2022-08-05T16:14:40-05:00 2021-09-30 FORVIS LLP 14241 DALLAS PARKWAY SUITE 1100 DALLAS TX 75254 990 2020-10-01 752705881 Cook Children's Health Care System % CORY RHOADES COOK 6828854000 801 Seventh Avenue Fort Worth TX 76104 CORY R RHOADES CFO & SVP, FINANCE 1111111111 2022-08-15 true CORY R RHOADES 999009999 MICHAEL J ENGLE P00482834 9727028262 3 2020 2022-09-23 18:48:47Z RICK W MERRILL 801 SEVENTH AVE FORT WORTH TX 76104 360576539 false X WWW.COOKCHILDRENS.ORG X 1996 TX KNOWING THAT EVERY CHILD'S LIFE IS SACRED IT IS OUR PROMISE TO IMPROVE THE HEALTH OF EVERY CHILD IN OUR REGION THROUGH THE PREVENTION AND TREATMENT OF ILLNESS, DISEASE AND INJURY 22 14 889 16 0 0 7637971 4073762 237325020 271864755 11162446 5438451 654855 785605 256780292 282162573 139458 66020 0 0 64708437 72686897 0 0 0 202026720 196498828 266874615 269251745 -10094323 12910828 566258574 553188226 292976426 272042541 273282148 281145685 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 228541384 66020 272650360 Cook Children's Health Care System (CCHCS) embraces an inspiring Promise-to improve the health of every child through the prevention and treatment of illness, disease and injury. As a not-for-profit, nationally recognized and integrated pediatric health care organization based in Fort Worth, Texas, Cook Children's comprises 14 entities. They include a medical center, physician network, health plan, home health company, health foundation, a child study center and three surgery centers located in Fort Worth, Hurst and Prosper. It also includes Cook Children's Health Services Inc., and Cook Children's Health Foundation. Cook Children's Health Care System's reputation for excellence draws patients from near and far. Families travel from across Texas and the United States, as well as internationally, to receive life-saving pediatric care and benefit from the collaboration and vast resources the system offers. In addition to the medical center, a network of more than 60 primary, specialty and urgent care locations provide numerous access points for families. Community Needs Spur System Growth As the population increases, the System continues to expand its services to meet the needs of children and families living in those areas. In 2019, the System added facilities near Walsh in Fort Worth, in Prosper and in Carrollton with primary care, urgent care and orthopedics services. In 2020, the Prosper campus grew to include an outpatient surgery center, outpatient imaging and lab services, and a number of specialty care services. The Peaks Tech Zone was added to the Prosper campus in 2021. It's a cross between a technology lounge and in-person help desk, complete with a self-service space and a consultation area for one-on-one assistance from a health technology advocate, or techspert. Here families can get guided, hands-on experience with devices and online applications recommended for their child's care. Expansion of the Prosper campus continues with the construction of an inpatient medical center that will add an emergency department, operating rooms, a medical/surgical unit and pediatric intensive care unit. The medical center's steel structure was completed in December 2021 with opening set for early FY22. Cook Children's pediatric surgery centers are home to specialty clinics and surgical teams specializing in many conditions, from simple to the most complex, and many of the procedures in these centers use minimally invasive techniques. The Dodson Surgery