2025-08-13T15:31:15+00:00 2024-09-30 440160260 Forvis Mazars LLP 1201 Walnut Street Suite 1700 Kansas City MO 641062246 990 2023-10-01 752051646 Cook Children's Medical Center COOK 6828854000 801 Seventh Avenue Fort Worth TX 76104 Nancy Cychol Nancy Cychol 2025-08-13 true true Michael Engle P00482834 8162216300 2025-08-13 2023 2025-03-06 01:10:19Z Nancy Cychol 801 Seventh Avenue Fort Worth TX 76104 2223282313 false X www.cookchildrens.org X 1985 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 13 6009 723 6608 2149 9969342 22942471 1908686275 2195940423 1679271 2770914 2375500 222910 1922710388 2221876718 93437071 100455428 0 542314966 574668377 0 0 886145356 988635221 1521897393 1663759026 400812995 558117692 1909959519 2486656392 794885185 814134605 1115074334 1672521787 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 1300721417 100455428 2195933815 Cook Children's Medical Center (CCMC) - Fort Worth is the cornerstone of Cook Children's Health Care System. This 462-bed facility is home to top medical minds, advanced technologies, family-centered treatments and leading-edge clinical research, all designed to fulfill the System's Promise to improve the health and well-being of every child in our care and our communities. It is one of only 10 freestanding children's hospitals in the world to achieve Magnet designation with three consecutive re-designations from the American Nursing Credentialing Center, most recently in 2021. Nationally recognized services such as the Level IV Neonatal Intensive Care Unit (NICU), the Jane and John Justin Institute for Mind Health, and the hematology and oncology center are leading the way in providing the highest level of care to families who travel from across Texas, the United States and internationally. From complicated surgeries and Level II trauma care to physical therapy and behavioral health services, CCMC - Fort Worth offers a variety of services and amenities to meet the unique needs of every patient and family. CCMC-- Fort Worth set a new census record in January 2024 with 101 babies in the NICU, a milestone that reflects the growth in demand for the hospital's services. Raising Awareness With the help of the Center for Community Health, led by Cook Children's, the System works to inform and educate the public on timely topics. In FY24, Cook Children's continued to build on a communications campaign for safe baby sleep. The effort began a year earlier when the Fort Worth medical center saw an alarming spike in sudden unexplained infant deaths (SUIDs). Through a series of articles on checkupnewsroom.org, Cook Children's raised awareness about the safest sleep environment for babies. Additional articles in FY24 highlighted the risks of weighted sleep sacks and blankets in the crib. Other messages for injury prevention in FY24 included the importance of car seats, reminders of summer pool safety, and awareness of bathtub safety. An article during Poison Prevention Week reported the growing number of young children treated in the Emergency Department (ED) for accidental marijuana ingestion. The Aim for Safety program at Cook Children's spreads awareness about proper storage of firearms, focusing on education to prevent accidental shootings in the home. In conjunction with leaders of the program, the city of Fort Worth and several other cities in North Texas declared August 2024 as Gun Safety Awareness Month. Surging cases of flu and respiratory illnesses strained the ED, pediatric offices and urgent care center several times in FY24. Cook Children's responded on social media and other outlets by asking for the community's help to limit the spread. Through articles, charts and videos, the communications team promoted tips to help families manage mild illness at home - and to recognize the more severe symptoms that warrant a trip to urgent care or the ED. Telehealth remains a critical resource for the hospital, especially during times of intense viral spread. Fiscal year 2024 virtual health visits totaled 82,365 across all of Cook Children's Health Care System, an increase of 42% from the previous year. Mental Well-Being The Raising Joy Podcast, an outgrowth of Cook Children's suicide prevention JOY Campaign, aired its 85th episode in June 2024. Topics in FY24 covered everything from coping with pet loss and holiday grief to prevention of teen drug and alcohol abuse. And during National Suicide Prevention Month in September 2024, Cook Children's targeted the stigma of taking prescription medication for anxiety, depression and other disorders. Experts from Cook Children's addressed the reasons that parents might hesitate to start their teens on psychiatric medication. The article included a graphic of mental health resources in English and Spanish. Collaborative Care CCMC - Fort Worth opened the Jane and John Justin Institute for Mind Health in October 2023. The Justin Institute brings together Cook Children's Jane and John Justin Neurosciences Center, Division of Behavioral Health and the Child Study Center under one roof to provide accessible, well-coordinated and comprehensive care for children with disorders affecting the nervous system. The Justin Institute displays an impressive collection of neuro art aimed at engaging the minds, senses and curiosity of visitors while creating a soothing ambiance. It's located in the recently expanded Dodson Specialty Clinics building, which also includes a retail pharmacy and sibling support center. November 2023 marked the 10-year anniversary of the NICU Early Support and Care Transition (NEST) Developmental Follow-Up Center. The NEST Clinic provides early intervention for babies born prematurely or those at risk for long-term challenges with hearing, seeing, talking, feeding, motor skills and intellectual development. Through age 5, the clinic connects patients with comprehensive assessments and care. Leading-Edge Research Cook Children's announced in May 2024 that four patients with a difficult-to-control form of epilepsy participated in trials for a medicine to improve seizure control and slow the progression of their disease. Cook Children's epileptologist M. Scott Perry, M.D. was the lead investigator for the SWALLOWTAIL trial, which studied the safety and tolerability of the drug. Participants treated with the RNA-based medicine experienced fewer convulsive seizures and showed improvement in other conditions. And for the first time in its history, CCMC - Fort Worth received a $2.3 million research project grant from the National Institute of Neurological Disorders and Stroke of the National Institutes of Health (NIH). The grant was awarded for a study led by Christos Papadelis, Ph.D., director of the Neurosciences Research Cener, to identify the origin point of seizures in children with drug-resistant epilepsy. The R01 grant is the most prestigious and competitive award given by the NIH. Thanks to another research study underway, patients with sickle cell disease (SCD) have hope for a life-changing genetic therapy. The first patient at Cook Children's received the treatment in January 2024 when he received an infusion of his own edited stem cells. Those edited stem cells began producing healthier blood, stopping the patient's episodes of pain and frequent hospitalization. CCMC - Fort Worth was the only pediatric site in Texas selected for this trial. High Expectations U.S. News & World Report in October 2024 ranked seven Cook Children's specialties among the top 50 in the nation for pediatrics. Ranked specialties were Behavioral Health, Neurology and Neurosurgery, Diabetes and Endocrinology, Orthopedics, Pulmonology and Lung Surgery, Cardiology and Heart Surgery, and Cancer. Also in 2024, the Pediatric Intensive Care Unit was presented with the Silver Beacon Award for Excellence by the American Association of Critical-Care Nurses. Cook Children's continually pursues quality and safety. That commitment to excellence was reflected in the 87% lihood to recommend" score for patient experience in FY24. Eligible employees were awarded a CareShare bonus for exceeding the goal. Our then director of the Heart Center at the medical center was named to the 2024 Dallas/Fort Worth Great 100 Nurses list. Honorees are nominated by their nursing peers for their example as leaders, role models and compassionate caregivers. 