COOK CHILDRENS MEDICAL CENTER: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization: COOK CHILDRENS MEDICAL CENTER (EIN 75-2051646)
Tax period: 2018-10-01 to 2019-09-30
Filed: 2020-08-12
IRS object ID: 202042259349301149
Schema version: 2018v3.3
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 D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2020-08-12T14:06:59-05:00	ReturnTs
Tax Period End	2019-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BKD 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	2018-10-01	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 RHOADES	PersonNm
Person Title	SVP, Finance	PersonTitleTxt
Signature	2020-08-17	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Kevin Ensminger	PreparerPersonNm
PTIN	P01310558	PTIN
Phone	9727028262	PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	167.68.126.162	IPv4AddressTxt

Field	Value	IRS element (for citing)
Federal Original Submission Id	76915820202255000011	FederalOriginalSubmissionId
Federal Original Submission Id	2020-08-12	FederalOriginalSubmissionIdDt
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	21E6481FF4EC5D606F81E380A49442717B3AD96E	AtSubmissionCreationDeviceId
At Submission Filing Device Id	EB976710118F518B8933A72D91D1D85239D99EDA	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2018	TaxYr
Build TS	2020-09-23 17:36:50Z	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	$1,195,154,419	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.COOKCHILDRENS.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1985	FormationYr
Legal Domicile State	TX	LegalDomicileStateCd
Activity Or Mission	KNOWING THAT EVERY CHILD'S LIFE IS SACRED OUR PROMISE IS TO IMPROVE THE HEALTH OF EVERY CHILD IN OUR REGION THROUGH THE PREVENTION AND TREATMENT OF ILLNESS, DISEASE AND INJURY.	ActivityOrMissionDesc
Voting Members Governing Body	13	VotingMembersGoverningBodyCnt
Voting Members Independent	12	VotingMembersIndependentCnt
Total Employee	5187	TotalEmployeeCnt
Total Volunteers	990	TotalVolunteersCnt
Total Gross UBI	$14,830	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$10,672	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$14,838,415	PYContributionsGrantsAmt
CY Contributions Grants	$12,053,920	CYContributionsGrantsAmt
PY Program Service Revenue	$1,074,156,886	PYProgramServiceRevenueAmt
CY Program Service Revenue	$1,180,339,581	CYProgramServiceRevenueAmt
PY Investment Income	$338,304	PYInvestmentIncomeAmt
CY Investment Income	$166,062	CYInvestmentIncomeAmt
PY Other Revenue	$1,588,551	PYOtherRevenueAmt
CY Other Revenue	$1,387,895	CYOtherRevenueAmt
PY Total Revenue	$1,090,922,156	PYTotalRevenueAmt
CY Total Revenue	$1,193,947,458	CYTotalRevenueAmt
PY Grants And Similar Paid	$63,945,605	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$65,050,938	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$363,030,732	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$380,095,875	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$486,324,744	PYOtherExpensesAmt
CY Other Expenses	$536,028,942	CYOtherExpensesAmt
PY Total Expenses	$913,301,081	PYTotalExpensesAmt
CY Total Expenses	$981,175,755	CYTotalExpensesAmt
PY Revenues Less Expenses	$177,621,075	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$212,771,703	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,200,788,157	TotalAssetsBOYAmt
Total Assets EOY	$1,426,284,240	TotalAssetsEOYAmt
Total Liabilities BOY	$436,324,447	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$450,333,040	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$764,463,710	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$975,951,200	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	$703,804,326	ExpenseAmt
Grant	$65,050,938	GrantAmt
Revenue	$1,181,579,232	RevenueAmt
Desc	COOK CHILDREN'S MEDICAL CENTER THE MEDICAL CENTER IS THE CORNERSTON OF COOK CHILDREN'S HEALTH CARE SYSTEM. IT'S THE HOME OF TOP MEDICALMINDS, ADVANCED TECHNOLOGIES AND TREATMENTS AND LEADING-EDGE CLINICAL RESEARCH, ALL DESIGNED TO MEET THE HEALTH CARE NEEDS OF CHILDREN. COOK CHILDREN'S 444-BED MEDICAL CENTER, LIKE MANY URBAN, PEDIATRIC CENTERS, HAS EXPERIENCED A GREAT DEAL OF GROWTH OVER THE PAST SEVERAL YEARS. THIS HAS PLACED INCREASE PRESSURE ON KEY DIAGNOSTIC DEPARTMENTS. IN RESPONSE TO THE CURRENT PRESSURE ON KEY DEPARTMENTS, COOK CHILDREN'S MEDICAL CENTER ENGAGED THEIR INTEGRATED PROJECT DELIVERY TEAM TO CONCEPTUALIZE, DESIGN AND CONSTRUCT FACILITY SOLUTIONS FOR A SOUTH TOWER, SOUTH UTILITY PLANT AND URGENT CARE CENTER. THE SOUTH TOWER IS AN APPROXIMATELY 318,000 BUILDING GROSS SQUARE FEET, EIGHT LEVEL BUILDING THAT INCLUDES TWO BASEMENT LEVELS, SIX LEVELS ABOVE GRADE, PLUS A ROOFTOP PENTHOUSE. THE BASEMENT PROVIDES A CLINICAL LABORATORY AND STERILE PROCESSING DEVELOPMENT (SPD). THE LABORATORY PROCESSES OVER 1.3 MILLION TESTS FOR BOTH CLINICAL TESTING AND RESEARCH PROTOCOLS. THE EXPANDED SPACE HAS ALLOWED FOR AN EXPANSION OF SPECIALITY SERVICES, GAINED EFFICIENCIES AND TECHNOLOGY ADVANCES. THE LABORATORY WAS THE FIRST PEDIATRIC INSTITUTION IN THE U.S. TO INSTALL AUTOMATED MICROBIOLOGY. TWO DEDICATED ELEVATORS CONNECT THESPD TO THE SURGERY DEPARTMENT FOR TRANSPORTING CLEAN AND SOILED MATERIALS. LEVEL ONE COOK CHILDREN'S EMERGENCY DEPARTMENT CURRENTLYSEES MORE THAN 120,000 PATIENTS EACH