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PAYABLE (THIRD PARTY) 19228119 DUE TO AFFILIATES 13872674 33100793 576179745 484345523 91834222 7101866 -2982650 4119216 95953438 615904574 7101866 33170720 40272586 575631988 547757 547757 576179745 519951136 35708194 35708194 484242942 102581 102581 484345523 SCHEDULE D, PART XI, LINE 8 OTHER CHANGE INTEREST RATE SWAP ADJUSTMENT ($2,537,474) CONTRIBUTION FROM HF RECORDED TO NET ASSETS ($ 279,426) CONTRIBUTION FROM HS RECORDED TO NET ASSETS ($ 165,750) ------------ ($2,982,650) SCHEDULE D, PART XII, LINE 2D OTHER CHANGE JOINT VENTURE ACCOUNTS NOT INCLUDED ON 990 $34,075,899 INTEREST RATE SWAP ADJUSTMENT ($ 2,537,474) RENT EXPENSE $ 1,632,296 ------------- $33,170,720 SCHEDULE D, PART XII, LINE 4B OTHER CHANGE CONTRIBUTION FROM HS RECORDED TO NET ASSETS $165,750 CONTRIBUTION FROM HF RECORDED TO NET ASSETS $279,426 GAIN IN AUDIT EXPENSE $102,581 ------------- $547,757 SCHEDULE D, PART XIII, LINE 2D OTHER CHANGE JOINT VENTURE ACCOUNTS NOT INCLUDED ON 990 $34,075,899 RENTAL EXPENSE $ 1,632,296 ------------- $35,708,194 SCHEDULE D, PART XIII, LINE 4B OTHER CHANGE GAIN IN AUDIT EXPENSE $ 102,581 UNCERTAIN TAX POSITIONS SCHEDULE D, PART X, LINE 2 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. true true X true X 300. true X 301. true false true true 1600318 1600318 0.00340 249323359 218877547 30445812 0.06510 250923677 218877547 32046130 0.06850 2127449 309181 1818268 0.00390 285507 169221 116286 0.00020 360510 360510 0.00080 36613780 36613780 0.07820 39387246 478402 38908844 0.08310 290310923 219355949 70954974 0.15160 20000 0 20000 0.00000 18799 0 18799 0.00000 25250 0 25250 0.00010 119000 0 119000 0.00030 2126 0 2126 0.00000 185175 0 185175 0.00040 true 7074846 0 2717340 3877652 -1160312 X true true CC NORTHEAST HOSP FREESTANDING SURGICAL HOSP 0.55140 0.00000 0.31860 COOK CHILDREN'S MEDICAL CENTER

801 SEVENTH AVENUE FORT WORTH TX 76104

X COOK CHILDREN'S NORTHEAST HOSPITAL

6316 Precinct Line Rd Hurst TX 76054

X CENTER FOR PEDIATRIC SURGERY

7000 W PLANO PARKWAY STE 100 PLANO TX 75093

X AMBULATORY SURGERY CENTER COOK CHILDREN'S USES FPG TO DETERMINE ELIGIBILITY FOR FREE AND DISCOUNTED CARE. THE ANNUAL REPORT AND COMMUNITY BENEFITS ARE LOCATED ON THE COOK CHILDREN'S WEB SITE (WWW.COOKCHILDRENS.ORG). A HARD COPY OF THE REPORT IS ALSO AVAILABLE IN THE PUBLICATION "KEEPING OUR PROMISE". COSTS FOR LINE 7 WERE CALCULATED USING AN OVERALL COST TO CHARGE RATIO CALCULATED BY THE HOSPITAL'S COST ACCOUNTING SYSTEM. NOT APPLICABLE BAD DEBT EXPENSE OF $16,339,167 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. FOOTNOTE DISCLOSURE REGARDING THE TREATMENT OF BAD