2023-08-15T14:36:45-05:00 2022-09-30 FORVIS LLP 14241 DALLAS PARKWAY STE 1100 DALLAS TX 75254 990 2021-10-01 752051649 WI Cook Foundation Inc % CORY RHOADES WICO 6828854000 801 Seventh Avenue Fort Worth TX 76104 CORY R RHOADES CFO, SVP FINANCE 6828854000 2023-08-15 true CORY R RHOADES 999009999 michael j engle P00482834 9727028262 2 2021 2023-04-26 12:10:37Z Cook Children's Health Foundation RICK W MERRILL 801 SEVENTH AVE FORT WORTH TX 76104 659694098 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 PREVENTION AND TREATMENT OF ILLNESS, DISEASE AND INJURY 32 32 45 78 1360635 1223571 17994140 40964773 0 0 241101049 146857048 564858 1295361 259660047 189117182 15994115 19689282 0 0 7007944 9036936 0 0 5644186 21042734 17929873 44044793 46656091 215615254 142461091 3246012284 3401810693 2679019 4211378 3243333265 3397599315 X KNOWING THAT EVERY CHILD'S LIFE IS SACRED, OUR PROMISE IS TO IMPROVE THE HEALTH OF EVERY CHILD IN OUR REGION THROUGH PREVENTION AND TREATMENT OF ILLNESS, DISEASE, AND INJURY. false false 34100291 19689282 0 About Cook Children's Health Care System For 105 years, Cook Children's Health Care System has worked to fulfill its Promise to improve the well-being of every child in our care and our communities. As a not-for-profit, nationally-recognized and integrated pediatric health care organization based in Fort Worth, Texas, Cook Children's comprises 14 entities. They include a medical center, physician network, health plan, home health company, health foundation, a child study center, two surgery centers and more. Cook Children's reputation for excellence draws patients from near and far. Families travel from across Texas and the United States, as well as internationally, to receive life-saving pediatric care and benefit from the collaboration and vast resources the system offers. In addition to the medical center, a network of more than 60 primary, specialty and urgent care locations provide numerous access points to life-saving pediatric care that's family-centered and built on leading technology, collaboration and a best-in-class patient experience. Cook Children's Health Foundation Donations to Cook Children's Health Foundation allow us to care for our families when and how they need us. Sometimes that's by providing new technology or equipment, funding research trials, helping a family with prescription medication costs or by giving a parent a clean change of clothes during an unexpected stay. Our Health Foundation helps connect the dots between those who want to help and the needs of our patients. While many gifts fund a number of vital programs each year, two significant funding sources in 2022 offer examples of how the support we receive from our communities helps create the magical experiences that Cook Children's is known for. Funding Care Close to Home Cook Children's believes all children deserve access to health care, no matter their zip code. Seven community-based Neighborhood Clinics give families a home for primary medical care close to where they live, work and attend school. The free-standing pediatric clinics are located in low-income neighborhoods identified as having inadequate access to primary care for children. About 90% of Neighborhood Clinic patients are Medicaid beneficiaries. Neighborhood Clinics are staffed with doctors and other clinical support staff that provide at-risk children