Center is one of three Cook Children's surgery centers in the Dallas/Fort Worth metroplex. In February 2021, plans to expand the Dodson Surgery Center entered the construction phase. The expansion will centralize 40 specialty clinics into one location in order to support a more seamless experience for children who receive care from multiple specialties. The expansion includes 240,000 square-feet of new building and 75,000 square-feet of renovated space. Award Winning Performance For more than 100 years, the System has worked to combine the art of caring with life-saving pediatric interventions that are family-centered and built on leading technology, collaboration and a best-in-class patient experience. This has earned the System a strong, far-reaching reputation-one for which it continually receives recognition for outstanding efforts and outcomes in pediatric health care. Cook Children's commitment to comply with the highest national standards for safety and quality of care repeatedly earns the System the Joint Commission's Gold Seal of Approval. In February 2021, Cook Children's Medical Center became one of only 10 freestanding children's hospitals in the world to receive this prestigious recognition four times in a row Cook Children's Medical Center has been named numerous times to the elite Leapfrog Top Hospitals list based on a national quality and safety survey. A number of CCHCS physicians, nurses, clinicians and programs received recognitions and awards in 2021. Perhaps most notably, in a year when telehealth was such a critical resource, the System was named a 2021 Digital Health Most Wired organization for the fourth consecutive year and nine of the last 10 years. Protecting Your Tomorrows Like all organizations, the system faced many challenges during the COVID-19 pandemic. Cook Children's used the unique circumstances as an opportunity to identify, assess and plan for current and future needs for system-wide operational coordination, crisis management and infectious disease control. In response, Cook Children's began construction of a year-round solutions center that will coordinate daily operational needs for the entire system and will house dedicated space for an incident command center. This expansion includes a new six-bed infectious diseases critical care unit (CCU) and a 32-bed medical surgical unit. An existing 20-bed unit will 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. A Cook Children's Health Foundation capital campaign, called Protecting Your Tomorrows, is funding the project. In spite of the many challenges of FY21, the System continued to lead with fiscal responsibility, service to its community and commitment to its employees. In August 2021, for the second time in 18 months, the System increased its minimum wage, now at $16 an hour. Cook Children's Health Care System emerged from a year punctuated by the pandemic with a stronger workforce, a more nimble organization and better positioned to meet the health needs of the community. 