2018-08-14T15:05:03-05:00 2017-09-30 BKD LLP 2700 Post Oak Blvd Ste 1500 HOUSTON TX 77056 990 2016-10-01 752485366 Cook Children's Physician Network % CORY RHOADES COOK 6828854000 801 Seventh Avenue Fort Worth TX 76104 CORY RHOADES SENIOR VP-FINANCE 2018-08-15 true Amanda Maya P01067777 7134994600 2016 2022-09-23 18:48:47Z W BRITT NELSON MD 801 SEVENTH AVE FORT WORTH TX 76104 298330696 false X WWW.COOKCHILDRENS.ORG X 1992 TX KNOWING THAT EVERY CHILD'S LIFE IS SACRED, OUR PROMISE IS TO IMPROVE THE HEALTH OF EVERY CHILD IN OUR REGION THROUGH THE PREVENTION AND TREATMENT OF ILLNESS, DISEASE AND INJURY. 13 0 1476 1 0 0 65674706 73284151 216609376 224948220 -479 -13431 535452 98325 282819055 298317265 0 0 0 0 221455035 238503600 0 0 0 61629907 64665042 283084942 303168642 -265887 -4851377 39056687 38912134 30648785 35355609 8407902 3556525 X KNOWING THAT EVERY CHILD'S LIFE IS SACRED, OUR PROMISE IS TO IMPROVE THE HEALTH OF EVERY CHILD IN OUR REGION THROUGH THE PREVENTION AND TREATMENT OF ILLNESS, DISEASE, AND INJURY. false false 270346207 225046545 COOK CHILDREN'S PHYSICIAN NETWORK (CCPN) IS THE LARGEST PEDIATRIC MULTI-SPECIALTY PHYSICIAN GROUP IN NORTH TEXAS. THE NETWORK INCLUDES MORE THAN 404 PHYSICIANS AND 265 MID-LEVEL PROVIDERS IN ADDITION TO THOUSANDS OF OTHER CARING EMPLOYEES. DURING 2017, THE PROVIDER COUNT GREW BY 53, INCLUDING 17 NEW NET PHYSICIANS. PATIENT FAMILIES HAVE ACCESS TO 15 SPECIALTIES VIA TELEMEDICINE: CARDIOLOGY, CARE TEAM, ENDOCRINOLOGY, GENETICS/METABOLIC GENETICS, HEMATOLOGY/ONCOLOGY, INFECTIOUS DISEASES, NEONATOLOGY, NEPHROLOGY, NEUROLOGY, NEUROPSYCHOLOGY, PEDIATRIC INTENSIVISTS, PSYCHOLOGY, RHEUMATOLOGY AND UROLOGY. THESE SPECIALISTS HOSTED 2,000 VISITS VIA TELEMEDICINE IN 2017 OFFERING IMMEDIATE CARE AND PATIENT MONITORING AND SAVING MANY HOURS OF TRAVEL FOR PATIENT FAMILIES. THE NETWORK'S PHYSICIANS AND SPECIALISTS HAVE OFFICES IN TARRANT, DENTON AND HOOD COUNTIES AND PROVIDE A PRIMARY CARE HOME IN ECONOMICALLY DISADVANTAGED AREAS WHERE ACCESS TO PEDIATRIC HEALTH CARE IS DIFFICULT TO OBTAIN. THE PHYSICIAN NETWORK HAS INCREASED ACCESS TO PEDIATRIC SPECIALTY CARE THROUGH OUTREACH CLINICS IN MANY COMMUNITIES IN NORTH, WEST, EAST AND CENTRAL TEXAS. EACH MONTH, PHYSICIANS TRAVEL TO PROVIDE SERVICES IN SEVERAL MARKETS THAT ARE NOT LARGE ENOUGH TO SUPPORT FULL-TIME SPECIALTY CARE. COOK CHILDREN'S OFFERS SEVEN NEIGHBORHOOD CLINICS (FIVE IN FORT WORTH, ONE IN ARLINGTON AND ALSO ONE IN RICHLAND HILLS) THAT OFFER WELL- AND SICK-CHILD VISITS, DENTAL CARE AND PROVIDE VACCINES. STAFF SPEAKS BOTH ENGLISH AND SPANISH, AND CLINICS ACCEPT MOST CHIP, MEDICAID AND COMMERCIAL INSURANCE PLANS. THE CLINICAL STAFF IS LED BY 23 TOTAL PHYSICIANS, TWO DENTISTS, AND FIVE ADVANCE PRACTICE PROVIDERS. DURING 2017 CCPN INCREASED TELEMEDICINE SUPPORT TO SCHOOL BASED NURSES IN FIVE LOCAL INDEPENDENT SCHOOL DISTRICTS (ISD). CURRENTLY THIS ENCOMPASSES 69 CAMPUSES. SIXTY PERCENT OF CHILDREN SEEN VIA TELEMEDICINE WERE ABLE TO REMAIN IN SCHOOL. CCPN ANTICIPATES IT WILL SUPPORT SEVERAL MORE ISD'S IN THE UPCOMING FISCAL YEAR. A NEW ELECTRONIC MEDICAL RECORD SYSTEM WAS IMPLEMENTED THIS YEAR TO ALLOW PATIENT FAMILIES IMPROVED ACCESS TO PRIOR VISIT SUMMARIES, MEDICATION LISTS, LAB RESULTS AND APPOINTMENT REQUESTS. 