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        <PersonNm>Charlie Harris</PersonNm>
        <TitleTxt>Director; Start 7/1/22</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Walter Porter</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Diane Gallagher</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Olga Koper</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Mary Ann Queen MD</PersonNm>
        <TitleTxt>Director; Start 1/1/23</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>491677</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>49212</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Robin Foster JD</PersonNm>
        <TitleTxt>EVP, General Counsel</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>790712</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>48240</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Robert Steele MD</PersonNm>
        <TitleTxt>EVP &amp; Chief Strategy/Innovation Off.</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>795302</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>40615</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jodi Coombs MBA BSN RN</PersonNm>
        <TitleTxt>EVP &amp; COO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>887403</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>28477</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Robert Lane MD</PersonNm>
        <TitleTxt>EVP &amp; Physician-in-Chief</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>823844</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>43665</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Alex Daneshmand DO MBA</PersonNm>
        <TitleTxt>EVP &amp; Chief Quality Officer</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>800627</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>29910</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Thomas Wright</PersonNm>
        <TitleTxt>EVP &amp; Chief HR Officer</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>605374</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>19530</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jennifer Kingry</PersonNm>
        <TitleTxt>Interim CFO; End 10/23/22</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>533882</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>40591</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>James Simaras</PersonNm>
        <TitleTxt>EVP &amp; CFO; Start 10/24/22</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>142509</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>2636</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Shawn St Peter MD</PersonNm>
        <TitleTxt>SVP/Surgeon-in-Chief;ChairDeptOfSurg</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>1069659</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>43665</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Thomas Curran PhD</PersonNm>
        <TitleTxt>SVP, CSO, Executive Director-CMRI</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>1018420</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>36096</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jeanne James MD</PersonNm>
        <TitleTxt>Sr VP, Chair of Pediatrics</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromOrgAmt>728663</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>29910</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>James O'Brien Jr MD</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromOrgAmt>1557650</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>48228</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>William Douglas MD</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>1503246</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>43665</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Charles Snyder MD</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
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        <OtherCompensationAmt>41766</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>John Gatti MD</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>799735</ReportableCompFromOrgAmt>
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        <OtherCompensationAmt>48240</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Paul Grabb MD</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
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        <OtherCompensationAmt>38787</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>David Cauble</PersonNm>
        <TitleTxt>Former EVP &amp; CFO; End 2/18/22</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>219576</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>17050</OtherCompensationAmt>
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      <TotalReportableCompFromOrgAmt>16314126</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>716865</TotalOtherCompensationAmt>
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      <FormerOfcrEmployeesListedInd>1</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Qualivis LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>5930 Cornerstone Court West Suite 3</AddressLine1Txt>
            <CityNm>San Diego</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>92121</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Employment Agency</ServicesDesc>
        <CompensationAmt>13875852</CompensationAmt>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Cerner Health Connections Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2800 Rockcreek Parkway</AddressLine1Txt>
            <CityNm>Kansas City</CityNm>
            <StateAbbreviationCd>MO</StateAbbreviationCd>
            <ZIPCd>64117</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Professional Services</ServicesDesc>
        <CompensationAmt>9577468</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Morrison Management Specialists Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>400 Northridge Rd Suite 600</AddressLine1Txt>
            <CityNm>Sandy Springs</CityNm>
            <StateAbbreviationCd>GA</StateAbbreviationCd>
            <ZIPCd>30350</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Food Service</ServicesDesc>
        <CompensationAmt>8942546</CompensationAmt>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>JE Dunn Construction Company</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1001 Locust Street</AddressLine1Txt>
            <CityNm>Kansas City</CityNm>
            <StateAbbreviationCd>MO</StateAbbreviationCd>
            <ZIPCd>64106</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Construction</ServicesDesc>
        <CompensationAmt>7183620</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Kelly Construction Group Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>4021 East 143rd Street</AddressLine1Txt>
            <CityNm>Grandview</CityNm>
            <StateAbbreviationCd>MO</StateAbbreviationCd>
            <ZIPCd>64030</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Construction</ServicesDesc>
        <CompensationAmt>5928283</CompensationAmt>
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      <CntrctRcvdGreaterThan100KCnt>545</CntrctRcvdGreaterThan100KCnt>
      <FederatedCampaignsAmt>200770</FederatedCampaignsAmt>
      <FundraisingAmt>6024557</FundraisingAmt>
      <RelatedOrganizationsAmt>8786502</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>35920469</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>73043101</AllOtherContributionsAmt>
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      <TotalContributionsAmt>123975399</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Net Patient Services</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>1776025558</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1776025558</RelatedOrExemptFuncIncomeAmt>
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      <TotalProgramServiceRevenueAmt>1776025558</TotalProgramServiceRevenueAmt>
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        <TotalRevenueColumnAmt>99366469</TotalRevenueColumnAmt>
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      <FundraisingDirectExpensesAmt>1784861</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>-966578</TotalRevenueColumnAmt>
        <ExclusionAmt>-966578</ExclusionAmt>
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        <Desc>Contract Revenue</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>29528387</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>29528387</RelatedOrExemptFuncIncomeAmt>
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      <OtherRevenueMiscGrp>
        <Desc>Late Claim Interest</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>1986393</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1986393</RelatedOrExemptFuncIncomeAmt>
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      <OtherRevenueMiscGrp>
        <Desc>Gift Shop</Desc>
        <BusinessCd>455000</BusinessCd>
        <TotalRevenueColumnAmt>1497362</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1497362</RelatedOrExemptFuncIncomeAmt>
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      <MiscellaneousRevenueGrp>
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        <ExclusionAmt>98399891</ExclusionAmt>
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      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>3305912</TotalAmt>
        <ProgramServicesAmt>3305912</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>84398238</TotalAmt>
        <ProgramServicesAmt>84398238</ProgramServicesAmt>
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      <ForeignGrantsGrp>
        <TotalAmt>116028</TotalAmt>
        <ProgramServicesAmt>116028</ProgramServicesAmt>
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      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>11641443</TotalAmt>
        <ProgramServicesAmt>3831418</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7810025</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>643740576</ProgramServicesAmt>
        <ManagementAndGeneralAmt>179389913</ManagementAndGeneralAmt>
        <FundraisingAmt>4381827</FundraisingAmt>
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        <TotalAmt>45864978</TotalAmt>
        <ProgramServicesAmt>35393842</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10231642</ManagementAndGeneralAmt>
        <FundraisingAmt>239494</FundraisingAmt>
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      <OtherEmployeeBenefitsGrp>
        <TotalAmt>96407808</TotalAmt>
        <ProgramServicesAmt>75196203</ProgramServicesAmt>
        <ManagementAndGeneralAmt>20726457</ManagementAndGeneralAmt>
        <FundraisingAmt>485148</FundraisingAmt>
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      <PayrollTaxesGrp>
        <TotalAmt>55402439</TotalAmt>
        <ProgramServicesAmt>42753867</ProgramServicesAmt>
        <ManagementAndGeneralAmt>12359276</ManagementAndGeneralAmt>
        <FundraisingAmt>289296</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>2993561</TotalAmt>
        <ProgramServicesAmt>40155</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2953406</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>376539</TotalAmt>
        <ProgramServicesAmt>75000</ProgramServicesAmt>
        <ManagementAndGeneralAmt>301539</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>374588</TotalAmt>
        <ManagementAndGeneralAmt>374588</ManagementAndGeneralAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>560992</TotalAmt>
        <FundraisingAmt>560992</FundraisingAmt>
      </FeesForServicesProfFundraising>
      <FeesForServicesOtherGrp>
        <TotalAmt>184105401</TotalAmt>
        <ProgramServicesAmt>85934493</ProgramServicesAmt>
        <ManagementAndGeneralAmt>98121447</ManagementAndGeneralAmt>
        <FundraisingAmt>49461</FundraisingAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>6515558</TotalAmt>
        <ProgramServicesAmt>20357</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6495201</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>4701045</TotalAmt>
        <ProgramServicesAmt>228911</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4470448</ManagementAndGeneralAmt>
        <FundraisingAmt>1686</FundraisingAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>20214791</TotalAmt>
        <ProgramServicesAmt>9147290</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10783419</ManagementAndGeneralAmt>
        <FundraisingAmt>284082</FundraisingAmt>
      </OccupancyGrp>
      <TravelGrp>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, line 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>Method Used to Account for Expenditures: Actual expenses for international travel and international grants.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Accounting Method:</FormAndLineReferenceDesc>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule F, Part II, Line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Method Used to Account for Cash Grants and Noncash Assistance on the Organization's Financial Statement: Accrual.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleF>
    <IRS990ScheduleG documentId="RetDoc1041200001">
      <MailSolicitationsInd>X</MailSolicitationsInd>
      <EmailSolicitationsInd>X</EmailSolicitationsInd>
      <InPersonSolicitationsInd>X</InPersonSolicitationsInd>
      <SolicitationOfNonGovtGrantsInd>X</SolicitationOfNonGovtGrantsInd>
      <SpecialFundraisingEventsInd>X</SpecialFundraisingEventsInd>
      <AgrmtProfFundraisingActyInd>1</AgrmtProfFundraisingActyInd>
      <FundraiserActivityInfoGrp>
        <OrganizationBusinessName>
          <BusinessNameLine1Txt>TrueSense</BusinessNameLine1Txt>
        </OrganizationBusinessName>
        <USAddress>
          <AddressLine1Txt>502 Keystone Dr</AddressLine1Txt>
