2016-08-14T22:20:55-05:00 2015-09-30 BKD LLP 2800 Post Oak Blvd Ste 3200 HOUSTON TX 77056 990 2014-10-01 752705881 COOK CHILDREN'S HEALTH CARE SYSTEM % CORY RHOADES COOK 6828854000 801 SEVENTH AVENUE FORT WORTH TX 76104 CORY RHOADES VP & CHIEF ACCOUNTING OFFICER 6828854480 2016-08-15 true Amanda Maya P01067777 7134994600 2014 2016-09-27 15:27:22Z RICK W MERRILL 801 SEVENTH AVE FORT WORTH TX 76104 141774115 false X WWW.COOKCHILDRENS.ORG X 1996 TX KNOWING THAT EVERY CHILD'S LIFE IS SACRED, IT IS OUR PROMISE TO IMPROVE THE HEALTH OF EVERY CHILD IN OUR REGION THROUGH THE PREVENTION AND TREATMENT OF ILLNESS, DISEASE AND INJURY. 22 12 570 27 0 0 915681 1253139 132184977 134752168 -748000 603884 5888900 3945547 138241558 140554738 162850 402824 0 0 40781306 42745855 0 0 0 80369691 95404230 121313847 138552909 16927711 2001829 117298603 191607529 45929225 38725643 71369378 152881886 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 109669479 402824 138697715 Cook Children's Health Care System is one of the country's leading vertically integrated pediatric health care organizations. Cook Children's represents an award-winning, not-for- profit system of seamless health care designed to fulfill our Promise; "Knowing that every child's life is sacred, it is the Promise of Cook Children's to improve the health of every child in our region through the prevention and treatment of illness, disease and injury." Cook Children's Health Care System is comprised of eight entities- a Medical Center, Physician Network, Home Health Company, Northeast Hospital, Pediatric Surgery Center, Health Plan, Health Services, Inc. and Health Foundation. Based in Fort Worth, Texas, Cook Children's primary service region includes Denton,Hood, Johnson, Parker, Tarrant and Wise counties, with an additional referral area encompassing approximately half of the state. The integrated system has more than 60 primary, specialty and urgent care offices throughout Texas and has served hundreds of international patients, as well as those from all 50 states. Cook Children's sustainable heritage dates back to 1918. Since then, it has been established as a leader in pediatric health care by fostering continual change and robust growth while always embracing the abiding Promise that all 6,281 employees commit to every day. Cook Children's lives up to its Promise by combining the art of caring with integrity-led, interdisciplinary collaboration, a commitment to evidence-based practice, the highest levels of safety and security, leading clinical research, state-of-the-art technology, effective financial stewardship and the re-investment of hundreds of millions of dollars in community benefits. The commitment and expertise of the system's trustees, physicians and staff, combined with Cook Children's vast resources, enable this institution to be recognized as sustainable and among the best for positive clinical outcomes. As such, rating agencies have cited Cook Children's market