<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2020v4.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2022-05-18T14:00:20-05:00</ReturnTs>
    <TaxPeriodEndDt>2021-06-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>431797482</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>THE CPA GROUP PC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>217 4TH ST</AddressLine1Txt>
        <CityNm>MONETT</CityNm>
        <StateAbbreviationCd>MO</StateAbbreviationCd>
        <ZIPCd>65708</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2020-07-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>237218344</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>CLARK COMMUNITY MENTAL HEALTH</BusinessNameLine1Txt>
        <BusinessNameLine2Txt>CENTER</BusinessNameLine2Txt>
      </BusinessName>
      <BusinessNameControlTxt>CLAR</BusinessNameControlTxt>
      <PhoneNum>4174761000</PhoneNum>
      <USAddress>
        <AddressLine1Txt>PO BOX 100</AddressLine1Txt>
        <CityNm>PIERCE CITY</CityNm>
        <StateAbbreviationCd>MO</StateAbbreviationCd>
        <ZIPCd>65723</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>BRADLEY RIDENOUR</PersonNm>
      <PersonTitleTxt>CEO</PersonTitleTxt>
      <PhoneNum>4174761000</PhoneNum>
      <SignatureDt>2022-01-26</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>BRADLEY</PersonFirstNm>
        <PersonLastNm>RIDENOUR</PersonLastNm>
      </PersonFullName>
      <SSN>XXX-XX-XXXX</SSN>
    </SigningOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>KURT W KRUEGER</PreparerPersonNm>
      <PTIN>P01200782</PTIN>
      <PhoneNum>4172353650</PhoneNum>
      <PreparationDt>2022-01-26</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2020</TaxYr>
    <BuildTS>2022-09-23 18:48:47Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="5">
    <IRS990 documentId="RetDoc1" referenceDocumentId="RetDoc4">
      <PrincipalOfficerNm>BRADLEY RIDENOUR</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>22 PIER LANE</AddressLine1Txt>
        <CityNm>MONETT</CityNm>
        <StateAbbreviationCd>MO</StateAbbreviationCd>
        <ZIPCd>65708</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>11906933</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.CLARKMENTALHEALTH.COM</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <ActivityOrMissionDesc>COMMUNITY BEHAVIORAL HEALTHCARE</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>8</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>8</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>166</TotalEmployeeCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>8992672</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>11891130</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>1384581</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>0</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>24892</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>15803</CYInvestmentIncomeAmt>
      <CYOtherRevenueAmt>0</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>10402145</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>11906933</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>7654042</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>8081606</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>2015297</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>2044218</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>9669339</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>10125824</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>732806</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>1781109</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>7916072</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>11571657</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>554075</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>2428551</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>7361997</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>9143106</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>COMMUNITY BEHAVIORAL HEALTHCARE</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>8360197</ExpenseAmt>
      <Desc>MEDICAL PSYCHOTHERAPY, PSYCHIATRIC MEDICATION SERVICES, PSYCHOLOGICAL EVALUATIONS, INFORMATION AND EDUCATION, INDIVIDUAL PSYCHOTHERAPY, SUBSTANCE ABUSE</Desc>
      <TotalProgramServiceExpensesAmt>8360197</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc5">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd>false</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc2">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc2">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc2">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc2">false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentId="RetDoc2">false</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc2">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc2">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc2">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc2">false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc2">false</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc2">false</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc2">true</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc2">false</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc3">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd>false</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>false</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd>false</DisregardedEntityInd>
      <RelatedEntityInd>false</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>9</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <EmployeeCnt>166</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>8</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>8</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>false</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>false</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>false</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>true</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>false</ConflictOfInterestPolicyInd>