          <CityNm>Warrendale</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15086</ZIPCd>
        </USAddress>
        <ActivityTxt>Consult/develop an annual fund and giving program</ActivityTxt>
        <FundraiserControlOfFundsInd>0</FundraiserControlOfFundsInd>
        <GrossReceiptsAmt>1699036</GrossReceiptsAmt>
        <RetainedByContractorAmt>560992</RetainedByContractorAmt>
        <NetToOrganizationAmt>1138044</NetToOrganizationAmt>
      </FundraiserActivityInfoGrp>
      <TotalGrossReceiptsAmt>1699036</TotalGrossReceiptsAmt>
      <TotalRetainedByContractorsAmt>560992</TotalRetainedByContractorsAmt>
      <TotalNetToOrganizationAmt>1138044</TotalNetToOrganizationAmt>
      <LicensedStatesCd>AL</LicensedStatesCd>
      <LicensedStatesCd>AK</LicensedStatesCd>
      <LicensedStatesCd>AZ</LicensedStatesCd>
      <LicensedStatesCd>CO</LicensedStatesCd>
      <LicensedStatesCd>FL</LicensedStatesCd>
      <LicensedStatesCd>GA</LicensedStatesCd>
      <LicensedStatesCd>ID</LicensedStatesCd>
      <LicensedStatesCd>IL</LicensedStatesCd>
      <LicensedStatesCd>IN</LicensedStatesCd>
      <LicensedStatesCd>KS</LicensedStatesCd>
      <LicensedStatesCd>KY</LicensedStatesCd>
      <LicensedStatesCd>MD</LicensedStatesCd>
      <LicensedStatesCd>MA</LicensedStatesCd>
      <LicensedStatesCd>MN</LicensedStatesCd>
      <LicensedStatesCd>MO</LicensedStatesCd>
      <LicensedStatesCd>MT</LicensedStatesCd>
      <LicensedStatesCd>NE</LicensedStatesCd>
      <LicensedStatesCd>NV</LicensedStatesCd>
      <LicensedStatesCd>NC</LicensedStatesCd>
      <LicensedStatesCd>ND</LicensedStatesCd>
      <LicensedStatesCd>OH</LicensedStatesCd>
      <LicensedStatesCd>OK</LicensedStatesCd>
      <LicensedStatesCd>OR</LicensedStatesCd>
      <LicensedStatesCd>PA</LicensedStatesCd>
      <LicensedStatesCd>SC</LicensedStatesCd>
      <LicensedStatesCd>SD</LicensedStatesCd>
      <LicensedStatesCd>UT</LicensedStatesCd>
      <LicensedStatesCd>VT</LicensedStatesCd>
      <LicensedStatesCd>VA</LicensedStatesCd>
      <LicensedStatesCd>WA</LicensedStatesCd>
      <LicensedStatesCd>WI</LicensedStatesCd>
      <LicensedStatesCd>WY</LicensedStatesCd>
      <FundraisingEventInformationGrp>
        <Event1Nm>Gala/Auction</Event1Nm>
        <GrossReceiptsEvent1Amt>2822599</GrossReceiptsEvent1Amt>
        <CharitableContriEvent1Amt>2349888</CharitableContriEvent1Amt>
        <GrossRevenueEvent1Amt>472711</GrossRevenueEvent1Amt>
        <FoodAndBeverageEvent1Amt>307427</FoodAndBeverageEvent1Amt>
        <EntertainmentEvent1Amt>10121</EntertainmentEvent1Amt>
        <OtherDirectExpensesEvent1Amt>376653</OtherDirectExpensesEvent1Amt>
        <Event2Nm>Event/Auction</Event2Nm>
        <GrossReceiptsEvent2Amt>3734177</GrossReceiptsEvent2Amt>
        <CharitableContriEvent2Amt>3389535</CharitableContriEvent2Amt>
        <GrossRevenueEvent2Amt>344642</GrossRevenueEvent2Amt>
        <FoodAndBeverageEvent2Amt>161512</FoodAndBeverageEvent2Amt>
        <EntertainmentEvent2Amt>7000</EntertainmentEvent2Amt>
        <OtherDirectExpensesEvent2Amt>907281</OtherDirectExpensesEvent2Amt>
        <OtherEventsTotalCnt>1</OtherEventsTotalCnt>
        <GrossReceiptsOtherEventsAmt>286064</GrossReceiptsOtherEventsAmt>
        <CharitableContriOtherEventsAmt>285134</CharitableContriOtherEventsAmt>
        <GrossRevenueOtherEventsAmt>930</GrossRevenueOtherEventsAmt>
        <RentFcltyCostsOtherEventsAmt>3540</RentFcltyCostsOtherEventsAmt>
        <OthDirectExpnssOtherEventsAmt>11327</OthDirectExpnssOtherEventsAmt>
        <GrossReceiptsTotalAmt>6842840</GrossReceiptsTotalAmt>
        <CharitableContributionsTotAmt>6024557</CharitableContributionsTotAmt>
        <GrossRevenueTotalEventsAmt>818283</GrossRevenueTotalEventsAmt>
        <RentFcltyCostsTotalEventsAmt>3540</RentFcltyCostsTotalEventsAmt>
        <FoodAndBeverageTotalEventsAmt>468939</FoodAndBeverageTotalEventsAmt>
        <EntertainmentTotalEventsAmt>17121</EntertainmentTotalEventsAmt>
        <OthDirectExpnssTotalEventsAmt>1295261</OthDirectExpnssTotalEventsAmt>
        <DirectExpenseSummaryEventsAmt>1784861</DirectExpenseSummaryEventsAmt>
        <NetIncomeSummaryAmt>-966578</NetIncomeSummaryAmt>
      </FundraisingEventInformationGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule G, Part I, Line 2b, Column (v)</FormAndLineReferenceDesc>
        <ExplanationTxt>Payments to TrueSense during FY23 totaled $659,544. This amount includes $560,992 for consulting services and $98,552 of fundraising expenses. The agreement distinguishes consulting costs separate from any expense payments of reimbursements.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleG>
    <IRS990ScheduleH documentId="RetDoc1041500001">
      <FinancialAssistancePolicyInd>1</FinancialAssistancePolicyInd>
      <WrittenPolicyInd>1</WrittenPolicyInd>
      <AllHospitalsPolicyInd>X</AllHospitalsPolicyInd>
      <FPGReferenceFreeCareInd>1</FPGReferenceFreeCareInd>
      <FreeCareOthPercentageGrp>
        <OtherInd>X</OtherInd>
        <FreeCareOtherPct>300.000000000000</FreeCareOtherPct>
      </FreeCareOthPercentageGrp>
      <FPGReferenceDiscountedCareInd>0</FPGReferenceDiscountedCareInd>
      <FreeCareMedicallyIndigentInd>1</FreeCareMedicallyIndigentInd>
      <FinancialAssistanceBudgetInd>1</FinancialAssistanceBudgetInd>
      <ExpensesExceedBudgetInd>0</ExpensesExceedBudgetInd>
      <AnnualCommunityBnftReportInd>1</AnnualCommunityBnftReportInd>
      <ReportPublicallyAvailableInd>1</ReportPublicallyAvailableInd>
      <FinancialAssistanceAtCostTyp>
        <ActivitiesOrProgramsCnt>2</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>79684</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>36988789</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>732822</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>36255967</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.02040</TotalExpensePct>
      </FinancialAssistanceAtCostTyp>
      <UnreimbursedMedicaidGrp>
        <ActivitiesOrProgramsCnt>9</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>284706</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>822638638</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>703094746</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>119543892</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.06720</TotalExpensePct>
      </UnreimbursedMedicaidGrp>
      <UnreimbursedCostsGrp>
        <ActivitiesOrProgramsCnt>0</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>0</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>0</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
      </UnreimbursedCostsGrp>
      <TotalFinancialAssistanceTyp>
        <ActivitiesOrProgramsCnt>11</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>364390</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>859627427</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>703827568</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>155799859</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.08760</TotalExpensePct>
      </TotalFinancialAssistanceTyp>
      <CommunityHealthServicesGrp>
        <ActivitiesOrProgramsCnt>39</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>480587</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>19392227</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>5719234</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>13672993</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00770</TotalExpensePct>
      </CommunityHealthServicesGrp>
      <HealthProfessionsEducationGrp>
        <ActivitiesOrProgramsCnt>9</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>10486</PersonsServedCnt>
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        <DirectOffsettingRevenueAmt>19485730</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>19189216</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.01080</TotalExpensePct>
      </HealthProfessionsEducationGrp>
      <SubsidizedHealthServicesGrp>
        <ActivitiesOrProgramsCnt>8</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>119747</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>71721855</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>34570474</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>37151381</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.02090</TotalExpensePct>
      </SubsidizedHealthServicesGrp>
      <ResearchGrp>
        <ActivitiesOrProgramsCnt>584</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>0</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>53346280</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>36303633</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>17042647</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00960</TotalExpensePct>
      </ResearchGrp>
      <CashAndInKindContributionsGrp>
        <ActivitiesOrProgramsCnt>5</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>9867</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>1194167</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>25000</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>1169167</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00070</TotalExpensePct>
      </CashAndInKindContributionsGrp>
      <TotalOtherBenefitsGrp>
        <ActivitiesOrProgramsCnt>645</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>620687</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>184329475</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>96104071</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>88225404</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.04970</TotalExpensePct>
      </TotalOtherBenefitsGrp>
      <TotalCommunityBenefitsGrp>
        <ActivitiesOrProgramsCnt>656</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>985077</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>1043956902</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>799931639</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>244025263</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.13730</TotalExpensePct>
      </TotalCommunityBenefitsGrp>
      <PhysicalImprvAndHousingGrp>
        <ActivitiesOrProgramsCnt>5</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>204</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>204163</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>9858</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>194305</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00010</TotalExpensePct>
      </PhysicalImprvAndHousingGrp>
      <EconomicDevelopmentGrp>
        <ActivitiesOrProgramsCnt>6</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>5</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>284969</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>284969</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00020</TotalExpensePct>
      </EconomicDevelopmentGrp>
      <CommunitySupportGrp>
        <ActivitiesOrProgramsCnt>0</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>0</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>0</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
      </CommunitySupportGrp>
      <EnvironmentalImprovementsGrp>
        <ActivitiesOrProgramsCnt>0</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>0</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>0</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
      </EnvironmentalImprovementsGrp>
      <LeadershipDevelopmentGrp>
        <ActivitiesOrProgramsCnt>0</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>0</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>0</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
      </LeadershipDevelopmentGrp>
      <CoalitionBuildingGrp>
        <ActivitiesOrProgramsCnt>2</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>901</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>194574</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>194574</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00010</TotalExpensePct>
      </CoalitionBuildingGrp>
      <HealthImprovementAdvocacyGrp>
        <ActivitiesOrProgramsCnt>6</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>18</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>90788</TotalCommunityBenefitExpnsAmt>
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        <NetCommunityBenefitExpnsAmt>90788</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00010</TotalExpensePct>
      </HealthImprovementAdvocacyGrp>
      <WorkforceDevelopmentGrp>
        <ActivitiesOrProgramsCnt>15</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>1391</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>453414</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>92885</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>360529</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00020</TotalExpensePct>
      </WorkforceDevelopmentGrp>
      <TotalCommuntityBuildingActyGrp>
        <ActivitiesOrProgramsCnt>34</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>2519</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>1227908</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>102743</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>1125165</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00070</TotalExpensePct>
      </TotalCommuntityBuildingActyGrp>
      <BadDebtExpenseReportedInd>1</BadDebtExpenseReportedInd>
      <BadDebtExpenseAmt>241318</BadDebtExpenseAmt>
      <BadDebtExpenseAttributableAmt>0</BadDebtExpenseAttributableAmt>
      <ReimbursedByMedicareAmt>4718015</ReimbursedByMedicareAmt>
      <CostOfCareReimbursedByMedcrAmt>4929476</CostOfCareReimbursedByMedcrAmt>
      <MedicareSurplusOrShortfallAmt>-211461</MedicareSurplusOrShortfallAmt>
      <CostingMethodologyUsedGrp>
        <CostToChargeRatioInd>X</CostToChargeRatioInd>
      </CostingMethodologyUsedGrp>