high-quality, comprehensive and culturally sensitive medical services from birth through their teen years, including well-child exams, vaccines, sick visits, nutrition, counseling, speech language intake services, and behavioral health evaluations. If a child has a chronic illness, the Neighborhood Clinic provides a medical home that will coordinate complex care among other Cook Children's providers. If not for the clinics, many of these families would turn to the emergency department (ED) for primary care at a cost much higher than a typical clinic visit. Neighborhood Clinics are helping kids all across Cook Children's service area lead healthier, more productive lives. In FY22, the Neighborhood Clinics conducted100,094 patient visits. Each year the clinics lose a combined $6.7 million due to the high number of Medicaid beneficiaries. Philanthropic funds through the Health Foundation help fill the financial gaps so that Cook Children's can deliver on its Promise to improve the well-being of every child regardless of their family's ability to pay. Thanks in part to a generous donation, children from birth through 16 years of age will have a medical home, which improves their access to primary and preventive care, increases the likelihood a child will see a pediatrician every 12 months, and ensures they receive the medical care needed to reduce their dependence on the ED as a source for primary care. Donor funding helps sustain Neighborhood Clinic services and gives all children the health care they deserve. Connected Care Thanks to a generous gift in 2022 from the Jane and John Justin Foundation, children diagnosed with disorders of the nervous system will enjoy an easier journey through the health care system. Disorders of the brain, spinal cord and nerves often require a child to visit a number of different specialists. Coordinating multiple appointments with multiple providers can be difficult and take lots of time, creating a barrier to treatment for some families. The new Jane and John Justin Institute for Mind Health at Cook Children's seeks to combine commonly overlapping specialties under one roof to provide easily accessible, well-coordinated and comprehensive care for children with nervous system disorders. The combination of specialties is about more than convenience. A central location and structure will foster increased communication and collaboration across departments. For patients, this translates to better care. The Justin Institute will be housed in the newly expanded Dodson Specialty Clinics building, and will connect nine specialties under one roof, including Neurology, Neuropsychology, Neurosurgery, Pain Management, Physical Medicine and Rehabilitation, Psychology, Psychiatry, Developmental Pediatrics and Developmental Psychology. Although the Justin Institute's physical space is not complete, the process of combining services and departments is underway. 