1300721417 true true false true true false false false true true false false true true false false true false false false false false false false false true true true true true true false false false false false false false false true false false false false false false true true true false false true 146 0 true 6009 true true true false false false false false false false false false false false false true false X 13 13 true true false false true true true true true false false true true true true true true true true true true TX X Cory Rhoades 6828854000 801 Seventh Avenue Fort Worth TX 76104 Andrew S Wayne Trustee - Vice Chairman 2.0 2.0 X X 0 0 0 Anne M Carvalho Trustee - Vice Chairman END 5/31/24 2.0 4.0 X X 0 0 0 John P Boswell Trustee - Chairman 2.0 3.0 X X 0 0 0 Ryan B Dickerson Trustee - Sec/Treasurer 2.0 3.0 X X 0 0 0 Bonnie Petsche Trustee 1.0 1.0 X 0 0 0 Edwin S Ryan Trustee 1.0 1.0 X 0 0 0 Frank A Anderson Trustee END 5/31/24 1.0 1.0 X 0 0 0 Judge Jeffrey L Cureton Trustee 1.0 3.0 X 0 0 0 Laura Miller Trustee 1.0 1.0 X 0 0 0 Leah M King Trustee 1.0 2.0 X 0 0 0 Michael A LaGatta Trustee 1.0 1.0 X 0 0 0 Na'im R Moses Trustee START 6/1/24 1.0 1.0 X 0 0 0 Peggy L Cassidy Trustee 1.0 2.0 X 0 0 0 Robert J Batton Trustee END 5/31/24 1.0 2.0 X 0 0 0 Thomas Breckinridge Ray Trustee 1.0 2.0 X 0 0 0 Wally Jones Trustee 1.0 2.0 X 0 0 0 Cory R Rhoades Chief Financial Officer 1.0 44.0 X 0 866208 136241 James C Cunningham MD EVP, CMO 1.0 41.0 X 0 1222776 105747 Jonathan Nedrelow MD Associate Chief Medical Officer 1.0 41.0 X 0 636879 101172 Joseph M Gallagher Sr. VP, Chief Legal Officer 1.0 42.0 X 0 883970 138911 Mary Cara Martz Secretary 1.0 40.0 X 0 183907 21095 Nancy C Cychol President/Chief Hospital Services 40.0 2.0 X 781360 420732 107119 Rick W Merrill CEO 10.0 32.0 X 688861 2066582 550074 Spencer D Seals VP Construction & Real Estate 1.0 40.0 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42558 Toni Smith Night/Weekend Administrator 40.0 0 X 222518 0 28224 Kevin Greene VP, Prosper Medical Center 0.0 40.0 X 0 299394 62629 Matthew Carroll MD FORMER VP, Assoc Chief Quality Officer 1.0 41.0 X 0 502751 89690 7706149 9113651 2590268 986 true true false LINBECK GROUP LLC 1263 W ROSEDALE STE 202 FORT WORTH TX 76104 CONSTRUCTION 36383777 FISK ELECTRIC CO 1617 W CROSBY RD 120 CARROLLTON TX 75006 CONSTRUCTION 4151259 Bottom Line Systems LLC 541 BUTTERMILK PIKE Ste 401 CRESCENT SPRINGS KY 41017 PROFESSIONAL SERVICES 2642074 DYNAMIC SYSTEMS INC 2315 EAST LOOP 820 NORTH FORT WORTH TX 76118 CONSTRUCTION 2180046 HKS INC PO BOX 731121 DALLAS TX 75373 PROFESSIONAL SERVICES 1485246 113 22276084 666387 22942471 PATIENT SERVICES 621110 1868356937 1868356937 OTHER OPERATING REVENUE 621110 304081228 304081228 JOINT VENTURE REVENUE 621110 23495650 23495650 LAB REFERRALS 621500 6608 6608 0 0 0 0 2195940423 2397841 2397841 1521560 1298650 222910 0 222910 222910 480018 106945 0 373073 373073 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OF USE ASSETS 7960443 INTERCOMPANY RECEIVABLES 16606646 231306260 INTERCOMPANY PAYABLES 171862122 ESTIMATED DUE TO THIRD PARTIES 46481809 RIGHT OF USE LIABILITY 7111430 225455361 2205926907 -3167527 -3167527 2209094434 12782284 12782284 2221876718 1662187315 925577 925577 1661261738 2497288 2497288 1663759026 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 D, Part V, Line 4 Intended uses 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 PLUS INFLATION OVER A ROLLING SEVEN-YEAR PERIOD, AS WELL AS SHOW FAVORABLE PERFORMANCE CHARACTERISTICS RELATIVE TO OTHER MARKET INDICES WEIGHTED FOR ASSET ALLOCATIONS AS WELL AS SIMILARLY MANAGED FUNDS. 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 PLACES A GREATER EMPHASIS ON PUBLIC AND PRIVATE EQUITY-BASED INVESTMENTS TO ACHIEVE ITS LONG-TERM RETURN OBJECTIVES WITHIN PRUDENT RISK CONSTRAINTS. COOK CHILDREN'S HAS A POLICY (THE SPENDING POLICY) IN WHERE W.I. COOK FOUNDATION, INC. MAY MAKE AVAILABLE EACH YEAR OF UP TO 5% Of THE FOUNDATION'S INVESTMENTS AVERAGE FAIR VALUE OVER THE PRIOR 5 YEARS ENDED JUNE 30 PRECEDING THE YEAR IN WHICH THE EXPENDITURE IS PLANNED AND/OR ACCORDING TO THE DONOR REQUIREMENTS AS SET FORTH IN EACH ENDOWMENT DOCUMENT. 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. THE INTENDED USE OF THE HIGHEST AMOUNTS OF ENDOWMENTS IS CHARITY CARE, OPERATIONAL NEEDS OF THE CHILD LIFE DEPARTMENT, OPERATIONS OF THE HOSPITAL, TO SUPPORT THE FACILITY DOG PROGRAM, SUPPORT THE OPERATIONAL NEEDS OF THE PASTORAL CARE DEPARTMENT AND NURSING RESEARCH. Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990 INTEREST RATE SWAP AGREEMENT - -670239 CCIC RETRO PREMIUM - -2497288 Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements GAIN ON DISPOSAL OF ASSET - 373073 ADDITIONAL CONTRIBUTIONS FROM FOUNDATION - 13707861 DIRECT RENT EXPENSE - -1298650 Schedule D, Part XII, Line 2(d) Other expenses in audited financial statements not in form 990 DIRECT RENT EXPENSE - 1298650 GAIN ON DISPOSAL OF ASSET - -373073 Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statements CCIC RETRO PREMIUM - 2497288 true true X true X 400 true X 500 true false true true 21535217 1899248 19635969 0.0118 988081993 982944615 5137378 0.0031 0 0.0 0 0 1009617210 984843863 24773347 0.0149 8524525 26291 8498234 0.0051 0 0.0 0 0.0 1149558 1149558 0 0.0 99827596 99827596 0.0600 0 0 109501679 1175849 108325830 0.0651 0 0 1119118889 986019712 133099177 0.0800 20000 20000 0.0000 0 0.0 0 0.0 0 0.0 0 0.0 3036 3036 0.0000 486145 486145 0.0003 0 0.0 0 0.0 0 0 509181 0 509181 0.0003 true 83377660 5701240 6840649 -1139409 X true true COOK CHILDRENS SURGERY CENTER SURGERY CENTER 0.5152 0.0 0.29 1 1 COOK CHILDREN'S MEDICAL CENTER 801 Seventh Ave Fort Worth TX 76104 WWW.COOKCHILDRENS.ORG 000332 X COOK CHILDREN'S MEDICAL CENTER 1 false false true X X X X X X X X X 21 true true true true X www.cookchildrens.org/about/community-outreach/community-health-needs-assessment/ X WWW.CENTERFORCHILDRENSHEALTH.ORG X true 21 true www.cookchildrens.org/about/community-outreach/community-health-needs-assessment/ false true X 400.0 500.0 X X X X X true true X X X true X www.cookchildrens.org/patients-families/billing-insurance/financial-assistance/ X www.cookchildrens.org/patients-families/billing-insurance/financial-assistance/ X www.cookchildrens.org/patients-families/billing-insurance/financial-assistance/ X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Cook Childrens Medical Center. The initial Cook Children's Community-Wide Children's Health Assessment and Planning Survey (CCHAPS) was conducted in 2009 and every three years thereafter (2012, 2015, 2018 and 2021). Our methodology varies slightly among assessment years but always includes gathering