COOK CHILDRENS MEDICAL CENTER: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: COOK CHILDRENS MEDICAL CENTER (EIN 75-2051646)
Tax period: 2021-10-01 to 2022-09-30
Filed: 2023-08-15
IRS object ID: 202322279349303237
Schema version: 2021v4.2
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R
Affiliated Group Schedule

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2023-08-15T14:19:09-05:00	ReturnTs
Tax Period End	2022-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	FORVIS LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	14241 DALLAS PARKWAY SUITE 1100	AddressLine1Txt
City	DALLAS	CityNm
State Abbreviation	TX	StateAbbreviationCd
ZIP	75254	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2021-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	752051646	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Cook Children's Medical Center	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% CORY RHOADES	InCareOfNm
Business Name Control	COOK	BusinessNameControlTxt
Phone	6828854000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	801 Seventh Avenue	AddressLine1Txt
City	Fort Worth	CityNm
State Abbreviation	TX	StateAbbreviationCd
ZIP	76104	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	CORY R RHOADES	PersonNm
Person Title	CFO, SVP FINANCE	PersonTitleTxt
Phone	6828854000	PhoneNum
Signature	2023-08-15	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	Cory R	PersonFirstNm
Person Last	Rhoades	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	MICHAEL J ENGLE	PreparerPersonNm
PTIN	P00482834	PTIN
Phone	9727028262	PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	2	TrustedCustomerCd

Field	Value	IRS element (for citing)
Tax	2021	TaxYr
Build TS	2023-04-26 12:10:37Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	NANCY CYCHOL	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	801 SEVENTH AVENUE	AddressLine1Txt
City	FORT WORTH	CityNm
State Abbreviation	TX	StateAbbreviationCd
ZIP	76104	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$1,773,582,757	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.COOKCHILDRENS.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1985	FormationYr
Legal Domicile State	TX	LegalDomicileStateCd
Activity Or Mission	KNOWING THAT EVERY CHILD'S LIFE IS SACRED OUR PROMISE IS TO IMPROVE THE HEALTH OF EVERY CHILD IN OUR REGION THROUGH THE PREVENTION AND TREATMENT OF ILLNESS, DISEASE and INjury.	ActivityOrMissionDesc
Voting Members Governing Body	13	VotingMembersGoverningBodyCnt
Voting Members Independent	12	VotingMembersIndependentCnt
Total Employee	5478	TotalEmployeeCnt
Total Volunteers	584	TotalVolunteersCnt
Total Gross UBI	$11,463	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$6,642	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$49,806,055	PYContributionsGrantsAmt
CY Contributions Grants	$17,108,404	CYContributionsGrantsAmt
PY Program Service Revenue	$1,463,493,299	PYProgramServiceRevenueAmt
CY Program Service Revenue	$1,754,264,051	CYProgramServiceRevenueAmt
PY Investment Income	$302,271	PYInvestmentIncomeAmt
CY Investment Income	$108,029	CYInvestmentIncomeAmt
PY Other Revenue	$58,522	PYOtherRevenueAmt
CY Other Revenue	$592,351	CYOtherRevenueAmt
PY Total Revenue	$1,513,660,147	PYTotalRevenueAmt
CY Total Revenue	$1,772,072,835	CYTotalRevenueAmt
PY Grants And Similar Paid	$73,422,672	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$83,326,957	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$402,390,436	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$490,600,737	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$679,291,913	PYOtherExpensesAmt
CY Other Expenses	$776,859,354	CYOtherExpensesAmt
PY Total Expenses	$1,155,105,021	PYTotalExpensesAmt
CY Total Expenses	$1,350,787,048	CYTotalExpensesAmt
PY Revenues Less Expenses	$358,555,126	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$421,285,787	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,871,901,068	TotalAssetsBOYAmt
Total Assets EOY	$1,720,011,003	TotalAssetsEOYAmt
Total Liabilities BOY	$624,234,763	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$656,624,458	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$1,247,666,305	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$1,063,386,545	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	KNOWING THAT EVERY CHILD'S LIFE IS SACRED, OUR PROMISE IS TO IMPROVE THE HEALTH OF EVERY CHILD IN OUR REGION THROUGH THE PREVENTION AND TREATMENT OF ILLNESS, DISEASE AND INJURY.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$929,689,482	ExpenseAmt
Grant	$83,326,957	GrantAmt
Revenue	$1,754,932,548	RevenueAmt
Desc	Cook Children's Medical Center is the cornerstone of Cook Children's Health Care System. This 444-bed facility is home to top medical minds, advanced technologies, family-centered treatments and leading-edge clinical research, all designed to fulfill the System's Promise to improve the health and well-being of every child. Nationally recognized services such as the Level IV Neonatal Intensive Care Unit, the Jane and John Justin Neurosciences Center and the hematology and oncology center are leading the way in providing the highest level of care to families who travel to the medical center from all across Texas and the United States, as well as internationally. From complicated surgeries and Level II trauma care to physical therapy and behavioral health services, the medical center offers a variety of services and amenities to meet the unique needs of every patient and family. It is one of only 10 freestanding children's hospitals in the world to achieve Magnet designation with three consecutive re-designations from the American Nursing Credentialing Center, most recently in February 2021. Viral Surge On the heels of the COVID-19 pandemic, the country experienced an unseasonal round of respiratory syncytial virus (RSV) followed by the return of influenza and other seasonal viruses that hit children hard and, subsequently, strained pediatric hospitals. The medical center had to be nimble, flexible and quick to adjust to each new viral surge. To reduce the spread of illness, Cook Children's maintained safety protocols put into place early in the pandemic, such as masking, limiting visitors and instituting work-from-home plans. The medical center released weekly RSV and flu numbers to the public and held press conferences with Cook Children's physicians. It also asked for the community's help in limiting the spread of illness, taking children to the appropriate provider based on their condition (e.g. pediatrician versus urgent care versus ER) and encouraged patience during long wait times in busy ERs and urgent care centers. Telehealth remains a critical resource for the hospital, especially during times of intense viral spread. In the early days of COVID-19, Cook Children's took steps to increase its bandwidth to support the explosive growth in virtual health visits. The year's virtual health visits totaled approximately 67,000 across all of Cook Children's Health Care System. Pandemic Inspires Improvement Out of the challenges of the pandemic emerged a stronger organization better equipped for the future. In early FY22, Cook Children's opened a new six-bed Infectious Disease Unit designed to treat the sickest patients while also protecting staff and the community from the spread of illness. It includes private patient rooms with private bathrooms, specialized air ventilation systems, dedicated areas for visitors and staff to put on and take off personal protective equipment and technology that allows technicians to closely monitor a patient without having to be directly by the patient's bedside. The expansion includes a 24-hour solutions center inspired by lessons learned from the pandemic. This center will operate year-round to serve as a one-stop shop for requesting assistance with a facility or operations issue at Cook Children's Health Care System. Raising Joy Cook Children's 2021 JOY campaign-an ongoing series of articles that addressed and educated readers on children's rising mental health care needs-grew to include a new podcast featuring honest conversations about the mental well-being of kids and teens. The Raising Joy Podcast premiered in March 2022, and aired a total of 35 episodes throughout the year. Topics covered everything from child trafficking to drug use to body image to parents sharing their personal experience losing a child to suicide. The podcast is hosted by Cook Children's senior vice president and chief communication, inclusion, diversity and equity officer, and Cook Children's medical director of psychiatry outpatient services and partial hospitalization program. Safety Saves Lives By April 2022, 17 children had been treated for drownings at Cook Children's since the start of the year. That includes three fatalities. This was an alarming increase in the number of drownings compared to January through May in the previous five years. In response, Cook Children's communications team, together with the Center for Children's Health, led by Cook Children's, ramped up its drowning prevention education efforts in tandem with its ongoing Lifeguard Your Child water safety program. Several articles about drowning prevention, the importance of swim lessons, proper fit of life vests and water safety resources were published to Cook Children's Checkup Newsroom and social media accounts. In May, the medical center erected a powerful display outside on its north lawn as a visual reminder to Lifeguard Your Child. Fifteen swimsuits and five rubber duckies hung on a clothesline, representing children who were treated for drowning injuries at the hospital since the beginning of 2022. Each swimsuit matched the age and gender of the swimming pool drowning patients treated up to that point in the year. The rubber duckies represented the five children who drowned in bathtubs. Cook Children's Aim for Safety program zeroed in on a new way to educate families on gun safety using an interactive kiosk that teaches children what to do if they discover a firearm in a home - all while reinforcing safe-storage techniques for adult gun owners. The mobile kiosk, which stands more than 7-feet high and resembles a giant smartphone, rolled out in December 2021 at Defender Outdoors, a sports shooting and outdoors equipment retailer in Fort Worth. As part of a first-time collaboration with Cook Children's, the kiosk was placed near the check-out registers in hopes it attracts the attention of parents and children alike. The Aim for Safety educational kiosk - activated by touch - uses advanced technology to engage and teach children as they progress through four levels, stumbling upon unsecured guns hidden in places such as cabinets and drawers while moving through a virtual home. If they find a gun, they must correctly answer questions on how to safely handle the situation in order to progress through the program. Other gun safety-related questions are asked as objects in the rooms are found and touched. The program emphasizes three steps: Safe Storage. Safe Children. Safe Play. New and Improved Cook Children's Medical Center announced its development of a clinical care model that brings together specialties for more seamless health care. The Jane and John Justin Institute for Mind Health will bring Cook Children's Jane and John Justin Neurosciences Center, Cook Children's Division of Behavioral Health and the Child Study Center under one collaborative roof to provide easily accessible, well-coordinated and comprehensive care for children with disorders affecting the nervous system. The Justin Institute will be located in the Dodson Specialty Building on the medical center campus and is slated to open Spring 2023. Exceeding Expectations Even while operating under the cloud of the pandemic and challenging viral seasons, CCMC continued to pursue quality, safety and communication. Patient experience scores exceeded the Children's Hospital Association (CHA) average, earning employees a performance bonus. Cook Children's was one of five children's hospitals from across the country selected to present its success in improving workplace safety at the 2022 Solutions for Patient Safety (SPS) Fall National Learning Conference. Over the past five years, with collaboration from SPS, Cook Children's has worked to reduce the number and severity of employee injuries in three focus areas-slips, trips and falls; patient behavior events; and overexertion injuries caused by handling patients, soiled linen and trash. At the conference, several Cook Children's executives, board members, leaders and clinical staff reported on the health system's journey to a safer and healthier workplace. In February 2022, Jill Koss, Cook Children's director of Family Support Services, was honored by Crown Council, an organization associated with Teammates for Kids, for her work championing Child Life Zones at Cook Children's and other hospitals throughout the country. At the recognition event, Koss was surprised with a recorded video message from Country music singer and songwriter Garth Brooks, who delivered an emotional thank you for Koss' tireless work advocating for interactive spaces designed to foster the creative arts for pediatric patients and siblings.	Desc
Total Program Service Expenses	$929,689,482	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	Yes (true)	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (true)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	Yes (true)	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (true)	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	false	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	147	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	5478	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
DAF Excess Business Holdings	false	DAFExcessBusinessHoldingsInd
Taxable Distributions	false	TaxableDistributionsInd
Distribution To Donor	false	DistributionToDonorInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	Yes (true)	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	13	GoverningBodyVotingMembersCnt
Independent Voting Member	12	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	Yes (true)	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	TX	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	CORY RHOADES	PersonNm
Phone	6828854000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	801 SEVENTH AVENUE	AddressLine1Txt
City	FORT WORTH	CityNm
State Abbreviation	TX	StateAbbreviationCd
ZIP	76104	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (38 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd
RICK W MERRILL
Chief Executive Officer	11.0	29.0	Yes (X)	$674,193	$1,733,639	$255,556
STEPHEN W KIMMEL
EVP, SYS FINANCE	16.0	24.0	Yes (X)	$417,068	$625,601	$162,506
James C Cunningham MD
EVP, CMO	1.0	40.0	Yes (X)	$0	$1,079,736	$45,761
Nancy C Cychol
President/Chief Hospital Svcs	40.0	2.0	Yes (X)	$1,054,983	$0	$33,010
JOSEPH M GALLAGHER
SR. VP, CHIEF LEGAL OFFICER	1.0	41.0	Yes (X)	$0	$748,085	$137,524
CORY R RHOADES
CFO	1.0	43.0	Yes (X)	$0	$740,482	$133,681
THERESA Z MEADOWS
Sr. VP, Chief Info Officer	1.0	41.0	Yes (X)	$0	$736,107	$54,863
STANLEY E DAVIS
Sr. Vice President, COO	40.0	1.0	Yes (X)	$619,089	$0	$124,319
CHERYL PETERSEN
VP Nursing, CNO	40.0	0.0		$428,381	$0	$94,077	Yes (X)
SPENCER D SEALS
VP Construction & Real Estate	1.0	43.0	Yes (X)	$0	$376,149	$86,425
JACK SOSEBEE
Vice President	40.0	2.0		$374,615	$0	$71,818	Yes (X)
ELIA VALENCIA-STOKES
AVP Finance	40.0	0.0		$325,574	$0	$46,358	Yes (X)
ORLANDO CHAPA
AVP Nursing	40.0	0.0		$297,273	$0	$38,829	Yes (X)
DEBORAH BOUDREAUX
AVP Nursing	40.0	0.0		$288,512	$0	$46,341	Yes (X)
TAMMY THOMLISON
AVP Revenue	40.0	0.0		$279,789	$0	$12,262	Yes (X)
OZIOMA OLOWU
Director of Pharmacy	40.0	0.0		$228,879	$0	$49,176		Yes (X)
Gary Munford
Day/Wknd Administrator	40.0	0.0		$221,591	$0	$36,776		Yes (X)
NICHOLAS MARKHAM
AVP Facilities/Campus Svcs	40.0	0.0		$206,073	$0	$37,508	Yes (X)
Tamara Sims
RN, Staff	40.0	0.0		$212,829	$0	$27,361		Yes (X)
KEVIN GREENE
AVP NORTH CAMPUS	40.0	0.0		$194,913	$0	$42,629	Yes (X)
Jessica Sibr
Pharmacist	40.0	0.0		$197,117	$0	$38,887		Yes (X)
MARGIE DORMAN-O'DONNELL
Director, Case Management	40.0	0.0		$205,673	$0	$26,220		Yes (X)
MARY CARA MARTZ
Secretary	1.0	40.0	Yes (X)	$0	$169,553	$23,484
Frank A Anderson
Trustee	1.0	1.0		$0	$0	$0			Yes (X)
ANNE M CARVALHO
Trustee	1.0	3.0		$0	$0	$0			Yes (X)
Judge Jeffrey L Cureton
Trustee	1.0	3.0		$0	$0	$0			Yes (X)
RYAN B DICKERSON
Trustee	1.0	2.0		$0	$0	$0			Yes (X)
WALLY JONES
TRUSTEE START: 06/22	1.0	2.0		$0	$0	$0			Yes (X)
LEAH M KING
Trustee - Secretary/Treasurer	2.0	2.0	Yes (X)	$0	$0	$0			Yes (X)
MICHAEL A LAGATTA
Trustee	1.0	1.0		$0	$0	$0			Yes (X)
JOSEPH LAMARCA JR
Trustee End: 05/22	1.0	1.0		$0	$0	$0			Yes (X)
LAURA MILLER
Trustee Start: 06/22	1.0	1.0		$0	$0	$0			Yes (X)
BONNIE PETSCHE
Trustee	1.0	1.0		$0	$0	$0			Yes (X)
BILLIE R PUGH JR MD
Trustee	1.0	2.0		$0	$0	$0			Yes (X)
ANDREW S WAYNE
Trustee - Vice Chairman	2.0	2.0	Yes (X)	$0	$0	$0			Yes (X)
JAMES E WEBB
Trustee End: 05/22	1.0	5.0		$0	$0	$0			Yes (X)
ROBERT J BATTON
Trustee	1.0	2.0		$0	$0	$0			Yes (X)
JOHN P BOSWELL
Trustee - Chairman	2.0	3.0	Yes (X)	$0	$0	$0			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$6,226,552	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$6,209,352	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,625,371	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	519	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
LINBECK GROUP LLC
1263 W ROSEDALE STE 202	FORT WORTH	TX	76104	CONSTRUCTION	$37,483,024
HKS INC
PO BOX 731121	DALLAS	TX	75373	PROFESSIONAL SVCS	$4,431,948
DYNAMIC SYSTEMS INC
2315 EAST LOOP 820 NORTH	FORT WORTH	TX	76118	CONSTRUCTION	$6,761,054
FISK ELECTRIC CO
1617 W CROSBY RD 120	CARROLLTON	TX	75006	CONSTRUCTION	$3,206,849
CURA REVENUE CYCLE MANAGEMENT
2202 N WEST SHORE BLVD STE 200	TAMPA	FL	33607	COLLECTION SVCS	$1,068,154