DEBTS IS AS FOLLOWS: COOK CHILDREN'S REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM GOVERNMENT PAYORS, MANAGED CARE PLANS, PATIENTS AND OTHERS. AMOUNTS DUE FROM PATIENTS INCLUDE BOTH AMOUNTS DUE FROM FULLY UNINSURED PATIENTS AND CO-PAYMENTS AND DEDUCTIBLES FOR WHICH INSURED PATIENTS ARE RESPONSIBLE. AS A SERVICE TO THE PATIENT, COOK CHILDREN'S BILLS THIRD-PARTY PAYORS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. COOK CHILDREN'S PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. 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 MEDICAL 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 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 IN SCREENING PATIENTS FOR CHARITY AND MEDICAL INDIGENT DISCOUNTS AND WRITTEN THE PATIENTS' BALANCES OFF AS SUCH. 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 THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. IN 2009 COOK CHILDREN'S COMPLETED THE FIRST COMMUNITY-WIDE CHILDREN'S HEALTH ASSESSMENT AND PLANNING SURVEY ("CCHAPS"). THIS RANDOM HOUSEHOLD SURVEY OF FAMILIES WITH A CHILD AGED 0 - 14 YEARS GENERATED 7,439 RESPONSES TO 200 QUESTIONS ABOUT THEIR CHILD'S HEALTH. THE CCHAPS EFFORT IS THE FIRST KNOWN PROJECT OF ITS KIND IN THIS STATE TO FOCUS SOLELY ON THE OVERALL HEALTH STATUS OF CHILDREN. COOK CHILDREN'S IS COMMITTED TO THE HEALTH AND WELL-BEING OF OUR CHILDREN, WHICH CAN ONLY BE ACHIEVED THROUGH ACTIONS BASED ON SOLID INFORMATION. WHILE A GREAT AMOUNT OF MEDICAL INFORMATION EXISTS ABOUT CHILDREN, THERE ARE LARGE GAPS IN UNDERSTANDING AND MEASUREMENT OF CHILDREN'S HEALTH. CCHAPS FILLS THAT VOID AND HELPS US HONOR OUR COMMITMENT. THE DATA GATHERED THROUGH CCHAPS ALLOWS OUR COMMUNITY TO: - EVALUATE CHILDREN'S HEALTH NEEDS WITHIN THE REGION BY REVIEWING MEASURES OF HEALTH STATUS, AS WELL AS FACTORS THAT INFLUENCE HEALTH STATUS. - IDENTIFY CHILDREN'S HEALTH PRIORITIES WITHIN OUR COMMUNITY. - PROMOTE AND SUPPORT COMMUNITY COLLABORATIONS THAT IDENTIFY AND IMPLEMENT SOLUTIONS TO SPECIFICALLY TARGETED CHILDREN'S HEALTH PRIORITIES. - CREATE AND MONITOR COMMUNITY BENCHMARKS TO MEASURE PROGRESS. ACCESS TO THE CHILDREN'S HEALTH DATA PROVIDES A VALUABLE COMMUNITY TOOL TO SUPPORT PLANNING AND FUNDRAISING EFFORTS ON BEHALF OF CHILDREN. HEALTH STATUS DATA CAN BE USED BY COMMUNITY PLANNING ORGANIZATIONS TO DEVELOP INITIATIVES FOR ACTION ON CHILDREN'S ISSUES, BY FOUNDATIONS FOR DETERMINING FUNDING PRIORITIES WHERE CHILDREN ARE AFFECTED AND BY FAITH-BASED ORGANIZATIONS TO FOCUS OUTREACH MINISTRY EFFORTS. THE DATA IS INSTRUMENTAL IN HELPING TO IDENTIFY ANY DISPARITIES IN CHILDREN'S HEALTHCARE. COOK CHILDREN'S HAS IDENTIFIED A GROUP OF "TOP-LINE" CHILDREN'S