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        <ManagementAndGeneralAmt>94634</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>1448289</TotalAmt>
        <ProgramServicesAmt>1336686</ProgramServicesAmt>
        <ManagementAndGeneralAmt>111603</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>0</TotalAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>245911</TotalAmt>
        <ProgramServicesAmt>213041</ProgramServicesAmt>
        <ManagementAndGeneralAmt>32870</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>119070</TotalAmt>
        <ProgramServicesAmt>103154</ProgramServicesAmt>
        <ManagementAndGeneralAmt>15916</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>1527</TotalAmt>
        <ManagementAndGeneralAmt>1527</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>18230</TotalAmt>
        <ManagementAndGeneralAmt>18230</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>24823</TotalAmt>
        <ManagementAndGeneralAmt>24823</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
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        <ManagementAndGeneralAmt>74037</ManagementAndGeneralAmt>
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      <AdvertisingGrp>
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        <ManagementAndGeneralAmt>2835</ManagementAndGeneralAmt>
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      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
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        <ManagementAndGeneralAmt>11928</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
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      </RoyaltiesGrp>
      <OccupancyGrp>
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        <ProgramServicesAmt>32967</ProgramServicesAmt>
        <ManagementAndGeneralAmt>38470</ManagementAndGeneralAmt>
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      <TravelGrp>
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        <ManagementAndGeneralAmt>2528</ManagementAndGeneralAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
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      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>2504</TotalAmt>
        <ManagementAndGeneralAmt>2504</ManagementAndGeneralAmt>
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      <InterestGrp>
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      <PaymentsToAffiliatesGrp>
        <TotalAmt>0</TotalAmt>
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      </DepreciationDepletionGrp>
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        <ManagementAndGeneralAmt>33398</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>NFAC &amp; NFRA FEES</Desc>
        <TotalAmt>259575</TotalAmt>
        <ProgramServicesAmt>259575</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
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        <ProgramServicesAmt>21767</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>LICENSES, DUES,&amp; SUBSCRIPTIONS</Desc>
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        <ManagementAndGeneralAmt>5829</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
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        <ProgramServicesAmt>2385130</ProgramServicesAmt>
        <ManagementAndGeneralAmt>547016</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
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        <EOYAmt>6303</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
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        <EOYAmt>509257</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
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        <EOYAmt>0</EOYAmt>
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      <AccountsReceivableGrp>
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        <EOYAmt>151405</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
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        <EOYAmt>0</EOYAmt>
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      <RcvblFromDisqualifiedPrsnGrp>
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        <EOYAmt>0</EOYAmt>
      </RcvblFromDisqualifiedPrsnGrp>
      <OthNotesLoansReceivableNetGrp>
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        <EOYAmt>0</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
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        <EOYAmt>10729</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
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        <EOYAmt>43878</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>2024105</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>885641</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
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        <EOYAmt>1138464</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
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        <EOYAmt>1778508</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
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        <EOYAmt>0</EOYAmt>
      </InvestmentsProgramRelatedGrp>
      <IntangibleAssetsGrp>
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        <EOYAmt>0</EOYAmt>
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      <OtherAssetsTotalGrp>
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        <EOYAmt>7080</EOYAmt>
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      <TotalAssetsGrp>
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        <EOYAmt>3645624</EOYAmt>
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      <AccountsPayableAccrExpnssGrp>
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        <EOYAmt>161799</EOYAmt>
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      <GrantsPayableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </GrantsPayableGrp>
      <DeferredRevenueGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </DeferredRevenueGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
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      <EscrowAccountLiabilityGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </EscrowAccountLiabilityGrp>
      <LoansFromOfficersDirectorsGrp>
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        <EOYAmt>0</EOYAmt>
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      <MortgNotesPyblScrdInvstPropGrp>
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      <UnsecuredNotesLoansPayableGrp>
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        <EOYAmt>0</EOYAmt>
      </UnsecuredNotesLoansPayableGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>160652</BOYAmt>
        <EOYAmt>161799</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
      <UnrestrictedNetAssetsGrp>
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        <EOYAmt>3483825</EOYAmt>
