the Form 990 with the Finance Committee of the Board of Directors for approval prior to filing.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>A conflict-of-interest disclosure form is completed and signed annually by each member of the Board of Directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>The practice states that the CEO submits an annual self-evaluation to the board, a written evaluation of the CEO be completed by the board and use of a comparable compensation survey report to set compensation level. Comparable compensation surveys are updated every three to five years. The CEO determines the salary of the CFO using performance evaluation and a comparable compensation survey report to set compensation levels. Comparable compensation surveys are updated every three to five years.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization's governing documents, conflict of interest policy, and financial statements are made 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 at HCS, Inc. 312 Marlboro Street Keene, NH 03431 EIN: 02-0360640 Section 1.263(a)-3(n) Election: VNA at HCS, Inc. is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n).</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Home Health Care Hospice &amp; Community Services Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>312 Marlboro Street</AddressLine1Txt>
          <CityNm>Keene</CityNm>
          <StateAbbreviationCd>NH</StateAbbreviationCd>
          <ZIPCd>03431</ZIPCd>
        </USAddress>
        <EIN>020464932</EIN>
        <PrimaryActivitiesTxt>Support to VNA at HCS, Inc.</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 12b, II</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>1</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>