      <WrittenDebtCollectionPolicyInd>1</WrittenDebtCollectionPolicyInd>
      <FinancialAssistancePrvsnInd>1</FinancialAssistancePrvsnInd>
      <HospitalFacilitiesCnt>2</HospitalFacilitiesCnt>
      <HospitalFacilitiesGrp>
        <FacilityNum>1</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>The Children's Mercy Hospital</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>2401 Gillham Road</AddressLine1Txt>
          <CityNm>Kansas City</CityNm>
          <StateAbbreviationCd>MO</StateAbbreviationCd>
          <ZIPCd>64108</ZIPCd>
        </USAddress>
        <WebsiteAddressTxt>http://www.childrensmercy.org/</WebsiteAddressTxt>
        <StateLicenseNum>39-54</StateLicenseNum>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <ChildrensHospitalInd>X</ChildrensHospitalInd>
        <TeachingHospitalInd>X</TeachingHospitalInd>
        <ResearchFacilityInd>X</ResearchFacilityInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
        <OtherDesc>Specialty Clinics; Primary Care Clinics</OtherDesc>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFacilitiesGrp>
        <FacilityNum>2</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>Children's Mercy Kansas</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>5808 W 110th</AddressLine1Txt>
          <CityNm>Overland Park</CityNm>
          <StateAbbreviationCd>KS</StateAbbreviationCd>
          <ZIPCd>66211</ZIPCd>
        </USAddress>
        <WebsiteAddressTxt>http://www.childrensmercy.org/</WebsiteAddressTxt>
        <StateLicenseNum>H-046-008</StateLicenseNum>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <ChildrensHospitalInd>X</ChildrensHospitalInd>
        <TeachingHospitalInd>X</TeachingHospitalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
        <OtherDesc>Specialty Clinics</OtherDesc>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFcltyPoliciesPrctcGrp>
        <HospitalFacilityName>
          <BusinessNameLine1Txt>Facility Reporting Group - A</BusinessNameLine1Txt>
        </HospitalFacilityName>
        <FirstLicensedCYOrPYInd>0</FirstLicensedCYOrPYInd>
        <TaxExemptHospitalCYOrPYInd>0</TaxExemptHospitalCYOrPYInd>
        <CHNAConductedInd>1</CHNAConductedInd>
        <CommunityDefinitionInd>X</CommunityDefinitionInd>
        <CommunityDemographicsInd>X</CommunityDemographicsInd>
        <ExistingResourcesInd>X</ExistingResourcesInd>
        <HowDataObtainedInd>X</HowDataObtainedInd>
        <CommunityHealthNeedsInd>X</CommunityHealthNeedsInd>
        <OtherHealthIssuesInd>X</OtherHealthIssuesInd>
        <CommunityHlthNeedsIdProcessInd>X</CommunityHlthNeedsIdProcessInd>
        <ConsultingProcessInd>X</ConsultingProcessInd>
        <PriorCHNAImpactInd>X</PriorCHNAImpactInd>
        <CHNAConductedYr>21</CHNAConductedYr>
        <TakeIntoAccountOthersInputInd>1</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>0</CHNAConductedWithOtherFcltsInd>
        <CHNAConductedWithNonFcltsInd>0</CHNAConductedWithNonFcltsInd>
        <CHNAReportWidelyAvailableInd>1</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>www.childrensmercy.org/communityneeds</OwnWebsiteURLTxt>
        <PaperCopyPublicInspectionInd>X</PaperCopyPublicInspectionInd>
        <ImplementationStrategyAdoptInd>1</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>22</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>1</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>www.childrensmercy.org/communityneeds</StrategyWebsiteURLTxt>
        <OrganizationIncurExciseTaxInd>0</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>1</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <FPGFamilyIncmLmtFreeCarePct>300.000000000000</FPGFamilyIncmLmtFreeCarePct>
        <IncomeLevelCriteriaInd>X</IncomeLevelCriteriaInd>
        <AssetLevelCriteriaInd>X</AssetLevelCriteriaInd>
        <MedicalIndigencyCriteriaInd>X</MedicalIndigencyCriteriaInd>
        <InsuranceStatusCriteriaInd>X</InsuranceStatusCriteriaInd>
        <UnderinsuranceStatCriteriaInd>X</UnderinsuranceStatCriteriaInd>
        <ResidencyCriteriaInd>X</ResidencyCriteriaInd>
        <OtherCriteriaInd>X</OtherCriteriaInd>
        <ExplainedBasisInd>1</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>1</AppFinancialAsstExplnInd>
        <DescribedInfoInd>X</DescribedInfoInd>
        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <IncludesPublicityMeasuresInd>1</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>www.childrensmercy.org/financialcounseling/</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>Same as 16a</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>Same as 16a</FAPSummaryOnWebsiteURLTxt>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
        <FAPSumAvlblOnRequestNoChrgInd>X</FAPSumAvlblOnRequestNoChrgInd>
        <NotifiedFAPCopyBillDisplayInd>X</NotifiedFAPCopyBillDisplayInd>
        <CommuntityNotifiedFAPInd>X</CommuntityNotifiedFAPInd>
        <FAPTranslatedInd>X</FAPTranslatedInd>
        <FAPActionsOnNonpaymentInd>1</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>0</CollectionActivitiesInd>
        <MadeEffortOrallyNotifyInd>X</MadeEffortOrallyNotifyInd>
        <ProcessedFAPApplicationInd>X</ProcessedFAPApplicationInd>
        <MadePresumptiveEligDetermInd>X</MadePresumptiveEligDetermInd>
        <NondisEmergencyCarePolicyInd>1</NondisEmergencyCarePolicyInd>
        <LookBackMedicarePrivateInd>X</LookBackMedicarePrivateInd>
        <AmountsGenerallyBilledInd>0</AmountsGenerallyBilledInd>
        <GrossChargesInd>0</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Part V, Section B</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility Reporting Group A</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Facility Reporting Group A consists of:</FormAndLineReferenceDesc>
        <ExplanationTxt>- Facility 1: The Children's Mercy Hospital, - Facility 2: Children's Mercy Kansas</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 1 -- The Children's Mercy Hospital Part V, Section B, line 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>Children's Mercy developed the most recent CHNA with input from persons who represent broad interests within the community. Data collection for the CHNA occurred between November 2021 and May 2022. During this time, Children's Mercy held activities and hosted meetings to solicit input and feedback from the community. Activities included: two community meetings with 21 neighborhood residents representing low income and vulnerable populations; a telephone survey of 1,250 randomly selected parents/caregivers of children under the age of 18 years old living in the Children's Mercy service area; a Key Informant Online Survey sent to 300 elected officials, physicians, public health leaders, health professionals, social service providers, and business, neighborhood, housing, and community leaders (26% response rate); a Children's Health Summit held April 28, 2022 that invited community representatives to review CHNA data and identify critical health needs (140 attended). Organizations participating in the CHNA surveys and events included: Ability KC; American Lung Association; Amethyst Place; Arvest Bank; B-C Education Consultant Services; Belton School District; BikeWalkKC; Black Health Care Coalition; Blue Springs Pediatrics; Calvary Community Outreach Network; CASA of Johnson and Wyandotte Counties; Catholic Charities of Kansas City-St. Joseph; CDC Foundation - MoDHSS; Center for Neighborhoods; Cerner Corporation; Child Protection Center; City of Kansas City, Missouri; Clay County Children's Services Fund; Clay County Public Health Center; Community Health Council of Wyandotte County; CMC, Cockerall and McIntosh Pediatrics; Commerce Bank; Comprehensive Mental Health; Communities in Schools; Community Health Council of Wyandotte County; Community LINC; Core Changing Concepts; Cornerstones of Care; Cradle Kansas City; Cradle Thru College Care Pediatrics, Inc.; Crittenton Children's Center; Cross-Lines Community Outreach, Inc.; DeBruce Foundation; DHSS - Office of the Assistant Secretary for Health; El Centro; Fore the Kids Foundation; Front Porch Alliance; Girl Scouts of NE Kansas NW Missouri; Greater Kansas City Coalition to End Homelessness; Green Acres Urban Farm and Research Project; Growing Futures; Harvesters - The Community Food Network; Health Resources and Services Administration; Health Forward Foundation; Health Partnership of Johnson County; H&amp;R Block Foundation and Bloch Family Foundation; Ivanhoe Neighborhood Council; Jackson County Community Mental Health Fund; Jackson County Court; JE Dunn Construction; Johnson County Department of Health and Environment; Kansas City Area Transit Authority; Kansas City Indian Center; Kansas City, Kansas Community College; Kansas City, Missouri Health Department; Kansas City, Missouri Health Commission; Kansas City, Missouri Public Schools; Kansas Department of Health and Environment; KC Common Good; KC Healthy Kids; Kids Win Missouri; Latino Health for All Coalition; Lee's Summit School District; Lee's Summit Pediatrics; Liberty Public Schools; March of Dimes; Marion and Henry Bloch Family Foundation; Mattie Rhodes Center; Mid-America Head Start; Mid-America Regional Council; Mid-Continent Public Library; Missouri Department of Health and Senior Services; MOCSA; Northland Neighborhoods, Inc.; Parent Leadership Training Institute; Pediatric Associates; Pediatric Care North; Phoenix Family; Planet Play; Platform Civic Strategies; Platte County Health Department; Platte County Prevention Coalition; Preferred Pediatrics; Public Progress; Project Eagle Early Head Start; REACH Healthcare Foundation; Samuel U. Rodgers Health Center; Sleepyhead Beds; Start at Zero, Stone County Health Department; Swope Health Services; Synergy Services, Inc.; The Family Conservancy; Tri-County Mental Health Services; Nurture KC; ReDiscover; Rose Brooks; SchoolSmart KC; University of Missouri - Kansas City School of Urban Planning &amp; Design; City of Kansas City, Missouri LGBTQ Commission; Unified Government Public Health Department of Wyandotte County; United Community Services of Johnson County; United Way of Greater Kansas City; University Health; University of Kansas Medical Center; Uzazi Village; Sierra Club of Greater Kansas City; Sophic Solutions; Urban Neighborhood Initiatives; Webster County Health Department; Westside Housing Organization; Wyandotte Economic Development Council; Wyandotte Health Foundation; Wyandotte Mental Health; YMCA of Greater Kansas City; Youth Ambassadors, Inc. The CHNA provides a comprehensive list of all organizations and specifics on the data collection process. The priority needs identified were: child and youth mental health; access to health services; violence prevention; housing and neighborhood conditions. Priority health needs were selected based on the issue's importance to children's health, potential measurable impact if addressed, and Children's Mercy's ability to mitigate the issue with resources and personnel. The Children's Mercy Board of Directors approved the Priority Health Needs on June 15, 2022. The Priority Health Needs will receive heightened attention and support from Children's Mercy. Children's Mercy's 2022-2025 Implementation Plan was adopted by the Children's Mercy Board of Directors on November 7, 2022.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 1 -- The Children's Mercy Hospital Part V, Section B, line 11:</FormAndLineReferenceDesc>
        <ExplanationTxt>The implementation strategy plan was approved on November 7, 2022 and made available to the public within the IRS required 4 1/2 months after year end associated with the conducted and approved CHNA completed during the 2021 tax year. The most recently adopted implementation strategy plan can be found on the hospital website:http://www.childrensmercy.org/communityneedsNo entity can alone address the health needs of a community. Our community engagement focuses on partnership development and expansion of collaborations. As such, Children's Mercy launched the Catalyst Partner Grant program to provide grants to organizations launching interventions in the priority health needs identified in the 2022 CHNA. Children's Mercy also continues to support program and efforts that addressed the 2022 CHNA identified priority health needs: Access to Care; Child &amp; Youth Mental Health; Violence Prevention; Housing &amp; Neighborhood Conditions. The following highlights key programs and activities that address the priority health needs. Access to Care: Maintained an online daily pollen and spore count accessed by 16,500 unique visitors; Maintained the Circulation transportation program to all clinical services at Children's Mercy Broadway and Operation Breakthrough locations, providing 2,496 rides between 2022-2023; Provided Project Adam education and training to create heart safe schools; provided health services at clinics located at Synergy Services, University Academy, and Operation Breakthrough; participated in back-to-school events providing health assessments and referrals to needed resources; participated in workforce development initiatives to increase, sustain and expand the pipeline of future healthcare providers within the region; implemented programs and practices to improve asthma care, support, and management across clinical, home, school, and community settings. Child &amp; Youth Mental Health: Launched a five-year mental and behavioral health strategic plan to increase access to evidence-based treatment with specific focus on equity for the most vulnerable children within the region; sustained and supported efforts to expand accessibility and availability of specialty mental health services, including the launch of a depression and anxiety clinic; provided education to 176 parents and caregivers of children who have experienced stressful or traumatic events