34100291 true true false false false false true false false true true true false false true false false true false false true false false false true false false true false true false false false false false false false false true true false false true true true true false false true 31 0 true 45 true true true false false false false true true false false false false false false false true false X 32 32 true false false false false false false true true false false true true true true true true true true false TX X CORY RHOADES 6828854000 801 SEVENTH AVENUE FORT WORTH TX 76104 X Rick W Merrill President & CEO 9.0 31.0 X 529723 1878109 255556 B ANTHONY BAGWELL SVP, CIIO 40.0 0.0 X 1076836 0 161378 Stephen W Kimmel EVP, System Finance 2.0 38.0 X 52133 990536 162506 Joseph M Gallagher SVP, Chief Legal Officer 1.0 39.0 X 0 748085 137524 CORY R RHOADES Chief Financial Officer 2.0 40.0 X 0 740482 133681 Grant W Harris SVP, Chief Development Officer 40.0 0.0 X 578198 0 116444 SPENCER D SEALS VP Construction & Real Estate 2.0 38.0 X 0 376149 86425 Kyle Daley Investment Manager 40.0 0.0 X 237675 0 42696 Christopher Tindell Investment Manager 40.0 0.0 X 235559 0 42012 Jennifer Johnson AVP Donor Relations 40.0 0.0 X 220337 0 14884 Kimberly Mcginnis Assistant Vice President 40.0 0.0 X 184276 0 40730 Mary Cara Martz Secretary 1.0 39.0 X 0 169553 23484 Dayle Lowry Investment Operations Manager 40.0 0.0 X 166219 0 23839 Martha Mattox Director, Philanthropy 40.0 0.0 X 140742 0 9800 Kristen Black Director, Philanthropy 40.0 0.0 X 134792 0 11690 Karl Biggs Trustee 1.0 1.0 X 0 0 0 Laura Bird Trustee 1.0 0.0 X 0 0 0 Ashli Blumenfeld Trustee 1.0 0.0 X 0 0 0 Teresa Brownlie Trustee 1.0 0.0 X 0 0 0 Jon S Brumley Trustee 1.0 0.0 X 0 0 0 Jerry R Conatser Trustee 1.0 6.0 X 0 0 0 BRIAN C CRUMLEY Trustee - Secretary/Treasurer 2.0 2.0 X X 0 0 0 Lezlie P Davis Trustee - End: 05/2022 1.0 0.0 X 0 0 0 Michael R Dike Trustee - End: 05/2022 1.0 5.0 X 0 0 0 Clarabele Pit Dodson Trustee - End: 05/2022 1.0 0.0 X 0 0 0 James R Dunaway Jr Trustee - End: 05/2022 1.0 0.0 X 0 0 0 Richard W Dyess Trustee - Vice Chair 2.0 3.0 X X 0 0 0 Rosalind Evans Trustee - End: 05/2022 1.0 1.0 X 0 0 0 Jay L Fierke MD Trustee - End: 05/2022 1.0 1.0 X 0 0 0 Belen M Garren Trustee 1.0 1.0 X 0 0 0 Michael M Gonzalez Sr Trustee 1.0 0.0 X 0 0 0 Kenneth Hampton Trustee - Start: 06/2022 1.0 0.0 X 0 0 0 Willie Houston III Trustee 1.0 0.0 X 0 0 0 Lisa H Jamieson Trustee 1.0 1.0 X 0 0 0 James Matthew Johnson Trustee 1.0 0.0 X 0 0 0 Wally Jones Trustee - Start: 06/2022 1.0 2.0 X 0 0 0 R Kyle Kight Trustee 1.0 0.0 X 0 0 0 W M MACK LAWHON Trustee 1.0 1.0 X 0 0 0 Andrew P Lombardi Trustee 1.0 0.0 X 0 0 0 Roger P Marcincuk Jr Trustee 1.0 0.0 X 0 0 0 John Merrifield Trustee - Start: 06/2022 1.0 0.0 X 0 0 0 R Russell Morton Trustee - Chair 2.0 5.0 X X 0 0 0 Brian C Newby Trustee 1.0 1.0 X 0 0 0 Michael R Pavell Trustee 1.0 1.0 X 0 0 0 PETER L PHILPOTT Trustee - Vice Chair 2.0 5.0 X X 0 0 0 FROST R PRIOLEAU Trustee 1.0 1.0 X 0 0 0 VICTORIA PUENTE-PETERS Trustee - Start: 06/2022 1.0 1.0 X 0 0 0 WILLIAM JACKSON RATTIKIN III Trustee 1.0 1.0 X 0 0 0 Andrew J Rosell Trustee 1.0 3.0 X 0 0 0 Rick Sorenson Trustee 1.0 3.0 X 0 0 0 James E Webb Trustee 1.0 5.0 X 0 0 0 Rachel R Werner Trustee 1.0 2.0 X 0 0 0 Hadley Woerner Trustee 1.0 1.0 X 0 0 0 3556490 4902914 1262649 10 false true false WCM INVESTMENT MANAGEMENT INC 281 BROOKS STREET LAGUNA BEACH CA 92651 INVESTMENT MGMT SVCS 930458 BNY MELLON 240 GREENWICH STREET NEW YORK NY 10286 CUSTODIAL SERVICES 641771 OBERWEIS ASSET MANAGEMENT INC 3333 WARRENVILLE ROAD SUITE 500 LISLE IL 60532 INVESTMENT MGMT SVCS 637478 SILCHESTER INTERNATIONAL INVESTORS 780 THIRD AVENUE 42ND FLOOR NEW YORK NY 10017 INVESTMENT MGMT SVCS 624077 COPELAND CAPITAL MANAGEMENT LLC 161 WASHINGTON STREET SUITE 1325 CONSHOHOCKEN PA 19428 INVESTMENT