data from multiple sources representing our community. Overall, our Community Health Needs Assessment (CHNA) methodology includes a survey of parents of children ages 0-17, a community leader survey, and focus groups outlined in the table below. We also gather feedback from community coalition members through facilitated discussions at regular meetings and at eight child health summits that we host to present the data to our various communities. In addition, Cook Children's collects data from publicly available sources to supplement perceptions of children's health obtained through the parent and community leader surveys, focus groups and/or community meetings. The 2021 CHNA parent survey was administered through an outside vendor (ETC Institute) to a statistically representative sample of parents with children ages 0-17 living in our primary service region (Collin, Denton, Grayson, Hood, Johnson, Parker, Tarrant, and Wise counties). The large sample size (5,715 completed surveys) provides statistically representative results applicable to all eight counties individually and collectively with a low margin of error (+/- 1.3%; 95% CI). The survey is administered through mail, telephone, and internet communications 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, marital status, 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) administered the parent survey to an intentional sample of caregivers within families experiencing homelessness in shelters or within families with at least one undocumented member at several Tarrant County homeless shelters (229 completed surveys). A team from University of North Texas Health Science Center at Fort Worth's School of Public Health conducted six virtual focus groups and one interview with parents (total of 22 parents/caregivers) across the eight-county service area. Community partners and program staff within the Center for Children's Health helped advertise and refer participants via email. These focus groups provided an opportunity for parents and caregivers to share additional information beyond questions within in the parent survey. Priority topics within these focus groups included asthma, oral health, mental health, healthy lifestyles, injury prevention, parenting support, COVID-19 and equitable access to care. The Center for Transforming Lives conducted a survey of families with children from birth to age 17 who were living within motels or extended-stay properties throughout Tarrant County from February to October 2021. Seventy families completed the anonymous surveys on-site at the motel locations. ETC Institute also conducted a survey with community leaders to obtain their feedback about the status of children's health. Surveys were mailed to 1,881 community leaders representing city and county governments, public agencies, not-for-profit organizations, independent school districts, faith based/clergy, and health care professionals. We received 306 responses (16% response rate). A complete list of who received the opportunity to participate in the leader survey is available upon request. Virtual interviews with 20 community leaders across the eight-county service area were also conducted. Leaders were recruited based on their expertise and diverse roles within the community. Interviewees discussed pressing issues or concerns in the community, providing additional context for the community leader and parent survey findings. Priority topics discussed during the interviews included the impact of COVID-19, mental health, ACEs, housing and food security, healthy lifestyles, injury prevention, and equitable access to health care. Based on the 2009 initial assessment results, Cook Children's Board of Trustees prioritized children's health issues identified by parents and community leaders and findings from subsequent CHNA processes in 2012, 2015, 2018, and 2021 confirmed the importance of these issues for continuing focused intervention: - Equitable access to health care - Oral Health - Mental Health - Healthy Lifestyles (obesity prevention) - Parenting and Family Support (abuse and neglect prevention) - Injury Prevention - Asthma Cook Children's continues to use the 2021 CHNA findings to assess parent and community leader perceptions of children's health needs and to inform our community health outreach and community engagement efforts. THE 2024 CHNA WAS COMPLETED AND APPROVED BY THE BOARD OF TRUSTEES IN APRIL 2025. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - Cook Childrens Medical Center. This 2021 Community Health Needs Assessment report is intended to serve as a joint assessment for the main Cook Children's Medical Center in Fort Worth and the new Cook Children's Medical Center in Prosper, opening in the fall of 2022. The Fort Worth Medical Center's primary service area encompasses Denton, Hood, Johnson, Parker, Tarrant and Wise counties. The Prosper Medical Center serves the primary counties of Collin, Denton and Grayson. Our 2021 assessment intentionally collected data in Collin and Grayson counties to represent those communities in the Prosper service area. Denton County falls within both the Fort Worth and Prosper service areas. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - Cook Childrens Medical Center. External vendors used to conduct the parent and community leader surveys included The Center for Transforming Lives, ETC Institute, Inc., My Health My Resources of Tarrant County, and University of North Texas Health Science Center. 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 Facility , 1 Facility , 1 - Cook Childrens Medical Center. Cook Children's created the Center for Children's Health in 2011 to provide an infrastructure for using children's 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 Children's Health develops strategies for addressing targeted children's 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 Children's cannot solve complex children's health needs alone, we lead coalitions and support partnerships 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 - Lifeguard Your Child (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-Fort Worth - Save a Smile - Wise Coalition for Healthy Children - Wellness Alliance for Total Children's Health of Denton County 2021 CHNA parent and community leader survey findings support Cook Children's continued focus on family outreach programs that address the children's health issues identified in our initial parent survey process in 2009. The family services addressing priority children's 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 Children's 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. Equitable Access to Health Care Goal: Improve overall health for children and increase equitable access to quality health care - Ensure that C4CH programs and community involvement exemplify Cook Children's Promise. Community Strategies - Monitor and identify priority children's health issues in Cook Children's 6-county FWSA/3-county PSA to guide equitable service delivery program designs > Held 6 local and 2 regional CHNA Summits to share findings from the 2021 CHNA. > Rolling data collection is in progress for the 2024 CHNA by administering the parent survey among a purposeful sample of caregivers and families across the 8-county region. - Draw on the power of community partnerships to increase the reach for equitable health care information and services to disproportionally impacted populations (C4CH Coalitions) > The Homeless Initiative