228541384 true true false true false false false false false true true false false true true false false true false false true false false false false false false true true true false false false false false false false false false false false false false true true true true false true 184 0 true 889 true false true CJ false false false false false false false false true false X 22 14 true false false false true true true true true false false true true true true true true true true false X CORY RHOADES 6828854480 801 SEVENTH AVENUE FORT WORTH TX 76104 X RICK W MERRILL PRESIDENT AND CEO 12.0 28.0 X 715316 1669071 255388 B ANTHONY BAGWELL SVP, CIIO 1.0 40.0 X 0 1360265 163897 JAMES C CUNNINGHAM MD EXEC VP, CHIEF MEDICAL OFFICER 40.0 2.0 X 1133126 0 50821 STEPHEN W KIMMEL EVP, SYSTEM FINANCE 10.0 30.0 X 253160 759480 129999 KEITH HOLTZ CHIEF ADMINISTRATION OFFICER 40.0 0.0 X 824975 0 108857 CORY R RHOADES CHIEF FINANCIAL OFFICER 40.0 3.0 X 771239 0 122729 JOANN M SANDERS MD CHIEF QUALITY OFFICER 40.0 0.0 X 757661 0 102962 THERESA Z MEADOWS SR V PRESIDENT - CIO 40.0 2.0 X 778452 0 53031 JOSEPH M GALLAHGER SVP, CHIEF LEGAL OFFICER 40.0 3.0 X 685506 0 117159 JAMES D MARSHALL MD CHIEF RESEARCH OFFICER 40.0 0.0 X 713382 0 53851 ERIC H HUBLI MD CHIEF SYS EFFECTIVENESS OFFCR 40.0 0.0 X 693848 0 61819 ROBERT K FEATHER SR. VP PUBLIC POLICY 40.0 0.0 X 608104 0 46484 MICHELLE MARCINCUK MD TRUSTEE START: 06/2021 1.0 42.0 X 0 587925 55932 DEBORAH SCHUTTE MD TRUSTEE START: 06/2021 1.0 42.0 X 0 573400 57896 GAVIN FINE MD TRUSTEE 1.0 40.0 X 0 572391 54607 CHRISTIAN PEDIGO VP SYS PLANNING & HEALTH ANALY 40.0 0.0 X 508553 0 103319 MATTHEW DZURIK MD TRUSTEE - VC END: 06/2021 2.0 42.0 X 0 548147 45493 SCOTT LEDDY CHIEF MEDICAL INFO OFFICER 40.0 0.0 X 524538 0 32420 JOHN MCNEY SR V PRESIDENT- OF COUNSEL 40.0 0.0 X 501891 0 54029 SAMSON CANTU MD TRUSTEE END: 06/2021 1.0 42.0 X 0 480559 58274 M SCOTT PERRY MD TRUSTEE END: 06/2021 1.0 43.0 X 0 478891 53931 GREGORY JIMERSON VP-PAYOR RELATIONS 40.0 0.0 X 402245 0 60893 KAREN WARDELL ASSOCIATE GENERAL COUNSEL 40.0 0.0 X 406787 0 47336 ALICE W PHILLIPS MD TRUSTEE - VICE CHAIRMAN 2.0 42.0 X X 0 394894 50576 SPENCER D SEALS VP CONSTRUCTION & REAL ESTATE 40.0 5.0 X 387200 0 55020 KENT SMITH VICE PRESIDENT - COMPLIANCE 40.0 0.0 X 390747 0 47820 MATTHEW CARROLL MD TRUSTEE 1.0 40.0 X 0 353961 59355 NATALIE WILKINS CHIEF OF STAFF 40.0 0.0 X 377601 0 23319 AARON WISHON VP-CHIEF INFO SECURITY OFFICER 40.0 0.0 X 354642 0 26375 DAVID LANCASTER VP-INTERNAL AUDIT 40.0 0.0 X 323363 0 52440 JULEE S MORROW MD TRUSTEE 1.0 44.0 X 0 305857 45224 WINIFRED J KING AVP CHEIF COMM & DE&I OFFICER 40.0 0.0 X 301006 0 41927 LINDSAY NEWTON MD TRUSTEE END: 06/2021 1.0 42.0 X 0 299448 39190 LORRAINEA WILLIAMS PAT/MEDICATION SAFETY OFFICER 40.0 0.0 X 263781 0 56561 BETH SCHMIDT AVP-HUMAN RESOURCES 40.0 0.0 X 285895 0 33614 JEAN TURPIN AVP, BUSINESS INTEL 40.0 0.0 X 263229 0 50194 MEGAN CHAVEZ VP PATIENT & FAMILY EXPERIENCE 40.0 0.0 X 268858 0 31373 MICHAEL ANNE PRITCHARD ASST GEN COUNSEL- CORP I/P 40.0 0.0 X 238588 0 53484 SARA Y GARZA MD TRUSTEE 1.0 40.0 X 0 244209 41812 AMIT PATEL ASSISTANT CHIEF MED INFO OFFCR 40.0 0.0 X 261425 0 23900 MATTHEW ALBERS AVP DIGITAL EXPERIENCE 40.0 0.0 X 246839 0 33944 MYRANDA MILLER AVP, CORPORATE CONTROLLER 40.0 0.0 X 231060 0 48515 LAURA E COPELAND ASSISTANT GENERAL COUNSEL 40.0 0.0 X 244595 0 34072 CYNTHIA W GUESS AVP ACCD COMPLIANCE END: 01/21 40.0 0.0 X 237983 0 37077 KATHY R MCLEAN AVP MARKETING 40.0 0.0 X 241042 0 31810 DEBORAH A RUBINSON AVP, ORG & PROF DEVELOPMENT 40.0 0.0 X 238047 0 28329 CHRISTOS PAPADELIS DIRECTOR RESEARCH CENTER 40.0 0.0 X 221578 0 39910 NICOLAE ANDREI AVP SUPPLY CHAIN 40.0 0.0 X 240281 0 20420 CHARITY N DARNELL AVP CLINICAL APPS 40.0 0.0 X 206879 0 45971 LAKAIMI j BRYANT AVP, ENTERPRISE APPLICATIONS 40.0 0.0 X 212313 0 39557 BIANKA SORIA-OLMOS DO TRUSTEE START: 06/2021 1.0 42.0 X 0 201205 45029 MARILYN NAPPIER AVP CENTER FOR CHILDREN HEALTH 