MGMT SVCS 451306 14 424856 40539917 8160856 40964773 0 20616474 1360635 19255839 0 1359983 1359983 0 0 0 596752868 470512294 126240574 126240574 126240574 0 424856 64622 -64622 -64622 0 0 0 0 0 0 0 189117182 1360635 146791774 19689282 19689282 0 0 0 2832584 984754 650004 1197826 0 4693688 2294163 2399525 344276 157682 186594 851925 314505 537420 314463 94732 219731 0 15450 15450 0 0 0 6154294 6154294 2757359 2651202 20507 85650 375727 375727 115821 34570 81251 0 0 92729 5522 87207 64512 35135 29377 0 13297 131 13166 0 476 476 73505 5425 67378 702 0 Physician Remuneration 8584072 8584072 Federal tax -670215 -767408 97193 FEES & FINANCING 42508 42508 DUES & SUBSCRIPTIONS 254142 4022 250120 56196 2574 267 53355 46656091 34100291 6911614 5644186 0 0 118585672 68359294 2631590 12202020 28 1087463 0 0 0 0 0 0 0 0 0 145469 7848675 116648 23926 7732027 459807570 2139276693 2647623000 1158648334 0 0 0 0 17340498 14359393 3246012284 3401810693 1895056 3418608 0 0 0 0 0 0 0 0 0 0 0 0 0 0 783963 792770 2679019 4211378 X 3071156598 3217744850 172176667 179854465 3243333265 3397599315 3246012284 3401810693 X 142461091 -199016813 210821772 X false true X true false X 19321032 20451723 15623049 17994140 40964773 114354717 0 0 19321032 20451723 15623049 17994140 40964773 114354717 10654579 103700138 23990105 28817719 11455046 21727722 20615822 106606414 0 0 2553726 960979 1224571 4739276 14113042 0 8373204 0 0 22486246 248186653 0.41783 0.39608 X SCHEDULE A, PART II UNUSUAL GRANTS THE ORGANIZATION RECEIVED THE FOLLOWING UNUSUAL GRANT IN 2017, WHICH WAS NOT INCLUDED IN THE PUBLIC SUPPORT CALCULATION IN PART II, COLUMN (B). UNUSUAL GRANT #1 $20,000,025 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X X X 1 1.43 1 1 false 194420888 777244 5477435 6632657 194042910 151358685 506299 48438782 5882878 194420888 140163649 9193123 5976208 3974295 151358685 134782310 545733 6377720 1542114 140163649 95010517 32237997 9352630 1818834 134782310 0.30700 0.56570 0.12730 false false 3735000 3735000 4060245 82833 3977412 53430 33815 19615 7732027 Alternative Investments 1158648334 F 1158648334 0 Gift Annuities 58532 Funds Held for Affiliates 734238 792770 -53064697 -199016813 -199016813 145952116 9292386 33872680 43165066 189117182 17955852 64622 64622 17891230 9292386 19472475 28764861 46656091 SCHEDULE D, PART II, LINE 9 CONSERVATION EASEMENTS: CONSERVATION EASEMENT ASSETS ARE REPORTED WITH PROPERTY AND EQUIPMENT IN THE BALANCE SHEET. CONSERVATION EASEMENT REVENUE AND EXPENSES ARE REPORTED AS OPERATING INCOME/LOSS. SCHEDULE D, PART V, LINE 4 INTENDED USE OF ENDOWMENT FUNDS: COOK CHILDREN'S HAS ADOPTED INVESTMENT AND SPENDING POLICIES FOR ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO PROGRAMS AND OTHER ITEMS SUPPORTED BY ITS ENDOWMENT WHILE SEEKING TO MAINTAIN THE PURCHASING POWER OF THE ENDOWMENT. UNDER COOK CHILDREN'S POLICIES, ENDOWMENT ASSETS ARE INVESTED IN A MANNER THAT IS INTENDED TO PRODUCE AN AMOUNT THAT IS EQUAL TO A RETURN HURDLE DEFINED AS THE SPENDING RATE, INFLATION RATE AND THE MANAGEMENT COST OF THE ENDOWMENT ON AN ANNUAL BASIS WHILE ASSUMING A PRUDENT LEVEL OF INVESTMENT RISK. ACTUAL RETURNS IN ANY GIVEN YEAR MAY VARY FROM THIS AMOUNT. TO SATISFY ITS LONG-TERM RATE OF RETURN OBJECTIVES, COOK CHILDREN'S RELIES ON A TOTAL RETURN STRATEGY IN WHICH INVESTMENT RETURNS ARE ACHIEVED THROUGH BOTH CURRENT YIELD (INVESTMENT INCOME SUCH AS