leadership in Tarrant County for its successful expansion efforts, robust growth in revenue and liquidity and stellar operating margins. At Cook Children's, it's not just about the bottom line. It's about keeping our Promise. As much as we take pride in the rewards and recognition we receive for our work, we measure our success by the improved health of children in our region. That is why our team continues to work collaboratively with our community partners to address identified pediatric health needs in our area. 109669479 true true false true false false false false false false true false false false false false false true false false true false false false false false false true true true false false false false false false false false false false false false false true true true false false true X 160 0 true 570 true false true CJ false false false false false false false false false X 22 12 false false false false true true true true true false false true true true true true true true true false X CORY RHOADES 6828854480 801 SEVENTH AVENUE FORT WORTH TX 76104 X G THOMAS BOSWELL TRUSTEE 1.0 1.0 X 0 0 0 JOHN P BOSWELL TRUSTEE-SECR/TREASURER 2.0 3.0 X X 0 0 0 JAMES R DUNAWAY JR TRUSTEE 1.0 1.0 X 0 0 0 NANCY KAY HOWARD TRUSTEE 1.0 1.0 X 0 0 0 MICHAEL R PAVELL TRUSTEE 1.0 3.0 X 0 0 0 PETER L PHILPOTT TRUSTEE-CHAIRMAN 2.0 3.0 X X 0 0 0 JASON V TERK MD TRUSTEE 1.0 40.0 X 0 346856 34787 JAMES E WEBB TRUSTEE 1.0 1.0 X 0 0 0 GRETCHEN EAMES MD TRUSTEE 1.0 40.0 X 0 313434 20119 MARSHA A HILCHER TRUSTEE 1.0 1.0 X 0 0 0 CHRISTOPHER M HUCKABEE TRUSTEE 1.0 1.0 X 0 0 0 SAMUEL E KLEINMAN MD TRUSTEE 1.0 40.0 X 0 603478 34685 LINDA THOMPSON MD TRUSTEE-VICE CHAIRMAN 2.0 42.0 X X 0 313659 16834 DEBORAH A SCHUTTE MD TRUSTEE 1.0 42.0 X 0 514355 35787 VANESSA CHARETTE MD TRUSTEE 1.0 42.0 X 0 419926 17133 MATT MAYFIELD MD TRUSTEE 1.0 41.0 X 0 605333 24778 JULIA DAVIDSON TRUSTEE 1.0 1.0 X 0 0 0 WM MACK LAWHON TRUSTEE 1.0 1.0 X 0 0 0 G MALCOLM LOUDEN TRUSTEE 1.0 2.0 X 0 0 0 SANDRA ARCA MD TRUSTEE 1.0 42.0 X 0 284259 40045 NICHOLAS M KYPREOS TRUSTEE 1.0 1.0 X 0 0 0 BRIAN C NEWBY TRUSTEE 1.0 3.0 X 0 0 0 TODD WOLF MD TRUSTEE 1.0 42.0 X 0 405579 34037 BRIAN D BARNARD TRUSTEE 1.0 3.0 X 0 0 0 JERRY R CONATSER TRUSTEE 1.0 3.0 X 0 0 0 MATTHEW DZURIK MD TRUSTEE 1.0 41.0 X 0 452834 26218 RYAN T MATTHEWS TRUSTEE 1.0 1.0 X 0 0 0 BONNIE PETSCHE TRUSTEE 1.0 3.0 X 0 0 0 LINDA S CHAPPELL SR. VP-QUALITY MGMT 40.0 0.0 X 370738 0 29707 DAVID F LANCASTER VP, INTERNAL AUDIT & COMPLIANC 40.0 0.0 X 314116 0 34679 CARA MARTZ SECRETARY 35.0 5.0 X 151839 0 14101 JOHN W MCNEY SR. VP-GENERAL COUNSEL 40.0 0.0 X 610080 0 32206 RICK W MERRILL PRESIDENT AND CEO 17.0 23.0 X 650577 926579 198144 GEORGE B MONTAGUE VP, REAL ESTATE 35.0 5.0 X 386794 0 34988 LARRY L TUBB SR. VP-SYSTEM PLANNING 40.0 0.0 X 520147 0 29340 CORY RHOADES VP-FINANCE, CHIEF ACCTG OFFCR 40.0 0.0 X 374203 0 32762 JAMES R STALDER VP-INFO SYS, CHIEF TECH OFFCR 40.0 0.0 X 265243 0 27657 THERESA ZAK MEADOWS SR VP-CIO 