YEAR. THE RENOVATED AND EXPANDED NENETTA BURTON CARTER EMERGENCY DEPARTMENT, WHICH OPENED ON AUGUST 2016, HAS MORE, AND LARGER, EXAM ROOMS AND A SUPERIOR LAYOUT AND DESIGN TO BETTER ACCOMMODATE THE EXISTING - AND FUTURE -VOLUME OF PATIENTS. LEVEL ONE IS THE HOME OF THE EXPANDED EMERGENCY DEPARTMENT (ED) AND EXTENSION OF MAIN STREET, THE PRIMARYPUBLIC CIRCULATION SYSTEM THAT CONNECTS ALL BUILDINGS AND IS POPULATED WITH NUMEROUS FAMILY AMENITIES. THE ED HOUSES 5 RESUSCITATION ROOMS, 10 INTAKES ROOMS, 70 GENERAL EXAM ROOMS, TWO GENERAL X-RAY ROOMS AND 1 NEW CT ROOM. THE SOUTH MAIN TOWER INCLUDES A GRAB 'N' GO FOR FAMILIES AND STAFF AND A LOUNGE WITHVIEWS AND ACCESS TO A SOUTH GARDEN. LEVEL TWO THE SECOND LEVEL OF THE SOUTH TOWER IS DEDICATED TO SURGICAL SERVICES. ALL OF THE OPERATING ROOMS ARE LOCATED IN THIS AREA WHOSE FLOOR-TO-FLOOR HEIGHT INCREASED TO 18 FEET TO ACCOMMODATE MODERN BUILDING SYSTEMS AND TECHNOLOGY. THE OR SUITE IS DESIGNED AROUND A STERILE CORE AND INCLUDES 17 OPERATING ROOMS (7 GENERAL, 1 TRAUMA, 2 NEURO, 2 ORTHO, 1 IMRI, 1 CYSTO AND SHELL SPACE FOR THREE FUTURE OPERATING ROOMS). LEVEL THREE THIS SPACE IS DEDICATED TO A HEART CENTER, WITH TWO CARDIOVASCULAR OPERATING ROOMS, TWO CARDIAC CATH LABS, 14 BED CVICU AND 1,000 SQUARE FEET ENCLOSED CORRIDOR CONNECTING TO A 15-BED STEP-DOWN UNIT IN THE MAIN HOSPITAL. THE FAMILY WAITING ROOMS HAS VIEWS AND ACCESS TO ONE OF TWO ROOFTOP GARDEN TERRACES. LEVEL FOUR AND FIVE LEVEL FOUR HAS AN ECHOCARDIOGRAM SUITE, BUT MAINLY IS DEDICATED TO MECHANICAL SPACE. LEVEL FIVE IS SHELLED FOR FUTURE USE/GROWTH. LEVEL SIX LEVEL SIX IS THE HOME TO OUR BEHAVIORAL HEALTH CENTER, FEATURING AN INPATIENT UNIT WITH 15 BEDS. THE REES-JONES BEHAVIORAL HEALTH CENTER AT COOK CHILDREN'S CARES FOR CHILDREN EXPERIENCING BEHAVIORAL, NEURODEVELOPMENTAL AND EMOTIONAL CHALLENGES, SUCH AS DEPRESSION, ANXIETY, ATTENTION DEFICIT DISORDERS (ADD/ADHD) AND AUTISM SPECTRUM DISORDERS. OVER THE PAST SEVERAL YEARS, COOK CHILDREN'S HAS EXPERIENCED EXPONENTIAL GROWTH IN THE DEMAND FOR BEHAVIORAL HEALTH SERVICES. THE CENTER ALLOWS US TO BETTER SERVE THIS DELICATE PATIENT POPULATION BY UNITING AND EXPANDING OUR INPATIENT PSYCHIATRIC UNIT AND PARTIAL HOSPITALIZATION PROGRAM. RECREATION AND RETAIL SERVICES FOR SOME FAMILIES, COOK CHILDREN'S IS THEIR SECOND HOME. WHETHER THEY ARE HERE FOR A VISIT OR A LENGTHY STAY, THE MEDICAL CENTER PROVIDES RESOURCES AVAILABLE TO HELP MAKE THEIR TIME AT COOK CHILDREN'S COMFORTABLE. Bomar Library - Located in the child life zone, the library offers: - BOOKS FOR ALL AGES - BOOKS AVAILABLE FOR ALL IN-PATIENTS AND THEIR SIBLINGS for check-out - A COMFORTABLE PLACE FOR FAMILIES TO READ, RELAX, PLAY BOARD GAMES AND PUT TOGETHER PUZZLES - R.E.A.D. DOGS - THERAPY DOGS VISIT THE CHILD LIFE ZONE AND BOMAR LIBRARY FOR A FUN READING EXPERIENCE. THERE IS ALWAYS A LIBRARIAN, CHILD LIFE SPECIALIST OR VOLUNTEER AVAILABLE TO ASSIST WITH THE BOOKS, GAMES AND PUZZLES, AS WELL AS TO PROVIDE SCHEDULES FOR LIBRARY EVENTS. BUILD-A-BEAR WORKSHOP COOK CHILDREN'S STORE OFFERS A SELECTION OF FURRY FRIENDS, CLOTHING AND ACCESSORIES WITH A MEDICAL THEME, INCLUDING: - "GET BETTER SETS" WITH CRUTCHES, SLINGS, BANDAGES AND CASTS - WHEELCHAIRS - LAB COATS - DOCTOR SCRUBS - MEDICAL OUTFITS - A SPECIALLY DESIGNED PEAK'S THE DRAGON - COOK CHILDREN'S MASCOT - TEDDY BEAR TRANSPORT BEAR-SIZED T-SHIRTS CAMELOT COURT COOK CHILDREN'S CAFETERIA IS LOCATED ON THE FIRST FLOOR OF THE MEDICAL CENTER. CAMELOT COURT OFFERS A CHICK-FIL-A, INTERNATIONAL CUISINE, PIZZA, HOMESTYLE COOKING, A SALAD BAR, GRILL AND DELI. CHILD LIFE ZONE THE CLZ IS A STATE-OF-THE ART ENVIRONMENT THAT LETS KIDS AND TEENS GET AWAY FROM THE HOSPITAL SETTING AND JUST BE A KID. GAMES, ART, MUSIC, CREATIVITY AND IMAGINATION ARE GREAT THERAPY AND DELIVER A BIG DOSE OF FUN TO HELP KIDS FEEL BETTER. CLZ IS A TREATMENT-FREE AREA AND IS THE HOME TO A RECORDING AND BROADCAST STUDIO, LIBRARY AND PLAY AREA WITH VIDEO GAMES AND A POOL TABLE. MIRROR MIRROR HAIR AND NAIL SALON AFTER A LONG STAY, PATIENTS OR FAMILIES MAY FEEL THE NEED FOR A LITTLE PAMPERING. SALON SERVICES INCLUDE: - HAIRCUTS FOR CHILDREN, WOMEN AND MEN - STYLE - COLOR - HAIR TREATMENTS - EYEBROW WAXING - MANICURES AND CHILDRENS MANICURES - PEDICURES AND CHILDRENS PEDICURES PLAY AREA AND GARDENS PLAY AREAS AND GARDENS AT COOK CHILDREN'S PROVIDE A WELCOME BREAK: - A PLAYROOM IS AVAILABLE ON EVERY FLOOR OF THE MEDICAL CENTER, EXCEPT FOR THE PEDIATRIC INTENSIVE CARE UNIT AND NEONATAL INTENSIVE CARE UNIT. - AN INDOOR PLAYGROUND IS LOCATED ON THE FIRST FLOOR OF THE MEDICAL CENTER BEHIND CAMELOT COURT. - AN OUTDOOR PLAYGROUND IS LOCATED OUTSIDE OF THE MAIN MEDICAL CENTER ENTRANCE ON THE FRONT GROUNDS. - OUTSIDE THE DODSON SPECIALTY CLINIC, ACROSS FROM THE OUTDOOR PLAY AREA, THERE IS A SPECIAL PLACE FOR QUIET MEDITATION OR RELAXATION WHEN YOU NEED A BREAK. THE GARDEN FEATURES TOPIARIES, FLOWERS AND SEATING AREAS. - DILLARD FAMILY GARDEN GIVES FAMILIES A QUIET AND TRANQUIL PLACE TO VISIT OUTDOORS OR SIMPLY RELAX, JUST STEPS FROM THE MEDICAL CENTER. STARBUCKS COFFEE THE STARBUCKS GIVES FAMILIES TIME TO TAKE A BREAK AND ENJOY A COFFEE, LATTE, ESPRESSO, FRAPPUCCINO, HOT AND ICED TEAS, CHOCOLATE BEVERAGES, BOTTLED DRINKS, PASTRIES AND MUCH MORE. ZOOTY FRUITY YOGURT SHOP FAMILIES CAN ENJOY A