addresses unmet health and psycho-social needs of children living in three shelters in Tarrant County by providing a medical home and a case management model to coordinate health and social services. > Cook Children's is regularly represented at community initiatives throughout our region addressing various child health issues. > The Center for Children's Health distributed 332,529 educational resources and 181,567 prevention tools through community events and community partners in FY22. - Lead community coalitions with multi-sector, geographically diverse membership. > The Center for Children's Health led over 800 community events and engaged over 600 community partners to promote the health and safety of children. - Maintain focus of C4CH service delivery programs designs on the principles of community collaboration, evidence-based information and practices, and reducing health disparities and inequities. - The Center for Children's Health contributes funding to the Immunization Collaboration of Tarrant County to provide easy access to immunizations for children from low-income families in Tarrant County. The collaboration hosts a multi-week event during August and September, with the help of nearly 100 volunteers to immunize approximately 6,000+ children each year. - The Center for Children's Health provides regular communication about health information to families and community partners through Checkup Magazine, YouTube videos, and presentations. - The Center maximizes the power of Cook Children's integrated health system by developing close partnerships with Neighborhood Clinics, Cook Children's Health Plan, and other departments offering case management services to distribute health and wellness messages and prevention tools. - The Center for Children's Health and Cook Children's Health Plan expanded their partnership with the addition of a C4CH/CCHP Liaison. This liaison has held multiple stakeholder meetings, educated children and families on prevention efforts to help keep their children healthy and safe, and assisted with resource distributions. In FY22, CCHP staff distributed 19,714 C4CH resources to members and potential members and provided 168 hours of support at C4CH meetings and events. - Community Health Workers (CHWs) are an integral piece to the success of several C4CH programs including Build-a-Bridge, Save-A-Smile, and Healthy Homes by connecting families to needed resources and support services to increase access to care. In FY22, CHWs provided 5,660 social services to families to help them meet basic needs and address social determinants of health and were responsible for 477 community referrals provided to families connecting them to basic needs and health services. CHWs, along with other C4CH staff, served 21,616 children, families, and partners. Additional information related to increasing access to care is also addressed throughout each of the remaining six focus areas discussed below. Oral Health Goal: Improve child oral health - Respond to the urgent needs of children at increased risk of poor oral health Community Strategies - Lead and sustain the Save a Smile Advisory Committee; and the Children's Oral Health Coalition (COHC) to plan and implement oral health collaborative interventions. The coalition's Legislative Advocacy committee monitors state and national legislative issues, especially those supporting expanded access to dental care for low-income children. - Develop and distribute evidence-informed oral health resources to educate families, medical/dental providers and other community partners. - Continue Save a Smile programming to conduct limited oral health evaluations for low-income children; identify those with acute dental problems in targeted schools; and provide comprehensive social and dental treatment services. - Provide evidence-based training to caregivers and children; pregnant women; school nurses; medical/dental providers; and other community partners. - Facilitate and track community-level oral health screening outcomes. - Reduce barriers to oral health care for pregnant teens and women. - Explore potential partnership with Renaissance Dental Clinic to expand patient family education opportunities. - Support community awareness campaigns and events to encourage good oral health Continued on next disclosure Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - Cook Childrens Medical Center. Continued from prior disclosure Mental Health Goal: Increase access to services for child mental health and well-being - Respond to the increasing critical need for mental health services to serve children Community Strategies - Lead and sustain the Wellness Alliance for Total Children's Health (WATCH) to plan and implement mental health collaborative interventions, targeting high-risk populations. - Sustain a strong community network of quality mental health services to support mental health services and treatment (Mental Health Connection). - Provide professional development opportunities for mental health providers who will share skills, knowledge, and tools with colleagues and caregivers within their reach (Wellness Workshops). - Develop and implement evidence-informed education and interventions for caregivers, children and adolescents to expand the reach of mental health messaging and strengthen connections to health care and community resources (Children's Feelings are a Work of Art, WatchDenton.org). - Support community campaigns and events to reduce stigma and promote awareness about mental health and well-being (Okay to SayT, Mental Health Awareness Month, JOY Campaign). Healthy Lifestyles (obesity prevention) Goal: Improve access to nutritious food and physical activity for children - Respond to the general health and wellness needs of families Community Strategies - Lead and sustain Johnson County Alliance for Healthy Kids (JCAHK), Healthy Children Coalition for Parker County (HCCPC), and classroom-based intervention to plan and implement programming that increases access to community resources and supports healthy parents and family resiliency. - Develop and distribute evidence-informed education and interventions for children to promote healthy lifestyles, nutritious food consumption, and physical activity (5210+ Every Day Coaching Sessions and in-school educational platform) - Provide healthy lifestyles training to providers and community members who will share skills, knowledge and tools with caregivers within their reach (5210+ Every Day Facilitator Training). - Support community awareness campaigns and events to encourage healthy lifestyles (National Gardening Week, Child Health Summits, and others). - Cook Children's promotes physical activity through offering a digital-based platform to all school districts within our service region. This platform, offered free to schools and families, provides children in school and at home an opportunity to cultivate good health now and lifelong healthy habits through daily physical activity. Parenting and Family Support (abuse neglect and prevention) Goal: Increase family resiliency through parenting and family support - Respond to the urgent needs of families raising children through challenging times or serious adversities (often referred to as ACEs) Community Strategies - Lead and sustain Adverse Childhood Experiences (ACEs) Task Force to plan and implement collaborative interventions to prevent or reduce trauma and protect well-being for children. Lead and sustain Hood County for Healthy