in their lives; continued the Red Card: Call It When You See It anti-bullying campaign in partnership with local MLS soccer Team, Sporting Kansas City, reaching 21,766 students, parents, teachers, and community members; partnered with schools to build sustainable systems for increasing mental health supports for students. Violence Prevention: Continue to serve as a leader with the Safe Kids Greater Kansas City Coalition; continued the Community Outreach &amp; Violence Response (COVER) program in the emergency department to serve as an intervention and support resource for families impacted by violence, reaching over 204 families between 2022-2023; continued to distribute gun locks; provided financial support to the Ad Hoc Group Against Crime, Mothers in Charge, Grandparents Against Gun Violence, and Charlie's House to support community-based initiatives to reduce injury and violence; continue to serve in county and state-level Child Fatality Review programs. Housing &amp; Neighborhood Conditions: Sustained efforts by the Children's Mercy Environmental Health Department to mitigate at-home asthma risks and lead exposures; sustained the Kansas City Physical Activity Plan's efforts that champion built environment improvements; continued leadership on the Health Sciences Community Improvement District; continued assessment and follow-up support for those who identify as housing insecure and/or as having issues impacting the health of homes; partnered with the local Continuum of Care to compete in the Department of Housing and Urban Developments annual Youth Homeless Demonstration Project grant program, supporting the CoC's efforts to secure funding to address youth homelessness in Jackson and Wyandotte Counties.Children's Mercy's website provides a link that allows community organizations to submit requests for Children's Mercy to provide resources, program support and/or expertise to address identified community needs. Between 2022-2023, Children's Mercy received 99 requests that included 62 community/school events/health fairs and over 29 technical assistance/presentations/workshops/training services. Organizations receiving financial support from Children's Mercy include: Ability KC; Ad Hoc Group Against Crime; American Heart Association; AIDS Service Foundation of Greater Kansas City; American Lung Association' Amethyst Place; Avila University; Awesome Ambitions; Big Brothers Big Sisters of Greater Kansas City; Bike Walk KC; Bionexus KC; Black Healthcare Coalition; Blind Spot Foundation; Blue Valley Educational Foundation; Boys and Girls Club of Greater Kansas City; Charlie's House; Community Health Council of Wyandotte County; Child Protection Center; Children's Center for the Visually Impaired; Children's Place; Community Capital Fund; Congenital Heart Defects Families Association; Crohns and Colitis Foundation; Early Start St. Mark's United Inner City Services; Erin Andra Wilson Foundation; Farmer's House; Junior Golf Foundation of Greater Kansas City; ADvent Health Foundation; Giving Hope and Help; Grandparents for Gun Safety; Greater Kansas City Community Foundation; Greater Kansas City Societas Docta; Happy Bottoms; Harris Park Midtown Sports and Activities; Head for the Cure Foundation; Health Partnership Clinic; Heartspring; JDRF International; Jewish Community Relations Bureau; Jewish Family Services of Greater Kansas City; Junior League of Kansas City; Kansas City Friends of Alvin Ailey; Kansas City Girls Preparatory Academy Foundation; Kansas City Hospice Foundation; Kansas City. Kansas School Foundation for Excellence; Kansas City Friends of the Zoo; Kansas University Endowment Association; KC Common Good; KC Healthy Kids; KC Mothers in Charge; Cooper Davis Memorial Foundation; Kids Win Missouri; Kids with Courage; KidsTLC; KVC Health Systems; Lead to Read; Leukemia and Lymphoma Society; Local Initiatives Support Corporation; Metro Council Community Mental Health; Midwest Hemophilia Association; Mission Project; Missouri Kids First Child Advocacy Centers; MOCSA; National Kidney Foundation; Nonprofit Connect; Northland Health Alliance; Operation Breakthrough; Park Hill School District; Partners in Public Health; Police Foundation of Kansas City; Rainbow Center for Communicative Disorders; Ronald McDonald House Charities of Kansas City; Rose Brooks Center; Safe Kids Kansas; SAVE, Inc.; North Kansas City School District; SchoolSmartKC; SevenDays, Inc.; Shawnee Mission Educational Foundation; Sheffield Place; Sleepyhead Beds; Suburban Balance; Sunflower House; Synergy Services; Truman Heartland Community Foundation; UMKC Foundation; United WE Women's Foundation of Greater Kansas City; University Academy Foundation; Urban Neighborhood Initiative; Variety of Greater Kansas City; Vibrant Health Clinic; Voices of Courage; Wichita Children's Home; William Jewell College.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 1 -- The Children's Mercy Hospital Part V, Section B, line 13b:</FormAndLineReferenceDesc>
        <ExplanationTxt>The written financial assistance policy explains criteria beyond FPG to include residency requirements, available payors to applicant, asset levels, and in-network insurance status.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 1 -- The Children's Mercy Hospital Part V, Section B, line 13h:</FormAndLineReferenceDesc>
        <ExplanationTxt>Patients seeking care at organization with out of network insurance plans are not eligible for charity care.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 1 -- The Children's Mercy Hospital Part V, Section B, Line 20a:</FormAndLineReferenceDesc>
        <ExplanationTxt>Because the Hospital is not exercising any extraordinary collection actions in the event of nonpayment, it has no occasion to provide a written notice about upcoming ECAs.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 2 -- Children's Mercy Kansas Part V, Section B, line 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>Children's Mercy developed the most recent CHNA with input from persons who represent broad interests within the community. Data collection for the CHNA occurred between November 2021 and May 2022. During this time, Children's Mercy held activities and hosted meetings to solicit input and feedback from the community. Activities included: two community meetings with 21 neighborhood residents representing low income and vulnerable populations; a telephone survey of 1,250 randomly selected parents/caregivers of children under the age of 18 years old living in the Children's Mercy service area; a Key Informant Online Survey sent to 300 elected officials, physicians, public health leaders, health professionals, social service providers, and business, neighborhood, housing, and community leaders (26% response rate); a Children's Health Summit held April 28, 2022 that invited community representatives to review CHNA data and identify critical health needs (140 attended). Organizations participating in the CHNA surveys and events included: Ability KC; American Lung Association; Amethyst Place; Arvest Bank; B-C Education Consultant Services; Belton School District; BikeWalkKC; Black Health Care Coalition; Blue Springs Pediatrics; Calvary Community Outreach Network; CASA of Johnson and Wyandotte Counties; Catholic Charities of Kansas City-St. Joseph; CDC Foundation - MoDHSS; Center for Neighborhoods; Cerner Corporation; Child Protection Center; City of Kansas City, Missouri; Clay County Children's Services Fund; Clay County Public Health Center; Community Health Council of Wyandotte County; CMC, Cockerall and McIntosh Pediatrics; Commerce Bank; Comprehensive Mental Health; Communities in Schools; Community Health Council of Wyandotte County; Community LINC; Core Changing Concepts; Cornerstones of Care; Cradle Kansas City; Cradle Thru College Care Pediatrics, Inc.; Crittenton Children's Center; Cross-Lines Community Outreach, Inc.; DeBruce Foundation; DHSS - Office of the Assistant Secretary for Health; El Centro; Fore the Kids Foundation; Front Porch Alliance; Girl Scouts of NE Kansas NW Missouri; Greater Kansas City Coalition to End Homelessness; Green Acres Urban Farm and Research Project; Growing Futures; Harvesters - The Community Food Network; Health Resources and Services Administration; Health Forward Foundation; Health Partnership of Johnson County; H&amp;R Block Foundation and Bloch Family Foundation; Ivanhoe Neighborhood Council; Jackson County Community Mental Health Fund; Jackson County Court; JE Dunn Construction; Johnson County Department of Health and Environment; Kansas City Area Transit Authority; Kansas City Indian Center; Kansas City, Kansas Community College; Kansas City, Missouri Health Department; Kansas City, Missouri Health Commission; Kansas City, Missouri Public Schools; Kansas Department of Health and Environment; KC Common Good; KC Healthy Kids; Kids Win Missouri; Latino Health for All Coalition; Lee's Summit School District; Lee's Summit Pediatrics; Liberty Public Schools; March of Dimes; Marion and Henry Bloch Family Foundation; Mattie Rhodes Center; Mid-America Head Start; Mid-America Regional Council; Mid-Continent Public Library; Missouri Department of Health and Senior Services; MOCSA; Northland Neighborhoods, Inc.; Parent Leadership Training Institute; Pediatric Associates; Pediatric Care North; Phoenix Family; Planet Play; Platform Civic Strategies; Platte County Health Department; Platte County Prevention Coalition; Preferred Pediatrics; Public Progress; Project Eagle Early Head Start; REACH Healthcare Foundation; Samuel U. Rodgers Health Center; Sleepyhead Beds; Start at Zero, Stone County Health Department; Swope Health Services; Synergy Services, Inc.; The Family Conservancy; Tri-County Mental Health Services; Nurture KC; ReDiscover; Rose Brooks; SchoolSmart KC; University of Missouri - Kansas City School of Urban Planning &amp; Design; City of Kansas City, Missouri LGBTQ Commission; Unified Government Public Health Department of Wyandotte County; United Community Services of Johnson County; United Way of Greater Kansas City; University Health; University of Kansas Medical Center; Uzazi Village; Sierra Club of Greater Kansas City; Sophic Solutions; Urban Neighborhood Initiatives; Webster County Health Department; Westside Housing Organization; Wyandotte Economic Development Council; Wyandotte Health Foundation; Wyandotte Mental Health; YMCA of Greater Kansas City; Youth Ambassadors, Inc. The CHNA provides a comprehensive list of all organizations and specifics on the data collection process. The priority needs identified were: child and youth mental health; access to health services; violence prevention; housing and neighborhood conditions. Priority health needs were selected based on the issue's importance to children's health, potential measurable impact if addressed, and Children's Mercy's ability to mitigate the issue with resources and personnel. The Children's Mercy Board of Directors approved the Priority Health Needs on June 15, 2022. The Priority Health Needs will receive heightened attention and support from Children's Mercy. Children's Mercy's 2022-2025 Implementation Plan was adopted by the Children's Mercy Board of Directors on November 7, 2022.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 2 -- Children's Mercy Kansas Part V, Section B, line 11:</FormAndLineReferenceDesc>
        <ExplanationTxt>The implementation strategy plan was approved on November 7, 2022 and made available to the public within the IRS required 4 1/2 months after year end associated with the conducted and approved CHNA completed during the 2021 tax year. The most recently adopted implementation strategy plan can be found on the hospital website:http://www.childrensmercy.org/communityneedsNo entity can alone address the health needs of a community. Our community engagement focuses on partnership development and expansion of collaborations. As such, Children's Mercy launched the Catalyst Partner Grant program to provide grants to organizations launching interventions in the priority health needs identified in the 2022 CHNA. Children's Mercy also continues to support program and efforts that addressed the 2022 CHNA identified priority health needs: Access to Care; Child &amp; Youth Mental Health; Violence Prevention; Housing &amp; Neighborhood Conditions. The following highlights key programs and activities that address the priority health needs. Access to Care: Maintained an online daily pollen and spore count accessed by 16,500 unique visitors; Maintained the Circulation transportation program to all clinical services at Children's Mercy Broadway and Operation Breakthrough locations, providing 2,496 rides between 2022-2023; Provided Project Adam education and training to create heart safe schools; provided health services at clinics located at Synergy Services, University Academy, and Operation Breakthrough; participated in back-to-school events providing health assessments and referrals to needed resources; participated in workforce development initiatives to increase, sustain and expand the pipeline of future healthcare providers within the region; implemented programs and practices to improve asthma care, support, and management across clinical, home, school, and community settings. Child &amp; Youth Mental Health: Launched a five-year mental and behavioral health strategic plan to increase access to evidence-based treatment with specific focus on equity for the most vulnerable children within the region; sustained and supported efforts to expand accessibility and availability of specialty mental health services, including the launch of a depression and anxiety clinic; provided education to 176 parents and caregivers of children who have experienced stressful or traumatic events in their lives; continued the Red Card: Call It When You See It