COOK CHILDRENS MEDICAL CENTER: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization: COOK CHILDRENS MEDICAL CENTER (EIN 75-2051646)
Tax period: 2020-10-01 to 2021-09-30
Filed: 2022-08-05
IRS object ID: 202212179349300436
Schema version: 2020v4.1
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	2022-08-05T16:49:36-05:00	ReturnTs
Tax Period End	2021-09-30	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	2020-10-01	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 AND SVP, FINANCE	PersonTitleTxt
Phone	6828854000	PhoneNum
Signature	2022-08-16	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	3	TrustedCustomerCd

Field	Value	IRS element (for citing)
Tax	2020	TaxYr
Build TS	2022-09-23 18:48:47Z	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	$1,514,997,758	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	13	VotingMembersIndependentCnt
Total Employee	5340	TotalEmployeeCnt
Total Volunteers	396	TotalVolunteersCnt
Total Gross UBI	$10,626	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$6,314	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$14,081,914	PYContributionsGrantsAmt
CY Contributions Grants	$49,806,055	CYContributionsGrantsAmt
PY Program Service Revenue	$1,297,518,713	PYProgramServiceRevenueAmt
CY Program Service Revenue	$1,463,493,299	CYProgramServiceRevenueAmt
PY Investment Income	$277,208	PYInvestmentIncomeAmt
CY Investment Income	$302,271	CYInvestmentIncomeAmt
PY Other Revenue	$866,043	PYOtherRevenueAmt
CY Other Revenue	$58,522	CYOtherRevenueAmt
PY Total Revenue	$1,312,743,878	PYTotalRevenueAmt
CY Total Revenue	$1,513,660,147	CYTotalRevenueAmt
PY Grants And Similar Paid	$76,066,892	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$73,422,672	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$392,525,167	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$402,390,436	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$606,849,625	PYOtherExpensesAmt
CY Other Expenses	$679,291,913	CYOtherExpensesAmt
PY Total Expenses	$1,075,441,684	PYTotalExpensesAmt
CY Total Expenses	$1,155,105,021	CYTotalExpensesAmt
PY Revenues Less Expenses	$237,302,194	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$358,555,126	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,804,052,601	TotalAssetsBOYAmt
Total Assets EOY	$1,871,901,068	TotalAssetsEOYAmt
Total Liabilities BOY	$677,130,790	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$624,234,763	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$1,126,921,811	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$1,247,666,305	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	$805,409,287	ExpenseAmt
Grant	$73,422,672	GrantAmt
Revenue	$1,463,482,673	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 its Promise to improve the health of every child through the prevention and treatment of illness, disease and injury. 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 the families it serves. 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. At the start of fiscal year 2021, Cook Children's remained in the throes of managing its response to the COVID-19 pandemic, all the while balancing a return to as normal of operations as safely possible. As variants came and went, the medical center had to be nimble, flexible and quick to adjust to each new surge, and it remained laser-focused on its three COVID-19 response guiding principles: 1. Zero transmission to staff from patient or caregiver. 2. No patient encounter without the appropriate personal protective equipment (PPE). 3. Have a bed and support for every patient. To reduce the spread of illness, Cook Children's COVID command center maintained safety protocols put into place early in the pandemic, such as limiting visitors and instituting work-from-home plans. A late summer COVID surge stressed pediatric hospital bed capacity throughout the community. Cook Children's responded by postponing elective surgeries for a period of time. This preserved bed space and also allowed perioperative nurses to be utilized on other patient care units that needed extra nursing hands. Telehealth became a critical resource throughout the pandemic. 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. Supporting telehealth services remained a priority in FY21. The year's virtual health visits totaled more than 80,000 across all of Cook Children's Health Care System. Operation Vaccination Protecting the workforce became paramount during the pandemic, because healthy and strong employees ensured the continuation of quality patient care. In December 2020, vaccinations were added to the medical center's arsenal of protective measures, and it led the way in educating its workforce and the community about COVID-19 immunizations through its various communications channels. It also prepared to receive, store and administer COVID shots to employees and the community. The first doses of the vaccine were given to Cook Children's employees on Dec. 17, 2020. Once vaccinations were open to community members, the IT team created a patient portal within days to support a massive drive-thru vaccination effort. Cook Children's Physician Network (CCPN) vaccination efforts resulted in 3,511 children receiving one or both of their vaccine doses through 24 vaccine clinic events in 2021. In addition, CCPN primary care practices and Cook Children's Neighborhood Clinics vaccinated 3,567 patients in 2021 and continue to do so as part of the patient care services they routinely offer. By the end of FY21, all Cook Children's employees not qualified for an exemption had received the vaccine. In total, Cook Children's provided vaccines for 19,822 people. Raising Joy As the pandemic stretched into a year, another critical health issue became apparent. Cook Children's physicians were among the first to sound the alarm on the mental health crisis in kids and teens. Isolation, fear and uncertainty had taken its toll. In March 2021, Cook Children's Medical Center reported record numbers of suicides and attempted suicides with patients as young as 7, and it marked the first time suicide became the leading cause of trauma death, surpassing child abuse and car wrecks. In response, the hospital system initiated the JOY campaign in April 2021-an ongoing series that addresses and educates readers on children's rising mental health care needs and issues they may face. Pandemic Inspires Improvement Fiscal years 2020 and 2021 were two of the most difficult years in the history of CCMC, but out of the challenges of the pandemic emerged a stronger organization better equipped for the future. The pandemic shined a light on the need for a dedicated infectious disease unit with facilities and technology to treat the sickest patients while also protecting