40.0 0.0 X 182708 0 37932 MARY CARA MARTZ SECRETARY 40.0 8.0 X 165987 0 24953 SHERNETTE KYDD AVP SYSTEM EFFECTIVENESS 40.0 0.0 X 150649 0 30641 LAURA VAN HOOSIER AVP PUBLIC RELATIONS 40.0 0.0 X 157067 0 21521 PETER L PHILPOTT TRUSTEE 1.0 3.0 X 0 0 0 JOHN P BOSWELL TRUSTEE 1.0 4.0 X 0 0 0 JERRY R CONATSER TRUSTEE 1.0 6.0 X 0 0 0 JEFFREY H CONNER TRUSTEE END: 06/2021 1.0 4.0 X 0 0 0 JAMES R DUNAWAY JR TRUSTEE END: 06/2021 1.0 1.0 X 0 0 0 W M MACK LAWHON TRUSTEE 1.0 1.0 X 0 0 0 BRIAN C NEWBY TRUSTEE 1.0 1.0 X 0 0 0 JAMES E WEBB TRUSTEE 1.0 5.0 X 0 0 0 ROBERT J BATTON TRUSTEE 1.0 3.0 X 0 0 0 ANNE M CARVALHO TRUSTEE 1.0 3.0 X 0 0 0 BRIAN C CRUMLEY TRUSTEE - SEC/TREASURER 2.0 2.0 X X 0 0 0 MICHAEL R DIKE TRUSTEE 1.0 5.0 X 0 0 0 RICHARD W DYESS TRUSTEE 1.0 6.0 X 0 0 0 R RUSSELL MORTON TRUSTEE - CHAIRMAN 2.0 3.0 X X 0 0 0 JONATHAN NEDRELOW MD TRUSTEE 1.0 0.0 X 0 0 0 ANDREW J ROSELL TRUSTEE 1.0 3.0 X 0 0 0 10665983 7425023 1996723 315 false true false TECHNOLOGENT 15821 VENTURAA BLVD SUITE 100 ENCINO CA 91436 HARDWARE/SOFTWARE SE 3343684 KUDELSKI SECURITY 5090 NORTH 40TH STREET SUITE 450 PHOENIX AZ 85018 HARDWARE/SOFTWARE SE 3130423 EPIC SYSTEMS CORPORATION PO BOX 88314 MILWAUKEE WI 532880314 SOFTWARE SERVICES 2736560 CHOICE SOLUTIONS 7015 COLLEGE BLVD SUITE 300 OVERLAND PARK KS 66211 SOFTWARE SERVICES 1850256 NETSYNC NETWORK SOLUTIONS 2500 WEST LOOP SOUTH SUITE 410 HOUSTON TX 77027 HARDWARE/SOFTWARE SE 1561360 39 1961697 2112065 0 4073762 SHARED SERVICES 900099 237508677 237508677 HUMAN RESOURCES 900099 12069278 12069278 RENT 900099 12844323 12844323 COMMUNITY HEALTH OUTREACH 900099 5715184 5715184 REAL ESTATE MANAGEMENT 900099 358504 358504 3368789 3368789 271864755 4500548 4500548 0 0 0 0 0 79311711 40158 78386808 27158 924903 13000 937903 937903 0 0 0 0 0 0 0 0 0 REBATE 900099 703510 703510 CONCIERGE 900099 21460 21460 OTHER REVENUE 900099 60635 60635 785605 282162573 272650360 5438451 16020 16020 50000 50000 0 0 16056065 4080874 11975191 0 37559402 28859867 8699535 1916819 621495 1295324 13906676 10946576 2960100 3247935 2344105 903830 0 2897902 1468877 1429025 0 281955 281955 0 0 13193568 10121322 3072246 4488527 913807 3574720 3020485 2950347 70138 113783851 113783851 0 1092654 1092654 250282 196437 53845 0 242542 230288 12254 0 0 17014750 17014750 0 MINOR EQUIPMENT 6274937 6274937 PHYSICIAN REMUNERATION 21904271 17225309 4678962 REINSURANCE 3927701 3927701 RECRUITMENT 1771282 1770532 750 6354121 4651635 1702486 269251745 228541384 40710361 0 10550 10750 23596069 31521836 979205 1084084 4814508 2301784 0 0 0 0 0 0 6203 4096 5187254 5749396 388762261 149447376 253055916 239314885 243042760 243185969 0 0 0 0 0 0 35566109 30015426 566258574 553188226 266541805 246760988 0 0 379496 491867 0 0 0 0 0 0 0 0 0 0 26055125 24789686 292976426 272042541 X 273282148 281145685 0 0 273282148 281145685 566258574 553188226 X 12910828 -5143711 96420 X false true X true true true X X 4 COOK CHILDREN'S MEDICAL CENTER 752051646 3 true 228541384 0 1 228541384 0 true false false false false true false false false false false false false false false true true false X true true SCHEDULE A, PART IV, SECTION E, LINE 3A POWER TO REGULARLY APPOINT: THE ORGANIZATION IS THE SOLE MEMBER OF THE SUPPORTED ORGANIZATION, COOK CHILDREN'S MEDICAL CENTER, AND AS SUCH HAS THE POWER TO DETERMINE THE NUMBER OF MEMBERS OF THE BOARD OF TRUSTEES AND TO ELECT THE MEMBERS OF THE BOARD OF TRUSTEES OF THE SUPPORTED ORGANIZATION. SCHEDULE A, PART IV, SECTION E, LINE 3B SUBSTANTIAL