270346207 true true false false false false false false false false true false false false true false false true false false false false false false false false false false false true false false false false false false true false false false false false false true true true false false true 84 0 true 1476 true false false false false false false false false false false X 13 0 false false false false true true true true true false false true true true true true true true true false X CORY RHOADES 6828854000 801 SEVENTH AVENUE FORT WORTH TX 76104 X MARK MAZADE MD TRUSTEE-VICE CHAIR SPEC CARE 42.0 1.0 X X 344122 0 53384 VIDA AMIN MD TRUSTEE 41.0 1.0 X 303527 0 27867 BRADLEY MERCER MD TRUSTEE 41.0 0.0 X 400172 0 54782 SANDRA ARCA MD TRUSTEE 41.0 1.0 X 323379 0 49396 BARRY BZOSTEK MD TRUSTEE 41.0 0.0 X 186078 0 21107 SAM CANTU MD TRUSTEE 41.0 0.0 X 387748 0 52672 VANESSA CHARETTE MD TRUSTEE 41.0 0.0 X 474584 0 20683 MATTHEW DZURIK MD TRUSTEE-CHAIRMAN 42.0 2.0 X X 442913 0 36818 JOSE IGLESIAS MD TRUSTEE-SECRETARY 42.0 1.0 X X 1033082 0 48851 LINDSAY NEWTON MD TRUSTEE-TREASURER 42.0 1.0 X X 202008 0 38317 SARA GARZA MD TRUSTEE 41.0 0.0 X 179612 0 41594 RAY RHODES MD TRUSTEE-VICE CHAIR 42.0 1.0 X X 368420 0 43053 JUSTIN SMITH MD TRUSTEE 41.0 0.0 X 323710 0 30941 LINDA THOMPSON MD TRUSTEE 41.0 1.0 X 421419 0 18974 DEBORAH VERT DO TRUSTEE 41.0 0.0 X 567958 0 30587 TODD WOLF MD TRUSTEE 41.0 1.0 X 490836 0 53210 MICHELLE MARCINCUK MD TRUSTEE 41.0 0.0 X 739750 0 35948 MARIA PEREZ MD TRUSTEE 41.0 0.0 X 294465 0 13655 ALICE PHILLIPS MD TRUSTEE 41.0 0.0 X 332620 0 53230 ROBERT GOODWILL V PRES-PRIM CARE & SPEC SVCS 40.0 0.0 X 418735 0 46026 SHERI KANTNER SECRETARY 41.0 0.0 X 61474 0 38616 STEPHEN W KIMMEL TREASURER 4.0 36.0 X 84239 681570 111103 W BRITT NELSON MD PRESIDENT 40.0 0.0 X 781434 0 48883 JOHNNIE HONEYCUTT MD PHYSICIAN 40.0 0.0 X 1031353 0 53218 KYRIACOS PANAYIDES MD PHYSICIAN 40.0 0.0 X 958562 0 45053 CHAD HAMNER MD PHYSICIAN 40.0 0.0 X 935604 0 56470 VINCENT TAM MD MEDICAL DIRECTOR 40.0 0.0 X 2348145 0 54782 JOHN UFFMAN MD MEDICAL DIRECTOR 40.0 0.0 X 992984 0 45186 15428933 681570 1224406 356 false true false ATHENAHEALTH 311 ARSENAL ST WATERTOWN MA 02472 CLAIMS PROCESSING 14971146 TARRANT CONSTRUCTION SERVICES 2225 W PETERSMITH ST FORT WORTH TX 76102 CONSTRUCTION 645453 PRIM CONSTRUCTION 252 ROBERTS CUT OFF RD FORT WORTH TX 76114 CONSTRUCTION 621764 CREDIT SYSTEMS INTERNATIONAL PO BOX 