REFRESHING FROZEN TREAT RIGHT IN THE MEDICAL CENTER. ZOOTY FRUITY OFFERS: - 18 FROZEN YOGURT FLAVORS INCLUDING SEASONAL FLAVORS (MOST ARE GLUTEN-FREE) - DELICIOUS SMOOTHIES MADE WITH FRESH FRUITS AND EVEN VEGGIES - ENJOY SORBET in your choice of great flavors, including three no-added-sugar flavors. - OVER 40 YUMMY TOPPINGS - Plus, 23 VARIETIES OF CANDY INCLUDING SUGAR-FREE, NO-ADDED SUGAR, GLUTEN-FREE AND PROBIOTIC OPTIONS. TRANSPORT COOK CHILDREN'S MEDICAL CENTER IS SUPPORTED BY ONE OF THE LARGEST NEONATAL/PEDIATRIC TRANSPORT PROGRAMS IN THE NATION, TEDDY BEAR TRANSPORT, WHICH BRINGS MORE THAN 4,000 CHILDREN TO THE MEDICAL CENTER ANNUALLY. SERVICES INCLUDE FIVE AMBULANCES, ONE HELICOPTER, ONE FIXED-WING AIRPLANE, AND ONE JET. COOK CHILDREN'S TEDDY BEAR TRANSPORT HAS A STAFF OF 76 CONSISTING OF CROSS-TRAINED NEONATAL/PEDIATRIC NURSES, RESPIRATORY THERAPISTS, PILOTS, MECHANICS, PARAMEDICS AND COMMUNICATION SPECIALISTS. THEY ARE PROUD TO HAVE MORE THAN 500 COMBINED YEARS OF TRANSPORT EXPERIENCE. THIS TEAM IS DEDICATED TO GETTING THE MOST MEDICALLY FRAGILE CHILDREN AND NEONATES TO OUR AWARD-WINNING MEDICAL CENTER QUICKLY AND SAFELY. OUR TRANSPORT VEHICLES INCLUDE A KING AIR B200 TWIN ENGINE CRITICAL CARE TRANSPORT AIRPLANE AND AN ENCORE + CESSNA CITATION 560 TWIN ENGINE JET, AN AMERICAN EUROCOPTER 145 HELICOPTER AND FIVE AMBULANCES. EACH MEANS OF TRANSPORT IS EQUIPPED TO CARRY CRITICAL CARE PATIENTS AND FEATURES NEONATAL/PEDIATRIC-ORIENTED TECHNOLOGY. THE TEAM ALSO HAS THE CAPABILITY TO TRANSPORT PATIENTS ON ECMO. THE TEAM BEGINS GIVING CARE TO PATIENTS IMMEDIATELY UPON ARRIVAL TO THEIR LOCATION, BRINGING COOK CHILDREN'S TO OUR REFERRING FACILITIES. NICU COOK CHILDREN'S NATIONALLY RECOGNIZED LEVEL IV NICU, DESIGNATED BY THE STATE OF TEXAS, PROVIDES THE HIGHEST LEVEL OF CARE FOR OUR TINY PATIENTS. LEVEL IV NICUS MAINTAIN A FULL RANGE OF ON-SITE PEDIATRIC MEDICAL AND SURGICAL SUBSPECIALISTS AND PEDIATRIC ANESTHESIOLOGISTS. COOK CHILDREN'S IS ONE OF ONLY A HANDFUL OF NICUS NATIONWIDE TO PROVIDE SINGLE PATIENT ROOMS. THE INDIVIDUAL ROOMS ENABLE STAFF TO PROVIDE THE HIGHLY SPECIALIZED INTENSIVE CARE SERVICES AND ATTENTION THAT MEDICALLY FRAGILE BABIES NEED.	Desc
Total Program Service Expenses	$703,804,326	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	false	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	Yes (true)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	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 With Officer Ent	false	BusinessRlnWithOfficerEntInd
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	199	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	5187	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
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	13	GoverningBodyVotingMembersCnt
Independent Voting Member	12	IndependentVotingMemberCnt
Family Or Business Rln	false	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 (26 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
Frank Anderson
Trustee	1.0	0.0	Yes (X)	$0	$0	$0
John Batton
Secretary/Treasurer	2.0	0.0	Yes (X)	$0	$0	$0	Yes (X)
John P Boswell
Trustee-Chairman	2.0	2.0	Yes (X)	$0	$0	$0	Yes (X)
Anne Carvalho
Trustee	1.0	1.0	Yes (X)	$0	$0	$0
Jeff Connor
Trustee - Chairman	2.0	2.0	Yes (X)	$0	$0	$0	Yes (X)
Dana C Kelly
Trustee	1.0	0.0	Yes (X)	$0	$0	$0
Leah King
Trustee	1.0	0.0	Yes (X)	$0	$0	$0
Joseph LaMarca Jr
Trustee	1.0	0.0	Yes (X)	$0	$0	$0
Billie R Pugh Jr MD
Trustee	1.0	2.0	Yes (X)	$0	$0	$0
John M Richardson MD
Trustee Emeritus	1.0	1.0	Yes (X)	$0	$0	$0	Yes (X)
Ryan Senter
Trustee	1.0	0.0	Yes (X)	$0	$0	$0
James E Webb
Trustee	1.0	0.0	Yes (X)	$0	$0	$0
Andrew S Wayne
Trustee-Vice Chairman	2.0	0.0	Yes (X)	$0	$0	$0	Yes (X)
Rick W Merrill
CEO	11.0	29.0		$496,574	$1,276,903	$234,192	Yes (X)
Nancy C Cychol
President/Chief Hospital Servi	40.0	0.0		$890,996	$0	$37,431	Yes (X)
Stephen W Kimmel
CFO	16.0	24.0		$352,369	$528,555	$94,313	Yes (X)
Cara Martz
Secretary	1.0	39.0		$0	$141,294	$22,922	Yes (X)
Stanley E Davis
Sr. Vice President, COO	40.0	0.0		$463,143	$0	$44,405	Yes (X)
Spencer D Seals
Vice President Construction &	1.0	39.0		$0	$172,845	$37,774	Yes (X)
Cheryl Peterson
AVP Nursing, CNO	40.0	0.0		$374,016	$0	$47,114	Yes (X)
Jack Sosebee
Vice President	40.0	0.0		$323,045	$0	$38,248	Yes (X)
Diana L Shannon
RNFA, CV SVC Coordinator	40.0	0.0		$220,797	$0	$24,093		Yes (X)
Deborah C Boudreaux
AVP Nursing	40.0	0.0		$212,272	$0	$37,970		Yes (X)
Orlando R Chapa
AVP Nursing	40.0	0.0		$245,494	$0	$29,969		Yes (X)
Tammy Thomlison
AVP Revenue	40.0	0.0		$255,959	$0	$13,637		Yes (X)
Elia Valencia-Stokes
AVP Finance	40.0	0.0		$251,079	$0	$37,413		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$4,085,744	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$2,119,597	TotReportableCompRltdOrgAmt
Total Other Compensation	$699,481	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	319	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
201 MAIN ST STE 1801	FORT WORTH	TX	76102	CONSTR CONTRACTOR	$21,961,691
Metro Aviation
PO Box 7008	SHREVEPORT	LA	71137	Aircraft Maintenance	$3,875,273
MEDTRONIC
PO BOX 848086	DALLAS	TX	75284	MED SUPPLY SERVICES	$3,244,387
Guidehouse Inc
150 N Riverside Plz Ste 2100	CHICAGO	IL	60606	Consulting Services	$2,144,980
HKS Inc
PO Box 731121	DALLAS	TX	75373	Professional Service	$1,703,925