HEALTH ISSUES IN ITS SIX-COUNTY SERVICE REGION WHICH WILL BE THE FOCUS OF COOK CHILDREN'S INITIAL EFFORTS TO ACT ON THE DATA: ABUSE/NEGLECT, ACCIDENTAL INJURY, ACCESS TO HEALTHCARE, ASTHMA, DENTAL HEALTH, MENTAL HEALTH AND OBESITY. ASTHMA AND OBESITY PROVED TO BE ESPECIALLY PREVALENT IN THE SURVEY FINDINGS. AS STEWARDS OF THE DATA, WHICH WAS GATHERED FOR THE BENEFIT OF THE COMMUNITY, COOK CHILDREN'S WANTS TO BE SURE THE DATA IS NOT ONLY WIDELY AVAILABLE, BUT ALSO THAT ADDITIONAL RESOURCES ACCOMPANY IT FOR THOSE INDIVIDUALS AND ORGANIZATIONS THAT WANT TO PUT THE INFORMATION TO USE. COOK CHILDREN'S WILL CONTINUE ITS IN-DEPTH ANALYSIS OF THE CCHAPS DATA TO BETTER UNDERSTAND AND COMMUNICATE CHILDREN'S HEALTH ISSUES AND POTENTIAL SOLUTIONS IN OUR AREA. COOK CHILDREN'S WILL FOCUS ITS EFFORTS OVER THE NEXT 10 YEARS TO REALIZE OUR PROMISE ... "TO IMPROVE THE HEALTH OF EVERY CHILD IN OUR REGION THROUGH THE PREVENTION AND TREATMENT OF ILLNESS, DISEASE AND INJURY." CCHAPS OFFERS THE POTENTIAL OF REGIONAL COLLABORATION ON CHILDREN'S HEALTH ISSUES. COOK CHILDREN'S RECOGNIZES THIS AND CALLS ON THE COMMUNITY TO PARTICIPATE IN A JOINT EFFORT. THE PLAN IS TO PARTNER WITH THE COMMUNITY AND THE VARIOUS ORGANIZATIONS THAT EMBRACE CHILDREN'S HEALTH. COOK CHILDREN'S WANTS TO PLAY THE ROLE IN THOSE EFFORTS THAT IS MOST APPROPRIATE FOR HELPING IMPROVE CHILDREN'S HEALTH - BE THAT LEADER, PARTNER, COLLABORATOR, FOLLOWER OR SUPPORTER. THE HOPE IS TO JOIN WITH MANY ALLIES AND PARTNERS IN THE QUEST TO BE ONE OF THE HEALTHIEST AREAS TO RAISE A CHILD IN THE COMING DECADE. THE GOAL OF IMPROVING CHILDREN'S HEALTH CAN ONLY BECOME A REALITY IF COMMUNITIES, COLLABORATIONS AND COALITIONS WORK TOGETHER TO USE CCHAPS TO SET AND ACHIEVE REALISTIC, QUANTITATIVE GOALS TO IMPROVE CHILDREN'S HEALTH IN AREAS OF SPECIFIC CONCERNS OR INTEREST TO THAT GROUP. COOK CHILDREN'S WILL CONTINUE TO OFFER SUPPORT AS NEEDED IN EFFORTS TO RESEARCH DATA, FOSTER SHARING INFORMATION AND BUILD A SOLID ENDURING FOUNDATION THAT CONTINUES THE WORK OF IMPROVING THE LIVES OF CHILDREN. A PUBLIC WEB SITE WAS LAUNCHED ON JANUARY 15, 2010 THAT ALLOWS ANYONE DIRECT ACCESS TO THE DATA FROM THE COMMUNITY-WIDE CHILDREN'S HEALTH ASSESSMENT AND PLANNING SURVEY. WWW.CCHAPS.ORG DELIBERATELY PLACES THE DATA INTO THE HANDS OF EACH COMMUNITY WHERE IT CAN BE BEST UNDERSTOOD AND USED FOR PLANNING ACTIONS. COOK CHILDREN'S HEALTH CARE SYSTEM EMPLOYED THREE ADDITIONAL COMMUNITY OUTREACH WORKERS SPECIFICALLY ASSIGNED TO COUNTIES TO FOSTER THE USE OF THE DATA AND COORDINATE CHILD HEALTH SUMMITS IN EACH COUNTY. DURING 2010, THE CCHAPS TEAM PRESENTED DATA AND INFORMATION IN EACH OF THE FIVE-OUTLYING