40.0 0.0 X 430818 0 27360 HARRY I SHUMAN CHIEF MEDICAL INFO OFFICER 40.0 0.0 X 335368 0 18553 COLEMAN D SKINNER VP-REVENUE CYCLE 40.0 0.0 X 266782 0 33636 ROBERT K FEATHER SR. VP-DEVELOPMENT 40.0 0.0 X 616441 0 36881 STEPHEN W KIMMEL CFO 10.0 30.0 X 149529 448586 25307 KEITH HOLTZ SR. VP-TALENT MGMT & STRATEGIC 40.0 0.0 X 526921 0 51195 GREGORY K JIMERSON VP-PAYOR RELATIONS 40.0 0.0 X 281795 0 33139 SCOTT LEDDY CHIEF MEDICAL INFORMATION OFFC 40.0 0.0 X 20675 0 5025 JOANN M SANDERS MD CHIEF QUALITY OFFICER 40.0 0.0 X 516583 0 36636 JAMES C CUNNINGHAM MD CHIEF MEDICAL OFFICER 40.0 0.0 X 843932 0 37975 ERIC H HUBLI CHIEF SYSTEM EFFECTIVENESS OFF 40.0 0.0 X 630586 0 33124 JAMES D MARSHALL MD MEDICAL DIRECTOR 40.0 0.0 X 643165 0 36674 JOSEPH GALLAGHER DEPUTY GENERAL COUNSEL 40.0 0.0 X 359522 0 37470 KAREN WARDELL ASSOCIATE GENERAL COUNSEL 40.0 0.0 X 316591 0 27400 DEBORAH RUBINSON AVP-EDUCATION 40.0 0.0 X 261983 0 12936 BILLY R KENNEDY SR. VP-CHIEF ADMIN OFFICER 40.0 0.0 X 457770 0 21420 FRANK J ROSSI SR. VP-HUMAN RESOURCES 0.0 0.0 X 473222 0 10970 10775420 5634878 1203708 156 true true false GENERAL DATATECH DEPT D8014 PO BOX 650002 DALLAS TX 75265 SOFTWARE SERVICES 2423647 MICROSOFT 1950 N STEMMONS FWY STE 5010 DALLAS TX 75207 SOFTWARE SERVICES 2367565 MCKESSON TECHNOLOGIES INC 22423 NETWORK PLACE CHICAGO IL 60673 CONSULTING/ANALYTICS 1201037 RATTIKIN TITLE 3707 CAMP BOWIE BLVD 120 FORT WORTH TX 76107 TITLE SERVICES 948243 MS TECHNOLOGIES 14175 PROTON ROAD DALLAS TX 75244 SOFTWARE SERVICES 870925 26 911448 81267 260424 1253139 SHARED SERVICES 900099 123661297 123661297 HUMAN RESOURCES 900099 6088085 6088085 RENT 900099 2221102 2221102 COMMUNITY HEALTH OUTREACH 900099 1435896 1435896 RESEARCH 900099 608927 608927 736861 736861 134752168 498261 498261 0 0 0 0 0 1325000 1219377 105623 105623 105623 0 0 0 REBATE 900099 3768479 3768479 CONCIERGE 900099 150340 150340 OTHER REVENUE 900099 26728 26728 3945547 140554738 138697715 603884 352824 352824 50000 50000 0 0 7565465 1103452 6462013 0 0 26171624 19006515 7165109 0 9008766 6196794 2811972 0 0 1045964 146939 899025 346620 346620 169449 169449 0 0 10954217 7951951 3002266 3499179 412862 3086317 1248259 1082585 165674 48304922 48304922 0 2591071 2591071 741475 563998 177477 0 217381 176540 40841 194175 1542 192633 0 7305930 7305930 1804781 1804781 MINOR EQUIPMENT 1840707 1832167 8540 PHYSICIAN REMUNERATION 12744020 8425201 4318819 DUES & SUBSCRIPTIONS 914696 421555 493141 RECRUITMENT 491594 491594 0 989790 930187 59603 138552909 109669479 28883430 0 9350 9500 48607895 29955136 207036 298946 10671505 1901701 0 0 0 0 0 0 3644 5587 1064162 599696 95887567 39625830 54372974 56261737 0 100143666 0 0 0 0 0 0 2362037 2431560 117298603 191607529 45367399 38313714 0 0 561826 411929 0 0 0 0 0 0 0 0 0 0 0 0 45929225 38725643 X 71369378 152881886 0 0 0 0 71369378 152881886 117298603 191607529 X 2001829 307878 79202801 X false true X true true true X X 1 CC MED CENTER 752051646 3 true 109669478 0 1 