staff and the community from the spread of illness. To that end, Cook Children's began construction of a new 6-bed infectious diseases critical care unit (CCU), a 32-bed medical surgical unit, and a 24-hour solutions center with space set aside for incident command. An existing 20-bed unit was slated to become a dedicated infectious diseases unit for the treatment of non-critical contagious patients such as those hospitalized for flu, COVID-19, respiratory syncytial virus (RSV) and other viruses. The expansion will be complete in FY22. Exceeding Expectations Even while operating under the cloud of the pandemic in all of FY21, CCMC continued to pursue quality, safety and communication. Patient experience scores averaged 88.6%, exceeding the Children's Hospital Association (CHA) average and earning employees a performance bonus. Capping its nationally recognized achievements in patient safety and quality, CCMC was named a Top Children's Hospital nationally by The Leapfrog Group in early FY21. The Leapfrog Top Hospital award is widely acknowledged as one of the most competitive awards American hospitals can receive. The Top Hospital designation is bestowed by The Leapfrog Group, a national watchdog organization of employers and other purchasers widely acknowledged as the toughest standard-setters for health care safety and quality. As of July 2021, Cook Children's Hyperinsulinism Center is one of only six Hyperinsulinism Centers of Excellence in the world. The designation, awarded by Congenital Hyperinsulinism International, recognizes centers that provide the highest level of multi-disciplinary care to congenital hyperinsulinism (CHI) patients and their families. Also in July, Cook Children's Medical Center became one of 33 hospitals in the world to receive the coveted Lantern Award from the Emergency Nurses Association (ENA). The group recognized Cook Children's Emergency Department (ED) for demonstrating exceptional and innovative performance through leadership, practices, education, advocacy and research. The award is given to health care institutions both in the U.S. and internationally, and is a visible symbol of commitment to quality, safety and a healthy work environment. Fiscal Responsibility Financials play a significant role in the sustainability of any organization. At the start of the pandemic, Cook Children's took several measures to conserve financial resources given the uncertainty of the pandemic's impact on operations and markets, and these efforts carried over into FY21. The organization reduced discretionary spending, developed systems to monitor and protect resources and secured available CARES Act funds. These steps, coupled with the medical center's long history of outstanding financial performance, allowed Cook Children's to save and invest its resources to ensure financial stability in these uncertain times. As a result, the strong financial position made it possible for the organization to respond with judicious and measured patience to the global health and economic crises. Many adjustments were difficult and required sacrifice. Perseverance was necessary as the pandemic moved into its second year. Leading with its guiding principles allowed the medical center to not just weather the storm, but to come out on the other side of it with a stronger workforce, a more nimble organization and better positioned to meet the health needs of the community going forward.	Desc
Total Program Service Expenses	$805,409,287	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	5340	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	13	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
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 (37 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)	$667,629	$1,716,758	$255,387
James C Cunningham MD
EVP CMO	1.0	40.0	Yes (X)	$0	$1,133,126	$50,821
Stephen W Kimmel
EVP Sys Finance	16.0	24.0	Yes (X)	$405,055	$607,584	$129,999
NANCY C CYCHOL
president/chief hospital svcs	40.0	3.0	Yes (X)	$1,021,983	$0	$36,098
CORY R RHOADES
CFO	3.0	40.0	Yes (X)	$0	$771,239	$122,729
THERESA Z MEADOWS
SR. VP, CHIEF INFO OFFICER	2.0	40.0	Yes (X)	$0	$778,452	$53,031
JOSEPH M GALLAGHER
SR. VP, CHIEF LEGAL OFFICER	3.0	40.0	Yes (X)	$0	$685,506	$117,159
STANLEY E DAVIS
SR. VICE PRESIDENT, COO	40.0	3.0	Yes (X)	$627,257	$0	$114,925
CHERYL PETERSEN
AVP NURSING, CNO	40.0	0.0		$485,828	$0	$59,901	Yes (X)
JACK SOSEBEE
VICE PRESIDENT	40.0	2.0		$434,425	$0	$35,793	Yes (X)
SPENCER D SEALS
VP CONSTRUCTION & REAL ESTATE	4.0	40.0	Yes (X)	$0	$387,200	$55,020
DEBORAH C BOUDREAUX
AVP NURSING	40.0	0.0		$291,254	$0	$48,103	Yes (X)
ORLANDO CHAPA
AVP NURSING	40.0	0.0		$292,206	$0	$38,565	Yes (X)
ELIA VALENCIA-STOKES
AVP FINANCE	40.0	0.0		$286,859	$0	$40,001	Yes (X)
TAMMY THOMLISON
AVP REVENUE	40.0	0.0		$275,622	$0	$14,486	Yes (X)
OZIOMA OLOWU
DIRECTOR OF PHARMACY	40.0	0.0		$231,010	$0	$55,840		Yes (X)
NICHOLAS MARKHAM
AVP FACILITIES/CAMPUS SVCS	40.0	0.0		$207,517	$0	$38,461	Yes (X)
MARGIE DORMAN-O'DONNELL
DIRECTOR, CASE MANAGEMENT	40.0	0.0		$205,388	$0	$28,295		Yes (X)
DIANA SHANNON
RNFA, CV SVC COORDINATOR	40.0	0.0		$193,739	$0	$27,293		Yes (X)
MARY HICKS
PHARMACIST	40.0	0.0		$185,631	$0	$30,833		Yes (X)
GINA HERNANDEZ
DIRECTOR, NURSE ADMIN	40.0	0.0		$188,060	$0	$18,100		Yes (X)
MARY CARA MARTZ
SECRETARY	1.0	40.0	Yes (X)	$0	$165,987	$24,953
JOHN P BOSWELL
TRUSTEE - CHAIRMAN	2.0	3.0	Yes (X)	$0	$0	$0			Yes (X)
ANDREW S WAYNE
TRUSTEE - VICE CHAIRMAN	2.0	2.0	Yes (X)	$0	$0	$0			Yes (X)
Frank A Anderson
TRUSTEE	1.0	1.0		$0	$0	$0			Yes (X)
R JOHN BATTON
TRUSTEE	1.0	3.0		$0	$0	$0			Yes (X)
ANNE M CARVALHO
TRUSTEE	1.0	3.0		$0	$0	$0			Yes (X)
JEFFREY H CONNER
TRUSTEE - CHAIRMAN END: 06/21	2.0	3.0	Yes (X)	$0	$0	$0			Yes (X)
DANA C KELLY
TRUSTEE - END: 06/2021	1.0	1.0		$0	$0	$0			Yes (X)
LEAH M KING
TRUSTEE - SEC/TREASURER	2.0	2.0	Yes (X)	$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)
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)
MICHAEL A LAGATTA
TRUSTEE	1.0	1.0		$0	$0	$0			Yes (X)
JOSEPH LAMARCA JR
TRUSTEE	1.0	1.0		$0	$0	$0			Yes (X)
JAMES E WEBB
TRUSTEE	1.0	4.0		$0	$0	$0			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$5,999,463	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$6,245,852	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,395,793	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	322	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	CONSTR CONTRACTOR	$35,619,934
HKS INC
PO BOX 731121	DALLAS	TX	75373	PROFESSIONAL SVCS	$4,354,665
DAVID M SCHWARZ ARCHITECTURAL
1707 L STREET NW STE 400	WASHINGTON	DC	20036	PROFESSIONAL SVCS	$3,710,352
METRO AVIATION
PO BOX 7008	SHREVEPORT	LA	71137	AIRCRAFT MAINTENANCE	$3,539,946
MEDTRONIC
PO BOX 848086	DALLAS	TX	75284	MED SUPPLY SERVICES	$3,144,932