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	65	CntrctRcvdGreaterThan100KCnt
Related Organizations	$12,048,369	RelatedOrganizationsAmt
All Other Contributions	$5,551	AllOtherContributionsAmt
Total Contributions	$12,053,920	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
Patient Services	621110	$1,061,221,579	$1,061,221,579
Other Operating Revenue	621110	$108,065,520	$108,065,520
Joint Venture Revenue	621110	$11,037,652	$11,037,652
LAB REFERRALS	621500	$14,620		$14,620
PHARMACY SERVICES	621500	$210		$210

Field	Value	IRS element (for citing)
Total Program Service Revenue	$1,180,339,581	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$242,197	TotalRevenueColumnAmt
Exclusion	$242,197	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	$1,249,570	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$1,101,326	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$148,244	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$148,244	TotalRevenueColumnAmt
Exclusion	$148,244	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$29,500	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$105,635	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	-$76,135	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$76,135	TotalRevenueColumnAmt
Exclusion	-$76,135	ExclusionAmt

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

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

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

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

Net Income From Gaming NetIncomeFromGamingGrp

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

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

Net Income Or Loss NetIncomeOrLossGrp

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

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	CCIC Retro Premium	Desc
Business	621110	BusinessCd
Total Revenue Column	$1,239,651	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,239,651	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$1,239,651	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,193,947,458	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,181,564,402	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$14,830	UnrelatedBusinessRevenueAmt
Exclusion	$314,306	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$64,793,490	TotalAmt
Program Services	$64,793,490	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$257,448	TotalAmt
Program Services	$257,448	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	$3,338,667	TotalAmt
Management And General	$3,338,667	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$70,111	TotalAmt
Program Services	$70,111	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$281,622,460	TotalAmt
Program Services	$248,110,608	ProgramServicesAmt
Management And General	$33,511,852	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$13,473,726	TotalAmt
Program Services	$12,140,909	ProgramServicesAmt
Management And General	$1,332,817	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$61,384,079	TotalAmt
Program Services	$55,063,980	ProgramServicesAmt
Management And General	$6,320,099	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$20,206,832	TotalAmt
Program Services	$18,164,114	ProgramServicesAmt
Management And General	$2,042,718	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$162,499,011	TotalAmt
Program Services	$2,038,308	ProgramServicesAmt
Management And General	$160,460,703	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$240,042	TotalAmt
Management And General	$240,042	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	$28,495,742	TotalAmt
Program Services	$22,157,513	ProgramServicesAmt
Management And General	$6,338,229	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$66,643	TotalAmt
Program Services	$51,524	ProgramServicesAmt
Management And General	$15,119	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$11,748,555	TotalAmt
Program Services	$3,510,342	ProgramServicesAmt
Management And General	$8,238,213	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	$31,459,457	TotalAmt
Program Services	$7,326,322	ProgramServicesAmt
Management And General	$24,133,135	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$1,486,841	TotalAmt
Program Services	$1,258,948	ProgramServicesAmt
Management And General	$227,893	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	$569,953	TotalAmt
Program Services	$426,830	ProgramServicesAmt
Management And General	$143,123	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$15,936,706	TotalAmt
Program Services	$15,905,564	ProgramServicesAmt
Management And General	$31,142	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

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

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$57,145,462	TotalAmt
Program Services	$40,687,325	ProgramServicesAmt
Management And General	$16,458,137	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$1,911,903	TotalAmt
Program Services	$1,911,903	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Physical Remuneration	$32,847,481	$32,320,294	$527,187
Medical Supplies	$97,296,104	$97,296,104
BAD DEBT EXPENSE	$62,837,916	$62,837,916
EQUIPMENT AND REPAIRS	$9,789,317	$5,324,635	$4,464,682

