2022-08-05T16:55:46-05:00 2021-09-30 FORVIS LLP 14241 DALLAS PARKWAY SUITE 1100 DALLAS TX 75254 990 2020-10-01 852354189 Cook Children's Medical Center - Prosper % CORY RHOADES COOK 6828854000 801 Seventh Avenue Fort Worth TX 76104 CORY R RHOADES CFO AND SVP, FINANCE 6828854000 2022-08-15 true CORY RHOADES 999009999 MICHAEL J ENGLE P00482834 9727028262 3 2020 2022-09-23 18:48:47Z NANCY CYCHOL 801 SEVENTH AVE FORT WORTH TX 76104 0 false X WWW.COOKCHILDRENS.ORG X 2020 TX KNOWING THAT EVERY CHILD'S LIFE IS SACRED OUR PROMISE IS TO IMPROVE THE HEALTH OF EVERY CHILD IN OUR REGION THROUGH THE PREVENTION... (CONTINUED ON SCHEDULE O) 13 13 1 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11331 0 0 0 0 35270 0 46601 0 -46601 5613484 59107939 5613484 59154540 0 -46601 X 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. false false 15920 Cook Children's pediatric care is unmatched in North Texas, serving millions of children over its 101-year history with seamless, coordinated care. That means whether a child is in need of a checkup visit with a pediatrician, visiting urgent care, or requiring more specialized care, Cook Children's Health Care system is able to officer its full complement of services and provide a unique medical home for children of the greater North Texas region. Currently, children in the greater Prosper area are having to travel up to two hours for inpatient pediatric services. Cook Children's is bringing a premier health care system to the backyards of thousands of families and with that comes a vast network of pediatric-trained physicians, and clinical team members. Our physicians will be able to coordinate a child's care throughout the entire care delivery system. A key differentiator compared to other health systems in the market. Our physicians will be able to access and share their patients' information through our EPIC-based electronic health system. Through the platform, the child's care team will be able to view and coordinate the various health care services that may be needed, such as primary care, specialists, and sub-specialty services. 15920 true false false false false false false false false false true false false false false false false true false false false false false false false false false false false true false false false false false false false false false false false false false true true true false false true X 0 0 1 true false false false false false false false false false false false false X 13 13 true false false false true true true true true false false true true true true true true true true false X CORY RHOADES 6828854000 801 SEVENTH AVENUE FORT WORTH TX 76104 X RICK W MERRILL PRESIDENT & CEO 1.0 40.0 X 0 2384387 255387 James C Cunningham MD EVP, CMO 1.0 40.0 X 0 1133126 50821 STEPHEN W KIMMEL CHIEF FINANCIAL OFFICER 1.0 40.0 X 0 1012639 129999 NANCY C CYCHOL PRESIDENT/CHIEF HOSPITAL SVCS 1.0 40.0 X 0 1021983 36098 Cory R Rhoades Chief Financial Officer 1.0 40.0 X 0 771239 122729 Theresa Z Meadows Sr VP, Chief Info Officer 1.0 