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        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>315426</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>23304</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ASHLEY POPEJOY</PersonNm>
        <TitleTxt>PEDIATRIC DENTAL DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>331425</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>35150</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHAN REYES</PersonNm>
        <TitleTxt>MEDICAL DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>236842</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>29570</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DEREK SMITH</PersonNm>
        <TitleTxt>DENTAL DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>254690</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>40399</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MATTHEW STINSON</PersonNm>
        <TitleTxt>VP OF MED AND BEHAVIORAL HEALT</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>285357</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>37318</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>NICK PFANNENSTIEL</PersonNm>
        <TitleTxt>VP OF ORAL HEALTH</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>311135</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>23534</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CLINT STRONG</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>232473</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>36011</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RAFAEL SANTIAGO</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>253570</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>29693</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RENDI PFANNENSTIEL</PersonNm>
        <TitleTxt>DENTIST</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>229248</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>27207</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JEAN MOORE</PersonNm>
        <TitleTxt>PEDIATRICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>259756</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>17910</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SALVADOR CENICEROS</PersonNm>
        <TitleTxt>PSYCHIATRIST</TitleTxt>
        <AverageHoursPerWeekRt>40.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>403597</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>22803</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>3113519</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>322899</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>47</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>OZARK ANESTHESIA ASSOC INC</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1000 E PRIMROSE ST 520</AddressLine1Txt>
            <CityNm>SPRINGFIELD</CityNm>
            <StateAbbreviationCd>MO</StateAbbreviationCd>
            <ZIPCd>65807</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>DENTAL SERVICES</ServicesDesc>
        <CompensationAmt>649550</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>ORAL SURGERY OF SPRINGFIELD</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>3237 E SUNSHINE ST B</AddressLine1Txt>
            <CityNm>SPRINGFIELD</CityNm>
            <StateAbbreviationCd>MO</StateAbbreviationCd>
            <ZIPCd>65804</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>DENTAL SERVICES</ServicesDesc>
        <CompensationAmt>294161</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>MERCY CLINIC</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2730 E SUNSHINE ST</AddressLine1Txt>
            <CityNm>SPRINGFIELD</CityNm>
            <StateAbbreviationCd>MO</StateAbbreviationCd>
            <ZIPCd>65804</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MEDICAL SERVICES</ServicesDesc>
        <CompensationAmt>229136</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>ROBERT CHARLES BLAIR DDS</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1462 S DOLLISON AVE</AddressLine1Txt>
            <CityNm>SPRINGFIELD</CityNm>
            <StateAbbreviationCd>MO</StateAbbreviationCd>
            <ZIPCd>65807</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>DENTAL SERVICES</ServicesDesc>
        <CompensationAmt>697046</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>LACLEDE COUNTY HEALTHCARE CONSORTIU</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>860 LYNN ST</AddressLine1Txt>
            <CityNm>LEBANON</CityNm>
            <StateAbbreviationCd>MO</StateAbbreviationCd>
            <ZIPCd>65536</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>RENT</ServicesDesc>
        <CompensationAmt>294161</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>7</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>7154786</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>2504770</AllOtherContributionsAmt>
      <NoncashContributionsAmt>1724667</NoncashContributionsAmt>