COUNTIES TO DIVERSE MEMBERS FROM EACH COMMUNITY. EACH, DAYLONG SUMMIT, CO-HOSTED BY ONE OR MORE LOCAL COMMUNITY SPONSORS, FORESHADOWED INDIVIDUAL STRATEGIC PLANNING EFFORTS AT THE LOCAL COMMUNITY LEVEL TO IMPROVE THE HEALTH OF CHILDREN IN EACH COMMUNITY PLANNED DURING 2011. THE CCHAPS DATA CONTINUES TO BE A SOURCE OF NEW INFORMATION. IN 2010, THE TEAM CALCULATED THE AGE AND GENDER SPECIFIC BMI PERCENTILES AND REPORTED THIS NEW INFORMATION IN A "CCHAPS SPECIAL REPORT ON CHILDHOOD OBESITY" AVAILABLE ON THE WEB SITE. TO GIVE STRATEGIC FOCUS TO COMMUNITY-PLANNING EFFORTS, A NOVEL ECOSYSTEM MODEL FOR CHILDREN'S HEALTH PROVIDES A WAY TO IDENTIFY THE RELEVANT FACTORS AND INTERACTION AFFECTING EACH CHILD HEALTH ISSUE. A "THINK-TANK" PROVIDED PARTICIPANTS FROM A WIDE-RANGE OF BACKGROUNDS THE OPPORTUNITY TO UNDERSTAND THE COMPLEX SYSTEMS AND INTERACTIONS INVOLVED IN CHILDHOOD ASTHMA. 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, NIGHT CLINIC, AND MEDICAL OFFICE BUILDING. THIS DOCUMENT EXPLAINS: 1)HOW ONE MIGHT QUALIFY FOR FINANCIAL ASSISTANCE 2)QUALIFICATION IS DETERMINED BY FAMILY SIZE AND INCOME, AND 3)TO CONTACT THE PATIENT ACCOUNTING DEPARTMENT TO APPLY FOR FINANCIAL ASSISTANCE. IN ALL AREAS OF PATIENT REGISTRATION, REGISTRATION CLERKS OFFER A MEDICAID APPLICATION TO ALL SELF PAY REGISTRATIONS. PATIENT REGISTRATION STAFF WILL ASSIST THE FAMILY WITH THE APPLICATION FOR MEDICAID, AND THEN CHARITY IF MEDICAID IS DENIED. PATIENT REPRESENTATIVES AND CASE MANAGEMENT PERSONNEL ALSO DIRECT FAMILIES TO THE PATIENT REGISTRATION STAFF WHEN THEY NEED FINANCIAL ASSISTANCE. THE MEDICAL CENTER PROVIDES PRIMARY, SECONDARY, TERTIARY, AND QUATERNARY LEVELS OF PEDIATRIC CARE IN TARRANT AND CONTIGUOUS COUNTIES AND APPROPRIATE SPECIALTY CARE REGIONALLY THROUGHOUT TEXAS. THE MEDICAL CENTER DEFINES ITS 132-COUNTY SERVICE AREA INTO THE MAJOR MARKETS LISTED BELOW: SIX-COUNTY AREA - TARRANT, HOOD, JOHNSON, PARKER, DENTON AND WISE COUNTIES. IN 2010, THE POPULATION OF THE SIX-COUNTY AREA WAS REPORTED TO BE 2,820,112, APPROXIMATELY 23% OF WHICH ARE AGES 0 TO 14. WITHIN THE SIX COUNTIES, TARRANT COUNTY SERVES AS COOK CHILDREN'S PRIMARY SERVICE AREA (PSA) GENERATING APPROXIMATELY 75% OF THE MEDICAL CENTER'S INPATIENTS EACH YEAR. REFERRAL MARKET - 126-COUNTIES TO THE SOUTH AND WEST OF THE DFW METROPLEX. FOR FISCAL YEAR 2010, 2,517 INPATIENT DISCHARGES ORIGINATE FROM THIS AREA. REGIONAL OUTPATIENT PEDIATRIC SPECIALTY CLINICS ARE STAFFED IN SEVERAL LOCATIONS IN THIS AREA WITH MULTI-SPECIALTY CLINICS LOCATED IN ABILENE, BROWNWOOD, MIDLAND/ODESSA, SAN ANGELO AND WACO. OTHER - OUTSIDE OF THE TRADITIONAL 132-COUNTIES AND INCLUDES OUT OF STATE