109669478 0 true false false false false false false false false false false false false false false true true false X true true PART IV, SECTION E, LINE 3A The organization is the sole member of the supported organization, Cook Children's Medical Center, and as such has the power to determine the number of members of the board of trustees and to elect the members of the board of trustees of the supported organization. PART IV, SECTION E, LINE 3B The organization is the sole member of the supported organization, Cook Children's Medical Center, and as such 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. THE ORGANIZATION IS ALSO RESPONSIBLE FOR IMPLEMENTATION AND ENFORCEMENT OF VARIOUS POLICIES AND PROCEDURES OF THE SUPPORTED ORGANIZATION INCLUDING THE CONFLICT OF INTEREST POLICY AND COMPENSATION ARRANGEMENTS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 169449 169449 138383460 138552909 1000000 250000 false 1000000 1000000 1000000 1000000 4000000 6000000 130918 131959 143972 169449 576298 250000 250000 250000 250000 1000000 1500000 20682964 20682964 18910165 7185439 11724726 755656 740696 14960 55036001 31268212 23767789 502781 431483 71298 56261737 142351062 307878 1594069 1901947 140449115 105623 105623 140554738 140083957 1531048 1531048 138552909 138552909 SCHEDULE D, PART XI, LINE 2D OTHER CHANGE: MANAGEMENT FEE REDUCTION $1,531,048 CCIC PREMIUM $ 63,021 -------------- $1,594,069 SCHEDULE D, PART XII, LINE 2D OTHER CHANGE: MANAGEMENT FEE REDUCTION $1,531,048 Central America and the Caribbean Investments 3145894 3145894 3145894 true false true false false false true COWTOWN MARATHON INC PO BOX 100192 FORT WORTH TX 76185 752541065 501(C)3 40000 SPONSORSHIP TEXAS HEALTH RESOURCES FOUNDATION 612 E LAMAR STREET SUITE 300 ARLINGTON TX 76011 752022128 501(C)3 250000 DONATION 2 0 SCHOLARSHIPS FOR INDIVIDUALS 10 50000 SCHEDULE I, PART I, LINE 2 PROCEDURE FOR MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES: THE ORGANIZATION USES PUBLIC AND PRIVATE DATA TO MONITOR THE USE OF FUNDS, AS NEEDED. IN ORDER TO BE ELIGIBLE FOR THE PRESIDENT'S SCHOLARSHIP AWARD THE APPLICANTS MUST MEET THE FOLLOWING REQUIREMENTS: 1) BE A CHILD OF A FULL TIME EMPLOYEE WITH ONE YEAR FULL TIME EXPERIENCE, 2) BE A FULL TIME STUDENT IN A BACCALAUREATE PROGRAM & 3) PURSUING A DEGREE APPLICABLE TO THE HEALTHCARE WORKFORCE. THE SCHOLARSHIP RECIPIENTS ARE SELECTED BY THE SCHOLARSHIP COMMITTEE. THE SELECTION IS BASED ON ESSAYS SUBMITTED BY THE APPLICANTS, AS WELL AS GRADES. THE MINIMUM AWARD IS $5,000 FOR FIRST TIME RECIPIENTS AND $2,500 FOR REPEAT RECIPIENTS. SCHOLARSHIP PAYMENTS ARE ISSUED DIRECTLY TO THE UNIVERSITIES. X false true X X X X X true true false false false false false false false JASON V TERK MD TRUSTEE 0 337746 0 0 0 9110 0 19500 0 15287 0 381643 0 0 LINDA S CHAPPELL SR. VP-QUALITY MGMT 164444 0 93405 0 112889 0 19500 0 10207 0 400445 0 0 0 BILLY R KENNEDY SR. VP-CHIEF ADMIN OFFICER 149525 0 0 0 308245 0 13569 0 7851 0 479190 0 0 