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      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>5010003</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2723861</DepreciationAmt>
        <BookValueAmt>2286142</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>43820</OtherCostOrOtherBasisAmt>
        <BookValueAmt>43820</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>15550837</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Uncertain tax positions</Desc>
        <Amt>0</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>0</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>50138150</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>-210139</NetUnrealizedGainsInvstAmt>
      <DonatedServicesAndUseFcltsAmt>185411</DonatedServicesAndUseFcltsAmt>
      <OtherRevenueAmt>3277879</OtherRevenueAmt>
      <RevenueNotReportedAmt>3253151</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>46884999</RevenueSubtotalAmt>
      <OtherRevenuesNotIncludedAmt>3438397</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>3438397</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>50323396</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>44701311</TotExpnsEtcAuditedFinclStmtAmt>
      <DonatedServicesUseFcltsAmt>185411</DonatedServicesUseFcltsAmt>
      <OtherExpensesIncludedAmt>3277879</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>3463290</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>41238021</ExpensesSubtotalAmt>
      <OtherExpensesNotIncludedAmt>3438397</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>3438397</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>44676418</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt X, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>CHCSEK believes it has no unrecognized tax liabilities or benefits at year-end, and continually evaluates changes in tax law, statutes of limitations, and new authoritative rulings. Should CHCSEK determine it has unrelated business income, it will accrue such liabilities plus any related interest and penalties in the statement of financial position. No such tax liability is reflected on its audited financials.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt XI, Line 2d</FormAndLineReferenceDesc>
        <ExplanationTxt>Cost of pharmaceuticals reflected as expense on audit report.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt XII, Line 2d</FormAndLineReferenceDesc>
        <ExplanationTxt>Cost of pharmaceuticals reflected as expense on audit report.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt XI, Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>Bad debt expense reflected as contra-income on audit report</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt XII, Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>Bad debt expense reflected as contra-income on audit report</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ-01">
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>true</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Krista Postai</PersonNm>
        <BaseCompensationFilingOrgAmt>263876</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>50000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>640</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>13750</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>13459</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>341725</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Douglas Stuckey</PersonNm>
        <BaseCompensationFilingOrgAmt>203841</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>10148</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>640</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>9798</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>13444</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>237871</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Dr Dawny Barnhart</PersonNm>
        <BaseCompensationFilingOrgAmt>230751</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>1024</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>9864</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>11410</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>33657</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>286706</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Dr Linda Bean</PersonNm>
        <BaseCompensationFilingOrgAmt>233926</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>10241</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>13808</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>11856</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>16739</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>286570</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Dr Bethany Enoch</PersonNm>
        <BaseCompensationFilingOrgAmt>209508</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>1024</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>43319</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>11766</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>16559</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>282176</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Dr William Stueve</PersonNm>
        <BaseCompensationFilingOrgAmt>205056</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>11655</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>216711</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Dr Julie Stewart</PersonNm>
        <BaseCompensationFilingOrgAmt>209944</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>1015</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>2752</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>9783</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>16801</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>240295</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt I Line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>Annual, end-of-year bonuses were provided to selected staff. Board approves CEO's bonus, CEO determines other staff bonuses.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleM documentId="IRS990ScheduleM-01">
      <SecuritiesPubliclyTradedGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>1</ContributionCnt>
        <NoncashContributionsRptF990Amt>50265</NoncashContributionsRptF990Amt>
      </SecuritiesPubliclyTradedGrp>
      <RealEstateCommercialGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>1</ContributionCnt>
        <NoncashContributionsRptF990Amt>2205993</NoncashContributionsRptF990Amt>
      </RealEstateCommercialGrp>
      <DrugsAndMedicalSuppliesGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>4</ContributionCnt>
        <NoncashContributionsRptF990Amt>328601</NoncashContributionsRptF990Amt>
      </DrugsAndMedicalSuppliesGrp>
      <AnyPropertyThatMustBeHeldInd>false</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>true</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>false</ThirdPartiesUsedInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt I col(b)</FormAndLineReferenceDesc>
        <ExplanationTxt>Column b represents number of donors contributing product, stock, tangible equipment and real estate.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="IRS990ScheduleO-01" softwareId="18007482">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>CHCSEK prepares and circulates proposed Form 990 to Finance Committee for detailed analysis, and then reviews proposed Form 990 with full board before submission. A copy of the filed return is made available to the full board after filing with the IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>CHCSEK board members and leadership staff complete annual compliance questionnaires to disclose possible conflicts of interest at any point during the tax year, and then reviewed by the compliance officer and shared with financial auditors. No significant conflicts were disclosed in the financial statements.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>CEO compensation determined solely by the board of directors, assisted by industry-specific salary surveys, comparable local nonprofit compensation, and other Form 990 schedules of comparable nonprofit organizations.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>Staff compensation is limited to salary ranges approved by the board of directors, as determined by the CEO and VP of Human Resources, assisted by industry-specific salary surveys and comparable local nonprofit compensation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Governing documents, Conflict of Interest policy and financials available upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt III, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>There have been no changes in the audit oversight or selection process during the tax year. Finance Committee selects, affirmed by the full board, on selection of independent auditor. Finance Committee and full board reviews all audit work product.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt XI</FormAndLineReferenceDesc>
        <ExplanationTxt>The fair market value of donated rent income($185,411) offsets rent expense on Fort Scott Main ($159,939) and Mound City ($25,4721); both income and expense components are excluded from Form 990.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e</FormAndLineReferenceDesc>
        <ExplanationTxt>Direct patient support 355718. 355718. 0. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e</FormAndLineReferenceDesc>
        <ExplanationTxt>Immunizations 904995. 904995. 0. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e</FormAndLineReferenceDesc>
        <ExplanationTxt>Education 135017. 126650. 8351. 16.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e</FormAndLineReferenceDesc>
        <ExplanationTxt>Dues 27731. 0. 27731. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e</FormAndLineReferenceDesc>
        <ExplanationTxt>Licenses 85170. 0. 85170. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e</FormAndLineReferenceDesc>
        <ExplanationTxt>Meals 51590. 0. 51590. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e</FormAndLineReferenceDesc>
        <ExplanationTxt>Laboratory 789454. 789454. 0. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e</FormAndLineReferenceDesc>
        <ExplanationTxt>Dental supplies 330627. 330627. 0. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e</FormAndLineReferenceDesc>
        <ExplanationTxt>Electronic Medical record 1093646. 822683. 270963. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e</FormAndLineReferenceDesc>
        <ExplanationTxt>Recruitment 62707. 0. 62707. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e</FormAndLineReferenceDesc>
        <ExplanationTxt>Miscellaneous exp 74209. 6367. 67842. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e</FormAndLineReferenceDesc>
        <ExplanationTxt>Bad Debts 3438397. 3438397. 0. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>