40.0 X 0 778452 53031 Joseph Gallagher Sr VP, Chief Legal Officer 1.0 40.0 X 0 685506 117159 STANLEY E DAVIS SR. VP, COO 1.0 40.0 X 0 627257 114925 SPENCER D SEALS VP CONSTRUCTION & REAL ESTATE 1.0 40.0 X 0 387200 55020 Kevin Greene AVP North Campus 40.0 0.0 X 0 202467 39823 MARY CARA MARTZ SECRETARY 1.0 40.0 X 0 165987 24953 Frank A Anderson TRUSTEE 1.0 1.0 X 0 0 0 ROBERT J BATTON TRUSTEE - SEC/TREASURER 2.0 2.0 X X 0 0 0 JOHN P BOSWELL TRUSTEE - CHAIRMAN START:06/21 2.0 3.0 X X 0 0 0 ANNE M CARVALHO TRUSTEE 1.0 3.0 X 0 0 0 JEFFREY H CONNER TRUSTEE - CHAIRMAN END: 06/21 2.0 3.0 X X 0 0 0 JUDGE JEFFREY L CURETON TRUSTEE 1.0 3.0 X 0 0 0 RYAN B DICKERSON TRUSTEE 1.0 2.0 X 0 0 0 DANA C KELLY TRUSTEE END: 06/2021 1.0 1.0 X 0 0 0 LEAH M KING TRUSTEE - SEC/TREASURER 2.0 2.0 X X 0 0 0 MICHAEL A LAGATTA TRUSTEE 1.0 1.0 X 0 0 0 JOSEPH LAMARCA JR TRUSTEE 1.0 1.0 X 0 0 0 BONNIE PETSCHE TRUSTEE 1.0 1.0 X 0 0 0 BILLIE R PUGH JR MD TRUSTEE 1.0 2.0 X 0 0 0 ANDREW S WAYNE TRUSTEE - VICE CHAIRMAN 2.0 2.0 X X 0 0 0 JAMES E WEBB TRUSTEE 1.0 5.0 X 0 0 0 0 9170243 999945 0 false true false LINBECK GROUP LLC 1263 W ROSEDALE SUITE 202 FORT WORTH TX 76104 CONSTRUCTION SERVICE 6111925 FISK ELECTRIC CO 1617 W CROSBY ROAD 120 CARROLTON TX 75006 ELECTRICIAN SERVICES 102732 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8541 8541 170 170 1985 1985 635 635 0 0 0 0 0 0 0 0 4589 4589 0 0 0 0 0 0 0 0 0 0 PHYSICIAN REMUNERATION 30000 30000 FEES & FINANCING 681 681 46601 15920 30681 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59107939 5613484 59107939 0 0 0 0 0 0 0 0 0 0 5613484 59107939 5613484 59154540 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5613484 59154540 X 0 -46601 0 0 0 -46601 5613484 59107939 -46601 X false true X true false X SCHEDULE A, PART I, LINE 3 REASON FOR PUBLIC CHARITY STATUS: COOK CHILDREN'S MEDICAL CENTER - PROSPER WAS CREATED TO BUILD AND OPERATE A LICENSED HOSPITAL IN PROSPER, TEXAS. AS OF THE 2021 FISCAL YEAR, THE HOSPITAL IS NOT YET IN OPERATION AND DOES NOT YET HAVE ITS LICENSE. WE ARE MARKING SCHEDULE A AS A 3 - HOSPITAL AS THAT IS THE DESIGNATION LISTED ON THE IRS DETERMINATION LETTER AND THE INTENDED PURPOSE OF THE ORGANIZATION. 59107939 59107939 59107939 0 0 0 46601 46601 46601 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. false true false false false false false false false NANCY C CYCHOL PRESIDENT/CHIEF HOSPITAL SVCS 0 582733 0 291470 0 147780 0 21375 0 14723 0 1058081 0 0 STANLEY E DAVIS SR. VP, COO 0 376102 0 175921 0 75234 0 74491 0 40434 0 742182 0 0 STEPHEN W KIMMEL CHIEF FINANCIAL OFFICER 0 589207 0 299218 0 124214 0 98756 0 31243 0 1142638 0 68837 MARY CARA MARTZ SECRETARY 0 127943 0 32854 0 5190 0 7972 0 16981 0 190940 0 0 RICK W MERRILL PRESIDENT & CEO 0 1241199 0 767545 0 375643 0 217375 0 38012 0 2639774 0 0 SPENCER D SEALS VP CONSTRUCTION & REAL ESTATE 0 248272 0 87207 0 51721 0 17760 0 37260 0 442220 0 0 James C Cunningham MD EVP, CMO 0 607397 0 307663 0 218066 0 21375 0 29446 0 1183947 0 0 Joseph Gallagher Sr VP, Chief Legal Officer 