DIVIDENDS AND INTEREST) AND CAPITAL APPRECIATION (BOTH REALIZED AND UNREALIZED). COOK CHILDREN'S TARGETS A DIVERSIFIED ASSET ALLOCATION THAT PLACES A GREATER EMPHASIS ON EQUITY-BASED INVESTMENTS TO ACHIEVE ITS LONG-TERM RETURN OBJECTIVES WITHIN PRUDENT RISK CONSTRAINTS. COOK CHILDREN'S HAS A POLICY (THE SPENDING POLICY) OF APPROPRIATING FOR EXPENDITURE EACH YEAR 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 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. SCHEDULE D, PART XI, LINE 4B RECONCILIATION OF REVENUE PER AUDITED FINANCIALS TO TAX RETURN: CONTRIBUTIONS IN RESTRICTED TO NET ASSETS $26,202,302 DIRECT FUNDRAISING EXPENSES (64,622) DONATED PP&E 7,735,000 ------------- TOTAL $33,872,680 SCHEDULE D, PART XII, LINE 2D RECONCILIATION OF EXPENSES PER AUDITED FINANCIALS TO TAX RETURN: DIRECT FUNDRAISING EXPENSES $64,622 SCHEDULE D, PART XII, LINE 4B RECONCILIATION OF EXPENSES PER AUDITED FINANCIALS TO TAX RETURN: DONATIONS FROM NET ASSETS $19,472,475 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. North America Investments 126483126 East Asia and the Pacific Investments 448851114 Sub-Saharan Africa Investments 82182383 Middle East and North Africa Investments 37051050 Europe (Including Iceland and Greenland) Investments 557837730 South America Investments 16663148 Central America and the Caribbean 16962674 South Asia 100906392 1386937617 1386937617 true false true true true false STELTER COMPANY CONSULTATIO false M GALE ASSOCIATES CONSULTATIO false THE ADVISORY BOARD RESEARCH false BUXTON CONSULTATIO false LEXIS NEXIS RESEARCH false THE BLAST 252051 252051 147 3875 417 1069 30264 PARTY ON THE PA 172805 172805 18322 10528 0 424856 424856 147 3875 18739 1069 40792 64622 -64622 true COOK CHILDREN'S HOME HEALTH 801 SEVENTH AVENUE FORT WORTH TX 76104 752896983 501(C)(3) 28820 FINANCIAL ASSISTANCE COOK CHILDREN'S MEDICAL CENTER-PROSPER 801 SEVENTH AVENUE FORT WORTH TX 76104 852354189 501(C)(3) 24008 FINANCIAL ASSISTANCE CHILD STUDY CENTER 801 SEVENTH AVENUE FORT WORTH TX 76104 751099536 501(C)(3) 4794879 FINANCIAL ASSISTANCE COOK CHILDREN'S MEDICAL CENTER 801 SEVENTH AVENUE FORT WORTH TX 76104 752051646 501(C)(3) 11128505 FINANCIAL ASSISTANCE COOK CHILDREN'S PHYSICIAN NETWORK 801 SEVENTH AVENUE FORT WORTH TX 76104 752575366 501(C)(3) 1031306 FINANCIAL ASSISTANCE COOK CHILDREN'S HEALTH CARE SYSTEM 801 SEVENTH AVENUE FORT WORTH TX 76104 752705881 501(C)(3) 2267654 FINANCIAL ASSISTANCE 6 SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS: FUNDS ARE PLACED IN THE APPROPRIATE DESIGNATED ACCOUNTS WITH NOTIFICATION FROM DEVELOPMENT STAFF TO THE AUTHORIZED SIGNER. AUTHORIZED SIGNERS AND OTHER APPROPRIATE INDIVIDUALS ARE NOTIFIED OF ANY RESTRICTIONS ON THE FUNDS. DEVELOPMENT STAFF FOLLOW UP WITH AUTHORIZED SIGNERS TO OBTAIN INFORMATION ON THE USE OF FUNDS AND THE IMPACT MADE TO THE PROGRAM. IMPACT REPORTS ARE THEN PREPARED BY DEVELOPMENT STAFF AND SENT TO THE DONOR ON AN ANNUAL BASIS OR AS REQUIRED BY THE DONOR AGREEMENT. X false true X X X false true false false false false false false false B ANTHONY BAGWELL SVP, CIIO 605844 0 449701 0 21291 0 129022 0 32356 0 1238214 0 0 0 Kyle Daley Investment Manager 179259 0 51190 0 7226 0 8128 0 34568 0 280371 0 0 0 Joseph M Gallagher SVP, Chief Legal Officer 0 509870 0 220899 0 17316 0 103168 0 34356 0 885609 0 0 Grant W Harris SVP, Chief Development Officer 365108 0 157783 0 55307 