      <TotalContributionsAmt>9659556</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>NET PATIENT SERVICE REVENUE</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>42888496</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>41635914</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>1252582</UnrelatedBusinessRevenueAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>EHR &amp; INCENTIVE REVENUE</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>250985</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>250985</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>OTHER REVENUE</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>726724</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>726724</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>CAPITATION REVENUE</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>860921</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>860921</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>44727126</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>720511</TotalRevenueColumnAmt>
        <ExclusionAmt>720511</ExclusionAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </RoyaltiesRevenueGrp>
      <GrossRentsGrp>
        <RealAmt>181106</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>146009</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>35097</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>35097</TotalRevenueColumnAmt>
        <ExclusionAmt>35097</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <OtherAmt>206805</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <OtherAmt>40959</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <OtherAmt>165846</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>165846</TotalRevenueColumnAmt>
        <ExclusionAmt>165846</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <FundraisingGrossIncomeAmt>0</FundraisingGrossIncomeAmt>
      <FundraisingDirectExpensesAmt>0</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncmFromFundraisingEvtGrp>
      <GamingGrossIncomeAmt>0</GamingGrossIncomeAmt>
      <GamingDirectExpensesAmt>0</GamingDirectExpensesAmt>
      <NetIncomeFromGamingGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeFromGamingGrp>
      <GrossSalesOfInventoryAmt>0</GrossSalesOfInventoryAmt>
      <CostOfGoodsSoldAmt>0</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>LOSS ON INVESTMENT IN EQUITY INVESTEE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>-108994</TotalRevenueColumnAmt>
        <ExclusionAmt>-108994</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>-108994</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>55199142</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>43474544</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>1252582</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>812460</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>155377</TotalAmt>
        <ProgramServicesAmt>155377</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>1924150</TotalAmt>
        <ProgramServicesAmt>1121843</ProgramServicesAmt>
        <ManagementAndGeneralAmt>802307</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>266153</TotalAmt>
        <ProgramServicesAmt>266153</ProgramServicesAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>22588151</TotalAmt>
        <ProgramServicesAmt>18663893</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3924258</ManagementAndGeneralAmt>
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      <PensionPlanContributionsGrp>
        <TotalAmt>622954</TotalAmt>
        <ProgramServicesAmt>522008</ProgramServicesAmt>
        <ManagementAndGeneralAmt>100946</ManagementAndGeneralAmt>
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      <OtherEmployeeBenefitsGrp>
        <TotalAmt>2256938</TotalAmt>
        <ProgramServicesAmt>1848725</ProgramServicesAmt>
        <ManagementAndGeneralAmt>408213</ManagementAndGeneralAmt>
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      <PayrollTaxesGrp>
        <TotalAmt>1684759</TotalAmt>
        <ProgramServicesAmt>1365834</ProgramServicesAmt>
        <ManagementAndGeneralAmt>318925</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>41611</TotalAmt>
        <ManagementAndGeneralAmt>41611</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>195275</TotalAmt>
        <ManagementAndGeneralAmt>195275</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>5353656</TotalAmt>
        <ProgramServicesAmt>4951062</ProgramServicesAmt>
        <ManagementAndGeneralAmt>402594</ManagementAndGeneralAmt>
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      <AdvertisingGrp>
        <TotalAmt>172304</TotalAmt>
        <ManagementAndGeneralAmt>172304</ManagementAndGeneralAmt>
      </AdvertisingGrp>
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        <ProgramServicesAmt>2470900</ProgramServicesAmt>
        <ManagementAndGeneralAmt>662182</ManagementAndGeneralAmt>
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      <InformationTechnologyGrp>
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        <ProgramServicesAmt>1814566</ProgramServicesAmt>
        <ManagementAndGeneralAmt>137348</ManagementAndGeneralAmt>
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      </RoyaltiesGrp>