Children and Wise Coalition for Healthy Children to plan and implement programming that increases access to community resources and supports healthy parents and family resiliency. - Develop and distribute ACEs/evidence-informed education and interventions for parents, caregivers and ACEs survivors (Build a Bridge and Caregiver Alliance; Parent Cafes; and Survivors Like Us). - Provide ACEs/evidence-informed education to providers and community members who will share skills, knowledge and tools with caregivers within their reach (Parent Cafe Facilitator Training, Early Detection of Child Abuse and Neglect). - Support community awareness campaigns and events to reduce child abuse and neglect (April National Child Abuse Awareness Month, Child Health Summits, and others). Injury Prevention Goal: Increase safety practices to reduce unintentional injuries to children - Respond to the urgent needs of families with unsafe sleep environments, where drownings are more likely to occur, who do not have properly installed car seats, recently prescribed medication, risk for accidental ingestion/overdose, or are more likely to have gun-related injury in the home Community Strategies - Lead and sustain Safe Kids North Texas- Fort Worth coalition and Safe Baby Sleep Council to plan and implement collaborative interventions - Provide evidence-informed education and interventions for parents and caregivers that encourage safer habits (planned vs unplanned water safety, child passenger safety in the car and on the road, medication storage, gun storage, and safe sleep) - Provide training to providers and community members who will share skills, knowledge, and safety tools with caregivers within their reach (Train the Trainer events, car seat technician training events, and Safe Baby Sleep Symposium) - Develop and distribute evidence-informed resources to promote safe practices for water safety, child passenger safety, poison prevention, gun safety, and safe infant sleep - Support community awareness campaigns and events to encourage safe practices for water safety, child passenger safety, poison prevention, gun safety, and safe infant sleep. Asthma Goal: Improve control of childhood asthma - Respond to the urgent needs of children with increased risk of uncontrolled asthma Community Strategies - Healthy Homes: > Coach families to identify asthma triggers in the home > Purchase and distribute practical asthma trigger remediation items and services to maintain a clean home environment. > Equip families with educational materials and practical tools for adapting prevention-oriented practices. > Follow up with families to support progress. > Connect families with community resources to address immediate needs (health care, food, etc.) > Support community campaigns and events to increase awareness about uncontrolled asthma - Asthma 411: Support prevention oriented care in school settings > Equip school nurses with training and medication needed to quickly respond to a child in respiratory distress > Enhance school asthma services - Engage community partners to plan and implement asthma management education in alignment with Healthy Homes strategies. - Provide evidence-based training to providers and community partners who will share skills, knowledge, and asthma prevention tools with caregivers within their reach. - Distribute evidence-informed prevention tools and educational resources among the community to increase awareness and knowledge of asthma control. - Support community awareness campaigns and events to increase awareness about uncontrolled asthma 2 CENTER FOR PEDIATRIC SURGERY 4200 W UNIVERSITY DRIVE STE 110 PROSPER TX 75075 AMBULATORY SURGERY CENTER COOK CHILDREN'S SURGERY CENTER 6313 PRECINCT LINE RD HURST TX 76054 AMBULATORY SURGERY CENTER Schedule H, Part I, Line 3c Other methods to determine eligibility for free or discounted care COOK CHILDREN'S ALSO USES ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS, AND RESIDENCY IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE. Schedule H, Part I, Line 6a Community Benefit Report COOK CHILDREN'S CONDUCTS A CHNA AND PREPARES A SUMMARY REPORT EVERY THREE YEARS. THE MOST RECENT CHNA WAS CONDUCTED IN 2021, AND THE WRITTEN CHNA REPORT WAS POSTED IN 2022. THE 2021 CHNA REPORT IS AVAILABLE TO THE PUBLIC ON OUR WEBSITE: (HTTPS://WWW.COOKCHILDRENS.ORG/ABOUT/COMMUNITY-OUTREACH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/). THE 2024 CHNA WAS COMPLETED AND APPROVED BY THE BOARD OF TRUSTEES IN APRIL 2025. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance LINE 7A IS CALCULATED USING WORKSHEET 1 AND THE COST TO CHARGE RATIO. LINE 7B MEDICAID SHORTFALL IS CALCULATED USING WORKSHEET 3 AND THE COST TO CHARGE RATIO. LINES 7E - I ARE CALCULATED USING THE HOSPITAL'S INTERNAL ACTIVITY REPORTS. Schedule H, Part II Community Building Activities COMMUNITY BUILDING ACTIVITIES: 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. OVER 1,000 HOURS WERE CONTRIBUTED TO MULTIPLE COALITIONS, COMMITTEES, AND COUNCILS FOR FYE 2024. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount 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, Line 3 Bad Debt Expense Methodology 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, Line 4 Bad debt expense - financial statement footnote Footnote disclosure regarding the treatment of bad debts is located on page 18 of the most recent audited financial statements attached to this form. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs 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, Line 9b Collection practices for patients eligible for financial assistance THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. Schedule H, Part V, Section B, Line 16a FAP website - COOK CHILDREN'S MEDICAL CENTER: Line 16a URL: www.cookchildrens.org/patients-families/billing-insurance/financial-assistance/; Schedule H, Part V, Section B, Line 16b FAP Application website - COOK CHILDREN'S MEDICAL CENTER: Line 16b URL: www.cookchildrens.org/patients-families/billing-insurance/financial-assistance/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - COOK CHILDREN'S MEDICAL CENTER: Line 16c URL: www.cookchildrens.org/patients-families/billing-insurance/financial-assistance/; Schedule H, Part VI, Line 2 Needs assessment Although various departments within Cook Children's periodically conduct patient needs assessments for specific medical specialties, the parent survey for our Community Health Needs Assessment, also known as the Community-wide Children's Health Assessment & 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 EIGHT-COUNTY SERVICE REGION IS BASED IN NORTH CENTRAL TEXAS AND COMPRISES COLLIN, DENTON, GRAYSON, HOOD, JOHNSON, PARKER, TARRANT, AND WISE COUNTIES. COOK CHILDREN'S EVALUATES THE STATISTICS DESCRIBING OUR COMMUNITY AND REPRESENTING OUR POPULATION SERVED WITH EVERY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). FOR FISCAL YEAR 2024, ALL INFORMATION PROVIDED IS IN RESPONSE TO OUR 2024 CHNA. FURTHERMORE, THE STATISTICS DESCRIBED WITHIN THIS SECTION REFLECT THOSE REPORTED IN OUR 2024 CHNA. THE 2024 CHNA WAS COMPLETED AND APPROVED BY THE BOARD OF TRUSTEES IN APRIL 2025. THE U.S. CENSUS BUREAU CLASSIFIES THESE COUNTIES AS FOLLOWS: COLLIN COUNTY-MOSTLY URBAN, 5% RURAL; DENTON COUNTY-MOSTLY URBAN, 7% RURAL; GRAYSON COUNTY-RURAL 43%; HOOD COUNTY MOSTLY URBAN, 33% RURAL; JOHNSON COUNTY-MOSTLY URBAN, 38% RURAL; PARKER COUNTY-RURAL 56%; TARRANT COUNTY-MOSTLY URBAN, 1% RURAL AND WISE COUNTY-MOSTLY RURAL 72%. THE