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The Visiting Nursing Association of Western New York has received state approval to expand into four additional counties.

The New York State Health Department’s Public Health and Health Planning Council approved the measure earlier this month, allowing for the VNA to operate in Cattaraugus, Orleans, Steuben and Wyoming counties, Kaleida Health announced.

The VNA, which is a part of Kaleida Health, currently operates in Allegany, Chautauqua, Erie, Genesee and Niagara counties.

The VNA is the largest home health agency in Western New York, serving more than 24,000 patients annually with more than 385,000 home visits, according to Kaleida Health. Its services include pediatric and adult skilled nursing, chronic disease management, and home infusion therapy.