      <OccupancyGrp>
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        <ProgramServicesAmt>32793</ProgramServicesAmt>
        <ManagementAndGeneralAmt>920907</ManagementAndGeneralAmt>
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      <TravelGrp>
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        <ProgramServicesAmt>155715</ProgramServicesAmt>
        <ManagementAndGeneralAmt>206032</ManagementAndGeneralAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
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      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>141704</TotalAmt>
        <ProgramServicesAmt>84789</ProgramServicesAmt>
        <ManagementAndGeneralAmt>56915</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>2385</ProgramServicesAmt>
        <ManagementAndGeneralAmt>285868</ManagementAndGeneralAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
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      </PaymentsToAffiliatesGrp>
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        <ProgramServicesAmt>280703</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1700415</ManagementAndGeneralAmt>
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      <InsuranceGrp>
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        <ProgramServicesAmt>276540</ProgramServicesAmt>
        <ManagementAndGeneralAmt>124360</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>BAD DEBT</Desc>
        <TotalAmt>287487</TotalAmt>
        <ProgramServicesAmt>287487</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL SUPPLIES &amp; DRUGS</Desc>
        <TotalAmt>7386183</TotalAmt>
        <ProgramServicesAmt>7386183</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>LICENSES, DUES, SUBSCRIPTIONS</Desc>
        <TotalAmt>280064</TotalAmt>
        <ProgramServicesAmt>221861</ProgramServicesAmt>
        <ManagementAndGeneralAmt>58203</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>REPAIRS &amp; MAINTENANCE</Desc>
        <TotalAmt>405484</TotalAmt>
        <ProgramServicesAmt>174826</ProgramServicesAmt>
        <ManagementAndGeneralAmt>230658</ManagementAndGeneralAmt>
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      <TotalFunctionalExpensesGrp>
        <TotalAmt>52832964</TotalAmt>
        <ProgramServicesAmt>42083643</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10749321</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <CashNonInterestBearingGrp>
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        <EOYAmt>15648001</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>24950450</BOYAmt>
        <EOYAmt>26891050</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>401348</BOYAmt>
        <EOYAmt>145293</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>3643748</BOYAmt>
        <EOYAmt>4127709</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
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        <EOYAmt>0</EOYAmt>
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      <RcvblFromDisqualifiedPrsnGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </RcvblFromDisqualifiedPrsnGrp>
      <OthNotesLoansReceivableNetGrp>
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        <EOYAmt>0</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>1222556</BOYAmt>
        <EOYAmt>1321678</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
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        <EOYAmt>850835</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>40753665</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>17316322</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>22684500</BOYAmt>
        <EOYAmt>23437343</EOYAmt>
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      <InvestmentsPubTradedSecGrp>
        <BOYAmt>146751</BOYAmt>
        <EOYAmt>203989</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>1304020</BOYAmt>
        <EOYAmt>1195027</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InvestmentsProgramRelatedGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </IntangibleAssetsGrp>
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      <SupplementalInformationDetail>
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      <SupplementalInformationDetail>
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        <BonusFilingOrganizationAmount>24848</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>1714</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>8327</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>14476</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>426400</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ASHLEY POPEJOY</PersonNm>
        <TitleTxt>PEDIATRIC DENTAL DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>230509</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>100280</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>636</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>12251</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>22899</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>366575</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CHAN REYES</PersonNm>