DEGREE OF DIRECTION OVER POLICIES, PROGRAMS, AND ACTIVITIES: THE ORGANIZATION IS THE SOLE MEMBER OF THE SUPPORTED ORGANIZATION, COOK CHILDREN'S MEDICAL CENTER, AND AS SUCH HAS THE EXCLUSIVE 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. THE ORGANIZATION IS ALSO RESPONSIBLE FOR IMPLEMENTATION AND ENFORCEMENT OF VARIOUS POLICIES AND PROCEDURES OF THE SUPPORTED ORGANIZATION INCLUDING THE CONFLICT OF INTEREST POLICY AND COMPENSATION ARRANGEMENTS. SCHEDULE A, PART IV, SECTION A, LINE 6 SUPPORT TO NON-SUPPORTED ORGANIZATIONS: THE SYSTEM SOMETIMES GIVES DONATIONS TO UNRELATED CHARITABLE ORGANIZATIONS THAT HAVE MISSIONS OR PROGRAMS THAT FUTHER THE EXEMPT PURPOSE OF THE SUPPORTED ORGANIZATION, COOK CHILDREN'S MEDICAL CENTER. THESE DONATIONS ARE MINIMAL AND THE SYSTEM TREATS THIS AS SUPPORT TO THE MEDICAL CENTER DUE TO THE NATURE OF THE DONATIONS. 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HOLDS AND ADMINISTERS THE ENDOWMENT FOR THE NEEDS RELATED TO THE PROGRAM(S) AS SPECIFIED IN THE DONATION DOCUMENTS. SCHEDULE D, PART XI, LINE 2D RECONCILIATION OF REVENUES PER AUDITED FINANCIALS TO TAX RETURN: MANAGEMENT FEE REDUCTION $2,721,453 SCHEDULE D, PART XI, LINE 4B RECONCILIATION OF REVENUES PER AUDITED FINANCIALS TO TAX RETURN: DONATED CAPITAL $91,700 GAIN ON DISPOSITION OF ASSETS 13,000 BAD DEBT RECOVERY 324,805 --------- TOTAL $429,505 SCHEDULE D, PART XII, LINE 2D RECONCILIATION OF EXPENSES PER AUDITED FINANCIALS TO TAX RETURN: MANAGEMENT FEE REDUCTION $2,721,453 GAIN ON DISPOSITION OF ASSET (13,000) BAD DEBT RECOVERY (324,805) ------------ $2,383,648 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. Central America and the Caribbean Investments 15293242 15293242 15293242 true false true false false false true CYSTIC FIBROSIS FOUNDATION 1600 AIRPORT FREEWAY STE 501 BEDFORD TX 76022 131930701 501(C)(3) 6020 GENERAL SUPPORT FIRST3YEARS 15851 DALLAS PARKWAY 106 ADDISON TX 75001 752067421 501(C)(3) 10000 BABY DAY COMMUNTY ENGAGEMENT 2 SCHOLARSHIPS FOR INDIVIDUALS 10 50000 SCHEDULE I, PART I, LINE 2 PROCEDURE FOR MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES: THE ORGANIZATION USES PUBLIC AND PRIVATE DATA TO MONITOR THE USE OF FUNDS, AS NEEDED. IN ORDER TO BE ELIGIBLE FOR THE PRESIDENT'S SCHOLARSHIP AWARD THE APPLICANTS MUST MEET THE FOLLOWING REQUIREMENTS: 1) BE A CHILD OF A FULL TIME EMPLOYEE WITH ONE YEAR FULL TIME EXPERIENCE, 2) BE A FULL TIME STUDENT IN A BACCALAUREATE PROGRAM AND 3) PURSUING A DEGREE APPLICABLE TO THE HEALTHCARE WORKFORCE. THE SCHOLARSHIP RECIPIENTS ARE SELECTED BY THE SCHOLARSHIP COMMITTEE. THE SELECTION IS BASED ON ESSAYS SUBMITTED BY THE APPLICANTS, AS WELL AS GRADES. THE MINIMUM AWARD IS $5,000 FOR FIRST TIME RECIPIENTS AND $2,500 FOR REPEAT RECIPIENTS. SCHOLARSHIP PAYMENTS ARE ISSUED DIRECTLY TO THE UNIVERSITIES. X false true X X X X X false true false false false false false false false RICK W MERRILL PRESIDENT AND CEO 372360 868839 230263 537282 112693 262950 65213 152163 11404 26608 791933 1847842 0 0 MATTHEW DZURIK MD TRUSTEE - VC END: 06/2021 0 502313 0 500 0 45334 0 21375 0 24118 0 593640 0 0 JOANN M SANDERS MD CHIEF QUALITY OFFICER 406360 0 184149 0 167152 0 80624 0 22338 0 860623 0 51822 0 DEBORAH A RUBINSON AVP, ORG & PROF DEVELOPMENT 181675 0 45963 0 10409 0 12246 0 16083 0 266376 0 0 0 JAMES C CUNNINGHAM MD EXEC VP, CHIEF MEDICAL OFFICER 607397 0 307663 0 218066 0 21375 0 29446 0 1183947 0 71048 0 MATTHEW CARROLL MD TRUSTEE 0 280535 0 51966 0 21460 0 17813 0 41542 0 413316 0 