PATIENTS. PATIENT VOLUME FROM THESE AREAS IS SIGNIFICANTLY SMALLER THAN FROM THE SIX-COUNTY AREA AND REFERRAL MARKETS DUE TO THE PRESENCE OF OTHER CHILDREN'S HOSPITALS. THE HOSPITALS THAT SERVE THE PEDIATRIC POPULATION AND COMPETE WITH THE MEDICAL CENTER FOR MARKET SHARE DIFFER FOR EACH OF THE MARKETS 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 NON-PROFIT 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 THIS AREA. COMMUNITY SUPPORT: MORE THAN 48 COOK CHILDREN'S EMPLOYEES PARTICIPATE AT A NEARBY ELEMENTARY SCHOOL AS MENTORS THROUGH THE JUNIOR ACHIEVEMENT PROGRAM. THESE EMPLOYEES SPENT 240 HOURS DURING WORK TIME TEACHING CLASSES TO HELP INSPIRE THE STUDENTS TO "DREAM BIG AND REACH THEIR POTENTIAL". THE EXPERIENTIAL PROGRAM DEVELOPS AND STRENGTHENS THE YOUTHS' ASSETS AS THE STUDENTS LEARN KEY CONCEPTS RELATED TO WORK READINESS, ENTREPRENEURSHIP, AND FINANCIAL LITERACY. COALITION BUILDING: COOK CHILDREN'S IS A CO-FOUNDING MEMBER OF THE INFANT MORTALITY NETWORK ORGANIZED TO ADDRESS THE HIGH RATES OF INFANT MORTALITY IN THE COUNTY. THE CURRENT CO-CHAIR OF THE NETWORK IS A NURSING DIRECTOR AT COOK CHILDREN'S. THE NETWORK HAS RAISED COMMUNITY AWARENESS OF THE PROBLEM AND WORKED WITH LEGISLATORS TO CREATE PUBLIC POLICY TO HELP ADDRESS THE PROBLEM. COOK CHILDREN'S IS ALSO AN ACTIVE MEMBER OF THE HEALTHY TARRANT COUNTY COLLABORATION - A HEALTH PROMOTION NETWORK OF NON-PROFIT HOSPITALS, PUBLIC HEALTH AND LOCAL UNIVERSITIES. THE COLLABORATION EFFORTS INCLUDE HEALTH EDUCATION AT A SUMMER CAMP FOR UNDERSERVED CHILDREN. THE CURRENT CO-CHAIR OF THE INTELLECTUAL AND DEVELOPMENTAL DISABILITIES NEEDS COUNCIL OF TARRANT COUNTY IS A DIRECTOR OF PSYCHIATRIC SERVICES AT COOK CHILDREN'S. COOK CHILDREN'S IS ALSO INVOLVED IN THE TEXAS EARLY HEARING DETECTION AND INTERVENTION COALITION. COMMUNITY HEALTH IMPROVEMENT ADVOCACY: ADVOCACY EFFORTS BY COOK CHILDREN'S ARE ENHANCED THROUGH MEMBERSHIP IN VARIOUS LOCAL, STATE, AND NATIONAL ORGANIZATIONS. ASSESSMENT OF COMMUNITY NEEDS, ACCESS TO HEALTH CARE AND INSURANCE FOR UNDERSERVED POPULATIONS, AND ADVOCACY ON SPECIFIC HEALTH ISSUES SUCH AS CHILD ABUSE AND NEGLECT AND PREVENTABLE INJURIES ARE AMONG THE ISSUES ADDRESSED. WORKFORCE DEVELOPMENT: COOK CHILDREN'S HAS REPRESENTATION ON ADVISORY BOARDS AT LOCAL UNIVERSITIES AND COLLEGES TO PROVIDE GUIDANCE IN SPECIFIC AREAS OF STUDY. 