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$21,697,809	TotalAmt
Program Services	$12,150,138	ProgramServicesAmt
Management And General	$9,547,671	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$981,175,755	TotalAmt
Program Services	$703,804,326	ProgramServicesAmt
Management And General	$277,371,429	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$16,434	BOYAmt
EOY	$16,607	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$298,096,828	BOYAmt
EOY	$532,777,239	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	$169,026,069	BOYAmt
EOY	$146,128,634	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	$24,219,660	BOYAmt
EOY	$30,559,237	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$10,794,394	BOYAmt
EOY	$10,825,408	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$113,997	BOYAmt
EOY	$710,640	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$1,170,094,731	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$512,705,525	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$660,819,491	BOYAmt
EOY	$657,389,206	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$7,468,828	BOYAmt
EOY	$7,976,148	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	$7,424,990	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$22,807,466	BOYAmt
EOY	$32,476,131	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,200,788,157	BOYAmt
EOY	$1,426,284,240	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$69,988,088	BOYAmt
EOY	$78,358,680	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	$49,957	BOYAmt
EOY	$171,751	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$363,718,331	BOYAmt
EOY	$366,450,710	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	$2,568,071	BOYAmt
EOY	$5,351,899	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$436,324,447	BOYAmt
EOY	$450,333,040	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$764,463,710	BOYAmt
EOY	$975,951,200	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

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

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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	$764,463,710	BOYAmt
EOY	$975,951,200	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,200,788,157	BOYAmt
EOY	$1,426,284,240	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$212,771,703	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	-$1,284,213	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 D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

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 Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$71,855,341	BeginningYearBalanceAmt
Contributions	$190,488	ContributionsAmt
Investment Earnings Or Losses	$4,883,138	InvestmentEarningsOrLossesAmt
Other Expenditures	$372,801	OtherExpendituresAmt
End Year Balance	$76,556,166	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$62,022,698	BeginningYearBalanceAmt
Contributions	$12,820,675	ContributionsAmt
Investment Earnings Or Losses	-$2,241,266	InvestmentEarningsOrLossesAmt
Other Expenditures	$746,766	OtherExpendituresAmt
End Year Balance	$71,855,341	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.38580	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.57320	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.04100	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	$14,740,320	OtherCostOrOtherBasisAmt
Book Value	$14,740,320	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$849,162,211	OtherCostOrOtherBasisAmt
Depreciation	$317,556,232	DepreciationAmt
Book Value	$531,605,979	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,397,803	OtherCostOrOtherBasisAmt
Depreciation	$4,245,740	DepreciationAmt
Book Value	$152,063	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$249,386,641	OtherCostOrOtherBasisAmt
Depreciation	$185,476,023	DepreciationAmt
Book Value	$63,910,618	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$52,407,756	OtherCostOrOtherBasisAmt
Depreciation	$5,427,530	DepreciationAmt
Book Value	$46,980,226	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$657,389,206	TotalBookValueLandBuildingsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
EST. PAYABLE (THIRD PARTY)	$5,371,260
DUE TO/FROM AFFILIATES	-$19,361

Field	Value	IRS element (for citing)
Total Liability	$5,351,899	TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt	$1,150,310,610	TotalRevEtcAuditedFinclStmtAmt
Other Revenue	-$40,661,690	OtherRevenueAmt
Revenue Not Reported	-$40,661,690	RevenueNotReportedAmt
Revenue Subtotal	$1,190,972,300	RevenueSubtotalAmt
Other Revenues Not Included	$2,975,158	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$2,975,158	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$1,193,947,458	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$935,635,360	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$17,297,521	OtherExpensesIncludedAmt
Expenses Not Reported	$17,297,521	ExpensesNotReportedAmt
Expenses Subtotal	$918,337,839	ExpensesSubtotalAmt
Other Expenses Not Included	$62,837,916	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$62,837,916	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$981,175,755	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, INFLATION RATE AND THE MANAGEMENT COST OF THE ENDOWMENT ON AN ANNUAL BASIS WHILE ASSUMING A PRUDENT LEVEL OF INVESTMENT RISK. 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 PLACED A GREATER EMPHASIS ON EQUITY-BASED INVESTMENTS TO ACHIEVE ITS LONG-TERM RETURN OBJECTIVES WITHIN PRUDENT RISK CONSTRAINTS. COOK CHILDREN'S HAS A POLICY (THE SPENDING POLICY) OF APPROPRIATING FOR EXPENDITURE EACH YEAR 5% OF THE FOUNDATION'S INVESTMENTS AVERAGE FAIR VALUE OVER THE PRIOR 5 YEARS ENDED JUNE 30 PRECEDING THE YEAR IN WHICH EXPENDITURE IS PLANNED. 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: (62,837,916) Joint Venture Revenue not on 990: 24,965,127 Interest Rate SWAP Adjustment: (2,682,913) Women's Board Loss: (105,988) --------------- (40,661,690)
Schedule D, Part XI, Line 4b	RECONCILIATION OF AUDITED revenue to form 990 revenue: Loss on Disposal of Asset: (76,135) Contributions from Foundation: 4,152,619 Direct Rent Expenses: (1,101,326) ------------ 2,975,158
Schedule D, Part XII, Line 2D	Reconciliation of audited expenses to form 990 expenses: direct rent expenses: 1,101,326 Loss on Disposal of Asset: 76,135 Women's Board Loss: 105,988 Joint Venture Expenses not on 990: 16,014,072 ------------------ 17,297,521
Schedule D, Part Xii, Line 4b	Reconciliation of audited expenses to form 990 expenses: Bad Debt Expense 62,837,916
Schedule D, Part X, Line 2	ASC 740 Footnote: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE Financial statements.