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	82	CntrctRcvdGreaterThan100KCnt
Related Organizations	$11,128,505	RelatedOrganizationsAmt
Government Grants	$5,979,899	GovernmentGrantsAmt
Total Contributions	$17,108,404	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
Patient Services	621110	$1,597,346,460	$1,597,346,460
Other Operating Revenue	621110	$140,123,885	$140,123,885
Joint Venture Revenue	621110	$16,782,243	$16,782,243
LAB REFERRALS	621500	$11,463		$11,463

Field	Value	IRS element (for citing)
Total Program Service Revenue	$1,754,264,051	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$17,502	TotalRevenueColumnAmt
Exclusion	$17,502	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$1,363,595	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$1,451,204	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	-$87,609	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$87,609	TotalRevenueColumnAmt
Exclusion	-$87,609	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$149,245	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$58,718	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	$90,527	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$90,527	TotalRevenueColumnAmt
Exclusion	$90,527	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	CCIC Retro Premium	Desc
Business	900099	BusinessCd
Total Revenue Column	$679,960	TotalRevenueColumnAmt
Related Or Exempt Func Income	$679,960	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$679,960	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,772,072,835	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,754,932,548	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$11,463	UnrelatedBusinessRevenueAmt
Exclusion	$20,420	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$82,691,540	TotalAmt
Program Services	$82,691,540	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$635,417	TotalAmt
Program Services	$635,417	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$6,353,542	TotalAmt
Program Services	$1,475,993	ProgramServicesAmt
Management And General	$4,877,549	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$91,990	TotalAmt
Program Services	$91,990	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$366,801,380	TotalAmt
Program Services	$337,900,095	ProgramServicesAmt
Management And General	$28,901,285	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$17,730,798	TotalAmt
Program Services	$16,286,776	ProgramServicesAmt
Management And General	$1,444,022	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$72,603,907	TotalAmt
Program Services	$67,559,724	ProgramServicesAmt
Management And General	$5,044,183	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$27,019,120	TotalAmt
Program Services	$25,119,816	ProgramServicesAmt
Management And General	$1,899,304	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$238,664,520	TotalAmt
Management And General	$238,664,520	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$2,082,872	TotalAmt
Management And General	$2,082,872	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$33,861,423	TotalAmt
Program Services	$24,445,779	ProgramServicesAmt
Management And General	$9,415,644	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$61,801	TotalAmt
Program Services	$61,801	ProgramServicesAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,957,639	TotalAmt
Program Services	$4,780,339	ProgramServicesAmt
Management And General	$1,177,300	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$10,274,236	TotalAmt
Program Services	$8,783,946	ProgramServicesAmt
Management And General	$1,490,290	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$590,915	TotalAmt
Program Services	$504,108	ProgramServicesAmt
Management And General	$86,807	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$423,311	TotalAmt
Program Services	$360,747	ProgramServicesAmt
Management And General	$62,564	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$10,614,730	TotalAmt
Program Services	$10,614,641	ProgramServicesAmt
Management And General	$89	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$9,289,525	TotalAmt
Program Services	$9,271,249	ProgramServicesAmt
Management And General	$18,276	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$52,725,189	TotalAmt
Program Services	$39,035,723	ProgramServicesAmt
Management And General	$13,689,466	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$2,063,461	TotalAmt
Program Services	$2,063,461	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Medical Supplies	$165,243,296	$165,241,546	$1,750
Bad Debt Expenses	$80,633,206	$80,633,206
LPPF SUPPLEMENTAL PAYMENTS	$95,575,081		$95,575,081
PHYSICIAN REMUNERATION	$34,134,220	$33,855,495	$278,725

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$34,663,929	TotalAmt
Program Services	$18,276,090	ProgramServicesAmt
Management And General	$16,387,839	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,350,787,048	TotalAmt
Program Services	$929,689,482	ProgramServicesAmt
Management And General	$421,097,566	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$16,350	BOYAmt
EOY	$16,501	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$813,189,653	BOYAmt
EOY	$634,351,404	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$210,785,197	BOYAmt
EOY	$257,360,190	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$6,464,746	BOYAmt
EOY	$7,144,706	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$14,491,511	BOYAmt
EOY	$15,091,349	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$643,447	BOYAmt
EOY	$264,129	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$1,330,112,679	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$662,723,580	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$603,566,875	BOYAmt
EOY	$667,389,099	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$6,212,941	BOYAmt
EOY	$7,924,814	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$6,682,491	BOYAmt
EOY	$5,939,992	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$209,847,857	BOYAmt
EOY	$124,528,819	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,871,901,068	BOYAmt
EOY	$1,720,011,003	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$89,834,410	BOYAmt
EOY	$110,185,596	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$150,545	BOYAmt
EOY	$116,392	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$494,289,995	BOYAmt
EOY	$481,113,684	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$39,959,813	BOYAmt
EOY	$65,208,786	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$624,234,763	BOYAmt
EOY	$656,624,458	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,247,666,305	BOYAmt
EOY	$1,063,386,545	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,247,666,305	BOYAmt
EOY	$1,063,386,545	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,871,901,068	BOYAmt
EOY	$1,720,011,003	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$421,285,787	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	-$605,565,547	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Organization Belongs Afflt Grp	Yes (X)	OrganizationBelongsAffltGrpInd

Total Grassroots Lobbying TotalGrassrootsLobbyingGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$0	FilingOrganizationsTotalAmt
Affiliated Group Total	$0	AffiliatedGroupTotalAmt