0 ROBERT K FEATHER SR. VP PUBLIC POLICY 323494 0 148562 0 136048 0 21375 0 25109 0 654588 0 0 0 KEITH HOLTZ CHIEF ADMINISTRATION OFFICER 475354 0 240510 0 109111 0 83522 0 25335 0 933832 0 53393 0 ERIC H HUBLI MD CHIEF SYS EFFECTIVENESS OFFCR 565666 0 15607 0 112575 0 21375 0 40444 0 755667 0 0 0 GREGORY JIMERSON VP-PAYOR RELATIONS 256877 0 93621 0 51747 0 20739 0 40154 0 463138 0 0 0 STEPHEN W KIMMEL EVP, SYSTEM FINANCE 147302 441905 74804 224414 31054 93161 24689 74067 7811 23432 285660 856979 68837 0 DAVID LANCASTER VP-INTERNAL AUDIT 202197 0 74496 0 46670 0 20464 0 31976 0 375803 0 0 0 SCOTT LEDDY CHIEF MEDICAL INFO OFFICER 356600 0 124517 0 43421 0 17813 0 14607 0 556958 0 0 0 JAMES D MARSHALL MD CHIEF RESEARCH OFFICER 531606 0 152691 0 29085 0 21375 0 32476 0 767233 0 0 0 MARY CARA MARTZ SECRETARY 127943 0 32854 0 5190 0 7972 0 16981 0 190940 0 0 0 JOHN MCNEY SR V PRESIDENT- OF COUNSEL 287214 0 135009 0 79668 0 21375 0 32654 0 555920 0 0 0 THERESA Z MEADOWS SR V PRESIDENT - CIO 439624 200828 138000 0 17813 0 35218 0 831483 0 0 0 CORY R RHOADES CHIEF FINANCIAL OFFICER 450778 0 207024 0 113437 0 84800 0 37929 0 893968 0 34702 0 NATALIE WILKINS CHIEF OF STAFF 268313 0 93730 0 15558 0 9321 0 13998 0 400920 0 0 0 JOSEPH M GALLAHGER SVP, CHIEF LEGAL OFFICER 401735 0 180189 0 103582 0 80436 0 36723 0 802665 0 0 0 BETH SCHMIDT AVP-HUMAN RESOURCES 216015 0 62438 0 7442 0 16312 0 17302 0 319509 0 0 0 KENT SMITH VICE PRESIDENT - COMPLIANCE 244810 0 89267 0 56670 0 16145 0 31675 0 438567 0 0 0 KAREN WARDELL ASSOCIATE GENERAL COUNSEL 248753 0 90643 0 67391 0 15416 0 31920 0 454123 0 0 0 MATTHEW ALBERS AVP DIGITAL EXPERIENCE 189334 0 42981 0 14524 0 9674 0 24270 0 280783 0 0 0 NICOLAE ANDREI AVP SUPPLY CHAIN 186766 0 50074 0 3441 0 5270 0 15150 0 260701 0 0 0 B ANTHONY BAGWELL SVP, CIIO 0 584795 0 661844 0 113626 0 127912 0 35985 0 1524162 0 0 LAKAIMI j BRYANT AVP, ENTERPRISE APPLICATIONS 166453 0 42640 0 3220 0 16079 0 23478 0 251870 0 0 0 SAMSON CANTU MD TRUSTEE END: 06/2021 0 453609 0 500 0 26450 0 17813 0 40461 0 538833 0 0 MEGAN CHAVEZ VP PATIENT & FAMILY EXPERIENCE 168339 0 22250 0 78269 0 7163 0 24210 0 300231 0 0 0 LAURA E COPELAND ASSISTANT GENERAL COUNSEL 191374 0 49977 0 3244 0 7646 0 26426 0 278667 0 0 0 CHARITY N DARNELL AVP CLINICAL APPS 161354 0 42640 0 2885 0 8575 0 37396 0 252850 0 0 0 GAVIN FINE MD TRUSTEE 0 559369 0 500 0 12522 0 21375 0 33232 0 626998 0 0 SARA Y GARZA MD TRUSTEE 0 238965 0 500 0 4744 0 12267 0 29545 0 286021 0 0 CYNTHIA W GUESS AVP ACCD COMPLIANCE END: 01/21 183455 0 47772 0 6756 0 9922 0 27155 0 275060 0 0 0 WINIFRED J KING AVP CHEIF COMM & DE&I OFFICER 226931 0 46062 0 28013 0 28439 0 13488 0 342933 0 0 0 SHERNETTE KYDD AVP SYSTEM EFFECTIVENESS 132653 0 14917 0 3079 0 6201 0 24440 0 181290 0 0 0 MICHELLE MARCINCUK MD TRUSTEE START: 06/2021 0 565404 0 500 0 22021 0 17813 0 38119 0 643857 0 0 KATHY R MCLEAN AVP MARKETING 188398 0 47180 0 5464 0 17790 0 14020 0 272852 0 0 0 MYRANDA MILLER AVP, CORPORATE CONTROLLER 177930 0 46415 0 6715 0 9680 0 38835 0 279575 0 0 0 JULEE S MORROW MD TRUSTEE 0 292013 0 500 0 13344 0 9593 0 35631 0 351081 0 0 MARILYN NAPPIER AVP CENTER FOR CHILDREN HEALTH 141690 0 32729 0 8289 0 8592 0 29340 0 220640 0 0 0 LINDSAY NEWTON MD TRUSTEE END: 06/2021 0 262809 0 15500 0 21139 0 8627 0 30563 0 338638 0 0 CHRISTOS PAPADELIS DIRECTOR RESEARCH CENTER 189172 0 30502 0 1904 0 6810 0 33100 0 261488 0 0 0 AMIT PATEL ASSISTANT CHIEF MED INFO OFFCR 216807 0 32954 0 11664 0 10365 0 13535 