0 DAVID F LANCASTER VP, INTERNAL AUDIT & COMPLIANC 172735 0 61766 0 79615 0 19500 0 15179 0 348795 0 0 0 CARA MARTZ SECRETARY 91147 0 22399 0 38293 0 8491 0 5610 0 165940 0 0 0 JOHN W MCNEY SR. VP-GENERAL COUNSEL 298248 0 142295 0 169537 0 19500 0 12706 0 642286 0 0 0 RICK W MERRILL PRESIDENT AND CEO 329684 469552 200569 285658 120324 171369 73528 104722 8207 11687 732312 1042988 133650 190350 GEORGE B MONTAGUE VP, REAL ESTATE 219366 0 78890 0 88538 0 19500 0 15488 0 421782 0 0 0 FRANK J ROSSI SR. VP-HUMAN RESOURCES 8952 0 0 0 464270 0 9963 0 1007 0 484192 0 0 0 LARRY L TUBB SR. VP-SYSTEM PLANNING 255053 0 105313 0 159781 0 19500 0 9840 0 549487 0 0 0 CORY RHOADES VP-FINANCE, CHIEF ACCTG OFFCR 250259 0 110022 0 13922 0 12147 0 20615 0 406965 0 0 0 GRETCHEN EAMES MD TRUSTEE 0 288716 0 11000 0 13718 0 19500 0 619 0 333553 0 0 SAMUEL E KLEINMAN MD TRUSTEE 0 591176 0 0 0 12302 0 19398 0 15287 0 638163 0 0 LINDA THOMPSON MD TRUSTEE-VICE CHAIRMAN 0 284332 0 18750 0 10577 0 16250 0 584 0 330493 0 0 DEBORAH A SCHUTTE MD TRUSTEE 0 494461 0 10000 0 9894 0 19500 0 16287 0 550142 0 0 JAMES R STALDER VP-INFO SYS, CHIEF TECH OFFCR 193296 0 66926 0 5021 0 10400 0 17257 0 292900 0 0 0 THERESA ZAK MEADOWS SR VP-CIO 249665 0 116062 0 65091 0 10400 0 16960 0 458178 0 0 0 HARRY I SHUMAN CHIEF MEDICAL INFO OFFICER 242654 0 84562 0 8152 0 10149 0 8404 0 353921 0 0 0 COLEMAN D SKINNER VP-REVENUE CYCLE 166952 0 58335 0 41495 0 15889 0 17747 0 300418 0 0 0 VANESSA CHARETTE MD TRUSTEE 0 413756 0 0 0 6170 0 16531 0 602 0 437059 0 0 MATT MAYFIELD MD TRUSTEE 0 593523 0 0 0 11810 0 10400 0 14378 0 630111 0 0 SANDRA ARCA MD TRUSTEE 0 275540 0 0 0 8719 0 18276 0 21769 0 324304 0 0 TODD WOLF MD TRUSTEE 0 272626 0 125313 0 7640 0 16250 0 17787 0 439616 0 0 ROBERT K FEATHER SR. VP-DEVELOPMENT 304020 0 126218 0 186203 0 19500 0 17381 0 653322 0 0 0 STEPHEN W KIMMEL CFO 99865 299596 45057 135169 4607 13821 2600 7800 3728 11179 155857 467565 0 0 KEITH HOLTZ SR. VP-TALENT MGMT & STRATEGIC 319079 0 174759 0 33083 0 32150 0 19045 0 578116 0 0 0 MATTHEW DZURIK MD TRUSTEE 0 426310 0 0 0 26524 0 16250 0 9968 0 479052 0 0 GREGORY K JIMERSON VP-PAYOR RELATIONS 202529 0 60368 0 18898 0 15691 0 17448 0 314934 0 0 0 JOANN M SANDERS MD CHIEF QUALITY OFFICER 370306 0 65281 0 80996 0 19500 0 17136 0 553219 0 0 0 ERIC H HUBLI CHIEF SYSTEM EFFECTIVENESS OFF 567105 0 15000 0 48481 0 13000 0 20124 0 663710 0 0 0 JAMES D MARSHALL MD MEDICAL DIRECTOR 467638 0 73766 0 101761 0 19500 0 17174 0 679839 0 0 0 JOSEPH GALLAGHER DEPUTY GENERAL COUNSEL 218495 0 77499 0 63528 0 19500 0 17970 0 396992 0 0 0 KAREN WARDELL ASSOCIATE GENERAL COUNSEL 193145 0 69528 0 53918 0 12525 0 14875 0 343991 0 0 0 DEBORAH RUBINSON AVP-EDUCATION 156093 0 36980 0 68910 0 11832 0 1104 0 274919 0 0 0 JAMES C CUNNINGHAM MD CHIEF MEDICAL OFFICER 518992 0 167929 0 157011 0 19500 0 18475 0 881907 0 0 0 SCHEDULE J, PART I, LINE 1A JAMES D. MARSHALL $125 GROSS-UP PART I, LINE 1A & 1B 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-UPS