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	82	CntrctRcvdGreaterThan100KCnt
Related Organizations	$8,630,829	RelatedOrganizationsAmt
Government Grants	$41,175,226	GovernmentGrantsAmt
All Other Contributions	$0	AllOtherContributionsAmt
Total Contributions	$49,806,055	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
Patient Services	621110	$1,309,028,345	$1,309,028,345
Other Operating Revenue	621110	$143,852,181	$143,852,181
Joint Venture Revenue	621110	$10,602,147	$10,602,147
LAB REFERRALS	621500	$10,626		$10,626

Field	Value	IRS element (for citing)
Total Program Service Revenue	$1,463,493,299	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$272,301	TotalRevenueColumnAmt
Exclusion	$272,301	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	$1,365,753	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$1,307,231	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$58,522	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$58,522	TotalRevenueColumnAmt
Exclusion	$58,522	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$60,350	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$30,380	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	$29,970	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$29,970	TotalRevenueColumnAmt
Exclusion	$29,970	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

Field	Value	IRS element (for citing)
Other Revenue Total	$0	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,513,660,147	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,463,482,673	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$10,626	UnrelatedBusinessRevenueAmt
Exclusion	$360,793	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$72,795,349	TotalAmt
Program Services	$72,795,349	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$627,323	TotalAmt
Program Services	$627,323	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	$5,903,107	TotalAmt
Program Services	$1,472,676	ProgramServicesAmt
Management And General	$4,430,431	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$78,168	TotalAmt
Program Services	$78,168	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$293,149,604	TotalAmt
Program Services	$258,222,752	ProgramServicesAmt
Management And General	$34,926,852	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$14,928,966	TotalAmt
Program Services	$13,370,939	ProgramServicesAmt
Management And General	$1,558,027	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$66,772,009	TotalAmt
Program Services	$60,040,596	ProgramServicesAmt
Management And General	$6,731,413	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$21,558,582	TotalAmt
Program Services	$19,498,538	ProgramServicesAmt
Management And General	$2,060,044	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$204,716,024	TotalAmt
Management And General	$204,716,024	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$1,213,900	TotalAmt
Management And General	$1,213,900	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	$30,612,336	TotalAmt
Program Services	$23,655,342	ProgramServicesAmt
Management And General	$6,956,994	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$28,915	TotalAmt
Program Services	$28,561	ProgramServicesAmt
Management And General	$354	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,295,554	TotalAmt
Program Services	$3,614,499	ProgramServicesAmt
Management And General	$1,681,055	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	$9,731,872	TotalAmt
Program Services	$8,297,150	ProgramServicesAmt
Management And General	$1,434,722	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$208,904	TotalAmt
Program Services	$135,359	ProgramServicesAmt
Management And General	$73,545	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	$244,989	TotalAmt
Program Services	$174,815	ProgramServicesAmt
Management And General	$70,174	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$13,713,077	TotalAmt
Program Services	$13,705,322	ProgramServicesAmt
Management And General	$7,755	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$9,003,850	TotalAmt
Program Services	$8,914,329	ProgramServicesAmt
Management And General	$89,521	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$56,662,577	TotalAmt
Program Services	$41,520,135	ProgramServicesAmt
Management And General	$15,142,442	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$1,958,866	TotalAmt
Program Services	$1,958,866	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Physical Remuneration	$34,397,661	$33,694,257	$703,404
Medical Supplies	$148,038,992	$148,037,162	$1,830
Bad Debt Expenses	$82,551,165	$82,551,165
LPPF SUPPLEMENTAL PAYMENTS	$54,821,836	$0	$54,821,836

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$26,091,395	TotalAmt
Program Services	$13,015,984	ProgramServicesAmt
Management And General	$13,075,411	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,155,105,021	TotalAmt
Program Services	$805,409,287	ProgramServicesAmt
Management And General	$349,695,734	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$16,543	BOYAmt
EOY	$16,350	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$786,959,319	BOYAmt
EOY	$813,189,653	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	$164,582,071	BOYAmt
EOY	$210,785,197	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	$31,257,963	BOYAmt
EOY	$6,464,746	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$11,592,250	BOYAmt
EOY	$14,491,511	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$260,793	BOYAmt
EOY	$643,447	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$1,214,979,944	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$611,413,069	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$610,569,106	BOYAmt
EOY	$603,566,875	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$5,394,772	BOYAmt
EOY	$6,212,941	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	$7,424,990	BOYAmt
EOY	$6,682,491	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$185,994,794	BOYAmt
EOY	$209,847,857	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,804,052,601	BOYAmt
EOY	$1,871,901,068	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$89,450,188	BOYAmt
EOY	$89,834,410	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	$56,012,015	BOYAmt
EOY	$150,545	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$511,829,817	BOYAmt
EOY	$494,289,995	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	$19,838,770	BOYAmt
EOY	$39,959,813	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$677,130,790	BOYAmt
EOY	$624,234,763	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	$1,126,921,811	BOYAmt
EOY	$1,247,666,305	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	$1,126,921,811	BOYAmt
EOY	$1,247,666,305	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,804,052,601	BOYAmt
EOY	$1,871,901,068	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$358,555,126	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	-$237,810,632	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	false	FederalGrantAuditRequiredInd