Schedule H IRS990ScheduleH

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

Free Care Oth Percentage FreeCareOthPercentageGrp

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

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

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

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

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$12,060,809	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$12,060,809	NetCommunityBenefitExpnsAmt
Total Expense	0.01310	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$475,142,097	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$394,166,935	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$80,975,162	NetCommunityBenefitExpnsAmt
Total Expense	0.08820	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$487,202,906	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$394,166,935	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$93,035,971	NetCommunityBenefitExpnsAmt
Total Expense	0.10130	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,128,165	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$98,210	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,029,955	NetCommunityBenefitExpnsAmt
Total Expense	0.00550	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$325,519	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$217,794	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$107,725	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$411,867	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$426,138	DirectOffsettingRevenueAmt

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$65,039,227	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$65,039,227	NetCommunityBenefitExpnsAmt
Total Expense	0.07080	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$70,904,778	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$742,142	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$70,176,907	NetCommunityBenefitExpnsAmt
Total Expense	0.07640	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$558,107,684	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$394,909,077	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$163,212,878	NetCommunityBenefitExpnsAmt
Total Expense	0.17770	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	$10,306	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$10,306	NetCommunityBenefitExpnsAmt

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$173,690	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$173,690	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$203,996	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$203,996	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$62,837,916	BadDebtExpenseAmt
Reimbursed By Medicare	$6,975,726	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$8,217,405	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$1,241,679	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

Entity Name EntityName

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

Field	Value	IRS element (for citing)
Primary Activities	SURGERY CENTER	PrimaryActivitiesTxt
Org Profit Or Ownership	0.60714	OrgProfitOrOwnershipPct
Physicians Profit Or Ownership	0.2857	PhysiciansProfitOrOwnershipPct

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	false	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	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 Childrens Community-Wide Childrens 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. Methodology includes a survey of parents of children ages 0-14, a community leader survey, and focus groups. 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 Childrens collects data from publicly available sources to supplement perceptions of childrens health obtained through the parent and community leader surveys, focus groups and/or community meetings. The 2018 household 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 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 childrens 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 Childrens Board of Trustees prioritized childrens health issues identified by parents and community leaders and findings from subsequent CCHAPS processes in 2012, 2015, and 2018 confirmed the importance of these issues for continuing focused intervention: - Child Abuse & Neglect - Dental Health - Wellness - Access to Health Care - Asthma - Mental Health - General Health: Childhood Obesity - General Health: Parenting Support - Injury Prevention - Child Passenger Safety - Drowning Prevention - Poison Prevention - Gun Safety Cook Childrens continues to use the 2018 CCHAPS findings to assess parent and community leader perceptions of childrens health needs and to inform our community health outreach and community engagement efforts.
Schedule H, Part V, Section B, Line 6B	Other Organizations other than Hospital Facilities: External vendors used to conduct the CCHAPS 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 Childrens created the Center for Childrens Health in 2011 to provide an infrastructure for using childrens 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 Childrens Health develops strategies for addressing targeted childrens 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 Childrens cannot solve complex childrens 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 - Drowning Prevention Campaign - Healthy Children Coalition of Parker County - Hood County for Healthy Children - Johnson County Alliance for Healthy Kids - Safe Baby Sleep Council - Safe Kids North Texas - Save a Smile - Wise Coalition for Healthy Children - Wellness Alliance for Total Children's Health of Denton County CCHAPS 2018 findings support Cook Childrens continued focus on family outreach programs that address the childrens health issues identified in our initial CCHAPS process in 2009. The family services addressing priority childrens health needs are provided using evidence-based/informed practices, including strict adherence to regulatory requirements, implementing proven program designs, obtaining appropriate staff certifications or licensures, providing adequate supervision, practicing accurate and confidential record-keeping, and conducting ongoing formal evaluation. Recognizing the need to improve access to care for vulnerable populations, the Center for Childrens Health focuses all programming listed in the following sections to families identified as high-risk either due to low income or high prevalence of health risk factors. Community Strategy: Prevent child abuse and neglect The Center for Prevention of Child Abuse and Neglect is housed within Cook Childrens Center for Childrens Health to lead initiatives targeting child abuse prevention. These include a county-wide Adverse Childhood Experiences (ACEs) Task Force working to develop and implement multiple strategies for reducing the impact of ACEs on childrens health; ACEs child abuse reporting and caregiver support trainings and presentations provided by staff; an evidence-informed training for medical professionals and first responders to recognize the signs of child abuse and know how to respond appropriately; and a website support product for survivors of abuse. The center also works with a larger Cook Childrens Health Care System team to expand a predictive mapping project to better focus on resource allocation. Community Strategy: Improve child oral health The Center for Childrens Health leads the Childrens 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 -- 4-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 supports collaboration with community partners to work with pregnant women and young children to improve overall health. And the coalitions 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. Approximately 7,000+ 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 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 Childrens Health implements a Healthy Homes program designed to mitigate asthma triggers in the home for families of children seen in the Cook Childrens Medical Center ER for asthma three or more times in a 12-month period. Healthy Homes uses trained community health staff to assess homes for asthma triggers and offers remediation of those triggers to reduce asthma episodes requiring ER visits. Cook Childrens is also a key partner in community efforts to address asthma, including the Asthma 411 Consortium. Through the Asthma 411 Consortium, Cook Childrens 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 mental health services Cook Childrens 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 Childrens Health leads the Wellness Alliance for Total Childrens 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 childrens 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 Childrens 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 Lets Go! and Coordinated Approach to Child Health, or CATCH). The program includes four education sessions during the school year to teach 3rd-4th grade 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. 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 facilitate school-based gardens. Cook Childrens also promotes physical activity through offering GoNoodle to all school districts within our service region. GoNoodle provides teachers access to online videos to promote physical activity in the classroom. Community Strategy: Increase support network for parents and families through community partnerships Coalitions led by the Center for Childrens Health in Hood and Wise Counties work to promote healthy parenting practices by offering Parent Cafs using a curriculum based on Nurturing Parenting 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 14 parenting lessons, discussion questions, handouts, sign-in sheets and evaluation forms. Co
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 NORTHEAST ASC
6313 PRECINCT LINE RD	HURST	TX	76054	AMBULATORY SURGERY CENTER