IN TAX PAYMENTS EXCEPT IN UNUSUAL CIRCUMSTANCES AND ONLY THEN IF APPROVED BY SENIOR MANAGEMENT. IN THIS CASE, $500.00 GIFT CARDS WERE DISTRIBUTED AT CHRISTMAS TO NON-EXECUTIVE EMPLOYEES. THE SENIOR VICE PRESIDENT OF HUMAN RESOURCES APPROVED THE GROSS-UP OF $125.00 PER CARD SO THAT EMPLOYEES WOULD RECEIVE THE FULL STATED BENEFIT OF THE GIFT CARD. PART II ALLOCATION OF CEO AND CFO SALARIES: SALARIES FOR THE CEO AND CFO ARE ALLOCATED PRO-RATA BASED ON THE AMOUNT OF TIME THEY SPEND WITH EACH OF THE FOLLOWING COMPANIES: COOK CHILDREN'S MEDICAL CENTER COOK CHILDREN'S HEALTH FOUNDATION COOK CHILDREN'S HOME HEALTH COOK CHILDREN'S HEALTH CARE SYSTEM COOK CHILDREN'S HEALTH PLAN SCHEDULE J PART I, LINE 4A SEVERANCE PAYMENTS BILLY R. KENNEDY SEVERANCE PAYMENT OF $199,670 FRANK J. ROSSI SEVERANCE PAYMENT OF $340,144 PART I, QUESTION 4B ARTICIPATION IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PARTICIPANTS IN SERP IN W-2 DEF COMP PAID BY -------------------- -------- ---------- --------- RICK W. MERRILL 125,644 162,000 CCHS LINDA S. CHAPPELL 37,545 NONE CCHS JAMES C. CUNNINGHAM, MD 68,326 NONE CCHS ROBERT K. FEATHER 53,525 NONE CCHS KEITH HOLTZ 17,500 21,750 CCHS ERIC H. HUBLI, MD 17,500 NONE CCHS BILLY R. KENNEDY 28,591 NONE CCHS JOHN W. MCNEY 56,380 NONE CCHS THERESA ZAK MEADOWS 47,776 NONE CCHS FRANK J. ROSSI 6,642 NONE CCHS LARRY L. TUBB 46,020 NONE CCHS FORM 990 PART VI, QUESTION 6 SOLE MEMBER: W. I. COOK FOUNDATION, INC., D/B/A COOK CHILDREN'S HEALTH FOUNDATION, A TEXAS NON-PROFIT CORPORATION, IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990 PART VI, QUESTION 7A MEMBER ELECTION ABILITIES: AS THE SOLE MEMBER OF THE ORGANIZATION, W.I. COOK FOUNDATION, INC., HAS THE POWER TO DETERMINE THE NUMBER OF MEMBERS OF THE BOARD OF TRUSTEES AND TO ELECT THE MEMBERS OF THE BOARD OF TRUSTEES. FORM 990 PART VI, QUESTION 7B MEMBER DECISION ABILITIES: AS THE SOLE MEMBER OF THE ORGANIZATION, W.I. COOK FOUNDATION, INC., HAS THE EXCLUSIVE POWER TO DO ANY OF THE FOLLOWING: A. AMEND, ALTER OR REPEAL THE BYLAWS; B. AMEND THE CERTIFICATE OF FORMATION OF THE ORGANIZATION; C. DETERMINE THE NUMBER OF MEMBERS OF THE BOARD OF TRUSTEES AND TO ELECT THE MEMBERS OF THE BOARD OF TRUSTEES; D. APPROVE ANY MERGER, ACQUISITION, LIQUIDATION, WINDING UP, TERMINATION OR CONSOLIDATION OF THE ORGANIZATION; E. APPROVE THE SALE, GIFT OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OF THE ORGANIZATION; F. APPROVE THE CREATION OF, OR INVESTMENT IN, ANY SUBSIDIARY ENTITY; G. APPROVE THE REMOVAL OF A MEMBER OF THE BOARD OF TRUSTEES OF THE ORGANIZATION; AND H. APPROVE THE PERSONS WHO ARE TO BE ELECTED BY THE ORGANIZATION TO FILL ANY VACANCIES ON THE BOARD OF TRUSTEES OR BOARD OF DIRECTORS, AS APPLICABLE, OF (1) COOK CHILDREN'S MEDICAL CENTER, (2) COOK CHILDREN'S PHYSICIAN NETWORK, (3) COOK CHILDREN'S HOME HEALTH, (4) COOK CHILDREN'S HEALTH PLAN, (5) COOK CHILDREN'S INDEMNITY COMPANY; AND (6) ANY OTHER SUBSIDIARY CORPORATION AFFILIATED WITH