      <WhistleblowerPolicyInd>false</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>false</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>false</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>false</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>SHELIA LAYTON</PersonNm>
        <PhoneNum>4174761035</PhoneNum>
        <USAddress>
          <AddressLine1Txt>PO BOX 100</AddressLine1Txt>
          <CityNm>PIERCE CITY</CityNm>
          <StateAbbreviationCd>MO</StateAbbreviationCd>
          <ZIPCd>65723</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <NoListedPersonsCompensatedInd>X</NoListedPersonsCompensatedInd>
      <Form990PartVIISectionAGrp>
        <PersonNm>JEFF CARR</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JIM INGLE</PersonNm>
        <TitleTxt>VICE PRESIDE</TitleTxt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARK NELSON</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AJ BAHL</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LAURIE BOWLING</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARK BURTON</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRADLEY RIDENOUR</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>199493</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHRISTY HENLEY</PersonNm>
        <TitleTxt>CLINIC DIREC</TitleTxt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>150260</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHARLES L GRAVES</PersonNm>
        <TitleTxt>MEDICAL DIRE</TitleTxt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>324725</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAMIE L RANDALL</PersonNm>
        <TitleTxt>NURSE PRACTI</TitleTxt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>126860</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KIMBERLY L BLACK</PersonNm>
        <TitleTxt>NURSE PRACTI</TitleTxt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>130110</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AMY S PERRY</PersonNm>
        <TitleTxt>TELEPSYCH NP</TitleTxt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>130110</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AMY M HERBST</PersonNm>
        <TitleTxt>NURSE PRACTI</TitleTxt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>130068</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>WARREN E WESTON</PersonNm>
        <TitleTxt>PSYCHIARIST</TitleTxt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>102342</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1293968</TotalReportableCompFromOrgAmt>
      <IndivRcvdGreaterThan100KCnt>9</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <GovernmentGrantsAmt>11891130</GovernmentGrantsAmt>
      <TotalContributionsAmt>11891130</TotalContributionsAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>15803</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>15803</RelatedOrExemptFuncIncomeAmt>
      </InvestmentIncomeGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>11906933</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>15803</RelatedOrExemptFuncIncomeAmt>
      </TotalRevenueGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>6373654</TotalAmt>
        <ProgramServicesAmt>5354661</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1018993</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>213883</TotalAmt>
        <ProgramServicesAmt>113095</ProgramServicesAmt>
        <ManagementAndGeneralAmt>100788</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>859330</TotalAmt>
        <ProgramServicesAmt>712715</ProgramServicesAmt>
        <ManagementAndGeneralAmt>146615</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>634739</TotalAmt>
        <ProgramServicesAmt>529533</ProgramServicesAmt>
        <ManagementAndGeneralAmt>105206</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>22654</TotalAmt>
        <ManagementAndGeneralAmt>22654</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>187419</TotalAmt>
        <ProgramServicesAmt>185150</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2269</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <OfficeExpensesGrp>
        <TotalAmt>200241</TotalAmt>
        <ProgramServicesAmt>169486</ProgramServicesAmt>
        <ManagementAndGeneralAmt>30755</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>244547</TotalAmt>
        <ProgramServicesAmt>200790</ProgramServicesAmt>
        <ManagementAndGeneralAmt>43757</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>131647</TotalAmt>
        <ProgramServicesAmt>71160</ProgramServicesAmt>
        <ManagementAndGeneralAmt>60487</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>418189</TotalAmt>
        <ProgramServicesAmt>396170</ProgramServicesAmt>
        <ManagementAndGeneralAmt>22019</ManagementAndGeneralAmt>
      </TravelGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>70799</TotalAmt>
        <ProgramServicesAmt>68311</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2488</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>63045</TotalAmt>
        <ProgramServicesAmt>59319</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3726</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>PHARMACY</Desc>
        <TotalAmt>150589</TotalAmt>
        <ProgramServicesAmt>150589</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>DUES &amp; SUBSCRIPTIONS</Desc>
        <TotalAmt>131256</TotalAmt>
        <ProgramServicesAmt>42534</ProgramServicesAmt>
        <ManagementAndGeneralAmt>88722</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>SERVICE AGREEMENTS</Desc>
        <TotalAmt>126685</TotalAmt>
        <ProgramServicesAmt>74406</ProgramServicesAmt>