1088 ARLINGTON TX 76004 CLAIM COLLECTION 269814 MUCKLEROY FALLS 5801 EDWARDS RANCH RD 100 FORT WORTH TX 76104 CONSTRUCTION 239496 12 72956307 327844 73284151 NET PATIENT FEES 621110 196781371 196781371 CONTRACTED FEES 621110 4064201 4064201 MANAGEMENT FEES 900099 21790270 21790270 OTHER INCOME 621110 2095428 2095428 RESEARCH 900099 216950 216950 224948220 0 0 0 0 0 0 13431 -13431 -13431 -13431 0 0 0 0 0 0 0 0 0 OTHER INCOME 900099 98325 98325 98325 298317265 225046545 -13431 0 0 0 0 9346007 5862545 3483462 0 359373 359373 197073808 191712962 5360846 0 31724412 29649435 2074977 0 4804527 4804527 0 0 0 0 0 1934067 1039894 894173 61333 35227 26106 615797 694411 -78614 0 0 7831534 7417357 414177 313734 274416 39318 0 208082 3788 204294 200 200 0 2252888 1737508 515380 1952512 1949584 2928 MEDICAL SUPPLIES 21264488 21169448 95040 COLLECTION EXPENSE 14273971 225199 14048772 BAD DEBT EXPENSE 6353613 6353613 MINOR EQUIPMENT EXPENSE 1322973 696107 626866 1475323 1165140 310183 303168642 270346207 32822435 0 11245 11383 11266320 6827408 0 0 11882535 15027629 0 0 0 0 107263 81327 1499995 1488855 250342 260983 20623347 8639335 10563102 11984012 0 0 0 0 0 0 1560000 1560000 1915885 1670537 39056687 38912134 8135432 8641902 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22513353 26713707 30648785 35355609 X 8407902 3556525 0 0 0 0 8407902 3556525 39056687 38912134 -4851377 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6701893 1483755 5218138 8516725 4079931 4436794 5056199 3075649 1980550 348530 0 348530 11984012 0 ACCRUED PAYROLL 2531390 ACCRUED PHYSICIAN RECONS 12607582 DUE TO AFFILIATES 4514570 ACCRUED PTO LIABILITY 3332182 ACCRUED EXECUTIVE BONUS 726007 ACCRUED COMP BONUS-CARE SHARE 602908 ACCRUED PHYSICIAN BONUS-PERC 2399068 26713707 291928392 -6353613 -6353613 298282005 35260 35260 298317265 296828460 13431 13431 296815029 6353613 6353613 303168642 PART XI, LINES 2D & 4B RECONCILIATION OF REVENUE FINANCIAL STATEMENTS TO FORM 990 BAD DEBT EXPENSE ($ 6,353,613) LOSS ON DISPOSAL OF ASSETS ($ 13,431) CONTRIBUTION FROM CCHF RECORDED TO NET ASSETS 48,691 --------- $ 35,260 PART XII, LINES 2D & 4B RECONCILIATION OF EXPENSES FINANCIAL STATEMENTS TO FORM 990 LOSS ON DISPOSAL OF ASSETS 13,431 BAD DEBT EXPENSE $ 6,353,613 X false true false true false false false false false false false MARK MAZADE MD TRUSTEE-VICE CHAIR SPEC CARE 337820 0 1000 0 5302 0 19875 0 33509 0 397506 0 0 0 VIDA AMIN MD TRUSTEE 248240 0 51743 0 3544 0 6164 0 21703 0 331394 0 0 0 BRADLEY MERCER MD TRUSTEE 394080 0 0 0 6092 0 19875 0 34907 0 454954 0 0 0 JOHNNIE HONEYCUTT MD PHYSICIAN 1007051 0 0 0 24302 0 19863 0 33355 0 1084571 0 0 0 SANDRA ARCA MD TRUSTEE 312752 0 5579 0 5048 0 18479 0 30917 0 372775 0 0 0 BARRY BZOSTEK MD TRUSTEE 162318 0 15000 0 8760 0 0 0 21107 0 207185 0 0 0 SAM CANTU MD TRUSTEE 383912 0 0 0 3836 0 