OR CONTROLLED BY THE ORGANIZATION (INCLUDING ANY VACANCIES ARISING FROM THE EXPIRATION OF THE TERMS OF ANY OF THE TRUSTEES OR DIRECTORS). FORM 990 PART VI, QUESTION 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, QUESTION 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., AN INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE DOCUMENTS THE BASIS FOR ITS DETERMINATIONS FOLLOWING CONTEMPORANEOUS SUBSTANTIATION OF THE COMPENSATION COMMITTEE'S DELIBERATIONS AND DECISIONS. THE COMPENSATION COMMITTEE REQUIRES THE COMPENSATION CONSULTANT TO UPDATE MARKET DATA PERIODICALLY, USUALLY EVERY TWO YEARS, WITH INTERIM REVIEWS BEING CONDUCTED AS NEEDED. WITH REGARD TO PHYSICIAN COMPENSATION, THE COMPENSATION COMMITTEE ALSO RETAINS THE LAW FIRM OF MCDERMOTT, WILL & EMERY OF CHICAGO, ILLINOIS, TO ISSUE A REASONABLENESS OPINION COVERING THE PHYSICIAN COMPENSATION PLAN FOR COOK CHILDREN'S PHYSICIAN NETWORK. FORM 990 PART VI, QUESTION 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 VI QUESTION 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 XI, LINE 9 OTHER CHANGES IN NET ASSETS OF FUND BALANCES: TRANSFER TO ROB ($20,910,830) TRANSFER FROM CCMC 100,000,000 DONATED CAPITAL FROM RF 26,110 CONTRIBUTIONS FOR CAPITAL (GRANTS) 24,500 CCIC RETRO PREMIUM 63,021 --------------- $79,202,801 COOK CHILDREN'S HEALTH PLAN 801 SEVENTH AVE FORT WORTH TX 76104 760585240 INSURANCE TX 501(C)(3) 9 CCHCS true COOK CHILDREN'S PHYSICIAN NETWORK 801 SEVENTH AVE FORT WORTH TX 76104 752485366 PHYSICIAN SVC TX 501(C)(3) 3 CCHCS true WI COOK FOUNDATION 801 SEVENTH AVE FORT WORTH TX 76104 752051649 FUNDRAISING TX 501(C)(3) 11D NA false COOK CHILDREN'S MEDICAL CENTER 801 SEVENTH AVE FORT WORTH TX 76104 752051646 HOSPITAL TX 501(C)(3) 3 CCHCS true COOK CHILDREN'S HOME HEALTH 801 SEVENTH AVE FORT WORTH TX 76104 752896983 HEALTHCARE TX 501(C)(3) 9 CCHCS true ROSEDALE OFFICE BUILDING INC 801 SEVENTH AVE FORT WORTH TX 76104 460866421 TITLE HOLDING TX 501(C)(2) N/A CCHF true COOK CHILDREN'S HEALTH SERVICES INC 801 7TH AVENUE FORT WORTH TX 76104 454024843 HEALTHCARE TX CCHCS C CORPORATION 714759 2307476 1.00000 true true true true false false false false false false false true false false false true true true false true COOK CHILDREN'S HEALTH PLAN A 295020 FMV COOK CHILDREN'S HEALTH PLAN O 179157 FMV COOK CHILDREN'S HEALTH PLAN Q 4062256 FMV COOK CHILDREN'S HEALTH SERVICES Q 174313 FMV COOK CHILDREN'S HOME HEALTH A 180000 FMV COOK CHILDREN'S HOME HEALTH Q 4504553 FMV COOK CHILDREN'S MEDICAL CENTER B 1161279 FMV COOK CHILDREN'S MEDICAL CENTER O 77230 FMV COOK CHILDREN'S MEDICAL CENTER Q 165027968 FMV COOK CHILDREN'S MEDICAL CENTER S 100000000 FMV COOK CHILDREN'S PHYSICIAN NETWORK A 1511525 FMV COOK CHILDREN'S PHYSICIAN NETWORK B 256519 FMV COOK CHILDREN'S PHYSICIAN NETWORK O 14268104 FMV COOK CHILDREN'S PHYSICIAN NETWORK P 245958 FMV COOK CHILDREN'S PHYSICIAN NETWORK Q 16030188 FMV ROSEDALE OFFICE BUILDING K 1226040 FMV ROSEDALE OFFICE BUILDING P 2710354 FMV