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 INTO APPROPRIATE PROGRAMS TO IMPROVE ACCESS TO CARE. COOK CHILDREN'S ALSO OPERATES FIVE NEIGHBORHOOD CLINICS PROVIDING PRIMARY CARE TO UNDERSERVED POPULATIONS AROUND THE CITY'S PERIMETER 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 OUTPATIENTS 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 OFFERS PEDIATRIC SPECIFIC HOME CARE TO ASSURE CARE IS PROVIDED IN THE MOST APPROPRIATE AND LOWEST COST SETTING. TX true COOK CHILDREN'S PHYSICIAN NETWORK 801 SEVENTH AVENUE FORT WORTH TX 76104 752485366 501(C)(3) 36489294 subsidize operations HISTORIC FORT WORTH INC 1110 PENN ST FORT WORTH TX 76103 237047051 501(C)(3) 65000 COMMUNITY BUILDING TMA 401 W 15TH ST AUSTIN TX 78701 746073346 501(C)(3) 10000 SPONSOR 3 0 MEDICATIONS 104 9335 TRANSPORTATION 212 6392 RENT/MORTGAGE 8 4331 UTILITIES 5 997 OTHER 24 6362 FUNERAL HOME 1 1000 PROCEDURES FOR MONITORING THE USE OF THE GRANT FUNDS IN THE US SCHEDULE I PART I QUESTION 2 THE ORGANIZATION USES PUBLIC AND PRIVATE DATA TO MONITOR THE USE OF FUNDS, AS NEEDED. X X X X X X true true false false false false false false false WILLIAM H CRAIG 179733 0 52922 0 1584 0 9515 0 11051 0 254804 0 JAMES C CUNNINGHAM MD 0 401043 0 102901 0 15360 0 0 0 14132 0 533436 NANCY C CYCHOL 349221 0 142672 0 117002 0 18375 0 8449 0 635719 0 STANLEY E DAVIS 152840 0 67370 0 1694 0 5742 0 16907 0 244554 0 RICHARD P GOODE 130964 136312 46055 47934 37543 39074 5077 5284 8942 9306 228581 237910 RICK W MERRILL 177147 455522 94500 243001 39966 102769 39704 102096 3965 10194 355282 913582 GEORGE B MONTAGUE 0 196720 0 56070 0 15005 0 15313 0 11097 0 294205 PAULA J WEBB 194286 0 54382 0 2956 0 12393 0 5615 0 269632 0 TERESA J CLARK 144976 0 19328 0 9496 0 8615 0 2582 0 184998 0 KEVIN L DAHLE 161598 0 0 0 7563 0 10484 0 13899 0 193544 0 EDWIN VIRGIL EASON 152380 0 0 0 19292 0 11792 0 12177 0 195641 0 MIKE SMITH 173259 0 0 0 19145 0 14147 0 7776 0 214328 0 MARK W THOMAS 98189 0 15496 0 84248 0 2630 0 6574 0 207137 0 JOHN A GRIGSON 0 0 0 161359 0 402522 0 0 0 0 0 563881 PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J PART I QUESTION 4B RICK W. MERRILL - PARTICIPATES, BUT RECEIVED $0 PAYMENT DURING CALENDAR YEAR 2009 ALLOCATION OF CEO AND CFO SALARIES SCHEDULE J PART II COOK CHILDREN'S HEALTH CARE SYSTEM IS COMPRISED OF 7 COMPANIES, INCLUDING A MEDICAL CENTER, PHYSICIAN NETWORK, HEALTH PLAN, HOME HEALTH, INDEMNITY COMPANY, FOUNDATION, AND HEALTH CARE SYSTEM COMPANY. THE CEO AND CFO ARE RESPONSIBLE FOR THE OVERSIGHT OF ALL AFOREMENTIONED COMPANIES. AS A RESULT, THEIR SALARIES ARE ALLOCATED PRO-RATA, BASED ON THE AMOUNT OF TIME THEY SPEND WITH EACH COMPANY. SEVERANCE PAYMENT SCHEDULE J, PART I, LINE 4A JOHN A. GRIGSON RECEIVED $402,522 AS A SEVERANCE PAYMENT DURING CALENDAR YEAR 2009. TARRANT COUNTY HEALTH FACILITIES DEVELOPMENT CORP 751881060 875906MV8 2007-06-27 52156976 REFUNDING OF BONDS ISSUED 00 & 05 false false BELL COUNTY HEALTH FACILITIES DEVELOPMENT CORP 