anti-bullying campaign in partnership with local MLS soccer Team, Sporting Kansas City, reaching 21,766 students, parents, teachers, and community members; partnered with schools to build sustainable systems for increasing mental health supports for students. Violence Prevention: Continue to serve as a leader with the Safe Kids Greater Kansas City Coalition; continued the Community Outreach &amp; Violence Response (COVER) program in the emergency department to serve as an intervention and support resource for families impacted by violence, reaching over 204 families between 2022-2023; continued to distribute gun locks; provided financial support to the Ad Hoc Group Against Crime, Mothers in Charge, Grandparents Against Gun Violence, and Charlie's House to support community-based initiatives to reduce injury and violence; continue to serve in county and state-level Child Fatality Review programs. Housing &amp; Neighborhood Conditions: Sustained efforts by the Children's Mercy Environmental Health Department to mitigate at-home asthma risks and lead exposures; sustained the Kansas City Physical Activity Plan's efforts that champion built environment improvements; continued leadership on the Health Sciences Community Improvement District; continued assessment and follow-up support for those who identify as housing insecure and/or as having issues impacting the health of homes; partnered with the local Continuum of Care to compete in the Department of Housing and Urban Developments annual Youth Homeless Demonstration Project grant program, supporting the CoC's efforts to secure funding to address youth homelessness in Jackson and Wyandotte Counties.Children's Mercy's website provides a link that allows community organizations to submit requests for Children's Mercy to provide resources, program support and/or expertise to address identified community needs. Between 2022-2023, Children's Mercy received 99 requests that included 62 community/school events/health fairs and over 29 technical assistance/presentations/workshops/training services. Organizations receiving financial support from Children's Mercy include: Ability KC; Ad Hoc Group Against Crime; American Heart Association; AIDS Service Foundation of Greater Kansas City; American Lung Association' Amethyst Place; Avila University; Awesome Ambitions; Big Brothers Big Sisters of Greater Kansas City; Bike Walk KC; Bionexus KC; Black Healthcare Coalition; Blind Spot Foundation; Blue Valley Educational Foundation; Boys and Girls Club of Greater Kansas City; Charlie's House; Community Health Council of Wyandotte County; Child Protection Center; Children's Center for the Visually Impaired; Children's Place; Community Capital Fund; Congenital Heart Defects Families Association; Crohns and Colitis Foundation; Early Start St. Mark's United Inner City Services; Erin Andra Wilson Foundation; Farmer's House; Junior Golf Foundation of Greater Kansas City; ADvent Health Foundation; Giving Hope and Help; Grandparents for Gun Safety; Greater Kansas City Community Foundation; Greater Kansas City Societas Docta; Happy Bottoms; Harris Park Midtown Sports and Activities; Head for the Cure Foundation; Health Partnership Clinic; Heartspring; JDRF International; Jewish Community Relations Bureau; Jewish Family Services of Greater Kansas City; Junior League of Kansas City; Kansas City Friends of Alvin Ailey; Kansas City Girls Preparatory Academy Foundation; Kansas City Hospice Foundation; Kansas City. Kansas School Foundation for Excellence; Kansas City Friends of the Zoo; Kansas University Endowment Association; KC Common Good; KC Healthy Kids; KC Mothers in Charge; Cooper Davis Memorial Foundation; Kids Win Missouri; Kids with Courage; KidsTLC; KVC Health Systems; Lead to Read; Leukemia and Lymphoma Society; Local Initiatives Support Corporation; Metro Council Community Mental Health; Midwest Hemophilia Association; Mission Project; Missouri Kids First Child Advocacy Centers; MOCSA; National Kidney Foundation; Nonprofit Connect; Northland Health Alliance; Operation Breakthrough; Park Hill School District; Partners in Public Health; Police Foundation of Kansas City; Rainbow Center for Communicative Disorders; Ronald McDonald House Charities of Kansas City; Rose Brooks Center; Safe Kids Kansas; SAVE, Inc.; North Kansas City School District; SchoolSmartKC; SevenDays, Inc.; Shawnee Mission Educational Foundation; Sheffield Place; Sleepyhead Beds; Suburban Balance; Sunflower House; Synergy Services; Truman Heartland Community Foundation; UMKC Foundation; United WE Women's Foundation of Greater Kansas City; University Academy Foundation; Urban Neighborhood Initiative; Variety of Greater Kansas City; Vibrant Health Clinic; Voices of Courage; Wichita Children's Home; William Jewell College.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 2 -- Children's Mercy Kansas Part V, Section B, line 13b:</FormAndLineReferenceDesc>
        <ExplanationTxt>The written financial assistance policy explains criteria beyond FPG to include residency requirements, available payors to applicant, asset levels, and in-network insurance status.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 2 -- Children's Mercy Kansas Part V, Section B, line 13h:</FormAndLineReferenceDesc>
        <ExplanationTxt>Patients seeking care at organization with out of network insurance plans are not eligible for charity care.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group A-Facility 2 -- Children's Mercy Kansas Part V, Section B, Line 20a:</FormAndLineReferenceDesc>
        <ExplanationTxt>Because the Hospital is not exercising any extraordinary collection actions in the event of nonpayment, it has no occasion to provide a written notice about upcoming ECAs.</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>10</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>1 - Children's Mercy Village West</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1801 N 98th Street</AddressLine1Txt>
            <CityNm>Kansas City</CityNm>
            <StateAbbreviationCd>KS</StateAbbreviationCd>
            <ZIPCd>66109</ZIPCd>
          </USAddress>
          <FacilityTxt>Rehabilitation</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>2 - Children's Mercy Wichita Clinic</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>3243 E Murdock Suite 201</AddressLine1Txt>
            <CityNm>Wichita</CityNm>
            <StateAbbreviationCd>KS</StateAbbreviationCd>
            <ZIPCd>67208</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Clinics</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>3 - Children's Mercy Topeka</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>909 Mulvane St</AddressLine1Txt>
            <CityNm>Topeka</CityNm>
            <StateAbbreviationCd>KS</StateAbbreviationCd>
            <ZIPCd>66606</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Clinics</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>4 - Children's Mercy at KU Hospital</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>2000 Olathe Boulevard</AddressLine1Txt>
            <CityNm>Kansas City</CityNm>
            <StateAbbreviationCd>KS</StateAbbreviationCd>
            <ZIPCd>66103</ZIPCd>
          </USAddress>
          <FacilityTxt>Outreach Clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>5 - Children's Mercy St Joseph</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>802 N Riverside Rd Suite 105</AddressLine1Txt>
            <CityNm>St Joseph</CityNm>
            <StateAbbreviationCd>MO</StateAbbreviationCd>
            <ZIPCd>64502</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Clinics</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>6 - Children's Mercy Joplin Clinic</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>3333 McIntosh Circle Suite 6</AddressLine1Txt>
            <CityNm>Joplin</CityNm>
            <StateAbbreviationCd>MO</StateAbbreviationCd>
            <ZIPCd>64804</ZIPCd>
          </USAddress>
          <FacilityTxt>Outpatient Clinics</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>7 - Children's Mercy Outreach Garden City</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>311 E Spruce St</AddressLine1Txt>
            <CityNm>Garden City</CityNm>
            <StateAbbreviationCd>KS</StateAbbreviationCd>
            <ZIPCd>67846</ZIPCd>
          </USAddress>
          <FacilityTxt>Outreach Clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>8 - Children's Mercy Outreach Junction City</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>361 Grant Ave</AddressLine1Txt>
            <CityNm>Junction City</CityNm>
            <StateAbbreviationCd>KS</StateAbbreviationCd>
            <ZIPCd>66441</ZIPCd>
          </USAddress>
          <FacilityTxt>Outreach Clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>9 - Children's Mercy Outreach Great Bend</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1021 Einsenhower Ave</AddressLine1Txt>
            <CityNm>Great Bend</CityNm>
            <StateAbbreviationCd>KS</StateAbbreviationCd>
            <ZIPCd>65730</ZIPCd>
          </USAddress>
          <FacilityTxt>Outreach Clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>10 - Children's Mercy Outreach Springfield</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1000 E Primrose Suite 300</AddressLine1Txt>
            <CityNm>Springfield</CityNm>
            <StateAbbreviationCd>MO</StateAbbreviationCd>
            <ZIPCd>65807</ZIPCd>
          </USAddress>
          <FacilityTxt>Outreach Clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 3c:</FormAndLineReferenceDesc>
        <ExplanationTxt>Free care eligibility is based on FPG and other factors such as residency and exhausting other available payor sources. For discounted care, if a financial assistance application was denied and the decision then appealed, the case is reviewed through a multi-disciplinary committee that uses a point system rubric using indicators such as FPG, total balance due as a percentage of annual income, out of pocket responsibility for upcoming year as a percentage of annual income, annual frequency of visits for ongoing care, financial hardship indicators such as recent bankruptcy/foreclosure, and medical complexity due to health condition. Each factor, if applicable, is reviewed and assigned point value based on a preset scale, that serves as a tool for the discounted care scale.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 7:</FormAndLineReferenceDesc>
        <ExplanationTxt>The cost-to-charge ratio derived from Worksheet 2 was used for Lines 7a and 7b. Cost from the Medicare Cost Report was used for Lines 7f (Health Professions Education). Cost from our decision support system was used for 7g (Subsidized Health Services).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 7g:</FormAndLineReferenceDesc>
        <ExplanationTxt>In FY23, over 119,000 children were reached through clinical services classified as Subsidized Health Services. Subsidized health services included: Endocrinology, gastroenterology, general pediatric primary care clinics, genetics, hematology &amp; oncology, pain management, rheumatology, and weight management clinics. The services are provided at a financial loss to Children's Mercy after removing Charity Care, unreimbursed Medicaid, private insurance shortages and contract, grants and philanthropic gifts. All subsidized health services meet an identified community need and a shortage of available services would exist in the community if Children's Mercy did not provide the service.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 7A:</FormAndLineReferenceDesc>
        <ExplanationTxt>Financial assistance cost reported on this line is derived from Worksheet 1 which takes gross charges for patients who have been awarded financial assistance and then multiplies those charges by a cost-to-charge ratio derived from Worksheet 2 to arrive at cost of providing financial assistance.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II, Community Building Activities:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Children's Mercy community building activities address identified community health needs such as physical activity, poverty, access to health services, mental and behavioral health, and employment. The activities include programs and/or resources intended to make physical improvements, provide community support, advocate for community health improvements, and address community-wide workforce issues through numerous workforce development outreach initiatives. Examples include the maintenance of the Hospital Hill Park and the Sylvia Nutter Playground, facilitation of the UMKC Health Sciences District, establishment of the Health Sciences District Community Improvement District (CID), the management of a community garden, advocacy activities, participation on Chamber of Commerce committees related to health improvement, health careers exploration activities for elementary students through support of Junior Achievement BizTown, and healthcare workforce development for high school students and community members.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>Audited Financial Statements Footnote 2(m), Page 13.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 8:</FormAndLineReferenceDesc>
        <ExplanationTxt>Cost to charge ratio</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 9b:</FormAndLineReferenceDesc>