Total Direct Lobbying TotalDirectLobbyingGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$0	FilingOrganizationsTotalAmt
Affiliated Group Total	$203,050	AffiliatedGroupTotalAmt

Total Lobbying Expend TotalLobbyingExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$0	FilingOrganizationsTotalAmt
Affiliated Group Total	$203,050	AffiliatedGroupTotalAmt

Other Exempt Purpose Expend OtherExemptPurposeExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$1,350,787,048	FilingOrganizationsTotalAmt
Affiliated Group Total	$3,058,073,223	AffiliatedGroupTotalAmt

Total Exempt Purpose Expend TotalExemptPurposeExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$1,350,787,048	FilingOrganizationsTotalAmt
Affiliated Group Total	$3,058,276,273	AffiliatedGroupTotalAmt

Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$1,000,000	FilingOrganizationsTotalAmt
Affiliated Group Total	$8,223,544	AffiliatedGroupTotalAmt

Grassroots Nontaxable GrassrootsNontaxableGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$250,000	FilingOrganizationsTotalAmt
Affiliated Group Total	$2,055,887	AffiliatedGroupTotalAmt

Field	Value	IRS element (for citing)
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp

Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp

Field	Value	IRS element (for citing)
Current Year Minus1	$1,000,000	CurrentYearMinus1Amt
Current Year	$1,000,000	CurrentYearAmt
Total	$2,000,000	TotalAmt

Field	Value	IRS element (for citing)
Lobbying Ceiling	$3,000,000	LobbyingCeilingAmt

Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp

Field	Value	IRS element (for citing)
Current Year Minus1	$0	CurrentYearMinus1Amt
Current Year	$0	CurrentYearAmt
Total	$0	TotalAmt

Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp

Field	Value	IRS element (for citing)
Current Year Minus1	$250,000	CurrentYearMinus1Amt
Current Year	$250,000	CurrentYearAmt
Total	$500,000	TotalAmt

Field	Value	IRS element (for citing)
Grassroots Ceiling	$750,000	GrassrootsCeilingAmt

Avg Grassroots Lobbying Expend AvgGrassrootsLobbyingExpendGrp

Field	Value	IRS element (for citing)
Current Year Minus1	$0	CurrentYearMinus1Amt
Current Year	$0	CurrentYearAmt
Total	$0	TotalAmt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Donor Advised Funds Held	1	DonorAdvisedFundsHeldCnt
Donor Advised Funds Contri	$7,550	DonorAdvisedFundsContriAmt
Donor Advised Funds Vl EOY	$266,669	DonorAdvisedFundsVlEOYAmt
Disclosed Org Leg Ctrl	Yes (true)	DisclosedOrgLegCtrlInd
Disclosed For Charitable Prps	Yes (true)	DisclosedForCharitablePrpsInd
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$145,006,389	BeginningYearBalanceAmt
Contributions	$777,244	ContributionsAmt
Investment Earnings Or Losses	$4,022,829	InvestmentEarningsOrLossesAmt
Other Expenditures	$1,647,900	OtherExpendituresAmt
End Year Balance	$148,158,562	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$111,257,225	BeginningYearBalanceAmt
Contributions	$503,149	ContributionsAmt
Investment Earnings Or Losses	$35,878,832	InvestmentEarningsOrLossesAmt
Other Expenditures	$2,632,817	OtherExpendituresAmt
End Year Balance	$145,006,389	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$116,417,669	BeginningYearBalanceAmt
Contributions	$1,190,873	ContributionsAmt
Investment Earnings Or Losses	$4,368,488	InvestmentEarningsOrLossesAmt
Other Expenditures	$10,719,805	OtherExpendituresAmt
End Year Balance	$111,257,225	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$111,568,298	BeginningYearBalanceAmt
Contributions	$545,683	ContributionsAmt
Investment Earnings Or Losses	$5,290,113	InvestmentEarningsOrLossesAmt
Other Expenditures	$986,425	OtherExpendituresAmt
End Year Balance	$116,417,669	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$95,010,517	BeginningYearBalanceAmt
Contributions	$9,396,884	ContributionsAmt
Investment Earnings Or Losses	$8,367,517	InvestmentEarningsOrLossesAmt
Other Expenditures	$1,206,620	OtherExpendituresAmt
End Year Balance	$111,568,298	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.40210	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.52950	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.06840	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (true)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (true)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$21,503,546	OtherCostOrOtherBasisAmt
Book Value	$21,503,546	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$880,972,616	OtherCostOrOtherBasisAmt
Depreciation	$431,448,604	DepreciationAmt
Book Value	$449,524,012	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$0	OtherCostOrOtherBasisAmt
Book Value	$0	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$256,247,615	OtherCostOrOtherBasisAmt
Depreciation	$218,923,578	DepreciationAmt
Book Value	$37,324,037	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$171,388,902	OtherCostOrOtherBasisAmt
Depreciation	$12,351,398	DepreciationAmt
Book Value	$159,037,504	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$667,389,099	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDesc	Book ValueBookValueAmt
Assets Limited to Use	$29,414,751
Other Receivables	$3,036,084
Supplemental Assets	$83,672,876
Rights of Use Assets	$8,368,960
Intercompany Receivables	$36,148

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$124,528,819	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
Est Due to Third Parties	$56,715,695
Right of Use Liability	$8,493,091

Field	Value	IRS element (for citing)
Total Liability	$65,208,786	TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt	$1,726,411,513	TotalRevEtcAuditedFinclStmtAmt
Other Revenue	-$44,149,025	OtherRevenueAmt
Revenue Not Reported	-$44,149,025	RevenueNotReportedAmt
Revenue Subtotal	$1,770,560,538	RevenueSubtotalAmt
Other Revenues Not Included	$1,512,297	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$1,512,297	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$1,772,072,835	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$1,288,611,046	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$18,457,204	OtherExpensesIncludedAmt
Expenses Not Reported	$18,457,204	ExpensesNotReportedAmt
Expenses Subtotal	$1,270,153,842	ExpensesSubtotalAmt
Other Expenses Not Included	$80,633,206	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$80,633,206	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$1,350,787,048	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE D, PART V, LINE 4	INTENDED USE OF ENDOWMENT FUNDS: COOK CHILDREN'S HAS ADOPTED INVESTMENT AND SPENDING POLICIES FOR ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO PROGRAMS AND OTHER ITEMS SUPPORTED BY ITS ENDOWMENT WHILE SEEKING TO MAINTAIN THE PURCHASING POWER OF THE ENDOWMENT. UNDER COOK CHILDREN'S POLICIES, ENDOWMENT ASSETS ARE INVESTED IN A MANNER THAT IS INTENDED TO PRODUCE AN AMOUNT THAT IS EQUAL TO A RETURN HURDLE DEFINED AS THE SPENDING RATE plus inflation over a rolling seven-year period, as well as show favorable performance characteristics relative to other market indiCES weighted for asset allocations as well as similarly managed funds. ACTUAL RETURNS IN ANY GIVEN YEAR MAY VARY FROM THIS AMOUNT. TO SATISFY ITS LONG-TERM RATE OF RETURN OBJECTIVES, COOK CHILDREN'S RELIES ON A TOTAL RETURN STRATEGY IN WHICH INVESTMENT RETURNS ARE ACHIEVED THROUGH BOTH CURRENT YIELD (INVESTMENT INCOME SUCH AS DIVIDENDS AND INTEREST) AND CAPITAL APPRECIATION (BOTH REALIZED AND UNREALIZED). COOK CHILDREN'S TARGETS A DIVERSIFIED ASSET ALLOCATION THAT PLACES A GREATER EMPHASIS on public and private EQUITY-BASED INVESTMENTS TO ACHIEVE ITS LONG-TERM RETURN OBJECTIVES WITHIN PRUDENT RISK CONSTRAINTS. COOK CHILDREN'S HAS A POLICY (THE SPENDING POLICY) in where W.I. Cook Foundation, Inc. may make available EACH YEAR OF UP TO 5% OF THE FOUNDATION'S INVESTMENTS AVERAGE FAIR VALUE OVER THE PRIOR 5 YEARS ENDED JUNE 30 PRECEDING THE YEAR IN WHICH THE EXPENDITURE IS PLANNED AND/OR ACCORDING TO THE DONOR REQUIREMENTS AS SET FORTH IN EACH ENDOWMENT DOCUMENT. IN ESTABLISHING THIS POLICY, COOK CHILDREN'S CONSIDERED THE LONG-TERM EXPECTED RETURN ON ITS ENDOWMENT. ACCORDINGLY, OVER THE LONG TERM, COOK CHILDREN'S EXPECTS THE CURRENT SPENDING POLICY TO ALLOW ITS ENDOWMENT TO GROW AT THE RETURN HURDLE. THIS IS CONSISTENT WITH COOK CHILDREN'S OBJECTIVE TO MAINTAIN THE PURCHASING POWER OF ENDOWMENT ASSETS HELD IN PERPETUITY OR FOR A SPECIFIED TERM, AS WELL AS TO PROVIDE ADDITIONAL REAL GROWTH THROUGH NEW GIFTS AND INVESTMENT RETURN.
SCHEDULE D, PART XI, LINE 2d	Reconciliation of audited revenue to form 990 revenue: Bad Debt expense: (80,633,206) Interest Rate SWAP Adjustment: 4,434,453 joint venture revenue: 32,049,728 --------------- (44,149,025)
Schedule D, Part XI, Line 4b	RECONCILIATION OF AUDITED revenue to form 990 revenue: Additional Gain on Disposal of Asset: 90,527 Additional Contributions from Foundation: 2,872,974 Direct Rent Expenses: (1,451,204) ------------ 1,512,297
Schedule D, Part XII, Line 2D	Reconciliation of audited expenses to form 990 expenses: direct rent expenses: 1,451,204 Additional gain on Disposal of Asset (90,527) Joint Venture Expenses 17,096,527 ----------------- 18,457,204
SCHEDULE D, PART XII, LINE 4B	Reconciliation of audited expenses to form 990 expenses: Bad Debt Expense: 80,633,206
Schedule D, Part X, Line 2	ASC 740 Footnote: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE Financial statements.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	400.	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Discounted Care Other	500.	DiscountedCareOtherPct

Field	Value	IRS element (for citing)
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	false	FinancialAssistanceBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$11,010,358	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,353,201	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$8,657,157	NetCommunityBenefitExpnsAmt
Total Expense	0.00680	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$665,761,692	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$643,355,002	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$22,406,690	NetCommunityBenefitExpnsAmt
Total Expense	0.01760	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$676,772,050	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$645,708,203	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$31,063,847	NetCommunityBenefitExpnsAmt
Total Expense	0.02440	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,336,734	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$19,644	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,317,090	NetCommunityBenefitExpnsAmt
Total Expense	0.00500	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$293,807	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$159,146	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$134,661	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$431,011	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$431,011	DirectOffsettingRevenueAmt

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$82,606,901	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$82,606,901	NetCommunityBenefitExpnsAmt
Total Expense	0.06500	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$89,668,453	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$609,801	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$89,058,652	NetCommunityBenefitExpnsAmt
Total Expense	0.07010	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$766,440,503	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$646,318,004	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$120,122,499	NetCommunityBenefitExpnsAmt
Total Expense	0.09450	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$20,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$20,000	NetCommunityBenefitExpnsAmt