FWSA TOTAL POPULATION OF 3,495,123 INCLUDES 877,448 CHILDREN FROM BIRTH TO AGE 17, WHILE THE PSA TOTAL POPULATION OF 2,131,031 INCLUDES 522,823 CHILDREN FROM BIRTH TO AGE 17. OVERALL, THIS EIGHT-COUNTY REGION IS HOME TO A DIVERSE POPULATION OF 4,711,284 PEOPLE, AND 1,181,591 (25%) ARE CHILDREN 17 YEARS AND YOUNGER. OF THOSE 1,181,591 CHILDREN AGES 0-17, THERE ARE 271,621 CHILDREN LIVING IN COLLIN COUNTY; 218,680 IN DENTON COUNTY; 32,522 IN GRAYSON COUNTY; 12,922 IN HOOD COUNTY; 46,951 IN JOHNSON COUNTY; 37,266 IN PARKER COUNTY; 544,440 IN TARRANT COUNTY; AND 17,189 IN WISE COUNTY. THE ANNUAL MEDIAN INCOME FOR FAMILIES WITH CHILDREN UNDER AGE 18 RANGE BETWEEN $73,993 IN GRAYSON COUNTY TO $140,862 IN COLLIN COUNTY. OF THE 1,181,591 CHILDREN UNDER AGE 18 LIVING IN THE REGION, NEARLY 140,000 (12%) LIVE IN HOUSEHOLDS WITH INCOME BELOW THE POVERTY LEVEL, AND CHILDREN IN HOUSEHOLDS THAT RECEIVE SUPPLEMENTAL SECURITY INCOME (SSI), CASH PUBLIC ASSISTANCE OR FOOD STAMPS/SNAP BENEFITS RANGES FROM 8% IN COLLIN COUNTY TO 24% IN TARRANT COUNTY. OF THE 1,181,591 CHILDREN UNDER AGE 18 LIVING IN THE REGION, BETWEEN 8%-24% LIVE IN HOUSEHOLDS THAT RECEIVE SUPPLEMENTAL SECURITY INCOME (SSI), CASH PUBLIC ASSISTANCE, OR FOOD STAMPS/SNAP BENEFITS. THE COOK CHILDREN'S EIGHT-COUNTY SERVICE REGION CONTAINS THREE MEDICALLY UNDERSERVED AREAS AND TWO MEDICALLY UNDERSERVED POPULATIONS AS DEFINED BY THE HEALTH RESOURCES & SERVICES ADMINISTRATION. THESE AREAS ARE: MEDICALLY UNDERSERVED AREAS (3) . DENTON COUNTY: KNOWN AS NORTH HARRIS COUNTY BY SERVICE AREA NAME, MEDICAL UNDERSERVICE SCORE IS 59.6, RURAL STATUS IS NON-RURAL. . DENTON COUNTY: KNOWN AS POVERTY POPULATION BY SERVICE AREA NAME, MEDICAL UNDERSERVICE SCORE IS 0 (GOVERNOR'S EXCEPTION), RURAL STATUS IS NON-RURAL. . TARRANT COUNTY: KNOWN AS CENTRAL SERVICE AREA AS ITS SERVICE AREA NAME, MEDICAL UNDERSERVICE SCORE IS 55.3, RURAL STATUS IS NON-RURAL. . TARRANT COUNTY: KNOWN AS FORT WORTH- NORTH AS ITS SERVICE AREA NAME, MEDICAL UNDERSERVICE SCORE IS 58, RURAL STATUS IS NON-RURAL. . TARRANT COUNTY: KNOWN AS DIAMOND HILL SERVICE AREA AS ITS SERVICE AREA NAME, MEDICAL UNDERSERVICE SCORE IS 57.5, RURAL STATUS AREA IS NON-RURAL. . TARRANT COUNTY: KNOWN AS NUECES SERVICE AREA AS ITS SERVICE AREA NAME, MEDICAL UNDERSERVICE SCORE IS 60.4, RURAL STATUS IS NON-RURAL. MEDICALLY UNDERSERVED POPULATION (3) . GRAYSON COUNTY: KNOWN AS LOW INCOME- GRAYSON COUNTY BY SERVICE AREA NAME, MEDICAL UNDERSERVICE SCORE IS 61, RURAL STATUS IS PARTIALLY RURAL. . GRAYSON COUNTY: KNOWN AS GRAYSON (MULTIPLE CENSUS TRACTS) BY SERVICE AREA NAME, MEDICAL UNDERSERVICE SCORE IS 61.5, RURAL STATUS IS NON-APPLICABLE. .TARRANT COUNTY: KNOWN AS LOW INCOME- EAST SIDE BY SERVICE AREA NAME, MEDICAL UNDERSERVICE SCORE IS 59.8, RURAL STATUS IS NON-RURAL. Schedule H, Part VI, Line 5 Promotion of community health IN FY2024, THE CENTER FOR CHILDREN'S HEALTH LED VARIOUS HEALTH OUTREACH EVENTS SERVING OVER 35,000 CHILDREN, FAMILIES, AND COMMUNITY PARTNERS. THESE OUTREACH EVENTS INCLUDE EDUCATION OR ACTIVITIES AROUND THE PRIORITIZED HEALTH ISSUES IDENTIFIED IN THE FINDINGS FROM OUR FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH INCLUDE: - ORAL HEALTH - ASTHMA - MENTAL HEALTH - HEALTHY LIFESTYLES - CAREGIVER AND FAMILY SUPPORT - INJURY PREVENTION - EQUITY ACCESS TO CARE (OVERALL HEALTH & WELL-BEING) IN FY2024 OUR COMMUNITY PARTNERS AND VOLUNTEERS GAVE OVER 5,000 HOURS OF VOLUNTEER SUPPORT TO THE CENTER FOR CHILDREN'S HEALTH. OUT OF OUR MANY HEALTH OUTREACH EVENTS, OVER 200 WERE COALITION, WORKGROUP, AND STAKEHOLDER MEETINGS, TRAININGS, AND WORKSHOPS THAT WE LED THROUGH OUR COLLABORATIONS BELOW: - ACES TASK FORCE - CHILDREN'S ORAL HEALTH COALITION - LIFEGUARD YOUR CHILD (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 SOME SELECTED HIGHLIGHTS OF OUR WORK IN FY2024 TO IMPROVE THE HEALTH OF CHILDREN AND FAMILIES IN THE COMMUNITY INCLUDE: - A TOTAL OF 2,828 DENTAL TREATMENT PROCEDURES WERE PROVIDED TO CHILDREN WITH SEVERE DENTAL DECAY AT A VALUE OF $457,211. - A TOTAL OF 389 CHILDREN WERE SERVED BY THE HEALTHY HOMES PROGRAM. ENROLLMENT RATES OF CHILDREN RECEIVING OUTREACH HAVE INCREASED OVER TIME, FROM 25% ENROLLED IN FY2019 TO 46% ENROLLED IN FY2024. -ASTHMA 411 PARTNERS DISTRIBUTED 2,169 PREVENTION TOOLS AND 9,445 EDUCATIONAL RESOURCES TO FAMILIES. - OVER 600 PEOPLE ATTENDED 3 WELLNESS WORKSHOP SESSIONS OBTAINING 1,585 HOURS OF CONTINUING EDUCATION CREDITS. WELLNESS WORKSHOPS PROVIDE PROFESSIONAL DEVELOPMENT OPPORTUNITIES FOR MENTAL HEALTH PROVIDERS TO SHARE SKILLS, KNOWLEDGE, AND RESOURCES WITH COLLEAGUES AND THE FAMILIES THAT THEY SERVE. RECORDINGS OF THE WORKSHOPS ARE AVAILABLE ONLINE TO EXTEND OUR REACH. - HOSTED 24 COALITION MEETINGS, ACTION TEAM/SUBCOMMITTEE GROUPS, AND COMMUNITY STAKEHOLDER MEETINGS SUPPORTING COMMUNITY COLLABORATION. SIXTY-FOUR VOLUNTEERS INVESTED 360 HOURS OF THEIR TIME TO IMPROVE MENTAL HEALTH SERVICES FOR CHILDREN. - HOSTED 10 ACTION TEAM MEETINGS, PARTICIPATED IN 38 COMMUNITY STAKEHOLDER MEETINGS, AND ENGAGED 22 VOLUNTEERS TO INVEST 153 HOURS TO SUPPORT HEALTHY LIFESTYLES PROGRAMMING. - THE HEALTHY LIFESTYLES ACTION TEAM DISTRIBUTED 18,017 EDUCATION AND PREVENTION MATERIALS VALUED AT $27,637. - OVER 9,500 CHILDREN AND ADULTS WERE EDUCATED ON DROWNING PREVENTION BY CAMPAIGN PARTNERS USING WATER SAFETY TOOLKITS. ADDITIONALLY, 5,539 CHILDREN RECEIVED SWIM LESSONS THROUGH THE WATER SAFETY CLUB, 50% OF THESE CHILDREN EDUCATED WERE IN THE AGE GROUP MOST AT RISK FOR DROWNING (AGES 1-4). - THE ACES TEAM AND REGIONAL COALITIONS FOCUSED ON PARENTING SUPPORT DISTRIBUTED 4,574 PREVENTION TOOLS AND 4,567 EDUCATIONAL RESOURCES TO PARTNERS, CHILDREN, AND FAMILIES. - IN TOTAL, 313 INJURY PREVENTION PARTNERS (DUPLICATED) PROVIDED 1,437 VOLUNTEER HOURS IN THE COMMUNITY ON BEHALF OF OUR INJURY PREVENTION PROGRAMS. - IN TOTAL FOR EQUITABLE ACCESS TO CARE TOPICS IN FY24, DISTRIBUTED 254,591 PREVENTION TOOLS VALUED AT $887,319 AND 276,540 EDUCATIONAL RESOURCES VALUED AT $111,673. 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 Chip, 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 State filing of community benefit report TX true Cook Children's Physician Network 801 Seventh Ave FORT Worth TX 76104 752485366 501(c)(3) 99658309 SUBSIDIZE OPERATIONS Junior League of Fort Worth 255 BAILEY AVE Fort Worth TX 76107 756022377 501(c)(3) 35000 SPONSORSHIP March of Dimes PO BX 18819 ATLANTA GA 31126 131846366 501(c)(3) 17500 SPONSORSHIP Ronald McDonald House 1001 8TH AVE Fort Worth TX 76104 751754490 501(c)(3) 10000 SPONSORSHIP Juvenile Diabetes Research Foundation 8140 Walnut Hill Lane DALLAS TX 75231 231907729 501(c)(3) 7500 SPONSORSHIP 5 0 Medication 2439 327381 Funeral Services 159 146725 Transportation 1762 37544 Lodging 385 79267 Gift Cards 506 22757 Baby Supplies 445 33471 Meals 779 16527 Medical Equipment 4 741 Utilities 11 5112 Miscellaneous 352 4594 Holiday Benevolence Gift Cards 89 28000 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. THE ORGANIZATION MAINTAINS RECORDS TO SUBSTANTIATE THE AMOUNT OF GRANTS OR ASSISTANCE AND HAS PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS. X false true false true false false false false false false false James C Cunningham MD EVP, CMO 0 716709 0 343100 0 162967 0 84051 0 21696 0 1328523 0 0 Nancy C Cychol President/Chief Hospital Services 458980 247143 218427 117614 103953 55975 53840 28991 15787 8501 850987 458224 0 0 Stanley E Davis Sr. VP, Chief Operating Officer 577823 0 252630 0 98652 0 120497 0 24932 0 1074534 0 66624 0 Joseph M