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	$298,322	AffiliatedGroupTotalAmt

Total Lobbying Expend TotalLobbyingExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$0	FilingOrganizationsTotalAmt
Affiliated Group Total	$298,322	AffiliatedGroupTotalAmt

Other Exempt Purpose Expend OtherExemptPurposeExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$1,155,105,021	FilingOrganizationsTotalAmt
Affiliated Group Total	$2,601,131,028	AffiliatedGroupTotalAmt

Total Exempt Purpose Expend TotalExemptPurposeExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$1,155,105,021	FilingOrganizationsTotalAmt
Affiliated Group Total	$2,601,429,350	AffiliatedGroupTotalAmt

Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$1,000,000	FilingOrganizationsTotalAmt
Affiliated Group Total	$7,362,790	AffiliatedGroupTotalAmt

Grassroots Nontaxable GrassrootsNontaxableGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$250,000	FilingOrganizationsTotalAmt
Affiliated Group Total	$1,840,698	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	$1,000,000	CurrentYearAmt
Total	$1,000,000	TotalAmt

Field	Value	IRS element (for citing)
Lobbying Ceiling	$1,500,000	LobbyingCeilingAmt

Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp

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

Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp

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

Field	Value	IRS element (for citing)
Grassroots Ceiling	$375,000	GrassrootsCeilingAmt

Avg Grassroots Lobbying Expend AvgGrassrootsLobbyingExpendGrp

Field	Value	IRS element (for citing)
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	$0	DonorAdvisedFundsContriAmt
Donor Advised Funds Grants	$0	DonorAdvisedFundsGrantsAmt
Donor Advised Funds Vl EOY	$252,225	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	$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 Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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 Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

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

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$76,556,166	BeginningYearBalanceAmt
Contributions	$11,777,744	ContributionsAmt
Investment Earnings Or Losses	$7,575,568	InvestmentEarningsOrLossesAmt
Other Expenditures	$898,961	OtherExpendituresAmt
End Year Balance	$95,010,517	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.40110	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.52530	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.07360	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	$16,793,324	OtherCostOrOtherBasisAmt
Book Value	$16,793,324	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$860,493,675	OtherCostOrOtherBasisAmt
Depreciation	$394,291,992	DepreciationAmt
Book Value	$466,201,683	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,710,222	OtherCostOrOtherBasisAmt
Depreciation	$0	DepreciationAmt
Book Value	$4,710,222	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$244,776,254	OtherCostOrOtherBasisAmt
Depreciation	$205,786,581	DepreciationAmt
Book Value	$38,989,673	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$88,206,469	OtherCostOrOtherBasisAmt
Depreciation	$11,334,496	DepreciationAmt
Book Value	$76,871,973	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$603,566,875	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDesc	Book ValueBookValueAmt
Assets Limited to Use	$116,817,215
Other Receivables	$7,762,250
Supplemental Assets	$78,409,414
Rights of Use Assets	$6,858,978

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$209,847,857	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDesc	AmtAmt
Intercompany Payables	-$12,345
Est Due to Third Parties	$33,065,509
Right of Use Liability	$6,906,649

Field	Value	IRS element (for citing)
Total Liability	$39,959,813	TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt	$1,458,392,466	TotalRevEtcAuditedFinclStmtAmt
Other Revenue	-$55,586,779	OtherRevenueAmt
Revenue Not Reported	-$55,586,779	RevenueNotReportedAmt
Revenue Subtotal	$1,513,979,245	RevenueSubtotalAmt
Other Revenues Not Included	-$319,098	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	-$319,098	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$1,513,660,147	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$1,089,246,196	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$17,265,897	OtherExpensesIncludedAmt
Expenses Not Reported	$17,265,897	ExpensesNotReportedAmt
Expenses Subtotal	$1,071,980,299	ExpensesSubtotalAmt
Other Expenses Not Included	$83,124,722	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$83,124,722	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$1,155,105,021	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: (82,551,165) Interest Rate SWAP Adjustment: 2,189,368 CCIC Retro Loss: (573,557) joint venture revenue: 25,348,575 --------------- (55,586,779)
Schedule D, Part XI, Line 4b	RECONCILIATION OF AUDITED revenue to form 990 revenue: Additional Gain on Disposal of Asset: 29,970 Additional Contributions from Foundation: 958,163 Direct Rent Expenses: (1,307,231) ------------ (319,098)
Schedule D, Part XII, Line 2D	Reconciliation of audited expenses to form 990 expenses: direct rent expenses: 1,307,231 Additional gain on Disposal of Asset (29,970) Joint Venture Expenses 15,988,636 ------------------ 17,265,897
SCHEDULE D, PART XII, LINE 4B	Reconciliation of audited expenses to form 990 expenses: Bad Debt Expense: 82,551,165 CCIC RETRO LOSS: 573,557 ---------------- 83,124,722
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	false	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$11,386,727	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$885,251	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$10,501,476	NetCommunityBenefitExpnsAmt
Total Expense	0.00980	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$583,777,678	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$493,766,429	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$90,011,249	NetCommunityBenefitExpnsAmt
Total Expense	0.08390	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$595,164,405	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$494,651,680	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$100,512,725	NetCommunityBenefitExpnsAmt
Total Expense	0.09370	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,839,684	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$76,985	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,762,699	NetCommunityBenefitExpnsAmt
Total Expense	0.00540	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$292,570	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$153,396	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$139,174	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$348,336	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$348,336	DirectOffsettingRevenueAmt
Total Expense	0.00000	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$72,942,430	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$72,942,430	NetCommunityBenefitExpnsAmt
Total Expense	0.06800	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$79,423,020	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$578,717	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$78,844,303	NetCommunityBenefitExpnsAmt
Total Expense	0.07350	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$674,587,425	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$495,230,397	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$179,357,028	NetCommunityBenefitExpnsAmt
Total Expense	0.16720	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	$97,757	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$97,757	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$446,688	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$446,688	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$564,445	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$564,445	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$82,551,165	BadDebtExpenseAmt
Reimbursed By Medicare	$7,231,794	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$10,124,711	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$2,892,917	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 SURGERY CENTER
SURGERY CENTER	0.51256	0.32161
cc pediatric surgery
surgery center	0.54663	0.03146