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$38,825	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$38,825	NetCommunityBenefitExpnsAmt

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$491,003	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$491,003	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$549,828	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$549,828	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$80,633,206	BadDebtExpenseAmt
Reimbursed By Medicare	$7,773,811	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$8,889,710	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$1,115,899	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)

Primary ActivitiesPrimaryActivitiesTxt	Org Profit Or OwnershipOrgProfitOrOwnershipPct	Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
CC PEDIATRIC SURGERY
SURGERY CENTER	0.54663	0.03146
CC SURGERY CENTER
SURGERY CENTER	0.51256	0.32161

Field	Value	IRS element (for citing)
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	COOK CHILDREN'S MEDICAL CENTER	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	801 SEVENTH AVE	AddressLine1Txt
City	FORT WORTH	CityNm
State Abbreviation	TX	StateAbbreviationCd
ZIP	76104	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.COOKCHILDRENS.ORG	WebsiteAddressTxt
State License	000332	StateLicenseNum
Childrens Hospital	Yes (X)	ChildrensHospitalInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	COOK CHILDREN'S MEDICAL CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	21	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART V, SECTION C	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	WWW.CENTERFORCHILDRENSHEALTH.ORG	OtherWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	21	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V, SECTION C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	400.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	500.	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, SECTION C	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr Prvt	Yes (X)	LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5	Input from representatives of the community: The initial Cook Children's Community-Wide Children's Health Assessment and Planning Survey (CCHAPS) was conducted in 2009 and every three years thereafter (2012, 2015, 2018 and 2021). Our methodology varies slightly among assessment years but always includes gathering data from multiple sources representing our community. Overall, our Community Health Needs Assessment (CHNA) methodology includes a survey of parents of children ages 0-17, a community leader survey, and focus groups outlined in the table below. We also gather feedback from community coalition members through facilitated discussions at regular meetings and at eight child health summits that we host to present the data to our various communities. In addition, Cook Children's collects data from publicly available sources to supplement perceptions of children's health obtained through the parent and community leader surveys, focus groups and/or community meetings. The 2021 CHNA parent survey was administered through an outside vendor (ETC Institute) to a statistically representative sample of parents with children ages 0-17 living in our primary service region (Collin, Denton, Grayson, Hood, Johnson, Parker, Tarrant, and Wise counties). The large sample size (5,715 completed surveys) provides statistically representative results applicable to all eight counties individually and collectively with a low margin of error (+/- 1.3%; 95% CI). The survey is administered through mail, telephone, and internet communications and ETC monitors responses to ensure that representation is similar to general population demographics in terms of total population in each geographic area, race/ethnicity, marital status, income, and education level. In order to assess the health of children living in families that are traditionally underrepresented in mail and telephone surveys, a research team from the Evaluation and Outcomes Division of My Health My Resources of Tarrant County (MHMRTC) administered the parent survey to an intentional sample of caregivers within families experiencing homelessness in shelters or within families with at least one undocumented member at several Tarrant County homeless shelters (229 completed surveys). A team from University of North Texas Health Science Center at Fort Worth's School of Public Health conducted six virtual focus groups and one interview with parents (total of 22 parents/caregivers) across the eight-county service area. Community partners and program staff within the Center for Children's Health helped advertise and refer participants via email. These focus groups provided an opportunity for parents and caregivers to share additional information beyond questions within in the parent survey. Priority topics within these focus groups included asthma, oral health, mental health, healthy lifestyles, injury prevention, parenting support, COVID-19 and equitable access to care. The Center for Transforming Lives conducted a survey of families with children from birth to age 17 who were living within motels or extended-stay properties throughout Tarrant County from February to October 2021. Seventy families completed the anonymous surveys on-site at the motel locations. ETC Institute also conducted a survey with community leaders to obtain their feedback about the status of children's health. Surveys were mailed to 1,881 community leaders representing city and county governments, public agencies, not-for-profit organizations, independent school districts, faith based/clergy, and health care professionals. We received 306 responses (16% response rate). A complete list of who received the opportunity to participate in the leader survey is available upon request. Virtual interviews with 20 community leaders across the eight-county service area were also conducted. Leaders were recruited based on their expertise and diverse roles within the community. Interviewees discussed pressing issues or concerns in the community, providing additional context for the community leader and parent survey findings. Priority topics discussed during the interviews included the impact of COVID-19, mental health, ACEs, housing and food security, healthy lifestyles, injury prevention, and equitable access to health care. Based on the 2009 initial assessment results, Cook Children's Board of Trustees prioritized children's health issues identified by parents and community leaders and findings from subsequent CHNA processes in 2012, 2015, 2018, and 2021 confirmed the importance of these issues for continuing focused intervention: - Equitable access to health care - Oral Health - Mental Health - Healthy Lifestyles (obesity prevention) - Parenting and Family Support (abuse and neglect prevention) - Injury Prevention - Asthma Cook Children's continues to use the 2021 CHNA findings to assess parent and community leader perceptions of children's health needs and to inform our community health outreach and community engagement efforts. The 2024 CHNA is currently in development and will be completed and posted by September 30, 2025.
Schedule H, Part V, Section B, Line 6a	CHNA CONDUCTED WITH OTHER HOSPITAL FACILITIES: This 2021 Community Health Needs Assessment report is intended to serve as a joint assessment for the main Cook Children's Medical Center in Fort Worth and the new Cook Children's Medical Center in Prosper, opening in the fall of 2022. The Fort Worth Medical Center's primary service area encompasses Denton, Hood, Johnson, Parker, Tarrant and Wise counties. The Prosper Medical Center serves the primary counties of Collin, Denton and Grayson. Our 2021 assessment intentionally collected data in Collin and Grayson counties to represent those communities in the Prosper service area. Denton County falls within both the Fort Worth and Prosper service areas.
SCHEDULE H, Part V, Section B, Line 6b	Other Organizations other than Hospital Facilities: External vendors used to conduct the parent and community leader surveys included The Center for Transforming Lives, ETC Institute, Inc., My Health My Resources of Tarrant County, and University of North Texas Health Science Center. No other organizations were involved other than these contracted surveyor entities and no other organizations are able to use this assessment to fulfill CHNA requirements.
SCHEDULE H, PART V, SECTION B, LINE 11	HOW WE ARE ADDRESSING SIGNIFICANT NEEDS: Cook Children's created the Center for Children's Health in 2011 to provide an infrastructure for using children's health assessment data to guide community programs and stakeholder collaborations that prevent illness, disease and injuries for children. The center oversees a regular community health needs assessment, community research and community health outreach. All three categories of Center activities are focused on increasing access to preventive services for underserved populations. The Center for Children's Health develops strategies for addressing targeted children's health priorities through research and an infrastructure that supports effective delivery of community and family services. Our services are data driven, evidence-informed and provided using high standards of community practice and service delivery. Recognizing that Cook Children's cannot solve complex children's health needs alone, we lead coalitions and support partnerships in every county within our primary service region to involve community partners in identifying health needs, and developing and implementing sustainable solutions. Collaborations are structured according to principles that research indicates are effective characteristics for successful community collaborations, including a commitment to using strategic plans to guide implementation of strategies, diverse representation within each community, and facilitating decisions guided by members according to formal coalition bylaws and meeting guidelines. Collaborations led by the Center for Children's Health include: - ACEs Task Force - Children's Oral Health Coalition - Lifeguard Your Child (Drowning Prevention Campaign) - Healthy Children Coalition of Parker County - Hood County for Healthy Children - Johnson County Alliance for Healthy Kids - Safe Baby Sleep Council - Safe Kids North Texas-Fort Worth - SaVe a Smile - Wise Coalition for Healthy Children - Wellness Alliance for Total Children's Health of Denton County 2021 CHNA parent and community leader survey findings support Cook Children's continued focus on family outreach programs that address the children's health issues identified in our initial parent survey process in 2009. The family services addressing priority children's health needs are provided using evidence-based/informed practices, including strict adherence to regulatory requirements, implementing proven program designs, obtaining appropriate staff certifications or licensures, providing adequate supervision, practicing accurate and confidential record-keeping, and conducting ongoing formal evaluation. Recognizing the need to improve access to care for vulnerable populations, the Center for Children's Health focuses all programming listed in the following sections to families identified as high-risk either due to low income or high prevalence of health risk factors. Equitable Access to Health Care Goal: Improve overall health for children and increase equitable access to quality health care - Ensure that C4CH programs and community involvement exemplify Cook Children's Promise. Community Strategies - Monitor and identify priority children's health issues in Cook Children's 6-county FWSA/3-county PSA to guide equitable service delivery program designs > Held 6 local and 2 regional CHNA Summits to share findings from the 2021 CHNA. > Rolling data collection is in progress for the 2024 CHNA by administering the parent survey among a purposeful sample of caregivers and families across the 8-county region. - Draw on the power of community partnerships to increase the reach for equitable health care information and services to disproportionally impacted populations (C4CH Coalitions) > The Homeless Initiative addresses unmet health and psycho-social needs of children living in three shelters in Tarrant County by providing a medical home and a case management model to coordinate health and social services. > Cook Children's is regularly represented at community initiatives throughout our region addressing various child health issues. > The Center for Children's Health distributed 332,529 educational resources and 181,567 prevention tools through community events and community partners in FY22. - Lead community coalitions with multi-sector, geographically diverse membership. > The Center for Children's Health led over 800 community events and engaged over 600 community partners to promote the health and safety of children. - Maintain focus of C4CH service delivery programs designs on the principles of community collaboration, evidence-based information and practices, and reducing health disparities and inequities. - The Center for Children's Health contributes funding to the Immunization Collaboration of Tarrant County to provide easy access to immunizations for children from low-income families in Tarrant County. The collaboration hosts a multi-week event during August and September, with the help of nearly 100 volunteers to immunize approximately 6,000+ children each year. - The Center for Children's Health provides regular communication about health information to families and community partners through Checkup Magazine, YouTube videos, and presentations. - The Center maximizes the power of Cook Children's integrated health system by developing close partnerships with Neighborhood Clinics, Cook Children's Health Plan, and other departments offering case management services to distribute health and wellness messages and prevention tools. - The Center for Children's Health and Cook Children's Health Plan expanded their partnership with the addition of a C4CH/CCHP Liaison. This liaison has held multiple stakeholder meetings, educated children and families on prevention efforts to help keep their children healthy and safe, and assisted with resource distributions. In FY22, CCHP staff distributed 19,714 C4CH resources to members and potential members and provided 168 hours of support at C4CH meetings and events. - Community Health Workers (CHWs) are an integral piece to the success of several C4CH programs including Build-a-Bridge, Save-A-Smile, and Healthy Homes by connecting families to needed resources and support services to increase access to care. In FY22, CHWs provided 5,660 social services to families to help them meet basic needs and address social determinants of health and were responsible for 477 community referrals provided to families connecting them to basic needs and health services. CHWs, along with other C4CH staff, served 21,616 children, families, and partners. Additional information related to increasing access to care is also addressed throughout each of the remaining six focus areas discussed below. Oral Health Goal: Improve child oral health - Respond to the urgent needs of children at increased risk of poor oral health Community Strategies - Lead and sustain the Save a Smile Advisory Committee; and the Children's Oral Health Coalition (COHC) to plan and implement oral health collaborative interventions. The coalition's Legislative Advocacy committee monitors state and national legislative issues, especially those supporting expanded access to dental care for low-income children. - Develop and distribute evidence-informed oral health resources to educate families, medical/dental providers and other community partners. - Continue Save a Smile programming to conduct limited oral health evaluations for low-income children; identify those with acute dental problems in targeted schools; and provide comprehensive social and dental treatment services. - Provide evidence-based training to caregivers and children; pregnant women; school nurses; medical/dental providers; and other community partners. - Facilitate and track community-level oral health screening outcomes. - Reduce barriers to oral health care for pregnant teens and women. - Explore potential partnership with Renaissance Dental Clinic to expand patient family education opportunities. - Support community awareness campaigns and events to encourage good oral health Mental Health Goal: Increase access to services for child mental health and well-being - Respond to the increasing critical need for mental health services to serve children Community Strategies - Lead and sustain the Wellness Alliance for Total Children's Health (WATCH) to plan and implement mental health collaborative interventions, targeting high-risk populations. - Sustain a strong community network of quality mental health services to support mental health services and treatment (Mental Health Connection). - Provide professional development opportunities for mental health providers who will share skills, knowledge, and tools with colleagues and caregivers within their reach (Wellness Workshops). - Develop and implement evidence-informed education and interventions for caregivers, children and adolescents to expand the reach of mental health messaging and strengthen connections to health care and commun
Schedule H, Part V, Section B, lines 7a & 10a	CHNA & Implementation strategy availability: The CHNA and implementation strategy are available upon request and at the following address: www.cookchildrens.org/about/community-outreach/pages/community-health-need s-assessment.aspx
Schedule H, Part V, Section B, lines 16a, 16b & 16c	Financial assistance documents: The financial assistance policy, application and plain language summary are available at the following address: https://www.cookchildrens.org/patients/billing-insurance/pages/financial-a ssistance.aspx