      </UnrestrictedNetAssetsGrp>
      <TemporarilyRstrNetAssetsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </TemporarilyRstrNetAssetsGrp>
      <PermanentlyRstrNetAssetsGrp>
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        <EOYAmt>0</EOYAmt>
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      <TotalNetAssetsFundBalanceGrp>
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      <TotLiabNetAssetsFundBalanceGrp>
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        <EOYAmt>3645624</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>2688</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-370536</NetUnrlzdGainsLossesInvstAmt>
      <PriorPeriodAdjustmentsAmt>375056</PriorPeriodAdjustmentsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>false</FSAuditedInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>1310</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3367</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>920</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1677</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2680</CurrentTaxYearAmt>
        <TotalAmt>9954</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
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        <CurrentTaxYearMinus3YearsAmt>2573589</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2685816</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2585013</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2815886</CurrentTaxYearAmt>
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      <GrossReceiptsNonUnrltBusGrp>
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      </GrossReceiptsNonUnrltBusGrp>
      <TaxRevLeviedOrgnztnlBnft509Grp>
        <TotalAmt>0</TotalAmt>
      </TaxRevLeviedOrgnztnlBnft509Grp>
      <GovtFurnSrvcFcltsVl509Grp>
        <TotalAmt>0</TotalAmt>
      </GovtFurnSrvcFcltsVl509Grp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>2484427</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>2576956</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2686736</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2586690</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2818566</CurrentTaxYearAmt>
        <TotalAmt>13153375</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>13153375</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>41243</CurrentTaxYearMinus4YearsAmt>
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        <CurrentTaxYearMinus2YearsAmt>48227</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>54786</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>64336</CurrentTaxYearAmt>
        <TotalAmt>251320</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <Post1975UBTIGrp>
        <TotalAmt>0</TotalAmt>
      </Post1975UBTIGrp>
      <InvestmentIncomeAndUBTIGrp>
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        <CurrentTaxYearMinus3YearsAmt>42728</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>48227</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>54786</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>64336</CurrentTaxYearAmt>
        <TotalAmt>251320</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <NetIncomeFromOtherUBIGrp>
        <TotalAmt>0</TotalAmt>
      </NetIncomeFromOtherUBIGrp>
      <OtherIncome509Grp>
        <TotalAmt>0</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
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        <CurrentTaxYearMinus3YearsAmt>2619684</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2734963</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2641476</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2882902</CurrentTaxYearAmt>
        <TotalAmt>13404695</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.98125</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.98182</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.01875</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.01818</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleC documentId="IRS990ScheduleC">
      <TotalGrassrootsLobbyingGrp />
      <TotalDirectLobbyingGrp />
      <TotalLobbyingExpendGrp />
      <OtherExemptPurposeExpendGrp />
      <TotalExemptPurposeExpendGrp />
      <LobbyingNontaxableAmountGrp />
      <GrassrootsNontaxableGrp />
      <TotLbbyngGrassrootMnsNonTxGrp />
      <TotLbbyExpendMnsLbbyngNonTxGrp />
      <VolunteersInd>false</VolunteersInd>
      <PaidStaffOrManagementInd>false</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>false</MediaAdvertisementsInd>
      <MailingsMembersInd>false</MailingsMembersInd>
      <PublicationsOrBroadcastInd>false</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>false</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>false</DirectContactLegislatorsInd>
      <RalliesDemonstrationsInd>false</RalliesDemonstrationsInd>
      <OtherActivitiesInd>true</OtherActivitiesInd>
      <OtherActivitiesAmt>750</OtherActivitiesAmt>
      <TotalLobbyingExpendituresAmt>750</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>false</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE C, PART II-B, LINE 1I</FormAndLineReferenceDesc>
        <ExplanationTxt>LOBBYING EXPENDITURES THE ORGANIZATION PAYS DUES TO THE MISSOURI HEALTH CARE ASSOCIATION, OF WHICH A PORTION OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING. IN 2018, THE PORTION OF DUES ATTRIBUTABLE TO LOBBYING WAS $750.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
      <ArtPublicExhibitionAmountsGrp />
      <HeldWorksArtGrp />
      <CYMinus3YrEndwmtFundGrp />
      <CYMinus4YrEndwmtFundGrp />
      <LandGrp>
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        <BookValueAmt>13417</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>1516832</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>515145</DepreciationAmt>
        <BookValueAmt>1001687</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>205243</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>175130</DepreciationAmt>
        <BookValueAmt>30113</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
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        <DepreciationAmt>195366</DepreciationAmt>
        <BookValueAmt>93247</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp />
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    </IRS990ScheduleD>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTANT. IT IS THEN REVIEWED BY MANAGEMENT BEFORE BEING PROVIDED TO THE BOARD AT A BOARD MEETING FOR REVIEW.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION DETERMINATION: THE BOARD OF DIRECTORS REVIEWS THE SALARY OF THE ADMINISTRATOR. THE DISCUSSION AND DECISION IS DOCUMENTED IN THE MINUTES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>GOVERNING DOCUMENT AVAILABILITY: THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>