        <ExplanationTxt>Collection attempts are discontinued once charges are determined to be eligible for charity care or financial assistance; insurance collection attempts continue as appropriate.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Children's Mercy Hospital has an initiative development process that brings forward new initiatives around strategic, operational, community health, and innovation based on community/market trends and needs and through consultation with community-based organizations. On a routine basis, the Strategic Planning Department monitors demographic and service trends of the region and compares this data to national benchmarks. The hospital strategic planning process also takes into account all of the qualitative and quantitative market data to define strategies and tactics that address the community need. In addition, Trauma Services maintains a Trauma Registry and the Promise 1000 centralizes the data collection on the health services and needs of children (0 - 3 years of age) who receive home visiting services.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>Flyers and financial counselor business cards and copies of the Financial Assistance Plain Language Summary are available at all access points within the Hospital. Efforts are made by the financial counselors to contact self pay patients and families, either in person, or through phone call or letters to inform/assist families with charity care and Medicaid or state program eligibility. Self pay or underinsured patients can also be referred to a financial counselor by an Access Representative, Patient Care Services, Social Work, Patient Financial Services, or other staff members for screening and assistance. All billing statements refer patients to financial counseling resources and the financial assistance policy posted on the hospital website.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>Children's Mercy serves over 230,000 children from across the states of Kansas and Missouri. In Kansas 102 counties and in Missouri 114 counties have federally designated primary care HPSA areas. Across the two states, Children's Mercy identifies 43 counties as the Outreach Service Area, 50 counties as the Secondary Service Area, and 18 counties as the Primary Service Area. Within the Primary Service Area are six counties called the Metro Service Area. Each of the service areas include urban, suburban and rural counties. The Outreach Service Area includes more rural counties than the other service areas. The Metro Service Area includes more urban and suburban areas than rural. Within the Metro Service Area are the five counties (Jackson, Clay, and Platte counties located in Missouri and Johnson and Wyandotte counties located in Kansas) that comprise the Children's Mercy CHNA service area. All five counties have primary care HPSA designations. Children's Mercy is the only children's hospital in the region. Limited pediatric services are available at the Kansas University Medical Center, St. Luke's Health System, Centerpoint, Liberty Hospital, North Kansas City, Research Medical Center, Shawnee Mission Medical Center and Overland Park hospitals. During the fiscal year in which Children's Mercy initiated the CHNA, residents of Jackson, Clay, Platte, Wyandotte, and Johnson Counties contribute over 72 percent of the encounters at Children's Mercy. The Children's Mercy CHNA service area serve as the location of our physical facilities (e.g., Children's Mercy Adele Hall Campus, Children's Mercy Hospital Kansas, Children's Mercy West, Children's Mercy Northland, Children's Mercy Broadway, Children's Mercy College Boulevard, Children's Mercy Olathe, Children's Mercy Blue Valley, Children's Mercy at The University of Kansas Hospital, Children's Mercy Sports Medicine at Village West, and Children's Mercy East) and the source of a majority of our patient encounters. The five counties house a total population of 1,861,214. Of these, 440,392 or 24 percent are children. Within this region, Wyandotte County has the greatest proportion of children under 18 and Jackson County has the smallest proportion, but largest in absolute number. The overall population of children in these five counties increased between 1980 and 2020 and the overall make-up of the population shifted as well. In 1980, black, Hispanic or other ethnicities comprised 21 percent of the five counties under 18 years of age population. In 2020 36.4 percent of the region's under 18 population made up these groups. A higher percentage of children under age 18 years live in poverty than the population as a whole. The percentage of children under age 18 who live in poverty has grown in four of the five counties from 2015 to 2020. The highest percentage of children living in poverty is in Wyandotte County (26.7%), followed by Jackson County (20.2%), Clay County (11.5%), Platte County (5.9%), and Johnson County (5.4%).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Children's Mercy Hospital is a nonprofit hospital operated to serve a public rather than a private interest and meeting the requirements of Revenue Ruling 69-545. Control of the Hospital rests with its Board, which is primarily composed of members of the community, in addition to a few select employees of the Hospital. The Hospital accepts patients paying with Medicaid and Medicare, and operates an active and generally accessible emergency room open to all children without regard to ability to pay. The Hospital uses any surplus funds to improve the quality of patient care, expand its facilities, and advance its medical training, education, and research programs.Children's Mercy provides funding and partnership to community organizations and efforts that support programs addressing the CHNA priority health needs. As such, Children's Mercy launched the Catalyst Partner Grant program to provide grants to organizations launching interventions in the priority health needs identified in the 2022 CHNA. Organizations include: Urban Neighborhood Initiatives; BikeWalk KC; Partners in Public Health; Harris Park; Park Hill School District. Children's Mercy continues to support the Kansas City Physical Activity and works with organizations across the community to improve physical infrastructures to promote healthy living and eating. Programs working to improve outcomes for children are strengthened through a community-wide strategy to organize home visiting; participation in community health fairs; support for healthy housing; decrease violence; support the mental health of children; service on key community committees (i.e. Infant and Child Mortality review boards), including each of health departments in the priority service area, and through the provision of training and education for families with children at-risk for obesity or diabetes.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 6:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Children's Mercy Hospital is not part of an affiliated health care system.</ExplanationTxt>
      </SupplementalInformationDetail>
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        <PurposeOfGrantTxt>To support vaping prevention, healthy living and physical activity activities and education for children and youth in Wichita and Kansas City region.</PurposeOfGrantTxt>
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          <BusinessNameLine1Txt>American Lung Association</BusinessNameLine1Txt>
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          <AddressLine1Txt>8400 W 110th St 130</AddressLine1Txt>
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        <PurposeOfGrantTxt>To support children's lung health.</PurposeOfGrantTxt>
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          <AddressLine1Txt>1106 E 30th Street Suite G</AddressLine1Txt>
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        <PurposeOfGrantTxt>To support safe routes to schools.</PurposeOfGrantTxt>
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          <BusinessNameLine1Txt>BioNexus</BusinessNameLine1Txt>
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        <PurposeOfGrantTxt>To support innovation in healthcare.</PurposeOfGrantTxt>
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        <RecipientBusinessName>
          <BusinessNameLine1Txt>Black Health Care Coalition</BusinessNameLine1Txt>
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          <AddressLine1Txt>6400 Independence Ave</AddressLine1Txt>
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        <PurposeOfGrantTxt>To support outreach to pregnant women and new parents.</PurposeOfGrantTxt>
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        <RecipientBusinessName>
          <BusinessNameLine1Txt>Boys and Girls Clubs of Greater Kansas City</BusinessNameLine1Txt>
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          <AddressLine1Txt>4001 Dr Martin Luther King Jr Blvd</AddressLine1Txt>
          <CityNm>Kansas City</CityNm>
          <StateAbbreviationCd>MO</StateAbbreviationCd>
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        <RecipientEIN>436072065</RecipientEIN>
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        <CashGrantAmt>10000</CashGrantAmt>
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        <PurposeOfGrantTxt>To support physical activity and social emotional health programs for children.</PurposeOfGrantTxt>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Charlie's House</BusinessNameLine1Txt>
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          <AddressLine1Txt>2425 Campbell Street</AddressLine1Txt>
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        <CashGrantAmt>8500</CashGrantAmt>
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        <PurposeOfGrantTxt>To support childhood injury prevention programs.</PurposeOfGrantTxt>
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        <RecipientBusinessName>
          <BusinessNameLine1Txt>Community Health Council of Wyandotte County</BusinessNameLine1Txt>
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          <AddressLine1Txt>803 Armstrong Avenue</AddressLine1Txt>
          <CityNm>Kansas City</CityNm>
          <StateAbbreviationCd>KS</StateAbbreviationCd>
          <ZIPCd>66101</ZIPCd>
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        <RecipientEIN>010674969</RecipientEIN>
        <IRCSectionDesc>501(c)3</IRCSectionDesc>
        <CashGrantAmt>17500</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>To support community health programs.</PurposeOfGrantTxt>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Child Protection Center Inc</BusinessNameLine1Txt>
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          <AddressLine1Txt>2940 Main Street</AddressLine1Txt>
          <CityNm>Kansas City</CityNm>
          <StateAbbreviationCd>MO</StateAbbreviationCd>
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        <RecipientEIN>204535728</RecipientEIN>
        <IRCSectionDesc>501(c)3</IRCSectionDesc>
        <CashGrantAmt>20000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>To support forensic interviews and counseling for abused and neglected children.</PurposeOfGrantTxt>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Community Capital Fund</BusinessNameLine1Txt>
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          <AddressLine1Txt>3200 Wayne Ave</AddressLine1Txt>
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        <RecipientEIN>454561134</RecipientEIN>
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        <CashGrantAmt>12500</CashGrantAmt>
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        <PurposeOfGrantTxt>To support under-resourced neighborhoods.</PurposeOfGrantTxt>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Congenital Heart Defects Families Association</BusinessNameLine1Txt>
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          <CityNm>Kansas City</CityNm>
          <StateAbbreviationCd>MO</StateAbbreviationCd>
          <ZIPCd>64155</ZIPCd>
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        <PurposeOfGrantTxt>To support children and youth with congenital heart defects.</PurposeOfGrantTxt>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>First Tee GKC Junior Golf Foundation of Greater KC</BusinessNameLine1Txt>
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          <CityNm>Prairie Village</CityNm>
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          <ZIPCd>66207</ZIPCd>
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        <RecipientEIN>431532215</RecipientEIN>
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        <CashGrantAmt>25000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>To support youth development programs.</PurposeOfGrantTxt>
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        <RecipientBusinessName>
          <BusinessNameLine1Txt>Adventhealth Foundation Shawnee Mission</BusinessNameLine1Txt>
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          <AddressLine1Txt>7315 Frontage Roade Suite 221</AddressLine1Txt>
          <CityNm>Merriam</CityNm>
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        <PurposeOfGrantTxt>To support early intervention services.</PurposeOfGrantTxt>
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        <RecipientBusinessName>
          <BusinessNameLine1Txt>Harris Park Midtown Sports and Activities</BusinessNameLine1Txt>
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        <CashGrantAmt>12500</CashGrantAmt>
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        <PurposeOfGrantTxt>To support child and youth development programs.</PurposeOfGrantTxt>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Head For The Cure Foundation</BusinessNameLine1Txt>
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          <AddressLine1Txt>1607 Oak Street</AddressLine1Txt>
          <CityNm>Kansas City</CityNm>
          <StateAbbreviationCd>MO</StateAbbreviationCd>
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        <RecipientEIN>208345719</RecipientEIN>
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        <CashGrantAmt>12500</CashGrantAmt>