Field	Value	IRS element (for citing)
Facility	2	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
CENTER FOR PEDIATRIC SURGERY
4200 W UNIVERSITY DRIVE STE 110	PROSPER	TX	75078	AMBULATORY SURGERY CENTER
COOK CHILDREN'S SURGERY CENTER
6313 PRECINCT LINE RD	HURST	TX	76054	AMBULATORY SURGERY CENTER

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART III, SECTION A, LINE 2	Bad debt expense: We record self-pay accounts at the full expected amount. Each account goes through the collection process as necessary. An allowance is established based on historical experience.
SCHEDULE H, PART III, SECTION A, LINE 3	Bad debt as a community benefit: Bad debt, in whole or in part, should be included in community benefit given the tangible and measurable benefit of the underlying services provided to, primarily, underserved members of our community. For instance, we have a significant non-insured, undocumented worker population that may not participate in the charity or medically indigent discount qualification process due to concerns about their immigration status. We provide critical inpatient, emergency room, and outpatient services to this demographic for little or no reimbursement and without regard for their ability to pay, but receive no community benefit consideration. At a minimum, hospitals should have the opportunity to delineate how much bad debt stems from non-insured patients and then be given community benefit consideration for the cost burden associated with providing these needed services knowing that we have already done all we can with regard to screening patients for charity and medically indigent discounts and written the patients' balances off as such.
SCHEDULE H, PART III, SECTION A, LINE 4	Bad debt footnote: Footnote disclosure regarding the treatment of bad debts is located on page 20 of the most recent audited financial statements attached to this form.
SCHEDULE H, PART III, SECTION B, LINE 8	Medicare shortfall and cost reported: The Medicare shortfall should be considered community benefit since it is representative of the non-covered cost of patient care that hospitals are using to justify the need for their tax exempt status. Presenting the Medicare shortfall in the community benefit section allows regulators and the public to see the unfunded costs of services that hospitals provide to community members. This presentation would help the community better understand that in the absence of a tax exempt status (which in effect is granted to them by the public), the hospitals would have to look to the community to fund the shortfall or risk losing valued hospital services. The ratio of cost to charges used in the calculation of costs for Medicare was taken from the Medicare cost report.
SCHEDULE H, PART III, SECTION C, LINE 9B	COLLECTION PRACTICES: THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE.
SCHEDULE H, PART VI, LINE 2	Needs assessment: Although various departments within Cook Children's periodically conduct patient needs assessments for specific medical specialties, the parent survey for our Community Health Needs Assessment, also known as the Community-wide Children's Health Assessment & Planning Survey (CCHAPS) as reported in Part V, Section B-is the only community-wide children's health needs assessment conducted by our health system.
SCHEDULE H, PART VI, LINE 3	Patient education of eligibility for assistance: English and Spanish versions of a one-page document explaining the charity care offered at Cook Children's are posted in each of the patient registration areas, the emergency room, urgent care, and medical office building. This document includes information on the following: 1. How one might qualify for financial assistance; 2. Explains qualification is determined by family size and income; and, 3. Guides families to contact the patient accounting department to apply for financial assistance. A financial counselor will assist all self-pay inpatients, observation stays and scheduled procedures, screening them for various government programs, such as Medicaid and Chip. In addition, a financial counselor will assist any patient that presents to registration for financial assistance, providing them with a Medicaid application and reviewing the charity policy. Patient representatives and Case Management personnel also direct families to the patient registration staff when they need financial assistance. In addition, the financial assistance policy, explanation of amounts generally billed and the charity application are posted on the Cook Children's website at www.cookchildrens.org. The charity application is posted in both English and Spanish versions.
SCHEDULE H, PART VI, LINE 4	Community Information: Cook Children's eight-county service region is based in North Central Texas and comprises Collin, Denton, Grayson, Hood, Johnson, Parker, Tarrant, and Wise Counties. Cook Children's evaluates the statistics describing our community and representing our population served with every Community Health Needs Assessment (CHNA). For Fiscal Year 2022, all information provided is in response to our 2021 CHNA. Furthermore, the statistics described within this section reflect those reported in our 2021 CHNA. Please note: Our 2024 CHNA is currently in development and will be approved and posted by September 30, 2025. The U.S. Census Bureau classifies these counties as follows: Collin County-mostly urban, 5% rural; Denton County-mostly urban, 7% rural; Grayson County-rural 43%; Hood County-mostly urban, 33% rural; Johnson County-mostly urban, 38% rural; Parker County-rural 56%; Tarrant County-mostly urban, 1% rural and Wise County-mostly rural 72% (1). The FWSA total population of 3,309,223 includes 972,470 children from birth to age 17, while the PSA total population of 1,938,813 includes 512,680 children from birth to age 17. Overall, this eight-county region is home to a diverse population of 4,414,214 people, and 1,269,810 (28%) are children 17 years and younger (2). Of those 1,269,810 children ages 0-17, there are 265,400 children living in Collin County; 215,340 in Denton County; 31,940 in Grayson County; 12,230 in Hood County; 145,140 in Johnson County; 36,070 in Parker County; 547,340 in Tarrant County; and 16,350 in Wise County (2). The annual median income for families with children under age 18 range between $63,311 in Grayson County to $117,935 in Collin County (2). Of the 1,269,810 children under age 18 living in the region, nearly 150,000 (12%) live in households with income below the poverty level, and children in households that receive Supplemental Security Income (SSI), cash public assistance or food stamps/SNAP benefits ranges from 8% in Collin County to 27% in Grayson County. Of the 1,269,810 children under age 18 living in the region, between 8%-27% live in households that receive Supplemental Security Income (SSI), cash public assistance, or Food Stamps/SNAP benefits (2). The information below reflects race and ethnicity by county within our region. 2021 U.S. Census Estimates of Race and Ethnicity (Children under 18 years) (2) . Asian: Collin 16.2%; Denton 9.6%; Grayson 1.7%; Hood 0.7%; Johnson 5.2%; Parker 0.7%; Tarrant 5.6%; Wise 0.6% . Black/African American: Collin 10.3%; Denton 9.9%; Grayson 6%; Hood 0.8%; Johnson 4.7%; Parker 1.0%; Tarrant 16.8%; Wise 1.3% . Other Race/Two or More Races: Collin 0.5%; Denton 0.5%; Grayson 0.5%; Hood 1.0%; Johnson 0.2%; Parker 0.5%; Tarrant 0.8%; Wise 0.6% . White: Collin 55.0%; Denton 57.6%; Grayson 74.6%; Hood 84.2%; Johnson 79.3%; Parker 82.6%; Tarrant 45.2%; Wise 76.8% . Hispanic or Latino (Any Race): Collin 15.5%; Denton 19.6%; Grayson 14.2%; Hood 12.4%; Johnson 7.9%; Parker 13.0%; Tarrant 29.5%; Wise 19.3% The Cook Children's eight-county service region contains three medically underserved areas and two medically underserved populations as defined by the Health Resources & Services Administration. These areas are: Medically Underserved Areas (3) . Denton County: Known as Poverty Population by Service Area Name, Medical Underservice Score is 0 (Governor's Exception), Rural Status is Non-Rural . Tarrant County: Known as Diamond Hill Service Area by Service Area Name, Medical Underservice Score is 57.5, Rural Status is Non-Rural . Tarrant County: Known as Fort Worth-North by Service Area Name, Medical Underservice Score is 58, Rural Status is Non-Rural Medically Underserved Population (3) . Grayson County: Known as Low Income-Grayson County by Service Area Name, Medical Underserved Score is 61, Rural Status is Partially Rural . Tarrant County: Known as Low Inc-East Side by Service Area Name, Medical Underserve Score is 59.8, Rural Status is Non-Rural
SCHEDULE H, PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH: In FY2022, the Center for Children's Health led 812 health outreach events serving over 33,000 children, families, and community partners. These outreach events include education or activities around the prioritized health issues identified in the findings from our first formal community health needs assessment in 2009, which include: - Equitable access to health care - Oral Health - Mental Health - Healthy Lifestyles (obesity prevention) - Parenting and Family Support (abuse and neglect prevention) - Injury Prevention - Asthma In FY2022 our community partners and volunteers gave over 4,200 hours of volunteer support to the Center for Children's Health, totaling a value of $130,000. Out of our 812 health outreach events, over 650 were coalition, workgroup, and stakeholder meetings, trainings, and workshops that we led through our collaborations below: - ACEs Task Force - Children's Oral Health Coalition - Lifeguard Your Child (Drowning Prevention Campaign) - Healthy Children Coalition of Parker County - Hood County for Healthy Children - Johnson County Alliance for Healthy Kids - Safe Baby Sleep Council - Safe Kids North Texas - Save a Smile - Wise Coalition for Healthy Children - Wellness Alliance for Total Children's Health of Denton County Selected highlights of our work in FY2022 to improve the health of children and families in the community include: - Over 6,600 children received a limited oral health evaluation and over 1,800 dental procedures were provided to children with dental disease for a total value of $255,000. - Provided over 355 car seat checks to families in need - Provided 452 continued education credits to over 255 community professionals at our mental health education workshops. - Coordinated and engaged 545+ volunteers and collaboration members. - Provided 5,660 support services and over 470 community referrals to families, meeting needs for food, rent and utilities assistance, school supplies, and mental health. - Distributed 514,096 prevention and educational resources at a value of $652,902 to families and community partners. - Supported 358 events coordinated by community partners.
SCHEDULE H, PART VI, LINE 6	Affiliated Health Care System: Cook Children's also operates seven neighborhood clinics providing primary care to underserved populations around the city's perimeter and inner city to help assure care is provided in the most appropriate setting. Both preventive and therapeutic dental health care are provided to underserved populations. Mental and behavioral health is provided in both inpatient and outpatient settings subsidized by Cook Children's. Cook Children's Health Plan is a contracted intermediary for Medicaid managed care and Chip, providing an open provider panel for all eligible children in the six-county primary service area. Cook Children's Home Health offers pediatric-specific home care to assure care is provided in the most appropriate and lowest cost setting.
SCHEDULE H, PART VI, LINE 7	STATE FILING OF COMMUNITY BENEFIT REPORT: Texas
Schedule H, Part I, Line 7, Column (F)	Bad debt expense of $80,633,206 was included on form 990, Part IX, line 25, column (A), but was subtracted from total expense for the calculation of "percent of total expense" in this column.
Schedule H, Part II, Lines 1-10	Community Building Activities: Physical Improvements and Housing: Cook Children's is located in the Near South Side of Fort Worth which includes the Medical District as well as a diverse mix of residential neighborhoods. To address neighborhood improvement needs, Cook Children's is a member of Fort Worth South, Inc., a nonprofit organization that partners with the city of Fort Worth and other community organizations to advance educational initiatives, public policies, and community programs that foster a revitalized and safe central city. Strategic planning has resulted in improved security, code enforcement, and transportation for residents and employees who work in the area. Coalition Building: Cook Children's is the lead organization for the Wellness Alliance for Total Children's Health of Denton County ("WATCH"). WATCH of Denton County is a collaboration of both public and private organizations and individuals who are invested in the total wellness of Denton County's children. WATCH currently works to increase awareness of and access to mental health services in Denton County. Cook Children's is also a participant in the Denton County Behavioral Health Leadership Team which advocates and facilitates a collaborative person-centered behavioral health system to repair and restore lives by ensuring behavioral health services are available to meet the needs of all, assessing data for continuous outcome measurements, prioritizing data driven recommendations, and providing a continuum of care in Denton County. Cook Children's is also a participant in the Intellectual and Developmental Disabilities Council of Tarrant County which is a community coalition of providers, public officials, families, and self-advocates who have come together to increase opportunities for people with intellectual disabilities in our community. Community Health Improvement Advocacy: Advocacy efforts by Cook Children's are enhanced through membership in various local, state, and national organizations. Issues addressed include community needs assessment, access to health care and insurance for underserved populations, and advocacy for specific health issues such as child abuse and neglect and preventable injuries. Over 1,000 hours were contributed to multiple coalitions, committees, and councils for FYE 2022.
Schedule H, Part I, Line 7	Financial Assistance & Certain Community Benefits at Cost: Line 7a is calculated using worksheet 1 and the cost to charge ratio. Line 7b Medicaid Shortfall is calculated using worksheet 3 and the cost to charge ratio. Lines 7e - i are calculated using the hospital's internal activity reports.
Schedule H, Part I, Line 3C	Cook Children's also uses asset level, medical indigency, insurance status, underinsurance status, and residency in determining eligibility for free or discounted care.
SCHEDULE H, PART I, LINE 6A & 6B	Cook Children's conducts a CHNA and prepares a summary report every three years. The most recent CHNA was conducted in 2021, and the written CHNA report was posted in 2022. The 2021 CHNA report is available to the public on our website: (https://www.cookchildrens.org/about/community-outreach/community-health-n eeds-assessment/). The next CHNA (2024) is currently in development and will be posted by September 30, 2025.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (6 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
COOK CHILDREN'S PHYSICIAN NETWORK
801 SEVENTH AVENUE	FORT WORTH	TX	76104	752485366	501(C)(3)	$82,531,217	SUBSIDIZE OPERATIONS
JUNIOR LEAGUE OF FORT WORTH
255 BAILEY AVE	FORT WORTH	TX	76107	756022377	501(C)(3)	$35,000	SPONSOR
WARM PLACE
809 LIPSCOMB STREET	FORT WORTH	TX	76104	752220859	501(C)(3)	$25,000	SPONSOR
MARCH OF DIMES
po box 18819	ATLANTA	GA	31126	131846366	501(C)(3)	$15,000	SPONSOR
RONALD MCDONALD HOUSE
1001 8TH AVENUE	FORT WORTH	TX	76104	751754490	501(C)(3)	$10,000	SPONSOR
WINDSONG RANCH COMMUNITY
1001 WINDSONG PARKWAY SOUTH	PROSPER	TX	75078	465352001	501(C)(3)	$10,000	SPONSOR