Supplemental Information Detail SupplementalInformationDetail (15 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 & 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 SPECIALITIES, THE COMMUNITY-WIDE CHILDREN'S HEALTH ASSESSMENT AND 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 HEALTH CARE SYSTEM SERVES A SIX-COUNTY PRIMARY SERVICE AREA IN NORTH TEXAS THAT INCLUDES TARRANT, DENTON, JOHNSON, PARKER, WISE AND HOOD COUNTIES. THE REGION IS HOME TO A DIVERSE POPULATION OF 3,382,569 PEOPLE AND 720,697 (21%) ARE CHILDREN UNDER 14 YEARS OF AGE. THE ANNUAL MEDIAN INCOME FOR FAMILIES WITH CHILDREN UNDER THE AGE OF 18 RANGES BETWEEN $63,072 IN WISE COUNTY TO $99,763 IN DENTON COUNTY. OF THE 834,108 CHILDREN UNDER THE AGE OF 18 LIVING IN THE REGION 151,931 (16%) LIVE IN HOUSEHOLDS WITH INCOME BELOW 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.
Schedule H, Part VI, Line 5	PROMOTION OF COMMUNITY HEALTH: COOK CHILDREN'S MAINTAINS AN OPEN MEDICAL STAFF, AND THE GOVERNING BODIES OF THE VARIOUS COMPANIES ARE MADE UP (UNLESS CONSTRAINED BY THE TEXAS MEDICAL PRACTICE ACT) OF VOLUNTARY COMMUNITY MEMBERS ALONG WITH PHYSICIANS. THE ORGANIZATION CARES FOR ALL CHILDREN REGARDLESS OF THEIR ABILITY TO PAY, AND PROACTIVELY SEEKS TO ENROLL ALL ELIGIBLE CHILDREN IN APPROPRIATE PROGRAMS TO IMPROVE THEIR ACCESS TO CARE.
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 SCHIP, 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	Texas
Schedule H, Part I, Line 7, Column (F)	Bad Debt Expense of $62,837,916 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 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.
Schedule H, Part I, Line 7	IN FY19, THE CENTER FOR CHILDREN'S HEALTH LED 705 HEALTH OUTREACH EVENTS SERVING OVER 20,000 CHILDREN, FAMILIES, AND COMMUNITY PARTNERS. THESE OUTREACH EVENTS INCLUDE EDUCATION OR ACTIVITIES AROUND THE PRIORITIZED HEALTH ISSUES IDENTIFIED IN THE FINDINGS FROM CCHAPS, WHICH ENCOMPASSES: - CHILD ABUSE & NEGLECT - DENTAL HEALTH - WELLNESS - ACCESS TO HEALTH CARE - ASTHMA - MENTAL HEALTH - GENERAL HEALTH: CHILDHOOD OBESITY - INJURY PREVENTION - 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 FY19 OUR COMMUNITY PARTNERS AND VOLUNTEERS GAVE OVER 6,500 HOURS OF VOLUNTEER SUPPORT TO THE CENTER FOR CHILDRENS HEALTH, TOTALING A VALUE OF $218,000. OUT OF OUR 705 HEALTH OUTREACH EVENTS, OVER 400 OF THOSE WERE COALITION, WORKGROUP, AND STAKEHOLDER MEETINGS THAT WE LED THROUGH OUR COLLABORATIONS BELOW: - ACES TASK FORCE - CHILDREN'S ORAL HEALTH COALITION - DROWNING PREVENTION CAMPAIGN - HEALTHY CHILDREN COALITION OF PARKER COUNTY - HOOD COUNTY FOR HEALTHY CHILDREN - SAFE BABY SLEEP COUNCIL - SAFE KIDS North Texas - SAVE A SMILE - WISE COALITION FOR HEALTHY CHILDREN - WELLNESS ALLIANCE FOR TOTAL CHILDREN'S HEALTH OF DENTON COUNTY SELECTED HIGHLIGHTS OF OUR WORK IN FY19 TO IMPROVE THE HEALTH OF CHILDREN AND FAMILIES IN THE COMMUNITY INCLUDE: - 2,335 DENTAL PROCEDURES VALUED AT $337,131 PROVIDED TO CHILDREN WITH DENTAL DISEASE. - CAR SEAT INSTALLATION EDUCATION RESULTING IN 1,025 CHILDREN RIDING SAFER IN CARS, AND NEW CAR SEATS FOR 650 OF THOSE CHILDREN. - 52,000 children and adults were educated on drowning prevention by the Lifeguard Your Child Campaign partners across eight counties. - 1,162 CHILDREN EDUCATED ON PROPER NUTRITION AND HEALTHY LIFESTYLES INFORMATION. - OVER 30 COMMUNITY MEMBERS TRAINED TO TEACH FAMILIES PROPER CARE FOR THEIR CHILDRENS TEETH.
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 I IRS990ScheduleI

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

Recipient Table RecipientTable (4 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)	$64,689,990	SUBSIDIZE OPERATIONS
JUNIOR LEAGUE OF FORT WORTH
255 BAILEY AVE	FORT WORTH	TX	76107	756022377	501(C)(3)	$60,000	SPONSOR
MARCH OF DIMES
555 HEMPHILL ST	FORT WORTH	TX	76104	131846366	501(C)(3)	$15,000	SPONSOR
Ronald Mcdonald House
1001 8th ave	Fort Worth	TX	76104	751754490	501(c)(3)	$10,000	Sponsor

Field	Value	IRS element (for citing)
Total501c3 Org	4	Total501c3OrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (8 entries)

Grant TypeGrantTypeTxt	RecipientRecipientCnt	Cash GrantCashGrantAmt
Medication	3417	$119,003
Transportation	1742	$53,287
LODGING	338	$47,902
Gift Cards	203	$9,511
UTILITIES	15	$5,104
MEALS	560	$8,147
MEDICAL EQUIPMENT	9	$2,197
BABY SUPPLIES	250	$12,297

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
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
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 (13 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 Rltd OrgsCompReportPrior990RltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt
Rick W Merrill
CEO	$283,071	$727,896	$137,266	$352,970	$76,237	$196,037	$59,693	$153,495	$5,882	$15,122	$562,149	$1,445,520
Nancy C Cychol
President/Chief Hospital Servi	$494,909	$0	$228,551	$0	$167,536	$0	$20,625	$0	$16,806	$0	$928,427	$0
Stephen W Kimmel
CFO	$175,626	$263,441	$116,818	$175,227	$59,925	$89,887	$32,481	$48,721	$5,245	$7,866	$390,095	$585,142	$63,144
Cara Martz
Secretary	$0	$95,694	$0	$24,526	$0	$21,074	$0	$7,553	$0	$15,369	$0	$164,216	$0	$0
Stanley E Davis
Sr. Vice President, COO	$255,818	$0	$112,920	$0	$94,405	$0	$16,960	$0	$27,445	$0	$507,548	$0	$0	$0
Spencer D Seals
Vice President Construction &	$0	$126,845	$0	$26,187	$0	$19,813	$0	$11,173	$0	$26,601	$0	$210,619
Diana L Shannon
RNFA, CV SVC Coordinator	$203,030	$0	$9,000	$0	$8,767	$0	$4,500	$0	$19,593	$0	$244,890	$0
Deborah C Boudreaux
AVP Nursing	$146,244	$0	$32,165	$0	$33,863	$0	$8,351	$0	$29,619	$0	$250,242	$0	$0
Orlando R Chapa
AVP Nursing	$150,271		$39,482	$0	$55,741	$0	$17,595	$0	$12,374	$0	$275,463	$0
Cheryl Peterson
AVP Nursing, CNO	$238,753		$84,121	$0	$51,142	$0	$18,743	$0	$28,371	$0	$421,130	$0
Jack Sosebee
Vice President	$227,081		$69,760	$0	$26,204	$0	$20,625	$0	$17,623	$0	$361,293	$0
Tammy Thomlison
AVP Revenue	$196,879		$43,261	$0	$15,819	$0	$10,009	$0	$3,628	$0	$269,596	$0
Elia Valencia-Stokes
AVP Finance	$192,914		$44,344	$0	$13,821	$0	$7,836	$0	$29,577	$0	$288,492	$0