        <TitleTxt>MEDICAL DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>226182</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>10000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>660</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>11620</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>17950</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>266412</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DEREK SMITH</PersonNm>
        <TitleTxt>DENTAL DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>203073</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>50969</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>648</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>10811</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>29588</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>295089</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MATTHEW STINSON</PersonNm>
        <TitleTxt>VP OF MED AND BEHAVIORAL HEALT</TitleTxt>
        <BaseCompensationFilingOrgAmt>231024</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>35000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>19333</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>13239</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>24079</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>322675</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>NICK PFANNENSTIEL</PersonNm>
        <TitleTxt>VP OF ORAL HEALTH</TitleTxt>
        <BaseCompensationFilingOrgAmt>231680</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>60058</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>19397</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>12583</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>10951</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>334669</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>NON-FIXED PAYMENTS: COMPENSATION PAYMENTS WERE PAID OUT TO CERTAIN PROVIDERS AND KEY EMPLOYEES FOR PERFORMANCE OF THE LAST YEAR. HOWEVER, THIS PAYMENT WAS NOT BASED UPON EARNINGS, REVENUES OR PERFORMANCES OF THE ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="IRS990ScheduleK">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>MISSOURI HEALTH AND EDUCATIONAL FACILITIES AUTH</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>431178966</BondIssuerEIN>
        <BondIssuedDt>2013-06-26</BondIssuedDt>
        <IssuePriceAmt>5000000</IssuePriceAmt>
        <PurposeDesc>CAPITAL PROJECTS</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>THE INDUSTRIAL DEVELOPMENT AUTH OF GREENE CO MO</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>431284357</BondIssuerEIN>
        <BondIssuedDt>2016-02-19</BondIssuedDt>
        <IssuePriceAmt>2656160</IssuePriceAmt>
        <PurposeDesc>REFUND PRIOR BONDS, CAPITAL PROJEC</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>THE INDUSTRIAL DEVELOPMENT AUTH OF TANEY CO MO</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>431288274</BondIssuerEIN>
        <BondIssuedDt>2016-02-19</BondIssuedDt>
        <IssuePriceAmt>1190000</IssuePriceAmt>
        <PurposeDesc>CAPITAL PROJECTS</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>0</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>5000000</TotalProceedsAmt>
        <InReserveFundAmt>0</InReserveFundAmt>
        <CapitalizedInterestAmt>0</CapitalizedInterestAmt>
        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>60000</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>0</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>4940000</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>0</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <SubstantialCompletionYr>2013</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>false</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <RetiredAmt>0</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>2656160</TotalProceedsAmt>
        <InReserveFundAmt>0</InReserveFundAmt>
        <CapitalizedInterestAmt>0</CapitalizedInterestAmt>
        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>53002</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>0</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>1414561</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>1188597</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <SubstantialCompletionYr>2016</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>true</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <RetiredAmt>0</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>1190000</TotalProceedsAmt>
        <InReserveFundAmt>0</InReserveFundAmt>
        <CapitalizedInterestAmt>0</CapitalizedInterestAmt>