0 401735 0 180189 0 103582 0 80436 0 36723 0 802665 0 0 Theresa Z Meadows Sr VP, Chief Info Officer 0 439624 0 200828 0 138000 0 17813 0 35218 0 831483 0 0 Cory R Rhoades Chief Financial Officer 0 450778 0 207024 0 113437 0 84800 0 37929 0 893968 0 34702 Kevin Greene AVP North Campus 0 146958 0 38636 0 16873 0 7770 0 32053 0 242290 0 0 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 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 75,286 SYSTEM STANLEY DAVIS NONE 54,345 CCMC Nancy c. cychol 73,794 none CCMC JAMES C. CUNNINGHAM 71,047 NONE SYSTEM THERESA Z MEADOWS 53,676 NONE SYSTEM CORY RHOADES 34,702 63,425 SYSTEM JOSEPH M. GALLAGHER NONE 59,221 SYSTEM FORM 990, PART I, LINE 1 CONTINUATION OF ORGANIZATION'S MISSION: ... AND TREATMENT OF ILLNESS, DISEASE, AND INJURY. FORM 990, PART V, LINE 2A NUMBER OF EMPLOYEES: THE NUMBER OF EMPLOYEES LISTED HERE ARE PAID OUT OF THE RELATED ORGANIZATION, COOK CHILDREN'S HEALTH CARE SYSTEM, AS THE COMMON PAYMASTER. THE SALARIES EXPENSE IS ALLOCATED TO COOK CHILDREN'S MEDICAL CENTER - PROSPER. 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 OF 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 PROCESS TO MONITOR COMPLIANCE: 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 STATE OF TEXAS. THE CONFLICT OF INTEREST POLICY IS POSTED ON THE ORGANIZATION'S INTERNAL WEBSITE AND AVAILBLE 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 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. COOK CHILDREN'S PHYSICIAN NETWORK 801 SEVENTH AVE FORT WORTH TX 76104 752485366 PHYSICIAN SVC TX 501(C)(3) 3 CCHCS 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 true COOK CHILDREN'S HEALTH CARE SYSTEM 801 SEVENTH AVE FORT WORTH TX 76104 752705881 HLTH CARE SUP TX 501(C)(3) 12C CCHF true COOK CHILDREN'S HEALTH PLAN 801 SEVENTH AVE FORT WORTH TX 76104 760585240 INSURANCE TX 501(C)(3) 10 CCHCS true ROSEDALE OFFICE BUILDING INC 1500 W ROSEDALE FORT WORTH TX 76104 460866421 TITLE HOLDING TX 501(C)(2) N/A CCHF true CHILD STUDY CENTER 1300 W LANCASTER FORT WORTH TX 76102 751099536 HLTHCARE SRVC TX 501(C)(3) 7 CCMC true COOK CHILDREN'S HEALTH ENTERPRISES 801 SEVENTH AVE FORT WORTH TX 76104 842625990 SUPPORT TX 501(C)(3) 12B CCHCS true COOK CHILDRENS MEDICAL CENTER 801 SEVENTH AVE FORT WORTH TX 76104 752051646 HEALTHCARE SV TX 501(C)(3) 3 CCHCS true COOK CHILDREN'S SURGERY CENTER 11221 ROE AVE SUITE 320 LEAWOOD KS 66211 205227064 ASC TX NA N/A CENTER FOR PEDIATRIC SURGERY 11221 ROE AVE SUITE 320 LEAWOOD KS 66211 470871715 ASC TN NA N/A CPS PEDIATRICS LLC 11221 ROE AVE SUITE 320 LEAWOOD KS 66211 470871718 ASC TX NA N/A COOK CHILDREN'S HEALTH SERVICES INC 801 7TH AVENUE FORT WORTH TX 76104 454024843 HEALTHCARE TX CCHCS C CORPORATION true COOK CHILDREN'S INDEMNITY COMPANY PO BOX 1159 CARIBBEAN PLAZA 2ND FL GRAND CAYMAN CJ KY1-1102 980424041 SELF-INSURANCE CJ CCHCS C CORPORATION true false false false false false false false false true false false false false false true false true false true COOK CHILDREN'S MEDICAL CENTER S 59107939 BOOK VALUE