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	18	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	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	18	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, and 2018). 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 0-14, 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 six 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 2018 CHNA parent survey was administered through an outside vendor (ETC Institute) to a statistically representative sample of parents with children ages 0-14 living in our primary service region (Denton, Hood, Johnson, Parker, Tarrant, and Wise counties). The large sample size (8,249 completed surveys) provides statistically representative results applicable to all six counties individually and collectively with a low margin of error (+/- 5%). The survey is administered through mail and telephone 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, 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) conducted intercept surveys with parents living with a child or children in one of several Tarrant County homeless shelters (209 completed surveys). ETC Institute also conducted a survey with community leaders to obtain their feedback about the status of children's health. Surveys were mailed to 1,156 community leaders representing city and county governments, public agencies, not-for-profit organizations, independent school districts, faith based/clergy, elected officials, and health care professionals. We received 301 responses (26% response rate). A complete list of who received the opportunity to participate in the leader survey is available upon request. 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, and 2018 and confirmed the importance of these issues for continuing focused intervention: - Child Abuse & Neglect - Dental Health - Wellness - Injury Prevention - Access to Health Care - Asthma - Mental Health - General Health: Childhood Obesity - General Health: Parenting Support - Child Passenger Safety - Drowning Prevention - Poison Prevention - Gun Safety Cook Children's continues to use the 2018 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 2021 CHNA is currently in development and will be completed and posted by September 30, 2022.
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 ETC Institute, Inc. and My Health My Resources of Tarrant County. 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 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 Community Strategy: Improve child oral health The Center for Children's Health leads the Children's Oral Health Coalition (COHC), a county-wide collaborative effort to address dental care needs for underserved children. COHC focuses on providing education and oral hygiene kits to families in priority zip codes and hosts Train the Trainer events - two 2-hour workshops for community professionals that teach them how to train parents they regularly serve on proper oral health care for infants and children ages 0-4 years old. COHC works to improve community collaboration around oral health care by bringing together those organizations in Tarrant County conducting limited oral exams in the school setting to reduce overlap, discuss common obstacles and promote best practices. COHC also promotes inter-disciplinary collaboration between medical and dental providers to work with pregnant women and young children to improve overall health. And the coalition's Legislative Advocacy committee monitors state and national legislative issues, especially those supporting expanded access to dental care for low-income children. The Center is also home to Save a Smile, an innovative and award-winning program that partners with schools to provide preventive and restorative treatment to children with serious dental disease. Each school year, children in targeted Title I schools are screened and assigned an oral health status to determine which children need treatment provided by volunteer dentists. Community health workers work under the supervision of a licensed social worker to provide social services that facilitate treatment completion for those children with serious dental disease. Save a Smile also provides oral health classroom education to children to promote good oral health. Community Strategy: Improve control of childhood asthma The Center for Children's Health implements a Healthy Homes program designed to mitigate asthma triggers in the home. Program eligibility is for families of children seen in the Cook Children's Medical Center Emergency Department two or more times or Urgent Care Clinics three or more times with a primary diagnosis of asthma in a 12-month period. The program also accepts referrals from other areas within the System, such as Case Management or the Health Plan, for children struggling with asthma. Healthy Homes uses trained community health workers to assess homes for asthma triggers and offer remediation of those triggers to reduce asthma episodes requiring ER visits. Cook Children's is also a key partner in community efforts to address asthma, including the Asthma 411 partnership. Through Asthma 411, Cook Children's provides support to equip school nurses with appropriate tools and knowledge of rescue meds to quickly respond to a child in respiratory distress. Community Strategy: Increase access to services for child mental health and well-being Cook Children's is a founding partner of the Mental Health Connection (MHC) and continues to support this group financially and through staff participation. MHC is a partnership of health and social service organizations that works to improve mental health services in Tarrant County through collaboration. In addition, the Center for Children's Health leads the Wellness Alliance for Total Children's Health of Denton County, a coalition working to increase awareness of and access to mental health services through maintaining a resource website (watchdenton.org), facilitating educational events for professionals, hosting an annual children's art expression initiative, and strengthening collaboration between mental health service providers. Community Strategy: Increase access to wellness activities for children Coalitions led by the Center for Children's Health in Johnson and Parker Counties work with schools and community organizations to implement a school-based wellness education program centered on evidence-based approaches (5-2-1-0 Let's Go! and Coordinated Approach to Child Health, or CATCH). The program includes four education sessions during the school year to teach children to eat five servings of fruits/vegetables per day, spend no more than two hours of recreation screen time per day, engage in physical activity for at least one hour per day and drink less sugary beverages and more water. The curriculum is currently being revised to also include best practices for getting enough sleep. Children are also taught about "Go" foods (good to eat almost anytime), "Slow" foods (can be eaten a few times per week) and "Whoa" foods (may be eaten up to a few times per month). Volunteer facilitators lead the sessions and in some sites teach children how to grow their own microgreens. Cook Children's also promotes physical activity through offering a digital-based platform to all school districts within our service region. This platform, offered free to schools and families, provides children in school and at home an opportunity to cultivate good health now and lifelong healthy habits through daily physical activity. Community Strategy: Increase support network for parents and families through community partnerships Coalitions led by the Center for Children's Health in Hood and Wise Counties work to promote healthy parenting practices by offering Parent Cafs (held both in-person and in virtual platforms) using a curriculum based on Nurturing ParentingTM and other evidence-informed parenting programs. The goal of the Parent Caf is to engage parents in building a support network which is one of the protective factors needed to promote healthy outcomes for their children. Volunteers are trained by licensed professionals on how to successfully facilitate parent discussions. The coalitions developed comprehensive toolkits for Parent Caf facilitators that include key messages for over 20 parenting lessons, discussion questions, handouts, sign-in sheets and evaluation forms. Community site partners provide the location and parking for Parent Cafs and qualified child care is provided as needed. Community Strategy: Increase access to pediatric medical care for children in Tarrant County Cook Children's works to improve access to care throughout our entire health system. One specific program is the Homeless Initiative that 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. A full-time nurse case manager and a social work case manager address medical and non-medical needs of the children, including providing parent education and newborn care classes that target health education needs identified by parents and staff. The behavioral health specialist provides on-site trauma assessments and makes referrals to outpatient counseling services, partial hospitalization programs, inpatient psychiatric services, and for psychological testing. Training sessions/consultation on trauma-informe
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
Schedule H, Part V, Section B, line 3	Board approval of CHNA: The deadline for presenting and obtaining board approval of the community health needs assessment for tax year 2018 was September 30, 2019, and all work had been completed on the assessment prior to that date to make it ready for approval. Due to an administrative oversight in finalizing the agenda for the September 30, 2019 board meeting, consideration and approval of the community health needs assessment for tax year 2018 was inadvertently postponed to the next board meeting. The community health needs assessment was posted for public comment on November 5, 2019 and subsequently approved at the next scheduled board meeting, December 3, 2019. The implementation strategies for the tax year 2018 CHNA were also approved at that meeting in a separate motion. Because the community health needs assessment was approved prior to the deadline for implementation (i.e., prior to February 15, 2020), and the implementation strategies were timely approved, this minor and inadvertent error in timing had no impact on the community we serve. In addition, governance staff who manage the board agenda have been educated as to the appropriate timeline for approval of future community health needs assessments and the hospital is reviewing its policies and procedures for other advisable improvements.