Field	Value	IRS element (for citing)
Total501c3 Org	6	Total501c3OrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (10 entries)

Grant TypeGrantTypeTxt	RecipientRecipientCnt	Cash GrantCashGrantAmt
Medication	1845	$236,741
Transportation	1810	$75,906
LODGING	583	$66,690
Gift Cards	570	$58,182
UTILITIES	21	$4,144
MEALS	873	$20,256
MEDICAL EQUIPMENT	42	$11,600
BABY SUPPLIES	427	$39,966
Funeral services	133	$120,445
miscellaneous	11	$1,487

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE I, PART I, LINE 2	FormAndLineReferenceDesc
Explanation	PROCEDURES FOR MONITORING THE USE OF THE GRANT FUNDS IN THE US: THE ORGANIZATION USES PUBLIC AND PRIVATE DATA TO MONITOR THE USE OF FUNDS, AS NEEDED.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Idemnification Gross Up Pmts	Yes (X)	IdemnificationGrossUpPmtsInd
Written Policy Ref T And E Expnss	false	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (23 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DEBORAH BOUDREAUX
AVP Nursing	$219,517	$0	$53,852	$0	$15,143	$0	$8,639	$0	$37,702	$0	$334,853	$0	$0	$0
ORLANDO CHAPA
AVP Nursing	$229,270	$0	$54,265	$0	$13,738	$0	$21,750	$0	$17,079	$0	$336,102	$0	$0	$0
James C Cunningham MD
EVP, CMO	$0	$629,003	$0	$296,290	$0	$154,443	$0	$21,750	$0	$24,011	$0	$1,125,497	$0	$0
Nancy C Cychol
President/Chief Hospital Svcs	$621,692	$0	$290,193	$0	$143,098	$0	$21,750	$0	$11,260	$0	$1,087,993	$0	$0	$0
STANLEY E DAVIS
Sr. Vice President, COO	$388,649	$0	$169,422	$0	$61,018	$0	$85,128	$0	$39,191	$0	$743,408	$0	$43,697	$0
MARGIE DORMAN-O'DONNELL
Director, Case Management	$167,495	$0	$24,341	$0	$13,837	$0	$11,200	$0	$15,020	$0	$231,893	$0	$0	$0
JOSEPH M GALLAGHER
SR. VP, CHIEF LEGAL OFFICER	$0	$509,871	$0	$220,899	$0	$17,315	$0	$103,168	$0	$34,356	$0	$885,609	$0	$0
KEVIN GREENE
AVP NORTH CAMPUS	$156,487	$0	$35,617	$0	$2,809	$0	$8,081	$0	$34,548	$0	$237,542	$0	$0	$0
STEPHEN W KIMMEL
EVP, SYS FINANCE	$251,317	$376,973	$119,415	$179,122	$46,336	$69,506	$52,562	$78,840	$12,443	$18,661	$482,073	$723,102	$0	$82,928
NICHOLAS MARKHAM
AVP Facilities/Campus Svcs	$158,811	$0	$38,108	$0	$9,154	$0	$15,156	$0	$22,352	$0	$243,581	$0	$0	$0
MARY CARA MARTZ
Secretary	$0	$131,942	$0	$31,642	$0	$5,969	$0	$7,810	$0	$15,674	$0	$193,037	$0	$0
THERESA Z MEADOWS
Sr. VP, Chief Info Officer	$0	$452,928	$0	$193,410	$0	$89,769	$0	$21,750	$0	$33,113	$0	$790,970	$0	$0
RICK W MERRILL
Chief Executive Officer	$357,589	$919,515	$206,971	$532,212	$109,633	$281,912	$60,970	$156,781	$10,586	$27,219	$745,749	$1,917,639	$0	$0
Gary Munford
Day/Wknd Administrator	$209,588	$0	$4,000	$0	$8,003	$0	$12,774	$0	$24,002	$0	$258,367	$0	$0	$0
OZIOMA OLOWU
Director of Pharmacy	$188,058	$0	$29,276	$0	$11,545	$0	$12,288	$0	$36,888	$0	$278,055	$0	$0	$0
CHERYL PETERSEN
VP Nursing, CNO	$314,677	$0	$107,282	$0	$6,422	$0	$54,975	$0	$39,102	$0	$522,458	$0	$0	$0
CORY R RHOADES
CFO	$0	$475,794	$0	$204,726	$0	$59,962	$0	$97,819	$0	$35,862	$0	$874,163	$0	$42,740
SPENCER D SEALS
VP Construction & Real Estate	$0	$279,522	$0	$94,063	$0	$2,564	$0	$52,284	$0	$34,141	$0	$462,574	$0	$0
Tamara Sims
RN, Staff	$191,983	$0	$15,500	$0	$5,346	$0	$15,951	$0	$11,410	$0	$240,190	$0	$0	$0
JACK SOSEBEE
Vice President	$278,738	$0	$92,089	$0	$3,788	$0	$51,643	$0	$20,175	$0	$446,433	$0	$0	$0
TAMMY THOMLISON
AVP Revenue	$222,277	$0	$49,945	$0	$7,567	$0	$8,542	$0	$3,720	$0	$292,051	$0	$0	$0
ELIA VALENCIA-STOKES
AVP Finance	$252,426	$0	$61,543	$0	$11,605	$0	$8,304	$0	$38,054	$0	$371,932	$0	$0	$0
Jessica Sibr
Pharmacist	$193,946	$0	$0	$0	$3,171	$0	$13,312	$0	$25,575	$0	$236,004	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE J, PART I, LINE 4B	PARTICIPATION IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: PARTICIPANTS IN SERP IN W-2 DEF COMP PAID BY ----------------------- --------- ------------ ------------ RICK W. MERRILL NONE 196,000 System STEPHEN W. KIMMEL $82,928 113,277 System Stanley Davis $43,697 63,378 ccmc JOSEPH M. GALLAGHER NONE 81,912 System CORY R. RHOADES $42,740 76,429 System CHERYL PETERSEN NONE 34,825 CCMC SPENCER D. SEALS NONE 30,534 SYSTEM JACK SOSEBEE NONE 29,893 CCMC
SCHEDULE J, PART II	ALLOCATION OF CEO AND CFO SALARIES: SALARIES FOR THE CEO AND CFO ARE ALLOCATED PRO-RATA BASED ON THE AMOUNT OF TIME THEY SPEND WITH EACH OF THE FOLLOWING COMPANIES: COOK CHILDREN'S MEDICAL CENTER COOK CHILDREN'S HEALTH FOUNDATION COOK CHILDREN'S HOME HEALTH COOK CHILDREN'S HEALTH CARE SYSTEM COOK CHILDREN'S HEALTH PLAN COOK CHILDREN'S PHYSICIAN NETWORK CHILD STUDY CENTER
SCHEDULE J, PART I, Line 1A & 1B	GENERAL GROSS UP PAYMENTS DISCLOSURE THERE IS NO WRITTEN POLICY REGARDING PAYMENT OR REIMBURSEMENT OF TAX INDEMNIFICATION AND GROSS-UP PAYMENTS BECAUSE THE COMPANY DOES NOT GENERALLY ALLOW FOR GROSS-UP PAYMENTS EXCEPT IN SPECIFIC CIRCUMSTANCES AND THEN ONLY IF APPROVED BY SENIOR MANAGEMENT FOLLOWED BY REVIEW OF THE COMPANY'S COMPLIANCE AND LEGAL DEPARTMENTS. THESE TYPE OF REIMBURSEMENTS GENERALLY RELATE TO TAXES OWED BY INDIVIDUALS WHO RECEIVE NOMINAL INCENTIVE PAYMENTS FOR SERVICE AWARDS OR QUALITY IMPROVEMENT PROGRAMS, AND THE GROSS-UP PAYMENTS USUALLY ARE IMMATERIAL, $250 OR LESS. CY 2021 GROSS UP PAYMENTS INCLUDED IN TAXABLE COMPENSATION: Margie Dorman-O'Donnell GARY MUNFORD TAMARA SIMS Ozioma Olowu
SCHEDULE J, PART I, Line 3	METHODS USED BY CCHCS TO ESTABLISH COMPENSATION OF THE CEO/EXEC DIRECTOR: COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT WRITTEN EMPLOYMENT CONTRACT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
TARRANT COUNTY CULTURAL EDUCATION FACILITIES
A	751181060	875906NY1	2010-02-24	$231,948,097	DEVELOPMENT, CONST, EQUIPMENT	false	false	false
Tarrant County Cultural Education Facilities
B	043833551	87638QJC4	2013-08-01	$71,222,592	REFUNDING PORTION OF 2010 BOND	false	false	false
Tarrant County Cultural Education Facilities
C	043833551	87638QKX6	2014-02-02	$176,767,688	CONSTRUCTION & EQUIPMENT COSTS	false	false	false
TARRANT COUNTY CULTURAL EDUCATION FACILITIES FINAN
D	043833551	87638QQq5	2020-02-25	$241,629,204	REFUNDING AND CONSTRUCTION AND EQU	false	false	false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Bond DefeasedBondDefeasedAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Capitalized InterestCapitalizedInterestAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	UnspentUnspentAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$199,770,000	$0	$231,948,097	$0	$0	$0	$2,686,446	$0	$0	$230,119,470	$0	$0	2011	false	false	Yes (true)	Yes (true)
B	$0	$0	$71,222,592	$0	$0	$70,145,003	$1,077,553	$0	$0	$0	$0	$0	2013	Yes (true)	false	Yes (true)	Yes (true)
C	$21,865,000	$0	$176,767,688	$0	$0	$0	$1,755,350	$0	$0	$176,023,031	$0	$0	2016	false	false	Yes (true)	Yes (true)
D	$7,780,000	$0	$241,629,204	$0	$0	$90,712,257	$2,221,088	$0	$0	$122,400,517	$0	$26,295,342		Yes (true)	false	false	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Any Research AgreementsAnyResearchAgreementsInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Total Private Business UseTotalPrivateBusinessUsePct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Remedial Action TakenRemedialActionTakenInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	false	Yes (true)	false	false	0.00184	0.00184	Yes (true)	false	false	Yes (true)
B	false	false	false	false	0.00184	0.00184	Yes (true)	false	false	Yes (true)
C	false	false	false	false	0.00000	0.00000	Yes (true)	false	false	Yes (true)
D	false	false	false	false	0		Yes (true)	false	false	Yes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Term Of HedgeTermOfHedgePct	Superintegrated HedgeSuperintegratedHedgeInd	Hedge TerminatedHedgeTerminatedInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Business Name Line1GICProviderName/BusinessNameLine1Txt	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
Bank of America
A	false	false	false	Yes (true)	Yes (true)	Yes (true)	0.213	false	false	false	0	false	Yes (true)
0
B	false	false	false	Yes (true)	false	false				false	0	false	Yes (true)
0
C	false	false	false	Yes (true)	false	false				false	0	false	Yes (true)
0
D	false	Yes (true)	false	false	false	false				false	0	false	Yes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (true)
B	Yes (true)
C	Yes (true)
D	Yes (true)