0 285325 0 0 0 CHRISTIAN PEDIGO VP SYS PLANNING & HEALTH ANALY 301717 0 140409 0 66427 0 65452 0 37867 0 611872 0 0 0 M SCOTT PERRY MD TRUSTEE END: 06/2021 0 465811 0 500 0 12580 0 19500 0 34431 0 532822 0 0 ALICE W PHILLIPS MD TRUSTEE - VICE CHAIRMAN 0 362158 0 500 0 32236 0 18394 0 32182 0 445470 0 0 MICHAEL ANNE PRITCHARD ASST GEN COUNSEL- CORP I/P 186147 0 49109 0 3332 0 15431 0 38053 0 292072 0 0 0 DEBORAH SCHUTTE MD TRUSTEE START: 06/2021 0 560378 0 500 0 12522 0 21375 0 36521 0 631296 0 0 SPENCER D SEALS VP CONSTRUCTION & REAL ESTATE 248272 0 87207 0 51721 0 17760 0 37260 0 442220 0 0 0 BIANKA SORIA-OLMOS DO TRUSTEE START: 06/2021 0 179355 0 15500 0 6350 0 11094 0 33935 0 246234 0 0 JEAN TURPIN AVP, BUSINESS INTEL 205484 0 54080 0 3665 0 15217 0 34977 0 313423 0 0 0 LAURA VAN HOOSIER AVP PUBLIC RELATIONS 129346 0 25000 0 2721 0 6360 0 15161 0 178588 0 0 0 LORRAINEA WILLIAMS PAT/MEDICATION SAFETY OFFICER 199074 0 53056 0 11651 0 14499 0 42062 0 320342 0 0 0 AARON WISHON VP-CHIEF INFO SECURITY OFFICER 248884 0 87964 0 17794 0 9884 0 16491 0 381017 0 0 0 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 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 B. ANTHONY BAGWELL NONE 116,512 FOUNDATION JOSEPH M. GALLAGHER NONE 59,221 SYSTEM KEITH HOLTZ 53,393 65,710 SYSTEM WINIFRED KING NONE 10,103 SYSTEM CHRISTIAN PEDIGO NONE 44,077 SYSTEM CORY R. RHOADES 34,702 63,425 SYSTEM JOANN SANDERS 51,822 59,249 SYSTEM JAMES CUNNINGHAM 71,048 NONE SYSTEM JOHN MCNEY 40,750 NONE SYSTEM THERESA MEADOWS 53,676 NONE SYSTEM Schedule J, Part I, Line 1a & 1b GENERAL GROSS UP PAYMENTS IN W-2 TAXABLE COMPENSATION: MATTHEW ALBERS MEGAN CHAVEZ STEPHEN ECKERT SHERMETTE KYDD LAURA VAN HOOSIER 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 EXTREMELY UNUSUAL 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. FORM 990, PART VI, SECTION A, LINE 6 SOLE MEMBER: W. I. COOK FOUNDATION, INC., D/B/A COOK CHILDREN'S HEALTH FOUNDATION, 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, W.I. COOK FOUNDATION, INC., 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, W.I. COOK FOUNDATION, INC., HAS THE EXCLUSIVE 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; F. APPROVE THE CREATION OF, OR INVESTMENT IN, ANY SUBSIDIARY ENTITY; G. APPROVE THE REMOVAL OF A MEMBER OF THE BOARD OF TRUSTEES OF THE ORGANIZATION; AND H. APPROVE THE PERSONS WHO ARE TO BE ELECTED BY THE ORGANIZATION TO FILL ANY VACANCIES ON THE BOARD OF TRUSTEES OR BOARD OF DIRECTORS, AS APPLICABLE, OF (1) COOK CHILDREN'S MEDICAL CENTER, (2) COOK CHILDREN'S PHYSICIAN NETWORK, (3) COOK CHILDREN'S HOME HEALTH, (4) COOK CHILDREN'S HEALTH PLAN, (5) COOK CHILDREN'S INDEMNITY COMPANY (6) COOK CHILDREN'S HEALTH ENTERPRISES; AND (7) ANY OTHER SUBSIDIARY CORPORATION AFFILIATED WITH OR CONTROLLED BY THE ORGANIZATION (INCLUDING ANY VACANCIES ARISING FROM THE EXPIRATION OF THE TERMS OF ANY OF THE TRUSTEES OR DIRECTORS). 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 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 OF FUND BALANCES: TRANSFERS FROM CCMC $82,902 NET ASSETS RELEASED FROM RESTRICTIONS 105,218 DONATED CAPITAL RELEASED FROM FOUNDATION (91,700) --------- 96,420 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 ON BOARD SERVICE WITH OTHER ORGANIZATIONS WITHIN THE SYSTEM. COOK CHILDREN'S HEALTH PLAN 801 SEVENTH AVE FORT WORTH TX 76104 760585240 INSURANCE TX 501(C)(3) 10 CCHCS true COOK CHILDREN'S PHYSICIAN NETWORK 801 SEVENTH AVE FORT WORTH TX 76104 752485366 PHYSICIAN