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 10 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 six-county service region is based in North Central Texas and comprises Denton, 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 2021, all information provided is in response to our 2018 CHNA. Furthermore, the statistics described within this section reflect those reported in our 2018 CHNA. Please note: Our 2021 CHNA is currently in development and will be approved and posted by September 30, 2022. The US Census Bureau classifies these counties as follows: Denton County (mostly urban, 7% rural), 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%). Overall, this six-county region is home to a diverse population of 3,382,569 people, and 720,697 (21%) are children under 14 years of age. Of those 720,697 children ages 0-14, there are 174,406 children living in Denton County; 10,716 in Hood County; 36,881 in Johnson County; 28,296 in Parker County; 456,492 in Tarrant County; and 13,906 in Wise County. The annual median income for families with children under age 18 ranges between $63,702 in Wise County to $99,763 in Denton County. Of the 834,108 children under age 18 living in the region, 151,931 (16%) live in households with income below the poverty level, and between 28.9%-52.5% of those living in poverty reside in female householder, no husband present households. Of the 834,108 children under age 18 living in the region, between 13%-38% live in households that receive Supplemental Security Income (SSI), cash public assistance, or Food Stamps/SNAP benefits. The information below reflects race and ethnicity by county within our region. 2017 U.S. Census Estimates of Race and Ethnicity (Children under 18 years) -Asian: Denton 7.7%; Hood 1.3%; Johnson 2.4%; Parker 0.6%; Tarrant 4.4%; Wise 0.4%; Regional Average: 2.5%. -Black/African American: Denton 8.9%; Hood 1.4%; Johnson 2.4%; Parker 1.6%; Tarrant 17.1%; Wise 0.4%; Regional Average: 5.3%. -Other Race/Two or More Races: Denton 10.6%; Hood 5.1%; Johnson 7.0%; Parker 6.3%; Tarrant 14.6%; Wise 7.5%; Regional Average: 8.5%. -White: Denton 72.7%; Hood 92.2%; Johnson 90.0%; Parker 91.5%; Tarrant 64.0%; Wise 91.8%; Regional Average: 83.7%. -Hispanic or Latino (Any Race): Denton 25.6%; Hood 20.9%; Johnson 28.2%; Parker 17.1%; Tarrant 38.0%; Wise 27.6%; Regional Average: 26.2%. The Cook Children's six-county service region contains four medically underserved areas and one medically underserved population as defined by the Health Resources & Services Administration. These areas are: Medically Underserved Areas -Denton County: Known as Poverty Population by Service Area Name, Medical Underservice Score is 0 (Governor's Exception), Rural Status is Non-Rural -Johnson County: Known as Johnson Service Area as its Service Area Name, Medical Underservice Score is 56.18, Rural Status is Partially Rural -Tarrant County: Known as Central Service Area by Service Area Name, Medical Underservice Score is 55.3, 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 -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 FY2021, the Center for Children's Health led 782 health outreach events serving over 25,000 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: - Child Abuse & Neglect - Dental Health - Wellness - Injury Prevention - Access to Health Care - Asthma - Mental Health - General Health: Childhood Obesity - General Health: Parenting Support - Child Passenger Safety - Drowning Prevention - Poison Prevention - Gun Safety Through our coalitions and collaborations we engage community partners and volunteers to help us reach children and families in need through outreach activities that support sustainable solutions within the community. In FY2021 our community partners and volunteers gave over 3,100 hours of volunteer support to the Center for Children's Health, totaling a value of $109,000. Out of our 782 health outreach events, over 600 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-Fort Worth - Save a Smile - Wise Coalition for Healthy Children - Wellness Alliance for Total Children's Health of Denton County Selected highlights of our work in FY2021 to improve the health of children and families in the community include: - Over 3,700 children received a limited oral health evaluation and over 1,100 dental procedures were provided to children with dental disease for a total value of $335,000. - Provided over 150 car seat checks to families in need, with the majority of these checks occurring virtually. - Provided 359 continued education credits to over 360 community professionals at our mental health education workshops. - Coordinated and engaged 600+ volunteers and collaboration members. - Provided 3,800 support services and over 400 community referrals to families, meeting needs for food, rent and utilities assistance, school supplies, and mental health. - Distributed 493,378 prevention and educational resources at a value of $462,828 to families and community partners. - Supported 230 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 $82,551,165 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 for FYE 2021.
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 2018, and the written CHNA report was posted in 2019. The 2018 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 (2021) is currently in development and will be posted by September 30, 2022.