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        <PurposeOfGrantTxt>To support services to children experiencing a head injury.</PurposeOfGrantTxt>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>JDRF International</BusinessNameLine1Txt>
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        <IRCSectionDesc>501(c)3</IRCSectionDesc>
        <CashGrantAmt>12500</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>To support juvenile diabetes programs.</PurposeOfGrantTxt>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Kansas City Zoo Friends of the Zoo Inc</BusinessNameLine1Txt>
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          <AddressLine1Txt>6800 Zoo Drive</AddressLine1Txt>
          <CityNm>Kansas City</CityNm>
          <StateAbbreviationCd>MO</StateAbbreviationCd>
          <ZIPCd>64132</ZIPCd>
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        <RecipientEIN>436048888</RecipientEIN>
        <IRCSectionDesc>501(c)3</IRCSectionDesc>
        <CashGrantAmt>5100</CashGrantAmt>
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        <PurposeOfGrantTxt>To support child &amp; youth development programs.</PurposeOfGrantTxt>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Kansas University Endowment Association</BusinessNameLine1Txt>
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          <CityNm>Lawrence</CityNm>
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        <RecipientEIN>480547734</RecipientEIN>
        <IRCSectionDesc>501(c)3</IRCSectionDesc>
        <CashGrantAmt>40000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>To support annual health equity conference and Medical Student Association.</PurposeOfGrantTxt>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>KC Common Goods Inc</BusinessNameLine1Txt>
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          <AddressLine1Txt>1100 Rockhurst Road</AddressLine1Txt>
          <CityNm>Kansas City</CityNm>
          <StateAbbreviationCd>MO</StateAbbreviationCd>
          <ZIPCd>64110</ZIPCd>
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        <RecipientEIN>834482500</RecipientEIN>
        <IRCSectionDesc>501(c)3</IRCSectionDesc>
        <CashGrantAmt>12500</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>To support violence prevention activities.</PurposeOfGrantTxt>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>KVC Health Systems</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>21350 W 153rd Street</AddressLine1Txt>
          <CityNm>Olathe</CityNm>
          <StateAbbreviationCd>KS</StateAbbreviationCd>
          <ZIPCd>66061</ZIPCd>
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        <RecipientEIN>262516589</RecipientEIN>
        <IRCSectionDesc>501(c)3</IRCSectionDesc>
        <CashGrantAmt>10000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>To support mental health services.</PurposeOfGrantTxt>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Leukemia and Lymphoma Society Inc</BusinessNameLine1Txt>
        </RecipientBusinessName>
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          <AddressLine1Txt>3 International Drive Suite 200</AddressLine1Txt>
          <CityNm>Rye Brook</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>10573</ZIPCd>
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        <RecipientEIN>135644916</RecipientEIN>
        <IRCSectionDesc>501(c)3</IRCSectionDesc>
        <CashGrantAmt>10000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>To support health care access.</PurposeOfGrantTxt>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Metro Council Community Mental Health</BusinessNameLine1Txt>
        </RecipientBusinessName>
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          <AddressLine1Txt>3100 NE 83Rd Street Suite 1001</AddressLine1Txt>
          <CityNm>Kansas City</CityNm>
          <StateAbbreviationCd>MO</StateAbbreviationCd>
          <ZIPCd>64119</ZIPCd>
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        <RecipientEIN>832063878</RecipientEIN>
        <IRCSectionDesc>501(c)3</IRCSectionDesc>
        <CashGrantAmt>6500</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>To support mental health services.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Midwest Hemophilia Association</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1471 West South Street F</AddressLine1Txt>
          <CityNm>Ozark</CityNm>
          <StateAbbreviationCd>MO</StateAbbreviationCd>
          <ZIPCd>65721</ZIPCd>
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        <RecipientEIN>431595395</RecipientEIN>
        <IRCSectionDesc>501(c)3</IRCSectionDesc>
        <CashGrantAmt>15000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>To support summer camp opportunities for children.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>National Kidney Foundation</BusinessNameLine1Txt>
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        <USAddress>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>857990</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>John Gatti MD</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>774175</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>2000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>23560</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>27450</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>22365</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>849550</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Robin Foster JD</PersonNm>
        <TitleTxt>EVP, General Counsel</TitleTxt>
        <BaseCompensationFilingOrgAmt>558895</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>199003</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>32814</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>27450</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>23236</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>841398</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Robert Steele MD</PersonNm>
        <TitleTxt>EVP &amp; Chief Strategy/Innovation Off.</TitleTxt>
        <BaseCompensationFilingOrgAmt>569399</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>202823</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>23080</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>19825</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>23240</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>838367</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Alex Daneshmand DO MBA</PersonNm>
        <TitleTxt>EVP &amp; Chief Quality Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>575166</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>203699</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>21762</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>9150</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>23210</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>832987</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Jeanne James MD</PersonNm>
        <TitleTxt>Sr VP, Chair of Pediatrics</TitleTxt>
        <BaseCompensationFilingOrgAmt>506943</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>149867</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>71853</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>9150</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>22056</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>759869</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Thomas Wright</PersonNm>
        <TitleTxt>EVP &amp; Chief HR Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>431843</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>146867</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>26664</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>10878</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>11044</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>627296</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Jennifer Kingry</PersonNm>
        <TitleTxt>Interim CFO; End 10/23/22</TitleTxt>
        <BaseCompensationFilingOrgAmt>435333</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>78959</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>19590</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>19825</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>23159</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>576866</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Mary Ann Queen MD</PersonNm>
        <TitleTxt>Director; Start 1/1/23</TitleTxt>
        <BaseCompensationFilingOrgAmt>392788</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>95941</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>2948</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>27450</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>22012</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>541139</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Douglas Swanson MD</PersonNm>
        <TitleTxt>Director; End 12/31/22</TitleTxt>
        <BaseCompensationFilingOrgAmt>224283</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>12147</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>21492</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>21689</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>1291</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>280902</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>David Cauble</PersonNm>
        <TitleTxt>Former EVP &amp; CFO; End 2/18/22</TitleTxt>
        <BaseCompensationFilingOrgAmt>192562</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>27014</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>13426</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>4025</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>237027</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc1053100001">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>Health and Educational Facilities Authority of the State of Missouri</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>431178966</BondIssuerEIN>
        <CUSIPNum>60637ALX8</CUSIPNum>
        <BondIssuedDt>2016-10-13</BondIssuedDt>
        <IssuePriceAmt>148207195</IssuePriceAmt>
        <PurposeDesc>see Part VI</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>Health and Educational Facilities Authority of the State of Missouri</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>431178966</BondIssuerEIN>
        <CUSIPNum>60637AMM1</CUSIPNum>
        <BondIssuedDt>2017-12-20</BondIssuedDt>
        <IssuePriceAmt>131226503</IssuePriceAmt>
        <PurposeDesc>see Part VI</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>Health and Educational Facilities Authority of the State of Missouri</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>431178966</BondIssuerEIN>
        <CUSIPNum>000000000</CUSIPNum>
        <BondIssuedDt>2019-02-28</BondIssuedDt>
        <IssuePriceAmt>17940000</IssuePriceAmt>
        <PurposeDesc>see Part VI</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>D</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>Health and Educational Facilities Authority of the State of Missouri</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>431178966</BondIssuerEIN>
        <CUSIPNum>000000000</CUSIPNum>
        <BondIssuedDt>2019-02-28</BondIssuedDt>
        <IssuePriceAmt>24750000</IssuePriceAmt>
        <PurposeDesc>see Part VI</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>11880000</RetiredAmt>
        <TotalProceedsAmt>148207195</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>638217</IssuanceCostsFromProceedsAmt>
        <OtherSpentProceedsAmt>147568978</OtherSpentProceedsAmt>
        <RefundingTaxExemptBondsInd>0</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>1</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>1</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <TotalProceedsAmt>133764094</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>1224610</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>132404922</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>134562</OtherSpentProceedsAmt>
        <RefundingTaxExemptBondsInd>0</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>0</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>0</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <RetiredAmt>14296700</RetiredAmt>
        <TotalProceedsAmt>17940000</TotalProceedsAmt>
        <OtherSpentProceedsAmt>17940000</OtherSpentProceedsAmt>
        <RefundingTaxExemptBondsInd>1</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>0</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>1</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>D</BondReferenceCd>
        <TotalProceedsAmt>24750000</TotalProceedsAmt>
        <OtherSpentProceedsAmt>24750000</OtherSpentProceedsAmt>
        <RefundingTaxExemptBondsInd>1</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>0</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>1</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>1</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>1</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>1</AnyResearchAgreementsInd>
        <EngageBondCounselResearchInd>1</EngageBondCounselResearchInd>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>1</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>1</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>1</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>1</AnyResearchAgreementsInd>
        <EngageBondCounselResearchInd>1</EngageBondCounselResearchInd>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>1</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>1</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>1</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>1</AnyResearchAgreementsInd>