SVC TX 501(C)(3) 3 CCHCS true COOK CHILDREN'S MEDICAL CENTER 801 SEVENTH AVE FORT WORTH TX 76104 752051646 HOSPITAL TX 501(C)(3) 3 CCHCS true WI COOK FOUNDATION 801 SEVENTH AVE FORT WORTH TX 76104 752051649 FUNDRAISING TX 501(C)(3) 7 NA false COOK CHILDREN'S HOME HEALTH 801 SEVENTH AVE FORT WORTH TX 76104 752896983 HEALTHCARE 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 WEST LANCASTER AVE FORT WORTH TX 76102 751099536 HEALTHCARE TX 501(C)(3) 7 CCMC true COOK CHILDREN'S HEALTH ENTERPRISES 801 7TH AVE FORT WORTH TX 76104 842625990 SUPPORT TX 501(C)(3) 12B cchcs true COOK CHILDREN'S MEDICAL CENTER PROSPER 801 SEVENTH AVE FORT WORTH TX 76087 852354189 HEALTHCARE SV TX 501(C)(3) 3 CCHCS true CPS PEDIATRICS LLC 11221 ROE AVE SUITE 320 LEAWOOD KS 66211 470871718 ASC TX NA N/A COOK CHILDREN'S SURGERY CENTER 11221 ROE AVE SUITE 320 LEAWOOD KS 66211 205227064 ASC TX NA N/A CENTER FOR PEDIATIC SURGERY 11221 ROE AVE SUITE 320 LEAWOOD KS 66211 470871715 ASC TX NA N/A COOK CHILDREN'S HEALTH SERVICES INC 801 7TH AVENUE FORT WORTH TX 76104 454024843 HEALTHCARE TX CCHCS C CORPORATION 1039109 7961117 1.00000 true COOK CHILDREN'S INDEMNITY COMPANY PO BOX 1159 CARIBBEAN PLAZA ND FL GRAND CAYMAN CJ KY11107 980424041 SELF INSURANCE CJ CCHCS C CORPORATION 432227 46336612 1.00000 true true false true true false false false false false false true true false false true true true true true COOK CHILDREN'S MEDICAL CENTER A 2441483 FMV COOK CHILDREN'S MEDICAL CENTER B 41890138 FMV COOK CHILDREN'S MEDICAL CENTER O 953264 FMV COOK CHILDREN'S MEDICAL CENTER P 401800 FMV COOK CHILDREN'S MEDICAL CENTER S 271114 FMV COOK CHILDREN'S MEDICAL CENTER Q 277878861 FMV COOK CHILDREN'S PHYSICIAN NETWORK A 5863469 FMV COOK CHILDREN'S PHYSICIAN NETWORK B 382053 FMV COOK CHILDREN'S PHYSICIAN NETWORK O 22260549 FMV COOK CHILDREN'S PHYSICIAN NETWORK P 311369 FMV COOK CHILDREN'S PHYSICIAN NETWORK Q 37916674 FMV COOK CHILDREN'S HOME HEALTH A 860937 FMV COOK CHILDREN'S HOME HEALTH Q 5823473 FMV COOK CHILDREN'S HEALTH PLAN A 1388497 FMV COOK CHILDREN'S HEALTH PLAN Q 17682967 FMV COOK CHILDREN'S HEALTH SERVICES q 193503 FMV ROSEDALE OFFICE BUILDING K 1712998 FMV ROSEDALE OFFICE BUILDING O 88877 FMV ROSEDALE OFFICE BUILDING P 620450 FMV CHILD STUDY CENTER Q 1815020 FMV cookc children's indemnity company r 7791106 fmv COOK CHILDREN'S HEALTH PLAN 801 SEVENTH AVE FORT WORTH TX 76104 760585240 0 16367 16367 668662384 668678751 1000000 250000 0 0 0 COOK CHILREN'S HEALTH CARE S 801 SEVENTH AVE FORT WORTH TX 76104 752705881 X 0 281955 281955 268969790 269251745 1000000 250000 0 0 0 COOK CHILDREN'S PHYSICIAN NE 801 SEVENTH AVE FORT WORTH TX 76104 752485366 0 0 0 386674905 386674905 1000000 250000 0 0 0 COOK CHILDREN'S MEDICAL CENT 801 SEVENTH AVE FORT WORTH TN 76104 752051646 0 0 0 1155105021 1155105021 1000000 250000 0 0 0 WI COOK FOUNDATION 801 SEVENTH AVE FORT WORTH TX 76104 752051649 0 0 0 44044793 44044793 1000000 250000 0 0 0 COOK CHILDREN'S HOME HEALTH 801 SEVENTH AVE FORT WORTH TX 76104 752896983 0 0 0 59558153 59558153 1000000 250000 0 0 0 ROSEDALE OFFICE BUILDING 1500 W ROSEDALE FORT WORTH TX 76104 460866421 0 0 0 2333451 2333451 266673 66668 0 0 0 CHILD STUDY CENTER 801 SEVENTH AVE FORT WORTH TX 76104 751099536 0 0 0 8995731 8995731 599787 149947 0 0 0 COOK CHILDREN'S HEALTH ENTER 801 SEVENTH AVE FORT WORTH TX 76104 842625990 0 0 0 6740199 6740199 487010 121753 0 0 0 COOK CHILDREN'S MEDICAL CENT 801 SEVENTH AVE FORT WORTH TX 76104 852354189 0 0 0 46601 46601 9320 2330 0 0 0