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (3 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)	$72,732,849	SUBSIDIZE OPERATIONS
JUNIOR LEAGUE OF FORT WORTH
255 BAILEY AVE	FORT WORTH	TX	76107	756022377	501(C)(3)	$35,000	SPONSOR
MENTAL HEALTH CONNECTION OF TARRANT COUNTY
3136 W 4TH ST	FORT WORTH	TX	76107	752659610	501(C)(3)	$20,000	SPONSOR

Field	Value	IRS element (for citing)
Total501c3 Org	3	Total501c3OrgCnt

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

Grant TypeGrantTypeTxt	RecipientRecipientCnt	Cash GrantCashGrantAmt
Medication	1888	$193,379
Transportation	1038	$44,217
LODGING	563	$116,538
Gift Cards	366	$58,581
UTILITIES	12	$2,246
MEALS	567	$17,118
MEDICAL EQUIPMENT	14	$5,565
BABY SUPPLIES	300	$72,038
Funeral services	130	$115,130
miscellaneous	4	$2,511

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 (22 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
Rick W Merrill
Chief Executive Officer	$347,536	$893,663	$214,913	$552,632	$105,180	$270,463	$60,865	$156,511	$10,643	$27,368	$739,137	$1,900,637	$0	$0
James C Cunningham MD
EVP CMO	$0	$607,397	$0	$307,663	$0	$218,066	$0	$21,375	$0	$29,446	$0	$1,183,947	$0	$0
Stephen W Kimmel
EVP Sys Finance	$235,683	$353,524	$119,687	$179,531	$49,685	$74,529	$39,502	$59,254	$12,497	$18,746	$457,054	$685,584	$0	$68,837
NANCY C CYCHOL
president/chief hospital svcs	$582,733	$0	$291,470	$0	$147,780	$0	$21,375	$0	$14,723	$0	$1,058,081	$0	$0	$0
CORY R RHOADES
CFO	$0	$450,778	$0	$207,024	$0	$113,437	$0	$84,800	$0	$37,929	$0	$893,968	$0	$34,702
THERESA Z MEADOWS
SR. VP, CHIEF INFO OFFICER	$0	$439,624	$0	$200,828	$0	$138,000	$0	$17,813	$0	$35,218	$0	$831,483	$0	$0
JOSEPH M GALLAGHER
SR. VP, CHIEF LEGAL OFFICER	$0	$401,735	$0	$180,189	$0	$103,582	$0	$80,436	$0	$36,723	$0	$802,665	$0	$0
STANLEY E DAVIS
SR. VICE PRESIDENT, COO	$376,102	$0	$175,921	$0	$75,234	$0	$74,491	$0	$40,434	$0	$742,182	$0	$0	$0
CHERYL PETERSEN
AVP NURSING, CNO	$305,367	$0	$111,399	$0	$69,062	$0	$19,500	$0	$40,401	$0	$545,729	$0	$0	$0
JACK SOSEBEE
VICE PRESIDENT	$273,474	$0	$95,623	$0	$65,328	$0	$21,375	$0	$14,418	$0	$470,218	$0	$0	$0
SPENCER D SEALS
VP CONSTRUCTION & REAL ESTATE	$0	$248,272	$0	$87,207	$0	$51,721	$0	$17,760	$0	$37,260	$0	$442,220	$0	$0
DEBORAH C BOUDREAUX
AVP NURSING	$213,346	$0	$60,916	$0	$16,992	$0	$8,726	$0	$39,377	$0	$339,357	$0	$0	$0
ORLANDO CHAPA
AVP NURSING	$222,559	$0	$56,347	$0	$13,300	$0	$21,375	$0	$17,190	$0	$330,771	$0	$0	$0
ELIA VALENCIA-STOKES
AVP FINANCE	$220,631	$0	$56,009	$0	$10,219	$0	$0	$0	$40,001	$0	$326,860	$0	$0	$0
TAMMY THOMLISON
AVP REVENUE	$215,806	$0	$52,509	$0	$7,307	$0	$10,677	$0	$3,809	$0	$290,108	$0	$0	$0
OZIOMA OLOWU
DIRECTOR OF PHARMACY	$184,487	$0	$35,418	$0	$11,105	$0	$12,412	$0	$43,428	$0	$286,850	$0	$0	$0
NICHOLAS MARKHAM
AVP FACILITIES/CAMPUS SVCS	$154,132	$0	$44,572	$0	$8,813	$0	$14,908	$0	$23,553	$0	$245,978	$0	$0	$0
MARGIE DORMAN-O'DONNELL
DIRECTOR, CASE MANAGEMENT	$166,379	$0	$25,463	$0	$13,546	$0	$11,453	$0	$16,842	$0	$233,683	$0	$0	$0
DIANA SHANNON
RNFA, CV SVC COORDINATOR	$187,447	$0	$1,000	$0	$5,292	$0	$3,890	$0	$23,403	$0	$221,032	$0	$0	$0
MARY HICKS
PHARMACIST	$175,416	$0	$1,600	$0	$8,615	$0	$13,687	$0	$17,146	$0	$216,464	$0	$0	$0
GINA HERNANDEZ
DIRECTOR, NURSE ADMIN	$150,866	$0	$28,073	$0	$9,121	$0	$13,904	$0	$4,196	$0	$206,160	$0	$0	$0
MARY CARA MARTZ
SECRETARY	$0	$127,943	$0	$32,854	$0	$5,190	$0	$7,972	$0	$16,981	$0	$190,940	$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 $167,069 196,000 System STEPHEN W. KIMMEL $68,837 80,943 System Nancy C. Cychol $73,794 None CCMC Stanley Davis none 54,345 ccmc JOSEPH M. GALLAGHER NONE 59,221 System CORY R. RHOADES $34,702 63,425 System JAMES CUNNINGHAM $71,048 NONE System THERESA MEADOWS $53,676 NONE System
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 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 2020 GROSS UP PAYMENTS INCLUDED IN TAXABLE COMPENSATION: Margie Dorman-O'Donnell Kevin Greene Gina Hernandez Mary Hicks Ozioma Olowu Diana Shannon
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 HEALTH FACILITIES DEVELOPMENT
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	$232,805,916	$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	$18,640,000	$0	$177,571,254	$0	$0	$0	$1,755,350	$0	$0	$176,023,031	$0	$0	2016	false	false	Yes (true)	Yes (true)
D	$3,645,000	$0	$241,629,204	$0	$0	$90,712,257	$2,221,088	$0	$0	$44,083,957	$0	$104,611,902		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	0.00700	0.00700	Yes (true)	false	false	Yes (true)
B	false	false	false	false	0.00212	0.00212	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 C & D. HOWEVER, THE AMOUNT OF PRIVATE BUSINESS USE WITH RESPECT TO THE BOND ISSUES DESCRIBED IN COLUMNS C & D 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	$78,168	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 3	DELEGATION OF MANAGEMENT AUTHORITY: A MANAGEMENT COMPANY MANAGES THE DAY TO DAY OPERATIONS OF BOTH OF OUR 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 retains the law firm of McDermott, Will & Emery of Chicago, Illinois, 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: Fund Balance Transfers Between Affiliates: (240,000,000) Change in FV of SWAP: 2,189,368 ------------- (237,810,632)
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.