742218760 078027HW2 2007-06-27 17523594 REFUNDING OF BONDS ISSUED 7/19/00 false false TARRANT COUNTY HEALTH FACILITIES DEVELOPMENT CORP 751881060 875906NY1 2010-02-04 231948097 DEVELOPMENT, CONSTR, & EQUIP COST false false 52156976 0 50861913 0 1295063 0 0 2007 true false true true 17523594 0 17088481 0 435113 0 0 2007 false true true true 232504399 0 0 137722802 2691188 0 92090409 false false false true false false false false true 0.00000 0.00000 0.00000 true false false false false false true false false false false false false false false false false false true false false false SOLE MEMBER FORM 990 PART VI, QUESTION 6 COOK CHILDREN'S HEALTH CARE SYSTEM, A TEXAS NON-PROFIT CORPORATION, IS THE SOLE MEMBER OF THE ORGANIZATION. MEMBER ELECTION ABILITIES FORM 990 PART VI, QUESTION 7A 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. MEMBER DECISION ABILITIES FORM 990 PART VI, QUESTION 7B AS THE SOLE MEMBER OF THE ORGANIZATION COOK CHILDREN'S HEALTH CARE SYSTEM HAS THE POWER TO APPROVE ANY MERGER, ACQUISITION, LIGUIDATION, DISSOLUTION OR CONSOLIDATION OF THE CORPORATION; THE POWER TO APPROVE THE SALE, GIFT, OR OTEHR DISPOSITION OF ALL OR SUBSTANTIALLY ALL THE PROPERTY OF THE CORPORATION; AND THE POWER TO APPROVE THE CREATION OF, OR INVESTMENT IN, ANY SUBSIDIARY ENTITY. REVIEW PROCESS FOR FORM 990 FORM 990 PART VI, QUESTION 11 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 FORMS ARE PREPARED, THEY ARE REVIEWED BY COMPANY EXECUTIVES AND THEN PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW. IN ADDITION, THEY ARE PRESENTED TO THE BOARD AUDIT COMMITTEE FOR REVIEW. SUBSEQUENT TO AUDIT COMMITTEE REVIEW, THE FORMS ARE FILED WITH THE INTERNAL REVENUE SERVICE AND MADE AVAILABLE TO THE PUBLIC FOR REVIEW. REVIEW AND APPROVAL OF COMPENSATION FORM 990 PART VI, QUESTION 15A & 15B COOK CHILDREN'S HEALTH CARE SYSTEM HAS ESTABLISHED A COMPENSATION COMMITTEE WITH OVERSIGHT OF EXECUTIVE AND PHYSICIAN COMPENSATION. THE COMMITTEE APPROVES COMPENSATION ARRANGEMENTS IN ADVANCE, RELYING UPON COMPARABLE MARKET DATA RELATING TO COMPENSATION, WHICH IS PROVIDED BY MERCER & ASSOCIATES (EXECUTIVE COMPENSATION) AND SULLIVAN COTTER (PHYSICIAN COMPENSATION), INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANTS. THE COMMITTEE DOCUMENTS THE BASIS FOR ITS DETERMINATIONS, AND REQUIRES THE COMPENSATION CONSULTANTS TO UPDATE MARKET DATA PERIODICALLY, USUALLY EVERY TWO YEARS. WITH REGARD TO PHYSICIAN COMPENSATION, THE 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. PROCESS OF MAKING GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC FORM 990 PART VI, QUESTION 19 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. CONSOLIDATED