        <EngageBondCounselResearchInd>1</EngageBondCounselResearchInd>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>1</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>D</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>1</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>1</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>1</AnyResearchAgreementsInd>
        <EngageBondCounselResearchInd>1</EngageBondCounselResearchInd>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>1</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>0</RebateNotDueYetInd>
        <ExceptionToRebateInd>1</ExceptionToRebateInd>
        <NoRebateDueInd>0</NoRebateDueInd>
        <VariableRateIssueInd>0</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>0</RebateNotDueYetInd>
        <ExceptionToRebateInd>0</ExceptionToRebateInd>
        <NoRebateDueInd>1</NoRebateDueInd>
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        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
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        <BondReferenceCd>C</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>1</RebateNotDueYetInd>
        <ExceptionToRebateInd>1</ExceptionToRebateInd>
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        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
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        <BondReferenceCd>D</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>1</RebateNotDueYetInd>
        <ExceptionToRebateInd>1</ExceptionToRebateInd>
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        <VariableRateIssueInd>1</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
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      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
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      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
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      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
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      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>D</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Date Rebate Computation Performed</FormAndLineReferenceDesc>
        <ExplanationTxt>Issuer Name: Health and Educational Facilities Authority of the State of Mi Date the Rebate Computation was Performed: 10/17/2023</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part I, Line A, Column (f)</FormAndLineReferenceDesc>
        <ExplanationTxt>Description of Purpose- The Series 2016 Bonds were issued to refinance a portion of the outstanding Series 2009 Bonds (issued Nov. 19, 2009).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part I, Line B, Column (f)</FormAndLineReferenceDesc>
        <ExplanationTxt>Description of Purpose- The Series 2017A Bonds were issued to construct and equip a professional office building and a research institute for the Corporation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part I, Line C, Column (f)</FormAndLineReferenceDesc>
        <ExplanationTxt>Description of Purpose- The Series 2019A Bonds were issued to refinance 2008A/B Bonds and remaining portion of 2009 Bonds.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part I, Line D, Column (f)</FormAndLineReferenceDesc>
        <ExplanationTxt>Description of Purpose- The Series 2019B Bonds were issued to refinance 2008A/B Bonds and remaining portion of 2009 Bonds.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part II, Line 3, Column B</FormAndLineReferenceDesc>
        <ExplanationTxt>Total Proceeds- Difference between issue price and total proceeds of the Series 2017A Bonds represent $2,537,591 of investment proceeds.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part II, Line 11, Column A</FormAndLineReferenceDesc>
        <ExplanationTxt>Other Spent Proceeds- $147,568,978 of Bond proceeds was used to establish a refunding escrow to refinance a portion of the outstanding Series 2009 Bonds.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part II, Line 11, Column C</FormAndLineReferenceDesc>
        <ExplanationTxt>Other Spent Proceeds- $17,940,000 of Bond proceeds were used to refund the series 2008A/B and 2009 Bonds.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part II, Line 11, Column D</FormAndLineReferenceDesc>
        <ExplanationTxt>Other Spent Proceeds- $24,750,000 of Bond proceeds was used to refund the series 2008A/B and 2009 Bonds.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part II, Line 13, Column A</FormAndLineReferenceDesc>
        <ExplanationTxt>Date of Substantial Completion- The Series 2016 Bonds were issued to refinance the Series 2009 Bonds, and therefore, there were no "new-money" projects financed by the Series 2016 Bonds.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part II, Line 13, Column B</FormAndLineReferenceDesc>
        <ExplanationTxt>Date of Substantial Completion- The projects financed by the Series 2017A Bonds have not yet been completed.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part II, Line 13, Column C</FormAndLineReferenceDesc>
        <ExplanationTxt>Date of Substantial Completion- The Series 2019A Bonds were issued to refinance the Series 2008A/B and 2009 Bonds, and therefore, there were no "new-money" projects financed by the Series 2019A Bonds.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part II, Line 13, Column D</FormAndLineReferenceDesc>
        <ExplanationTxt>Date of Substantial Completion- The Series 2019B Bonds were issued to refinance the Series 2008A/B and 2009 Bonds, and therefore, there were no "new-money" projects financed by the Series 2019B Bonds.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
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          <PersonNm>John Barth</PersonNm>
        </NameOfInterested>
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        <TransactionDesc>Employment</TransactionDesc>
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        <NameOfInterested>
          <PersonNm>Francesca Barth</PersonNm>
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        <TransactionDesc>Employment</TransactionDesc>
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      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>Chandra Swanson</PersonNm>
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        <TransactionDesc>Employment</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
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        <TransactionDesc>Payment for FMV of Services Provided</TransactionDesc>
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      <BusTrInvolveInterestedPrsnGrp>
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        <RelationshipDescriptionTxt>Substantial Contributor</RelationshipDescriptionTxt>
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        <TransactionDesc>Payment for FMV of Services Provided</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
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      <BusTrInvolveInterestedPrsnGrp>
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        <TransactionDesc>Payment for FMV of Services Provided</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
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      <BusTrInvolveInterestedPrsnGrp>
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        <RelationshipDescriptionTxt>Substantial Contributor</RelationshipDescriptionTxt>
        <TransactionAmt>229002</TransactionAmt>
        <TransactionDesc>Payment for FMV of Services Provided</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
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      <BusTrInvolveInterestedPrsnGrp>
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        <TransactionDesc>Payment for FMV of Services Provided</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
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      <BusTrInvolveInterestedPrsnGrp>
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        <TransactionDesc>Payment for FMV of Services Provided</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
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        <NoncashContributionsRptF990Amt>20136</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>FMV</MethodOfDeterminingRevenuesTxt>
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        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>15</ContributionCnt>
        <NoncashContributionsRptF990Amt>253377</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>FMV</MethodOfDeterminingRevenuesTxt>
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        <ContributionCnt>5</ContributionCnt>
        <NoncashContributionsRptF990Amt>61634</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>FMV</MethodOfDeterminingRevenuesTxt>
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        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <Desc>Miscellaneous</Desc>
        <ContributionCnt>58</ContributionCnt>
        <NoncashContributionsRptF990Amt>53104</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>FMV</MethodOfDeterminingRevenuesTxt>
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      <OtherNonCashContriTableGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <Desc>Food</Desc>
        <ContributionCnt>15</ContributionCnt>
        <NoncashContributionsRptF990Amt>10475</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>FMV</MethodOfDeterminingRevenuesTxt>
      </OtherNonCashContriTableGrp>
      <OtherNonCashContriTableGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <Desc>Jewelry</Desc>
        <ContributionCnt>1</ContributionCnt>
        <NoncashContributionsRptF990Amt>6500</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>FMV</MethodOfDeterminingRevenuesTxt>
      </OtherNonCashContriTableGrp>
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      <AnyPropertyThatMustBeHeldInd>0</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>1</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>0</ThirdPartiesUsedInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Column (b):</FormAndLineReferenceDesc>
        <ExplanationTxt>The amounts in Part I, Column (b) represent the number of contributions received during the taxable year.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The final Form 990, including all required schedules, was provided to each voting member of the Board of Directors prior to its filing with the IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Corporate compliance reviews all potential conflicts disclosed, and reviews and approves completion of the related management plan.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>The People and Compensation Committee of the Board of Directors (the "Committee") is responsible for approving the compensation of the CEO and, based on the CEO's recommendation, the compensation of the Executive Vice Presidents ("EVPs"). The Committee's deliberations and approvals of such compensation are documented in the minutes of the Committee's meetings. The Committee is composed of independent directors who receive no compensation for their service on the Board of Directors. The Committee engages an independent consulting firm, with expertise and experience in analysis of compensation of not-for-profit hospital executives (including review and application of market data), to advise the Committee with regard to compensation of the CEO and the EVPs. The consulting firm provides an opinion to the Committee regarding the reasonableness of such compensation, which is maintained in the Committee's records.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization's governing documents, conflict of interest policy, and audited financial statements are available upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Other Fees: Program service expenses 85,934,493. Management and general expenses 98,121,447. Fundraising expenses 49,461. Total expenses 184,105,401.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, line 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>Change in benefit obligation 107,138. Change in interest rate swap valuation 1,685,100. Net Unrealized Change in Income Beneficiary and Charitable Remainder Trusts 1,996,427. Unrealized Loss on Equity Investments 15,666,835.</ExplanationTxt>
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          <AddressLine1Txt>2401 Gillham Road</AddressLine1Txt>
          <CityNm>Kansas City</CityNm>
          <StateAbbreviationCd>MO</StateAbbreviationCd>
          <ZIPCd>64108</ZIPCd>
        </USAddress>
        <PrimaryActivitiesTxt>Insurance for The Children's Mercy Hospital</PrimaryActivitiesTxt>
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        <DirectControllingEntityName>
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          <BusinessNameLine1Txt>Physician Business Partners LLC</BusinessNameLine1Txt>
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          <CityNm>Kansas City</CityNm>
          <StateAbbreviationCd>MO</StateAbbreviationCd>
          <ZIPCd>64108</ZIPCd>
        </USAddress>
        <PrimaryActivitiesTxt>Physician network for education and purchasing</PrimaryActivitiesTxt>
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          <CityNm>Kansas City</CityNm>
          <StateAbbreviationCd>MO</StateAbbreviationCd>
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        <PrimaryActivitiesTxt>Supports research activities of The Children's Mercy Hospital</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>The Children's Mercy Hospital</BusinessNameLine1Txt>
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          <BusinessNameLine1Txt>PedsMarket LLC</BusinessNameLine1Txt>
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