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	752056149	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	SUPPORT	TX	501(C)(3)	12B	CCHcs	Yes (true)
COOK CHILDRENS MEDICAL CENTER PROSPER
801 SEVENTH AVE	FORT WORTH	TX	76104	852354189	HEALTHCARE SV	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	$2,706,588	$1,114,918	false	$0	false	0.51256
CENTER FOR PEDIATRIC SURGERY
11221 ROE AVE SUITE 320	LEAWOOD	KS	66211	470871715	ASC	TX	NA	RELATED	$3,356,435	$13,296,249	false	$0	false	0.54931
CPS PEDIATRICS LLC
11221 ROE AVE SUITE 320	LEAWOOD	KS	66211	470871718	ASC	TX	NA	RELATED	$19,285	$108,604	false	$0	false	0.55201

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	CountryForeignAddress/CountryCd	Foreign PostalForeignAddress/ForeignPostalCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd	Direct Controlling NADirectControllingNACd
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			C-CORPORATION	Yes (true)	PO BOX 1159 CARIBBEAN PLAZA 2ND FL	GRAND CAYMAN	CJ	KY1-1103	CJ	N/A

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	Yes (true)	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	Yes (true)	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 (16 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
cook children's surgery center llc
s	$5,066,234	fmv
center for pediatric surgery ltd
s	$4,729,942	fmv
COOK CHILDREN'S PHYSICIAN NETWORK
A	$1,714,872	FMV
COOK CHILDREN'S SURGERY CENTER (NE)
J	$1,365,753	FMV
COOK CHILDREN'S PHYSICIAN NETWORK
O	$31,643,596	FMV
COOK CHILDREN'S HEALTH PLAN
S	$169,589,166	FMV
COOK CHILDREN'S PHYSICIAN NETWORK
R	$133,493	FMV
COOK CHILDREN'S PHYSICIAN NETWORK
Q	$582,590	FMV
COOK CHILDREN'S HEALTH ENTERPRISES
S	$5,170,427	FMV
COOK CHILDREN'S HEALTH ENTERPRISES
N	$5,551,289	FMV
COOK CHILDREN'S PHYSICIAN NETWORK
B	$72,732,849	FMV
Cook Children's Home Health
R	$3,133,020	FMV
Cook Children's Home Health
P	$196,006	FMV
Cook Children's Home Health
Q	$61,081	FMV
CHILD STUDY CENTER
O	$168,373	FMV
COOK CHILDREN'S MC PROSPER
S	$59,107,939	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	$1,155,105,021	$1,155,105,021	$1,000,000	$250,000	$0	$0	$0
COOK CHILDREN'S HEALTH PLAN
801 SEVENTH AVE	FORT WORTH	TX	76104	760585240		$0	$16,367	$16,367	$668,662,384	$668,678,751	$1,000,000	$250,000	$0	$0	$0
COOK CHILDREN'S HEALTH CARE
801 SEVENTH AVE	FORT WORTH	TX	76104	752705881	Yes (X)	$0	$281,955	$281,955	$268,969,790	$269,251,745	$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	$386,674,905	$386,674,905	$1,000,000	$250,000	$0	$0	$0
WI COOK FOUNDATION
801 SEVENTH AVE	FORT WORTH	TX	76104	752051649		$0	$0	$0	$44,044,793	$44,044,793	$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	$59,558,153	$59,558,153	$1,000,000	$250,000	$0	$0	$0
ROSEDALE OFFICE BUILDING
1500 W ROSEDALE	FORT WORTH	TX	76104	460866421		$0	$0	$0	$2,333,451	$2,333,451	$266,673	$66,668	$0	$0	$0
CHILD STUDY CENTER
801 SEVENTH AVE	FORT WORTH	TX	76104	751099536		$0	$0	$0	$8,995,731	$8,995,731	$599,787	$149,947	$0	$0	$0
COOK CHILDREN'S HEALTH ENTER
801 SEVENTH AVE	FORT WORTH	TX	76104	842625990		$0	$0	$0	$6,740,199	$6,740,199	$487,010	$121,753	$0	$0	$0
COOK CHILDREN'S MEDICAL CENT
801 SEVENTH AVE	FORT WORTH	TX	76104	852354189		$0	$0	$0	$46,601	$46,601	$9,320	$2,330	$0	$0	$0