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part IV, Column A, Line 2C	No Rebate Due The final rebate computation was performed as of 2/4/2014
Part IV, Column B, Line 2C	No rebate due The final rebate computation was performed as of 2/4/2014.
Part IV, Column C, Line 2C	No rebate due the final rebate computation was performed as of 03/22/2017.
Part III, line 7, Columns A, B, & C	FOR THE PURPOSES OF CALCULATING THE PRIVATE SECURITY OR PAYMENT TEST, COOK CHILDREN'S MEDICAL CENTER (CCMC) HAS INCLUDED GROSS RECEIPTS FROM CERTAIN ACTIVITIES THAT CCMC HAS CONCLUDED GENERATE PRIVATE PAYMENTS. CALCULATED IN THAT MANNER, CCMC HAS CONCLUDED THAT THE PRIVATE PAYMENT TEST HAS BEEN MET WITH RESPECT TO THE BOND ISSUES DESCRIBED IN COLUMNS A, B & C. HOWEVER, THE AMOUNT OF PRIVATE BUSINESS USE WITH RESPECT TO THE BOND ISSUES DESCRIBED IN COLUMNS A, B & C IS LESS THAN 5%, IN EACH CASE, SO THAT EACH OF THOSE BOND ISSUES FAILS THE PRIVATE BUSINESS USE TEST AND CONTINUES TO MEET THE REQUIREMENTS IMPOSED ON "QUALIFIED 501(C)(3) BONDS."
Part II, Column A & C, Line 3	Total Proceeds include investment earnings.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Field	Value	IRS element (for citing)
Person	KATHARINE CARVALHO	PersonNm

Field	Value	IRS element (for citing)
Relationship Description	DAUGHTER OF BOARD MEMBER	RelationshipDescriptionTxt
Transaction	$91,990	TransactionAmt
Transaction	COMPENSATION	TransactionDesc
Sharing Of Revenues	false	SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2	BUSINESS RELATIONSHIPS: VARIOUS OFFICERS AND TRUSTEES HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER DUE TO THEIR EMPLOYMENT OR BOARD SERVICE WITH OTHER ORGANIZATIONS WITHIN THE SYSTEM.
FORM 990, PART VI, SECTION A, LINE 3	DELEGATION OF MANAGEMENT AUTHORITY: A MANAGEMENT COMPANY MANAGES THE DAY TO DAY OPERATIONS OF THE JOINT VENTURES.
FORM 990, PART VI, SECTION A, LINE 6	SOLE MEMBER: COOK CHILDREN'S HEALTH CARE SYSTEM, A TEXAS NON-PROFIT CORPORATION, IS THE SOLE MEMBER OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7A	MEMBER ELECTION ABILITIES: AS THE SOLE MEMBER OF THE ORGANIZATION, COOK CHILDREN'S HEALTH CARE SYSTEM HAS THE POWER TO DETERMINE THE NUMBER OF MEMBERS OF THE BOARD OF TRUSTEES AND TO ELECT THE MEMBERS OF THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION A, LINE 7B	MEMBER DECISION ABILITIES: AS THE SOLE MEMBER OF THE ORGANIZATION, COOK CHILDREN'S HEALTH CARE SYSTEM HAS THE EXCLUSIVE POWER AND RESERVED POWER TO DO ANY OF THE FOLLOWING: A. AMEND, ALTER OR REPEAL THE BYLAWS; B. AMEND THE CERTIFICATE OF FORMATION OF THE ORGANIZATION; C. DETERMINE THE NUMBER OF MEMBERS OF THE BOARD OF TRUSTEES AND TO ELECT THE MEMBERS OF THE BOARD OF TRUSTEES; D. APPROVE ANY MERGER, ACQUISITION, LIQUIDATION, WINDING UP, TERMINATION OR CONSOLIDATION OF THE ORGANIZATION; E. APPROVE THE SALE, GIFT OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OF THE ORGANIZATION; AND, F. APPROVE THE CREATION OF, OR INVESTMENT IN, ANY SUBSIDIARY ENTITY.
FORM 990, PART VI, SECTION B, LINE 11B	REVIEW PROCESS FOR FORM 990: The organization engages an outside independent accounting firm to assist in the preparation of the Form 990 and related filings. All information provided to the outside accounting firm is gathered by key company employees and executives. Once the Form 990 is prepared, it is reviewed by company Finance, Legal and Compliance staff and then provided to the Board of Trustees for review and comment. In addition, it is provided to the Cook Children's Health Care System Audit Committee for review and comment. Subsequent to the Board and Audit Committee review, the Form 990 is filed with the Internal Revenue Service and made available to the public for review.
FORM 990, PART VI, SECTION B, LINE 12C	WRITTEN CONFLICT OF INTEREST POLICY: EVERY YEAR THE LEGAL DEPARTMENT OF THE COOK CHILDREN'S HEALTH CARE SYSTEM (SYSTEM) SENDS OUT A FORM 990 QUESTIONNAIRE/CONFLICT OF INTEREST DISCLOSURE STATEMENT TO OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES OF ALL SYSTEM COMPANIES, AS WELL AS CERTAIN OTHER EMPLOYEES, INCLUDING PHYSICIANS, WHO ARE DETERMINED TO BE EMPLOYED IN POSITIONS THAT MIGHT BE SUBJECT TO THE SYSTEM'S CONFLICT OF INTEREST POLICY. THE RESPONSES ARE REVIEWED BY THE LEGAL, FINANCE, AND COMPLIANCE DEPARTMENTS. FOLLOW UP AND/OR CORRECTIVE ACTION IS TAKEN AS NEEDED WITH RESPECT TO RESPONSES THAT INDICATE THE EXISTENCE OF ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. A SUMMARY OF THE RESPONSES TO THE QUESTIONNAIRES AND FOLLOW-UP INFORMATION ARE PROVIDED TO THE SYSTEM AUDIT COMMITTEE FOR REVIEW AND FOLLOW-UP. FURTHER, THE AUDIT COMMITTEE OF COOK CHILDREN'S HEALTH CARE SYSTEM IS RESPONSIBLE FOR MONITORING THE IMPLEMENTATION AND ENFORCEMENT OF THE CONFLICT OF INTEREST POLICY THAT IS APPLICABLE TO ALL AFFILIATED COMPANIES OF THE COOK CHILDREN'S HEALTH CARE SYSTEM. THE AUDIT COMMITTEE IS ALSO RESPONSIBLE FOR OVERSIGHT OF THE COMPLIANCE DEPARTMENT OF COOK CHILDREN'S HEALTH CARE SYSTEM. THE COMPLIANCE DEPARTMENT MAINTAINS A HOTLINE TO RECEIVE REPORTS OF INAPPROPRIATE ACTIVITIES INCLUDING ACTIVITIES THAT MIGHT CONSTITUTE A CONFLICT OF INTEREST. INTERNAL AUDIT AND COMPLIANCE ALSO CONDUCT RANDOM AUDITS OF CORPORATE ACTIVITIES SUCH AS EXPENSE REIMBURSEMENTS AND ACCOUNTS PAYABLE TO DETERMINE IF ANY INAPPROPRIATE PAYMENTS ARE BEING MADE TO INDIVIDUALS, SOME OF WHICH COULD BE EVIDENCE OF A CONFLICT OF INTEREST. ANY CORRECTIVE ACTION RELATED TO CONFLICTS OF INTEREST WOULD BE REPORTED TO THE AUDIT COMMITTEE FOR REVIEW, APPROVAL, AND MODIFICATION, AS NECESSARY, WITH FURTHER REPORTING TO THE SYSTEM BOARD OF TRUSTEES AS APPROPRIATE.
FORM 990, PART VI, SECTION B, LINE 15A & 15B	REVIEW AND APPROVAL OF COMPENSATION: Cook Children's Health Care System has established a Compensation Committee with oversight of executive and physician compensation, which includes the organization's CEO and other officers and key employees of the organization. The Compensation Committee approves compensation arrangements in advance, which includes a review and approval by independent committee members, using comparable market data relating to compensation, which is provided by Sullivan Cotter and Associates, Inc. for executive compensation and physician compensation, which is an independent, nationally recognized compensation consultant. The Compensation Committee documents the basis for its determinations following contemporaneous substantiation of the Compensation Committee's deliberations and decisions. The Compensation Committee requires the compensation consultant to update market data periodically, usually every two years, with interim reviews being conducted as needed. With regard to physician compensation, the Compensation Committee also RETAINED SULLIVAN COTTER AND ASSOCIATES, INC. IN 2022 to issue a reasonableness opinion covering the physician compensation plan for Cook Children's Physician Network.
FORM 990, PART VI, SECTION C, LINE 19	PROCESS OF MAKING GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC: THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC, EXCEPT TO THE EXTENT THEY ARE ON FILE WITH THE SECRETARY OF THE STATE OF TEXAS. THE CONFLICT OF INTEREST POLICY IS POSTED ON THE ORGANIZATION'S INTERNAL WEBSITE AND AVAILABLE TO ALL EMPLOYEES AND BOARD MEMBERS OF COOK CHILDREN'S HEALTH CARE SYSTEM ENTITIES. CONSOLIDATED FINANCIAL STATEMENTS ARE REPORTED ELECTRONICALLY FOR ALL COOK CHILDREN'S HEALTH CARE SYSTEM ENTITIES VIA THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEB SITE.
Form 990, Part XI, Line 9	OTHER CHANGES IN NET ASSETS OR FUND BALANCES: NET Fund Balance Transfers Between Affiliates: (610,000,000) Change in FV of SWAP: 4,434,453 ------------- (605,565,547)