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE J, PART I, LINE 1A	Tax Gross-up payments: Diana Shannon had $220 of gross-up payments in her taxable compensation.
SCHEDULE J, PART I, LINE 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.
SCHEDULE J, PART I, LINE 3	METHODS USED BY CCHCS TO ESTABLISH COMPENSATION OF THE CEO/EXEC DIRECTOR: cOMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT 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 126,903 196,000 CCHS STEPHEN KIMMEL 63,144 70,202 CCHS NANCY C. CYCHOL 68,731 NONE CCMC Stanley Davis none 36,991 CCMC
Schedule J, Part II	ALLOCATION OF CEO AND CFO SALARIES: SALARIES FOR THE CEO AND CFO ARE ALLOCATED PRO-RATA BASED ON THE AMOUNT OF TIME THEY SPEND WITH EACH OF THE FOLLOWING COMPANIES: COOK CHILDREN'S MEDICAL CENTER COOK CHILDREN'S HEALTH FOUNDATION COOK CHILDREN'S HOME HEALTH COOK CHILDREN'S HEALTH CARE SYSTEM COOK CHILDREN'S HEALTH PLAN COOK CHILDREN'S PHYCISIAN NETWORK CHILD STUDY CENTER

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
TARRANT COUNTY CULTURAL EDUCATION FACILITIES
A	043833551	87638QJC4	2013-08-01	$71,222,592	Refunding portion of 2010 Bond	false	false	false
Tarrant County Cultural Education Facilities
B	043833551	87638QKX6	2014-02-28	$176,767,688	Construction and Equipment Cost	false	false	false
Tarrant County Health Facilities Development
C	751181060	875906NY1	2010-02-24	$231,948,097	Development, Constr, Equipment	false	false	false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 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	$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)
B	$12,650,000	$0	$177,571,254	$0	$0	$0	$1,755,350	$0	$0	$176,023,031	$0	$0	2016	false	false	Yes (true)	Yes (true)
C	$107,605,000	$0	$232,805,916	$0	$0	$0	$2,686,446	$0	$0	$230,119,470	$0	$0	2011	false	false	Yes (true)	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 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	false	false	false	0.00080	0.00080	Yes (true)	false	false	Yes (true)
B	false	false	false	false	0.00000	0.00000	Yes (true)	false	false	Yes (true)
C	false	Yes (true)	false	false	0.00210	0.00210	Yes (true)	false	false	Yes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 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	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Business Name Line1GICProviderName/BusinessNameLine1Txt	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd	Term Of HedgeTermOfHedgePct	Superintegrated HedgeSuperintegratedHedgeInd	Hedge TerminatedHedgeTerminatedInd
0
A	false	false	false	Yes (true)	false	false	false	0	false	Yes (true)
0
B	false	false	false	Yes (true)	false	false	false	0	false	Yes (true)
Bank of America
C	false	false	false	Yes (true)	Yes (true)	Yes (true)	false	0	false	Yes (true)	21.25	false	false

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (true)
B	Yes (true)
C	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 rebate computation was performed as of 3/22/2017.
Part IV, Column C, Line 2C	No rebate due the final rebate computation was performed as of 2/4/2014.
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 B & 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	$70,111	TransactionAmt
Transaction	COMPENSATION	TransactionDesc
Sharing Of Revenues	false	SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 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 PRESENTED TO THE COOK CHILDREN'S HEALTH CARE SYSTEM AUDIT COMMITTEE FOR REVIEW AND COMMENT. SUBSEQUENT TO 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 BY ECG MANAGEMENT CONSULTANTS FOR PHYSICIAN COMPENSATION, BOTH OF WHICH ARE INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANTS. 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 AND 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 OR FUND BALANCES: Fund Balance Transfers Between Affiliates: 1,398,700 Change in FV of SWAP: (2,682,913) ------------- (1,284,213)

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 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	false
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	false
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	SUPPORTING OR	TX	501(C)(3)	12B	CCHF	false

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	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct
COOK CHILDREN'S SURGERY CENTER LLC
11221 ROE AVE	LEAWOOD	KS	66211	205227064	ASC	TX	NA	RELATED	$3,171,853	$1,110,638	false	false	0.58959
CENTER FOR PEDIATRIC SURGERY LTD
11221 ROE AVE	LEAWOOD	KS	66211	470871715	ASC	TX	NA	RELATED	$6,735,098	$11,722,584	false	false	0.53477
CPS PEDIATRICS LLC
11221 ROE AVE	LEAWOOD	KS	66211	470871718	ASC	TX	NA	RELATED	$30,769	$92,459	false	false	0.53733

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	COOK CHILDREN'S HEALTH SERVICES INC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	801 7TH AVENUE	AddressLine1Txt
City	FORT WORTH	CityNm
State Abbreviation	TX	StateAbbreviationCd
ZIP	76104	ZIPCd

Field	Value	IRS element (for citing)
EIN	454024843	EIN
Primary Activities	HEALTHCARE	PrimaryActivitiesTxt
Legal Domicile State	TX	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

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

Field	Value	IRS element (for citing)
Entity Type	C CORPORATION	EntityTypeTxt
Controlled Organization	Yes (true)	ControlledOrganizationInd

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	false	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 (10 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
cook children's physician network
b	$64,689,990	fmv
Cook Children's Physician Network
A	$1,359,986	FMV
Cook Children's Surgery Center
J	$1,249,570	FMV
COOK CHILDREN'S HEALTH PLAN
S	$114,436,676	FMV
COOK CHILDREN'S HOME HEALTH
R	$2,038,307	FMV
Cook Children's Physician Network
O	$30,595,418	FMV
Cook Children's Home Health
P	$170,415	FMV
Cook Children's Physician Network
Q	$532,766	FMV
Cook Children's Health Plan
Q	$80,607	FMV
Cook Children's Physician Network
R	$337,715	FMV