FINANCIAL STATEMENTS ARE REPORTED ELECTRONICALLY FOR ALL COOK CHILDREN'S HEALTH CARE SYSTEM ENTITIES VIA THE ELECTRONIC MUNICIPAL MARKET ACCESS ("EMMA") WEB SITE. EXEMPT PURPOSE ACHIEVEMENTS CONTINUED 990 PART III QUESTION 4A THE 302-BED MEDICAL CENTER IS THE CORNERSTONE OF COOK CHILDREN'S HEALTH CARE SYSTEM. IT OFFERS TOP MEDICAL MINDS, ADVANCED TECHNOLOGICAL EQUIPMENT, LEADING SURGICAL TECHNIQUES, REHABILITATION FACILITIES, AND ANCILLARY SERVICES DESIGNED TO MEET THE UNIQUE NEEDS OF CHILDREN. THE CENTER HAS A PROFESSIONAL STAFF OF NURSES, TECHNOLOGISTS, THERAPISTS, AND OTHER CLINICIANS, AS WELL AS MORE THAN 500 PHYSICIANS AND DENTISTS WHO PROVIDE PRIMARY, SECONDARY, TERTIARY, AND QUATERNARY LEVELS OF PEDIATRIC CARE. CHILD LIFE STAFF, CHAPLAINS, TEACHERS, SOCIAL SERVICES COORDINATORS, AND TRANSLATORS HELP PATIENTS AND FAMILIES COPE WITH THE STRESS THAT ACCOMPANIES A CHILD'S HOSPITALIZATION. THE MEDICAL CENTER IS HOME TO THE COOK CHILDREN'S EMERGENCY DEPARTMENT, THE ONLY EMS-DESIGNATED PEDIATRIC TRAUMA CENTER IN TARRANT COUNTY, TEXAS. MORE THAN 100,000 PATIENTS PRESENT TO THE EMERGENCY DEPARTMENT AND URGENT CARE CENTER FOR TREATMENT EACH YEAR. COOK CHILDREN'S MEDICAL CENTER IS SUPPORTED BY ONE OF THE COUNTRY'S LARGEST PEDIATRIC TRANSPORT PROGRAMS, WHICH BRINGS MORE THAN 2,000 CHILDREN TO THE MEDICAL CENTER ANNUALLY, PRIMARILY FOR CRITICAL CARE. SERVICES INCLUDE AMBULANCE, HELICOPTER, AND FIXED-WING AIRPLANE TRANSPORTATION. DURING HURRICANE IKE, IN 2008, COOK CHILDREN'S TRANSPORT TEAM HELPED TO EVACUATE INTENSIVE CARE PATIENTS FROM CORPUS CHRISTI, TEXAS. DELEGATION OF CONTROL OVER MANAGEMENT FORM 990 PART VI QUESTION 3 A MANAGEMENT COMPANY MANAGES THE DAY TO DAY OPERATIONS OF BOTH OF OUR JOINT VENTURES. WRITTEN CONFLICT OF INTEREST POLICY FORM 990 PART VI, QUESTION 12C EVERY YEAR THE LEGAL DEPARTMENT SENDS OUT A FORM 990 QUESTIONNAIRE TO OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES. 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 ARE PROVIDED TO THE 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 IN FORCE FOR ALL AFFILIATED ENTITIES 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. ANY CORRECTIVE ACTION RELATED TO CONFLICTS OF INTEREST WOULD BE REPORTED TO THE AUDIT COMMITTEE FOR REVIEW, APPROVAL, AND MODIFICATION, AS NECESSARY. RELATED COMPENSATION HOURS WORKED FORM 990 PART VII AVG HOURS WORKED FOR RELATED ORG CARA MARTZ 43 GEORGE B. MONTAGUE 42 JAMES C. CUNNINGHAM 40 RICHARD P. GOODE 35 RICK W. MERRILL 40 OTHER OFFICERS AND DIRECTORS LISTED IN PART VII MAY DEVOTE AN AVERAGE OF 1 TO 4 HOURS PER WEEK TO RELATED ORGANIZATIONS. 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