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
COOK CHILDREN'S PHYSICIAN NETWORK
801 SEVENTH AVE	FORT WORTH	TX	76104	752485366	PHYSICIAN SVC	TX	501(C)(3)	3	CCHCS	Yes (true)
WI COOK FOUNDATION
801 SEVENTH AVE	FORT WORTH	TX	76104	752051649	FUNDRAISING	TX	501(C)(3)	7	NA	false
COOK CHILDREN'S HOME HEALTH
801 SEVENTH AVE	FT WORTH	TX	76104	752896983	HEALTHCARE	TX	501(C)(3)	10	CCHCS	Yes (true)
COOK CHILDREN'S HEALTH CARE SYSTEM
801 SEVENTH AVE	FORT WORTH	TX	76104	752705881	HLTH CARE SUP	TX	501(C)(3)	12C	CCHF	Yes (true)
COOK CHILDREN'S HEALTH PLAN
801 SEVENTH AVE	FORT WORTH	TX	76104	760585240	INSURANCE	TX	501(C)(3)	10	CCHCS	Yes (true)
ROSEDALE OFFICE BUILDING INC
1500 W ROSEDALE	FORT WORTH	TX	76104	460866421	TITLE HOLDING	TX	501(C)(2)	N/A	CCHF	Yes (true)
CHILD STUDY CENTER
1300 W LANCASTER	FORT WORTH	TX	76102	751099536	HLTHCARE SRVC	TX	501(C)(3)	7	CCMC	Yes (true)
COOK CHILDREN'S HEALTH ENTERPRISES
801 SEVENTH AVE	FORT WORTH	TX	76104	842625990	HLTHCARE SUPP	TX	501(C)(3)	12B	CCHCS	Yes (true)
COOK CHILDRENS MEDICAL CENTER PROSPER
801 SEVENTH AVE	FORT WORTH	TX	76104	852354189	HOSPITAL	TX	501(C)(3)	3	CCHCS	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	UBI Code VUBICodeVAmt	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct
COOK CHILDREN'S SURGERY CENTER
11221 ROE AVE SUITE 320	LEAWOOD	KS	66211	205227064	ASC	TX	NA	RELATED	$6,046,154	$2,164,516	false	$0	false	0.51256
CENTER FOR PEDIATRIC SURGERY
11221 ROE AVE SUITE 320	LEAWOOD	KS	66211	470871715	ASC	TX	NA	RELATED	$6,218,847	$13,566,632	false	$0	false	0.54398
CPS PEDIATRICS LLC
11221 ROE AVE SUITE 320	LEAWOOD	KS	66211	470871718	ASC	TX	NA	RELATED	$33,288	$110,075	false	$0	false	0.54663

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	Province Or StateForeignAddress/ProvinceOrStateNm	CountryForeignAddress/CountryCd	Foreign PostalForeignAddress/ForeignPostalCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
COOK CHILDREN'S HEALTH SERVICES INC
801 7TH AVENUE	FORT WORTH	TX	76104	454024843	HEALTHCARE	TX	CCHCS	C CORPORATION	Yes (true)
COOK CHILDREN'S INDEMNITY COMPANY
				980424041	SELF INSURANCE		CCHCS	C CORPORATION	Yes (true)	878 WEST BAY RD	GRAND CAYMAN	CJ	CJ	KY1-1102	CJ

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (true)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	Yes (true)	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (true)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (20 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
COOK CHILDREN'S PHYSICIAN NETWORK
A	$1,732,721	fmv
COOK CHILDREN'S HEALTH CARE SYSTEM
A	$2,676,418	fmv
COOK CHILDREN'S PHYSICIAN NETWORK
B	$82,531,217	FMV
COOK CHILDREN'S SURGERY CENTER (NE)
J	$1,363,595	FMV
COOK CHILDREN'S HEALTH ENTERPRISES
N	$5,998,682	FMV
COOK CHILDREN'S PHYSICIAN NETWORK
O	$113,890,220	FMV
CHILD STUDY CENTER
O	$154,240	FMV
COOK CHILDREN'S HEALTH CARE SYSTEM
O	$1,074,393	FMV
COOK CHILDREN'S HOME HEALTH
P	$195,613	FMV
COOK CHILDREN'S HEALTH CARE SYSTEM
P	$306,801	FMV
COOK CHILDREN'S PHYSICIAN NETWORK
Q	$581,090	FMV
COOK CHILDREN'S HOME HEALTH
Q	$81,138	FMV
COOK CHILDREN'S HEALTH CARE SYSTEM
Q	$318,996,455	FMV
COOK CHILDREN'S PHYSICIAN NETWORK
R	$332,540	FMV
COOK CHILDREN'S HOME HEALTH
R	$3,007,419	FMV
COOK CHILDREN'S HEALTH CARE SYSTEM
R	$400,000,000	FMV
COOK CHILDREN'S HEALTH PLAN
S	$222,081,506	FMV
COOK CHILDREN'S HEALTH CARE SYSTEM
S	$1,315,126	FMV
COOK CHILDREN'S SURGERY CENTER LLC
S	$4,656,499	FMV
Center for Pediatric Surgery Ltd
S	$6,657,822	fmv

Affiliated Group Schedule AffiliatedGroupSchedule

Affiliated Schedule AffiliatedScheduleGrp (10 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Electing OrganizationElectingOrganizationInd	Total Grassroots LobbyTotalGrassrootsLobbyAmt	Total Direct LobbyTotalDirectLobbyAmt	Total Lobby ExpenditureTotalLobbyExpenditureAmt	Other Exempt Purpose ExpendOtherExemptPurposeExpendAmt	Total Exempt Purpose ExpendTotalExemptPurposeExpendAmt	Lobby NontxLobbyNontxAmt	Grassroots NontxGrassrootsNontxAmt	Total Lobby Grssroot Mns NontxTotalLobbyGrssrootMnsNontxAmt	Tot Lbby Expend Mns Lobby NontxTotLbbyExpendMnsLobbyNontxAmt	Share Excess Lobby ExpendShareExcessLobbyExpendAmt
COOK CHILDREN'S MEDICAL CENT
801 seventh ave	FORT WORTH	TX	76104	752051646	Yes (X)	$0	$0	$0	$1,350,787,048	$1,350,787,048	$1,000,000	$250,000	$0	$0	$0
COOK CHILDREN'S HEALTH PLAN
801 SEVENTH AVE	FORT WORTH	TX	76104	760585240		$0	$22,478	$22,478	$840,298,549	$840,321,027	$1,000,000	$250,000	$0	$0	$0
COOK CHILDREN'S HEALTH CARE
801 SEVENTH AVE	FORT WORTH	TX	76104	752705881	Yes (X)	$0	$180,572	$180,572	$287,722,338	$287,902,910	$1,000,000	$250,000	$0	$0	$0
COOK CHILDREN'S PHYSICIAN NE
801 SEVENTH AVE	FORT WORTH	TX	76104	752485366	Yes (X)	$0	$0	$0	$432,113,954	$432,113,954	$1,000,000	$250,000	$0	$0	$0
WI COOK FOUNDATION
801 SEVENTH AVE	FORT WORTH	TX	76104	752051649		$0	$0	$0	$46,656,091	$46,656,091	$1,000,000	$250,000	$0	$0	$0
COOK CHILDREN'S HOME HEALTH
801 SEVENTH AVE	FORT WORTH	TX	76104	752896983	Yes (X)	$0	$0	$0	$68,024,379	$68,024,379	$1,000,000	$250,000	$0	$0	$0
ROSEDALE OFFICE BUILDING
1500 W ROSEDALE	FORT WORTH	TX	76104	460866421		$0	$0	$0	$2,316,032	$2,316,032	$265,802	$66,451	$0	$0	$0
CHILD STUDY CENTER
801 SEVENTH AVE	FORT WORTH	TX	76104	751099536		$0	$0	$0	$9,401,256	$9,401,256	$620,063	$155,016	$0	$0	$0
COOK CHILDREN'S HEALTH ENTER
801 SEVENTH AVE	FORT WORTH	TX	76104	842625990		$0	$0	$0	$7,200,844	$7,200,844	$510,042	$127,511	$0	$0	$0
COOK CHILDREN'S MEDICAL CENT
801 SEVENTH AVE	FORT WORTH	TX	76104	852354189		$0	$0	$0	$13,552,732	$13,552,732	$827,637	$206,909	$0	$0	$0