13250 0 39422 0 440420 0 0 0 VANESSA CHARETTE MD TRUSTEE 448898 0 4167 0 21519 0 19875 0 808 0 495267 0 0 0 MATTHEW DZURIK MD TRUSTEE-CHAIRMAN 424845 0 10000 0 8068 0 16563 0 20255 0 479731 0 0 0 JOSE IGLESIAS MD TRUSTEE-SECRETARY 1005618 0 0 0 27464 0 16563 0 32288 0 1081933 0 0 0 LINDSAY NEWTON MD TRUSTEE-TREASURER 121494 0 72418 0 8096 0 11325 0 26992 0 240325 0 0 0 KYRIACOS PANAYIDES MD PHYSICIAN 951397 0 0 0 7165 0 10146 0 34907 0 1003615 0 0 0 SARA GARZA MD TRUSTEE 177496 0 0 0 2116 0 9797 0 31797 0 221206 0 0 0 RAY RHODES MD TRUSTEE-VICE CHAIR 346517 0 5833 0 16070 0 19875 0 23178 0 411473 0 0 0 JUSTIN SMITH MD TRUSTEE 218058 0 103309 0 2343 0 10600 0 20341 0 354651 0 0 0 LINDA THOMPSON MD TRUSTEE 391875 0 25000 0 4544 0 16563 0 2411 0 440393 0 0 0 DEBORAH VERT DO TRUSTEE 563431 0 0 0 4527 0 19875 0 10712 0 598545 0 0 0 TODD WOLF MD TRUSTEE 307296 0 179555 0 3985 0 18341 0 34869 0 544046 0 0 0 ROBERT GOODWILL V PRES-PRIM CARE & SPEC SVCS 303691 0 109222 0 5822 0 10600 0 35426 0 464761 0 0 0 STEPHEN W KIMMEL TREASURER 54526 441153 24944 201830 4769 38587 8435 68235 3787 30646 96461 780451 0 0 MICHELLE MARCINCUK MD TRUSTEE 719319 0 0 0 20431 0 1381 0 34567 0 775698 0 0 0 W BRITT NELSON MD PRESIDENT 524889 0 207801 0 48744 0 19875 0 29008 0 830317 0 0 0 CHAD HAMNER MD PHYSICIAN 927622 0 0 0 7982 0 16563 0 39907 0 992074 0 0 0 MARIA PEREZ MD TRUSTEE 231386 0 57216 0 5863 0 10271 0 3384 0 308120 0 0 0 VINCENT TAM MD MEDICAL DIRECTOR 2328718 0 10000 0 9427 0 19875 0 34907 0 2402927 0 0 0 JOHN UFFMAN MD MEDICAL DIRECTOR 967683 0 1000 0 24301 0 10600 0 34586 0 1038170 0 0 0 ALICE PHILLIPS MD TRUSTEE 327045 0 23 0 5552 0 19875 0 33355 0 385850 0 0 0 SCHEDULE J, PART I, LINE 1A VIDA AMIN, MD $125 GROSS UP SANDRA ARCA, MD $125 GROSS UP BARRY BZOSTEK $125 GROSS UP SAM CANTU, MD $125 GROSS UP VANESSA CHARETTE, MD $125 GROSS UP MATTHEW DZURIK, MD $125 GROSS UP SARA GARZA, MD $125 GROSS UP CHAD HAMNER, MD $125 GROSS UP JOSE IGLESIAS, MD $125 GROSS UP SHERI KANTNER $250 GROSS UP STEPHEN KIMMEL $5 GROSS UP MICHELLE MARCINCUK, MD $125 GROSS UP MARK MAZADE, MD $125 GROSS UP BRADLEY MERCER, MD $125 GROSS UP W. BRITT NELSON, MD $10 GROSS UP LINDSAY HUGGINS NEWTON, MD $125 GROSS UP KYRIACOS PANAYIDES, MD $125 GROSS UP MARIA PEREZ, MD $125 GROSS UP ALICE PHILLIPS, MD $125 GROSS UP RAY RHODES, MD $125 GROSS UP JUSTIN SMITH, MD $125 GROSS UP VINCENT TAM, MD $125 GROSS UP LINDA THOMPSON, MD $125 GROSS UP JOHN UFFMAN, MD $125 GROSS UP DEBORAH VERT, DO $125 GROSS UP TODD WOLF, MD $125 GROSS UP 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. CY 2016 CME GROSS UP AMOUNTS: SANDRA ARCA, MD $1,500.00 VIDA AMIN, MD $1,500.00 BARRY BZOSTEK, MD $1,500.00 SAM CANTU, MD $900.00 VANESSA CHARETTE, MD $1,125.00 MATTHEW DZURIK, MD $1,500.00 CHAD HAMNER, MD $4,500.00 SARA GARZA, MD $675.00 JOHNNIE HONEYCUTT, MD $3,000.00 JOSE L. IGLESIAS, MD $4,500.00 MARK MAZADE, MD $2,100.00 BRADLEY MERCER, MD $1,500.00 W. BRITT NELSON, MD $4,550.00 LINDSAY HUGGINS NEWTON, MD $1,125.00 KYRIACOS PANAYIDES MD $4,500.00 MARIA PEREZ, MD $1,500.00 ALICE PHILLIPS, MD $1,500.00 VINCENT TAM, MD $3,000.00 LINDA THOMPSON, MD $2,100.00 JOHN UFFMAN, MD $4,500.00 DEBORAH VERT, DO $750.00 TODD WOLF, MD $1,500.00 CME GROSS UPS PAYMENTS DISCLOSURE: IN ADDITION TO THE GIFT CARD AND INCENTIVE BONUSES DESCRIBED ABOVE, THERE IS NO WRITTEN POLICY REGARDING PAYMENT OR REIMBURSEMENT OF TAX INDEMNIFICATION AND GROSS-UP PAYMENTS FOR CONTINUING MEDICAL EDUCATION ALLOWANCES PAID TO EMPLOYED PHYSICIANS OF COOK CHILDREN'S PHYSICIAN NETWORK. THESE TYPE OF EXPENSES ARE USUALLY HANDLED AS NON TAXABLE ACCOUNTABLE PLAN BUSINESS EXPENSES UNDER THE INTERNAL REVENUE CODE, BUT THE COMPANY HAS ELECTED TO TREAT THESE PAYMENTS AND THE GROSS-UP PAYMENTS AS TAXABLE INCOME TO THE AFFECTED INDIVIDUALS. THESE PAYMENTS ARE APPROVED IN ADVANCE BY SENIOR MANAGEMENT AND REVIEWED BY THE COMPANY'S COMPLIANCE AND LEGAL DEPARTMENTS. FURTHER,THESE EXPENSES ARE INCLUDED IN THE BENEFITS CALCULATION FOR SUCH PHYSICIANS WHICH ARE REVIEWED BY THE COMPANY'S COMPENSATION COMMITTEE TO VERIFY THAT SUCH PAYMENTS ARE PAID AT FAIR MARKET VALUE AND COMMERCIALLY REASONABLE. SCHEDULE J, PART I, LINE 3 METHODS USED BY CCHCS TO ESTABLISH COMPENSATION OF THE COMPANY'S PRESIDENT: COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT WRITTEN EMPLOYMENT CONTRACT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE SCHEDULE J, PART I, LINE 4B PARTICIPATION IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: PARTICIPANTS IN SERP IN W-2 DEF COMP PAID BY -------------------- -------- -------- -------- MATTHEW DZURIK, MD 3,386 NONE CCPN JOHNNIE HONEYCUTT, MD 18,000 NONE CCPN JOSE L. IGLESIAS, MD 18,000 NONE CCPN W. BRITT NELSON, MD 76,388 NONE CCPN JOHN UFFMAN, MD 18,000 NONE CCPN STEPHEN KIMMEL 18,000 66,070 CCHS LINDSAY HUGGINS NEWTON, MD 5,811 NONE CCPN MICHELLE MARCINCUK, MD 18,000 NONE CCPN BRADLEY MERCER, MD 305 NONE CCPN VANESSA CHARETTE, MD 18,000 NONE CCPN YVETTE DZURIK M. DZURIK SPOUSE 153237 COMPENSATION false TOM ROGERS JR MD A. ROGERS FATHER-IN-LAW 66552 COMPENSATION false KEVIN BRISCOE J. MASON-BRISCOE SPOUSE 139584 COMPENSATION false 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 ABSOLUTE RIGHT TO APPOINT OR APPROVE MEMBERSHIP ON THE BOARD OF DIRECTORS OF THE ORGANIZATION. 