        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>22365</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>0</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>1167635</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>0</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <SubstantialCompletionYr>2016</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>false</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>false</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0</PrivateBusUseByOthersPct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <RemedialActionTakenInd>false</RemedialActionTakenInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>false</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0</PrivateBusUseByOthersPct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <RemedialActionTakenInd>false</RemedialActionTakenInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>false</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0</PrivateBusUseByOthersPct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <RemedialActionTakenInd>false</RemedialActionTakenInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>true</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <HedgeProviderName>
          <BusinessNameLine1Txt>0</BusinessNameLine1Txt>
        </HedgeProviderName>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GICProviderName>
          <BusinessNameLine1Txt>0</BusinessNameLine1Txt>
        </GICProviderName>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>false</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>true</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <HedgeProviderName>
          <BusinessNameLine1Txt>0</BusinessNameLine1Txt>
        </HedgeProviderName>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GICProviderName>
          <BusinessNameLine1Txt>0</BusinessNameLine1Txt>
        </GICProviderName>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>false</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>true</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <HedgeProviderName>
          <BusinessNameLine1Txt>0</BusinessNameLine1Txt>
        </HedgeProviderName>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GICProviderName>
          <BusinessNameLine1Txt>0</BusinessNameLine1Txt>
        </GICProviderName>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>false</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="IRS990ScheduleL">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>RENDI PFANNENSTIEL</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>SPOUSE OF N. PFANNENSTIEL</RelationshipDescriptionTxt>
        <TransactionAmt>266153</TransactionAmt>
        <TransactionDesc>COMPENSATION</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
    </IRS990ScheduleL>
    <IRS990ScheduleM documentId="IRS990ScheduleM">
      <WorksOfArtGrp />
      <ArtHistoricalTreasuresGrp />
      <ArtFractionalInterestGrp />
      <BooksAndPublicationsGrp />
      <ClothingAndHouseholdGoodsGrp />
      <CarsAndOtherVehiclesGrp />
      <BoatsAndPlanesGrp />
      <IntellectualPropertyGrp />
      <SecuritiesPubliclyTradedGrp />
      <SecuritiesCloselyHeldStockGrp />
      <SecurPrtnrshpTrustIntrstsGrp />
      <SecuritiesMiscellaneousGrp />
      <QualifiedContribHistStructGrp />
      <QualifiedContribOtherGrp />
      <RealEstateResidentialGrp />
      <RealEstateCommercialGrp />
      <RealEstateOtherGrp />
      <CollectiblesGrp />
      <FoodInventoryGrp />
      <DrugsAndMedicalSuppliesGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>1</ContributionCnt>
        <NoncashContributionsRptF990Amt>1699475</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>FMV</MethodOfDeterminingRevenuesTxt>
      </DrugsAndMedicalSuppliesGrp>
      <TaxidermyGrp />
      <HistoricalArtifactsGrp />
      <ScientificSpecimensGrp />
      <ArchaeologicalArtifactsGrp />
      <OtherNonCashContriTableGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <Desc>EQUIPMENT</Desc>
        <ContributionCnt>2</ContributionCnt>
        <NoncashContributionsRptF990Amt>25192</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>FMV</MethodOfDeterminingRevenuesTxt>
      </OtherNonCashContriTableGrp>
      <AnyPropertyThatMustBeHeldInd>false</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>false</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>false</ThirdPartiesUsedInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE M, PART I, COLUMN B</FormAndLineReferenceDesc>
        <ExplanationTxt>NON-CASH CONTRIBUTIONS: THE NUMBER IN COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 1</FormAndLineReferenceDesc>
        <ExplanationTxt>ORGANIZATION MISSION: OUR MISSION: IMPROVING OUR COMMUNITY'S HEALTH THROUGH ACCESS AND RELATIONSHIPS OUR VISION: PARTNERING TO PROVIDE ESSENTIAL LEADERSHIP IN HEALTHCARE FOR THE UNDERSERVED OUR CORE VALUES: TO IMPROVE OUR COMMUNITY'S HEALTH BECAUSE "I2 CARE" *INNOVATION - WE WILL INNOVATE TO MEET OUR PATIENTS' NEEDS TO ACCESS PRIMARY MEDICAL, DENTAL, VISION, AND BEHAVIORAL HEALTHCARE BY DESIGNING PROCESSES THAT KEEP US FLEXIBLE AND RESPONSIVE - WHERE WE CAN BUILD SOLID RELATIONSHIPS *INTEGRITY - WE WILL SPEAK AND ACT IN AN HONEST AND ETHICAL MANNER *COLLABORATION - WE WILL WORK TOGETHER AS A TEAM TO PROVIDE QUALITY HEALTH SERVICES WITH PARTNERSHIPS TO PROVIDE INTEGRATED SERVICES. WE WILL FOSTER AND MAINTAIN KEY COMMUNITY RELATIONSHIPS TO LEVERAGE OUR EXPERTISE AND IMPROVE THE HEALTH OF OUR COMMUNITIES *ACCOUNTABILITY - WE WILL BE FINANCIALLY ACCOUNTABLE AND TAKE A LONG-TERM APPROACH TO DECISIONS ENSURING SUSTAINABLE PRACTICES THUS ESTABLISHING A FIRM FOUNDATION FOR THE FUTURE *RESPECT - WE WILL CREATE CARING RELATIONSHIPS WITH OUR PATIENTS AND COMMUNITIES BASED ON COMPASSION, TAKING CARE TO PROTECT INDIVIDUAL DIGNITY IN DIVERSE POPULATIONS *EXCELLENCE - WE WILL PURSUE EXCELLENCE IN OUR SERVICE, FACILITIES AND INTERACTIONS, STRIVING TO IMPROVE THE QUALITY OF OUR PATIENT-CENTERED HEALTHCARE</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 4A</FormAndLineReferenceDesc>