Gallagher Sr. VP, Chief Legal Officer 0 550082 0 240616 0 93272 0 114616 0 24295 0 1022881 0 70553 Stephen W Kimmel EVP, SYS FINANCE 260695 463458 125547 223194 52123 92663 55649 98932 7488 13313 501502 891560 38482 68415 Mary Cara Martz Secretary 0 142535 0 35260 0 6112 0 8934 0 12161 0 205002 0 0 Theresa Z Meadows Sr. VP, Chief Information Officer 0 521469 0 231930 0 94243 0 62334 0 23677 0 933653 0 0 Rick W Merrill CEO 366013 1098036 219150 657450 103698 311096 131099 393298 6419 19258 826379 2479138 0 0 Jonathan Nedrelow MD Associate Chief Medical Officer 0 462464 0 156766 0 17649 0 83316 0 17856 0 738051 0 0 Cory R Rhoades Chief Financial Officer 0 534312 0 232745 0 99151 0 112564 0 23677 0 1002449 0 77403 Spencer D Seals VP Construction & Real Estate 0 298612 0 102463 0 2420 0 61751 0 23003 0 488249 0 0 Kevin Greene VP, Prosper Medical Center 0 221525 0 76339 0 1530 0 40032 0 22597 0 362023 0 0 Deborah Boudreaux AVP Nursing 244019 0 77618 0 41270 0 41690 0 17555 0 422152 0 0 0 Orlando Chapa AVP, Nursing 249944 0 73181 0 40628 0 52332 0 12901 0 428986 0 0 0 Aldrena Head Assistant VP 164254 0 41438 0 10389 0 14115 0 24343 0 254539 0 0 0 Nicholas Markham AVP Facilities/Campus Svcs 211760 0 60023 0 9427 0 38337 0 16080 0 335627 0 0 0 Ozioma Olowu Chief Pharmacy Officer 215625 0 54944 0 18562 0 14282 0 24191 0 327604 0 0 0 Cheryl Petersen VP Nursing, CNO 339737 0 150248 0 16457 0 79436 0 24932 0 610810 0 0 0 Jack Sosebee Vice president 348978 0 155047 0 13995 0 79929 0 11034 0 608983 0 0 0 Tammy Thomlison AVP Revenue 237035 0 44964 0 8253 0 14219 0 6034 0 310505 0 0 0 Elia Valencia-Stokes VP Finance 318662 0 112276 0 8474 0 57278 0 26274 0 522964 0 0 0 Natalie Wilkins VP, Operations 311580 0 105448 0 1910 0 54282 0 10171 0 483391 0 0 0 Matthew Carroll MD FORMER VP, Assoc Chief Quality Officer 0 366330 0 129118 0 7303 0 67251 0 22439 0 592441 0 0 Tammy Elizondo Program Coordinator 231122 0 3000 0 2853 0 18099 0 7714 0 262788 0 0 0 Tommie Moss Pharmacist 218385 0 15201 0 3225 0 18338 0 24220 0 279369 0 0 0 Eric Nimely Respiratory Therapist 231458 0 7700 0 3082 0 17593 0 18330 0 278163 0 0 0 Jessica Sibr Pharmacist 237813 0 2625 0 3330 0 17982 0 16099 0 277849 0 0 0 Toni Smith Night/Weekend Administrator 193057 0 18741 0 10720 0 16654 0 11570 0 250742 0 0 0 Schedule J, Part I, Line 1a Tax indemnification and gross-up payments GROSS UP PAYMENTS INCLUDED IN TAXABLE COMPENSATION: DEBORAH BOURDEAUX, ORLANDO CHAPA, NANCY CYCHOL, STANLEY DAVIS, NICHOLAS MARKHAM, JACK SOSEBEE, ELIA VALENCIA-STOKES Schedule J, Part I, Line 1b Written policy regarding payment or reimbursement of expenses 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 Arrangement used to establish the top management official's compensation COOK CHILDREN'S HEALTH CARE SYSTEM, A RELATED ORGANIZATION, USES THE FOLLOWING METHODS TO DETERMINE CEO/EXECUTIVE DIRECTOR COMPENSATION: 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 Supplemental nonqualified retirement plan RICK W MERRILL - PAID BY SYSTEM - $366,672 DEFERRED, $0 W-2 STEPHEN W KIMMEL - PAID BY SYSTEM - $133,956 DEFERRED, $106,897 W-2 JOSEPH GALLAGHER - PAID BY SYSTEM - $90,572 DEFERRED, $70,553 W-2 CORY R RHOADES - PAID BY SYSTEM - $87,814 DEFERRED, $77,403 W-2 SPENCER D SEALS - PAID BY SYSTEM - $37,001 DEFERRED, $0 W-2 STANLEY DAVIS - PAID BY CCMC - $95,747 DEFERRED, $66,624 W-2 JACK SOSEBEE - PAID BY CCMC - $55,179 DEFERRED, $0 W-2 Cheryl Petersen - Paid by CCMC - $54,686 Deferred, $0 W-2 Elia Valencia-Stokes - Paid by CCMC - $40,076 Deferred, $0 W-2 Natalie Wilkins - Paid by System - $37,639 Deferred, $0 W-2 JONATHAN NEDRELOW - PAID BY SYSTEM - $70,116 DEFERRED, $0 W-2 Nicholas Markham - Paid by CCMC - $21,204 Deferred, $0 W-2 KEVIN GREENE - PAID BY PROSPER - $27,714 DEFERRED, $0 W-2 Orlando Chapa - Paid by CCMC - $27,582 Deferred, $0 W-2 Deborah Boudreaux - Paid by CCMC - $27,285 Deferred, $0 W-2 Schedule J, Part II Allocation of CEO & CFO Salaries SALARIES FOR THE CEO AND EVP, SYSTEM FINANCE 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 PHYSICIAN NETWORK COOK CHILDREN'S MEDICAL CENTER - PROSPER CHILD STUDY CENTER A TARRANT COUNTY CULTURAL EDUCATION FACILITIES 751181060 875906NY1 2010-02-24 231948097 DEVELOPMENT, CONST, EQUIPMENT true false false B TARRANT COUNTY CULTURAL EDUCATION FACILITIES 043833551 87638QKX6 2014-02-02 176767688 CONSTRUCTION & EQUIPMENT COSTS true false false C TARRANT COUNTY CULTURAL EDUCATION FACILITIES 043833551 87638QQQ5 2020-02-25 241629204 REFUNDING AND CONSTRUCTION AND EQUIPMENT false false false D Tarrant County Cultural Education Facilities 043833551 000000000 2023-09-05 163310000 Refunding 2013 & 2014 Bonds false false false A 199770000 0 231948097 2686446 230119470 2011 false false true true B 28820000 89600000 176767688 1755350 176023031 2016 false false true true C 17685000 242464102 90712257 2221088 198738578 2023 true false true true D 2225000 165369955 162599938 710063 2059954 2023 true false true true A false true false false 0.0049 0.0049 false false true B false false false false 0.0 false false true C false true false false 0.0019 0.0019 false false true D false true false false 0.0021 0.0021 false false true A false false false true true true Bank of America 0.2 false false false false true B false false false true false false false false true C false false false true false false false false true D false true false false false false false false true A true B true C true D true Schedule K, 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 A, B & C. HOWEVER, THE AMOUNT OF PRIVATE BUSINESS USE WITH RESPECT TO THE BOND ISSUES DESCRIBED IN COLUMNS A, B & C 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." Schedule K, Part II Columns A-D TOTAL EXPENDITURES INCLUDE AMOUNTS SPENT AFTER INVESTMENT EARNINGS. Schedule K, Part IV, Line 2c COLUMN A Issuer name: TARRANT COUNTY CULTURAL EDUCATION FACILITIES The calculation for computing no rebate due was performed on 02/14/2014 Schedule K, Part IV, Line 2c COLUMN B Issuer name: TARRANT COUNTY CULTURAL EDUCATION FACILITIES The calculation for computing no rebate due was performed on 03/22/2017 Schedule K, Part IV, Line 2c COLUMN C Issuer name: TARRANT COUNTY CULTURAL EDUCATION FACILITIES The calculation for computing no rebate due was performed on 06/14/2021 Katharine Carvalho Daughter of Board Member 91032 Compensation false Form 990, Part VI, Line 2 Family/business relationships amongst interested persons VARIOUS TRUSTEES & OFFICERS EMPLOYED OR SERVING BOARDS WITHIN THE SYSTEM - Business relationship Form 990, Part VI, Line 3 Delegation of management duties A MANAGEMENT COMPANY MANAGES THE DAY TO DAY OPERATIONS OF THE JOINT VENTURES. Form 990, Part VI, Line 6 Classes of members or stockholders COOK CHILDREN'S HEALTH CARE SYSTEM, A TEXAS NON-PROFIT CORPORATION, IS THE SOLE MEMBER OF THE ORGANIZATION. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body 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, Line 7b Decisions requiring approval by members or stockholders 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, Line 11b Review of form 990 by governing body THE ORGANIZATION ENGAGES AN OUTSIDE INDEPENDENT ACCOUNTING FIRM TO ASSIST IN THE PREPARATION OF THE FORM 990 AND RELATED FILINGS. ALL INFORMATION PROVIDED TO THE OUTSIDE ACCOUNTING FIRM IS GATHERED BY KEY COMPANY EMPLOYEES AND EXECUTIVES. ONCE THE FORM 990 IS PREPARED, IT IS REVIEWED BY COMPANY FINANCE, LEGAL AND COMPLIANCE STAFF AND THEN PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW AND COMMENT. IN ADDITION, IT IS PROVIDED TO THE COOK CHILDREN'S HEALTH CARE SYSTEM AUDIT COMMITTEE FOR REVIEW AND COMMENT. SUBSEQUENT TO THE BOARD AND AUDIT COMMITTEE REVIEW, THE FORM 990 IS FILED WITH THE INTERNAL REVENUE SERVICE AND MADE AVAILABLE TO THE PUBLIC FOR REVIEW. Form 990, Part VI, Line 12c 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, Line 15a Process to establish compensation of top management official COOK CHILDREN'S HEALTH CARE SYSTEM HAS ESTABLISHED A COMPENSATION COMMITTEE WITH OVERSIGHT OF THE CEO. THE COMPENSATION COMMITTEE APPROVES COMPENSATION ARRANGEMENT 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. , WHICH IS AN INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE DOCUMENTS THE BASIS FOR ITS DETERMINATIONS FOLLOWING CONTEMPORANEOUS SUBSTANTIATION OF THE COMPENSATION COMMITTEE'S DELIBERATIONS AND DECISIONS. THE COMPENSATION COMMITTEE REQUIRES THE COMPENSATION CONSULTANT TO UPDATE MARKET DATA PERIODICALLY, USUALLY EVERY TWO YEARS, WITH INTERIM REVIEWS BEING CONDUCTED AS NEEDED. Form 990, Part VI, Line 15b Process to establish compensation of other employees COOK CHILDREN'S HEALTH CARE SYSTEM HAS ESTABLISHED A COMPENSATION COMMITTEE WITH OVERSIGHT OF THE COMPENSATION OF THE OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. THE COMPENSATION COMMITTEE APPROVES COMPENSATION ARRANGEMENTS IN ADVANCE, WHICH INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT COMMITTEE MEMBERS, USING COMPARABLE MARKET DATA RELATING TO COMPENSATION, WHICH IS PROVIDED BY SULLIVAN COTTER AND ASSOCIATES, INC. FOR EXECUTIVE COMPENSATION AND PHYSICIAN COMPENSATION, WHICH IS AN INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE DOCUMENTS THE BASIS FOR ITS DETERMINATIONS FOLLOWING CONTEMPORANEOUS SUBSTANTIATION OF THE COMPENSATION COMMITTEE'S DELIBERATIONS AND DECISIONS. THE COMPENSATION COMMITTEE REQUIRES THE COMPENSATION CONSULTANT TO UPDATE MARKET DATA PERIODICALLY, USUALLY EVERY TWO YEARS, WITH INTERIM REVIEWS BEING CONDUCTED AS NEEDED. WITH REGARD TO PHYSICIAN COMPENSATION, THE COMPENSATION COMMITTEE ALSO RETAINS THE LAW FIRM OF MCDERMOTT, WILL & EMERY OF CHICAGO, ILLINOIS, TO ISSUE A REASONABLENESS OPINION COVERING THE PHYSICIAN COMPENSATION PLAN FOR COOK CHILDREN'S PHYSICIAN NETWORK. Form 990, Part VI, Line 19 Required 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 TEXAS SECRETARY OF STATE. 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 CHANGE IN FAIR VALUE OF SWAP - -670239; Cook Children's Health Care System 801 Seventh Ave Fort Worth TX 76104 752705881 Health Care Support TX 501(c)(3) Type III-FI CCHF true COOK CHILDREN'S PHYSICIAN NETWORK 801 Seventh Ave Fort Worth TX 76104 752485366 Physician Services TX 501(c)(3) 3 CCHCS true WI COOK FOUNDATION dba Cook Children's Health Foundation 801 Seventh Ave Fort Worth TX 76104 752051649 Fundraising TX 501(c)(3) 7 NA false ROSEDALE OFFICE BUILDING 1500 W ROSEDALE Fort Worth TX 76104 460866421 TITLE HOLDING TX 501(c)(2) CCHF true COOK CHILDREN'S HOME HEALTH 801 Seventh Ave Fort Worth TX 76104 752896983 Healthcare TX 501(c)(3) 10 CCHCS true COOK CHILDREN'S HEALTH PLAN 801 Seventh Ave Fort Worth TX 76104 760585240 Insurance TX 501(c)(3) 10 CCHCS true CHILD STUDY CENTER 1300 West Lancaster Fort Worth TX 76102 751099536 Healthcare Services TX 501(c)(3) 7 CCMC true COOK CHILDREN'S HEALTH ENTERPRISES 801 Seventh Ave Fort Worth TX 76104 842625990 Healthcare Services TX 501(c)(3) Type II CCHCS true COOK CHILDREN'S MEDICAL CENTER PROSPER 801 Seventh Ave Fort Worth TX 76104 852354189 Hospital TX 501(c)(3) 3 CCHCS true CPS Pediatrics LLC 340 Seven Springs Way Ste 600 Brentwood TN 37027 470871718 ASC TX NA Related 54484 113868 false false 0.5311 COOK CHILDREN'S SURGERY CENTER 340 Seven Springs Way Ste 600 Brentwood TN 37027 205227064 ASC TX NA Related 12261536 3537192 false false 0.5152 CENTER FOR PEDIATRIC SURGERY 340 Seven Springs Way Ste 600 Brentwood TN 37027 470871715 ASC TX NA Related 11518159 13481504 false false 0.5311 Sandia Crest LP 201 Washington Street Boston MA 02108 871831241 Investments MA NA N/A SCP OPPORTUNITY FUND 56A Boat Quay SN 049845 981647424 Investments SN NA N/A SAGAMORE HEALTHCARE I LP 100 PAINTERS MILL ROAD SUITE 700 OWINGS MILLS MD 21117 262821679 Investments MD NA N/A Oberweis International Select Fund LLC 3333 Warrenville Road Ste 500 Lisle IL 60532 842094004 Investments IL NA N/A HT STORK LP 120 STATE ROUTE 28 UNIT 9 Crystal Bay NV 89402 881770748 Investments NV NA N/A CC TRUEACCORD SPV II LLC 520 E COOPER AVE 2ND FL STE C-7 Aspen CO 81611 822997101 Investments CO NA N/A STEPSTONE VC HEALTHCARE I LP 100 PAINTERS MILL ROAD SUITE 700 OWINGS MILLS MD 21117 262423493 Investments MD NA N/A GOFF FOCUSED ENERGY STRATEGIES LP 500 COMMERCE ST SUITE 700 FORT WORTH TX 76102 822764240 INVESTMENTS TX NA N/A Cook Children's Health Services 801 Seventh Ave Fort Worth TX 76104 454024843 Healthcare TX CCHCS C Corporation true Cook Children's Indemnity Company 878 West Bay Road PO Box 1159 Grand Cayman Grand Cayman CJ KY1110 980424041 Self Insurance CJ CCHCS C Corporation true SPLIT INTEREST TRUSTS (2) SPLIT INTEREST TRUST TX NA Trust true true true true false false false false false true true true false true true true true true true true Cook Children's Physician Network A 1541643 FMV Cook Children's Physician Network R 265420 FMV Cook Children's Physician Network O 159288654 FMV Cook Children's Physician Network B 99658309 FMV Cook Children's Physician Network Q 538028 FMV Cook Children's Home Health R 1799502 FMV Cook Children's Home Health P 308684 FMV Cook Children's Health Plan S 254394982 FMV Cook Children's Health Plan Q 63244 FMV COOK CHILDREN'S HEALTH PLAN P 230361 FMV Child Study Center O 87782 FMV Cook Children's Surgery Center (NE) J 1521560 FMV Cook Children's Health Enterprises N 6804402 FMV Cook Children's MC Prosper O 2163572 FMV Cook Children's Health Care System A 753607 FMV Cook Children's Health Care System S 257448 FMV Cook Children's Health Care System O 1402457 FMV Cook Children's Health Care System P 475171 FMV Cook Children's Health Care System Q 254212120 FMV COOK CHILDREN'S HEALTH CARE SYSTEM S 961380 FMV COOK CHILDREN'S HEALTH CARE SYSTEM P 411397171 FMV COOK CHILDREN'S SURGERY CENTER S 10768643 FMV CENTER FOR PEDIATRIC SURGERY LTD S 11353649 FMV CPS PEDIATRICS LLC S 53741 FMV Cook Children's Medical Center 801 Seventh Avenue Fort Worth TX 76104 752051646 X 0 0 0 1663759026 1663759026 1000000 250000 0 0 0 COOK CHILDREN'S HEALTH PLAN 801 SEVENTH AVE FORT WORTH TX 76104 760585240 0 0 0 878325485 878325485 1000000 250000 0 0 0 COOK CHILDREN'S HEALTH CARE SYSTEM 801 SEVENTH AVE FORT WORTH TX 76104 752705881 X 0 218773 218773 385562866 385781639 1000000 250000 0 0 0 COOK CHILDREN'S PHYSICIAN NETWORK 801 SEVENTH AVE FORT WORTH TX 76104 752485366 X 0 0 0 539056459 539056459 1000000 250000 0 0 0 WI COOK FOUNDATION 801 SEVENTH AVE FORT WORTH TX 76104 752051649 0 0 0 65381749 65381749 1000000 250000 0 0 0 ROSEDALE OFFICE BUILDING 801 SEVENTH AVE FORT WORTH TX 76104 460866421 0 0 0 2355915 2355915 267796 66949 0 0 0 CHILD STUDY CENTER 801 SEVENTH AVE FORT WORTH TX 76104 751099536 0 0 0 8400981 8400981 570049 142512 0 0 0 COOK CHILDREN'S HEALTH ENTERPRISES 801 SEVENTH AVE FORT WORTH TX 76104 842625990 0 0 0 8202202 8202202 560110 140028 0 0 0 COOK CHILDREN'S MEDICAL CENTER - PROSPER 801 SEVENTH AVE FORT WORTH TX 76104 852354189 0 0 0 129431422 129431422 1000000 250000 0 0 0 COOK CHILDREN'S HOME HEALTH 801 SEVENTH AVE FORT WORTH TX 76104 752896983 X 0 0 0 76825496 76825496 1000000 250000 0 0 0