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 AND RESERVED POWER TO DO ANY OF THE FOLLOWING: A. APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE ORGANIZATION AND THE LONG-RANGE FINANCIAL AND STRATEGIC PLANS FOR THE CORPORATION; B. APPROVE DEVIATIONS FROM ANNUAL OPERATING AND CAPITAL BUDGETS IN EXCESS OF SUCH LIMITS AS ESTABLISHED BY THE MEMBER; C. APPROVE THE PURCHASE OR ACQUISITION OF ANY PROPERTY, REAL, PERSONAL, OR MIXED, BY THE ORGANIZATION IN EXCESS OF SUCH LIMITS AS ESTABLISHED BY THE MEMBER; D. APPROVE THE SALE, GIFT OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OF THE ORGANIZATION; E. APPROVE THE MORTGAGE OR OTHER ENCUMBRANCE OF ANY PROPERTY, REAL, PERSONAL, OR MIXED, OF THE ORGANIZATION IN EXCESS OF SUCH LIMITS AS ESTABLISHED BY THE MEMBER; F. APPROVE THE ACQUISITION, LIQUIDATION, MERGER, WINDING UP, TERMINATION, OR CONSOLIDATION OF THE ORGANIZATION; G. APPROVE THE CREATION OF, OR INVESTMENT IN, ANY SUBSIDIARY ENTITY, JOINT VENTURE, ACCOUNTABLE CARE ORGANIZATION OR SIMILAR ENTITIES; H. APPROVE THE ADOPTION, AMENDMENT OR REPEAL OF THE CERTIFICATE OF FORMATION OF THE ORGANIZATION AND THESE BYLAWS; I. APPROVE INCURRING DEBT WHICH WOULD EXCEED SUCH LIMITS ESTABLISHED BY THE MEMBER; J. APPROVE THE SETTLEMENT OF CLAIMS AND LITIGATION OF THE ORGANIZATION; AND K. SUBSEQUENT TO THE ORGANIZING AND INCORPORATING PHYSICIAN'S SELECTION OF THE INITIAL BOARD OF DIRECTORS, APPROVE THE APPOINTMENT OR ELECTION OF DIRECTORS IN ACCORDANCE WITH SECTION 3.2 OF THE ORGANIZATION'S BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B PROCESS FOR REVIEW OF THE 990: THE ORGANIZATION ENGAGES AN OUTSIDE 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. 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 HOT-LINE 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, LINES 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 PRESIDENT 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 & 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 MAKING GOVERNING DOCUMENTS 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. COOK CHILDREN'S MEDICAL CENTER 801 SEVENTH AVE FORT WORTH TX 76104 752051646 HOSPITAL TX 501(C)(3) 3 CCHCS true WI COOK FOUNDATION 801 SEVENTH AVENUE FORT WORTH TX 76104 752051649 FUNDRAISING TX 501(C)(3) 7 NA false COOK CHILDREN'S HOME HEALTH 801 SEVENTH AVENUE FORT WORTH TX 76104 752896983 HEALTHCARE TX 501(C)(3) 10 CCHCS true COOK CHILDREN'S HEALTH CARE SYSTEM 801 SEVENTH AVE FORT WORTH TX 76104 752705881 HLTH CARE SUP TX 501(C)(3) 12C CCHF false COOK CHILDREN'S HEALTH PLAN 801 SEVENTH AVE FORT WORTH TX 76104 760585240 INSURANCE TX 501(C)(3) 10 CCHCS true ROSEDALE OFFICE BUILDING INC 1500 W ROSEDALE FORT WORTH TX 76104 460866421 TITLE HOLDING TX 501(C)(2) N/A CCHF false COOK CHILDREN'S HEALTH SERVICES 801 7TH AVENUE FORT WORTH TX 76104 454024843 HEALTHCARE TX CCHCS C CORPORATION true true true true false false false false false true true true false false false true true true true true COOK CHILDREN'S MEDICAL CENTER O 79239688 FMV COOK CHILDREN'S MEDICAL CENTER R 2070948 FMV COOK CHILDREN'S MEDICAL CENTER Q 393427 FMV COOK CHILDREN'S MEDICAL CENTER A 1422158 FMV COOK CHILDREN'S HEALTH PLAN R 17806625 FMV COOK CHILDREN'S HEALTH PLAN O 1147999 FMV