        <ManagementAndGeneralAmt>52279</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>REPAIRS AND MAINTENANCE</Desc>
        <TotalAmt>102532</TotalAmt>
        <ProgramServicesAmt>86972</ProgramServicesAmt>
        <ManagementAndGeneralAmt>15560</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>194615</TotalAmt>
        <ProgramServicesAmt>145306</ProgramServicesAmt>
        <ManagementAndGeneralAmt>49309</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>10125824</TotalAmt>
        <ProgramServicesAmt>8360197</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1765627</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>3178852</BOYAmt>
        <EOYAmt>6948090</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>1788622</BOYAmt>
        <EOYAmt>1803976</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>1110628</BOYAmt>
        <EOYAmt>989880</EOYAmt>
      </AccountsReceivableGrp>
      <LandBldgEquipCostOrOtherBssAmt>2692670</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>863410</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>1801332</BOYAmt>
        <EOYAmt>1829260</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>36638</BOYAmt>
        <EOYAmt>451</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>7916072</BOYAmt>
        <EOYAmt>11571657</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>554075</BOYAmt>
        <EOYAmt>937304</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <UnsecuredNotesLoansPayableGrp>
        <EOYAmt>1491247</EOYAmt>
      </UnsecuredNotesLoansPayableGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>554075</BOYAmt>
        <EOYAmt>2428551</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>7361997</BOYAmt>
        <EOYAmt>9143106</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>7361997</BOYAmt>
        <EOYAmt>9143106</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>7916072</BOYAmt>
        <EOYAmt>11571657</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>1781109</ReconcilationRevenueExpnssAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc5">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>6012030</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>8123523</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>9311066</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>8992672</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>11891130</CurrentTaxYearAmt>
        <TotalAmt>44330421</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>6012030</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>8123523</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>9311066</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>8992672</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>11891130</CurrentTaxYearAmt>
        <TotalAmt>44330421</TotalAmt>
      </TotalCalendarYear170Grp>
      <PublicSupportTotal170Amt>44330421</PublicSupportTotal170Amt>
      <OtherIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>1083611</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>799663</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>917355</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1384581</CurrentTaxYearMinus1YearAmt>
        <TotalAmt>4185210</TotalAmt>
      </OtherIncome170Grp>
      <TotalSupportAmt>48515631</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>79621</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0.91370</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.87720</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>PART II, LINE 10</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER INCOME 4,185,210</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="RetDoc2">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>207880</OtherCostOrOtherBasisAmt>
        <BookValueAmt>207880</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>735425</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>246674</DepreciationAmt>
        <BookValueAmt>488751</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>325839</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>322154</DepreciationAmt>
        <BookValueAmt>3685</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>1423526</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>294582</DepreciationAmt>
        <BookValueAmt>1128944</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>1829260</TotalBookValueLandBuildingsAmt>
      <TotalRevEtcAuditedFinclStmtAmt>11906933</TotalRevEtcAuditedFinclStmtAmt>
      <RevenueSubtotalAmt>11906933</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>11906933</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>10125824</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>10125824</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>10125824</TotalExpensesPerForm990Amt>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc3">
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BRADLEY RIDENOUR</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>199493</BaseCompensationFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>199493</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CHRISTY HENLEY</PersonNm>
        <TitleTxt>CLINIC DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>150260</BaseCompensationFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>150260</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CHARLES L GRAVES</PersonNm>
        <TitleTxt>MEDICAL DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>324725</BaseCompensationFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>324725</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc4">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>BOARD OF DIRECTORS RECEIVE DRAFT COPY OF FORM 990, REVIEW, AND AUTHORIZE DIRECTOR TO FILE THE RETURN UPON THEIR APPROVAL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>AVAILABLE UPON REQUEST</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