        <ExplanationTxt>MEDICAL SERVICES: MEDICAL PROGRAM SERVICES INCLUDE: FAMILY MEDICINE, PEDIATRIC CARE, INTERNAL MEDICINE, GERIATRIC CARE, PAIN MANAGEMENT, PRIMARY &amp; PREVENTIVE HEALTH, IMMUNIZATIONS, CHRONIC DISEASE MANAGEMENT, GYNECOLOGY/WOMEN'S HEALTH (INCLUDING SHOW ME HEALTHY WOMEN), PRENATAL CARE, IN-PATIENT SERVICES FOR NEWBORNS, NURSERY CARE, OUTPATIENT PROCEDURES (CIRCUMCISIONS, COLPOSCOPY, SPIROMETRY, ENDOMETRIAL BIOPSY, EKG &amp; STRESS TESTING, IMPLANON, VASECTOMY, MINOR SKIN PROCEDURES, JOINT INJECTIONS), DIABETES EDUCATION, DIETARY COUNSELING, WEIGHT MANAGEMENT SUPPORT, IN-SCHOOL PRIMARY CARE, LAB SERVICES, OPTOMETRY, BEHAVIORAL HEALTH COUNSELING, PSYCHIATRIC CARE AND GROUP THERAPY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>DENTAL SERVICES: DENTAL PROGRAM SERVICES INCLUDE: GENERAL DENTISTRY, PEDIATRIC DENTISTRY, ORAL HYGIENE, URGENT DENTAL CARE, ORAL SURGERY, DENTURES AND PARTIALS, MOBILE DENTAL CARE AND IN-SCHOOL PREVENTIVE SERVICES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE FINANCE DEPARTMENT OF THE ORGANIZATION. PRIOR TO FILING, A DRAFT OF THE 990 IS FIRST REVIEWED BY SENIOR MANAGEMENT. AFTER ANY CHANGES ARE MADE, A FINAL DRAFT IS PROVIDED TO THE BOARD OF DIRECTORS BEFORE FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS EVALUATED WITH ALL EMPLOYEES UPON HIRE AND ON A YEARLY BASIS WITH ALL EMPLOYEE AND BOARD MEMBERS IN CONJUNCTION WITH CORPORATE COMPLIANCE TRAINING. A COPY OF THE CONFLICT OF INTEREST STATEMENT SHALL BE PROVIDED ANNUALLY TO EACH DIRECTOR AND OFFICER TO REVIEW AND ACKNOWLEDGE FOR THE PURPOSE OF IDENTIFYING CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST. A CONFLICT OF INTEREST SHALL EXIST WHEN, IN THE OPINION OF THE BOARD, A BOARD MEMBER OR FAMILY MEMBER OF A BOARD MEMBER HAS A RELATIONSHIP WHICH WOULD INTERFERE WITH THE EXERCISE OF INDEPENDENT JUDGEMENT IN CARRYING OUT THE RESPONSIBILITIES OF A DIRECTOR OR AS FURTHER EXPRESSLY DEFINED BY THE CORPORATION'S CODE OF CONDUCT. FOR PURPOSES OF THIS SECTION, FAMILY MEMBER IS DEFINED AS A DIRECTOR'S SPOUSE, PARENTS, CHILDREN AND SIBLINGS, WHETHER BY BLOOD, MARRIAGE OR ADOPTION, OR ANY ONE RESIDING IN SUCH PERSON'S HOME. THE BOARD OF DIRECTORS SHALL NOT APPROVE ANY ACTION OR TRANSACTION BEARING UPON THE CONFLICT UNLESS THE FOLLOWING PROCEDURES ARE OBSERVED: A) THE AFFECTED DIRECTOR OR OTHER DIRECTOR(S) SHALL MAKE KNOWN THAT A CONFLICT EXISTS AND THE AFFECTED DIRECTOR SHALL WITHDRAW FROM THE MEETING FOR AS LONG AS THE MATTER REMAINS UNDER CONSIDERATION. SHOULD THE MATTER BE BROUGHT TO A VOTE OF THE DIRECTORS, THE AFFECTED DIRECTOR SHALL NEITHER BE PRESENT NOR CAST A VOTE. B) IF THE WITHDRAWAL OF THE AFFECTED DIRECTOR RESULTS IN THE ABSENCE OF QUORUM, NO ACTION SHALL BE TAKEN ON THE MATTER UNTIL A QUORUM OF DISINTERESTED DIRECTORS IN PRESENT. C) IF A) AND B) DO NOT OCCUR, THE BOARD OF DIRECTORS SHALL NOT GO FORWARD WITH A TRANSACTION OR ARRANGEMENT IN WHICH AN AFFECTED DIRECTOR ACKNOWLEDGES THAT A CONFLICT OF INTEREST EXISTS, OR WHERE A MAJORITY OF THE OTHER DIRECTORS DETERMINE THAT A CONFLICT OF INTEREST EXISTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION REVIEW: ANNUALLY, THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS EVALUATED AND VOTED ON BY THE BOARD OF DIRECTORS AFTER REVIEWING PERFORMANCE AND COMPARABILITY DATA OF CEO'S/EXECUTIVE DIRECTORS AT LIKE HEALTH CARE FACILITIES. THE OCCURRENCE OF THIS REVIEW IS DOCUMENTED IN THE EXECUTIVE COMMITTEE BOARD MINUTES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>DOCUMENT DISCLOSURES: GOVERNING DOCUMENTS, INCLUDING THE CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS, ARE AVAILABLE BY WRITTEN REQUEST AND MAY BE VIEWED AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER CHANGES IN NET ASSETS: $ 1,191,399 CHANGE IN INTEREST IN JVFHF (74,764) CONTRIBUTIONS RETURNED ------------ $ 1,116,635</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:CONTRACT LABOR TOTAL FEES:3446489</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:340B ADMINISTRATIVE FEES TOTAL FEES:1216921</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:318218</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:TRANSLATION SERVICES TOTAL FEES:157947</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:TEMPORARY EMPLOYMENT TOTAL FEES:120055</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:CONSULTING TOTAL FEES:93917</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:TRANSCRIPTION SERVICES TOTAL FEES:109</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>