0 80774 0 35670 0 694642 0 42075 0 Jennifer Johnson AVP Donor Relations 174755 0 40568 0 5014 0 11560 0 3324 0 235221 0 0 0 Stephen W Kimmel EVP, System Finance 31414 596876 14927 283610 5792 110050 6570 124832 1555 29549 60258 1144917 0 82928 Dayle Lowry Investment Operations Manager 134992 0 21775 0 9452 0 8205 0 15634 0 190058 0 0 0 Mary Cara Martz Secretary 0 131942 0 31642 0 5969 0 7810 0 15674 0 193037 0 0 Martha Mattox Director, Philanthropy 120247 0 17958 0 2537 0 5588 0 4212 0 150542 0 0 0 Kimberly Mcginnis Assistant Vice President 144813 0 36455 0 3008 0 4837 0 35893 0 225006 0 0 0 Rick W Merrill President & CEO 280963 996141 162620 576563 86140 305405 47905 169845 8317 29489 585945 2077443 0 0 CORY R RHOADES Chief Financial Officer 0 475794 0 204726 0 59962 0 97819 0 35862 0 874163 0 42740 SPENCER D SEALS VP Construction & Real Estate 0 279522 0 94063 0 2564 0 52284 0 34141 0 462574 0 0 Christopher Tindell Investment Manager 174748 0 50212 0 10599 0 9697 0 32315 0 277571 0 0 0 SCHEDULE J, PART I, LINE 4B PARTICIPATION IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: PARTICIPANTS IN SERP IN W-2 DEF COMP PAID BY -------------------- -------- -------- -------- B. ANTHONY BAGWELL NONE 117,422 CCHF JOSEPH M. GALLAGHER NONE 81,912 SYSTEM GRANT W. HARRIS 42,075 59,024 CCHF STEPHEN W. KIMMEL 82,928 113,277 SYSTEM CORY R. RHOADES 42,740 76,429 SYSTEM Rick W. Merrill NONE 196,000 SYSTEM SPENCER D. SEALS NONE 30,534 SYSTEM SCHEDULE J, PART II ALLOCATION OF CEO AND CFO SALARIES: SALARIES FOR THE CEO AND CFO ARE ALLOCATED PRO-RATA BASED ON THE AMOUNT OF TIME THEY SPEND WITH EACH OF THE FOLLOWING COMPANIES: COOK CHILDREN'S MEDICAL CENTER COOK CHILDREN'S HEALTH FOUNDATION COOK CHILDREN'S HOME HEALTH COOK CHILDREN'S HEALTH CARE SYSTEM COOK CHILDREN'S HEALTH PLAN CHILD STUDY CENTER COOK CHILDREN'S PHYSICIAN NETWORK SCHEDULE J, PART I, Line 3 METHODS USED BY CCHCS TO ESTABLISH COMPENSATION OF THE CEO/EXEC DIRECTOR: COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT WRITTEN EMPLOYMENT CONTRACT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE Schedule J, Part I, Lines 1a & 1b GENERAL GROSS UP PAYMENTS DISCLOSURE: THERE IS NO WRITTEN POLICY REGARDING PAYMENT OR REIMBURSEMENT OF TAX INDEMNIFICATION AND GROSS-UP PAYMENTS BECAUSE THE COMPANY DOES NOT GENERALLY ALLOW FOR GROSS-UP PAYMENTS EXCEPT IN EXTREMELY UNUSUAL CIRCUMSTANCES AND THEN ONLY IF APPROVED BY SENIOR MANAGEMENT FOLLOWED BY REVIEW OF THE COMPANY'S COMPLIANCE AND LEGAL DEPARTMENTS. THESE TYPES OF REIMBURSEMENTS GENERALLY RELATE TO TAXES OWED BY INDIVIDUALS WHO RECEIVE NOMINAL INCENTIVE PAYMENTS FOR SERVICE AWARDS OR QUALITY IMPROVEMENT PROGRAMS, AND THE GROSS-UP PAYMENTS USUALLY ARE IMMATERIAL, $250 OR LESS. CY 2021 Gross UP Payments included in taxable compensation: KYLE DALEY DAYLE LOWRY CHRISTOPHER TINDELL X 11 425856 AVG HIGH/LOW FOR DAy X 1 7735000 APPRAISAL false true false SCHEDULE M, PART 1, COLUMN B NUMBER OF CONTRIBUTIONS OR NUMBER OF ITEMS RECEIVED: THE AMOUNTS REPORTED IN THIS COLUMN REFLECT THE NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, PART VI, SECTION A, LINE 2 OFFICER, DIRECTOR, TRUSTEE, OR KEY EMPLOYEE FAMILY/BUSINESS RELATIONSHIPS: RICK SORENSON AND JAMES WEBB HAVE A BUSINESS RELATIONSHIP. R. KYLE KIGHT AND JON BRUMLEY HAVE A BUSINESS RELATIONSHIP. LISA JAMIESON AND JERRY CONATSER HAVE A BUSINESS RELATIONSHIP. WILLIE HOUSTON III AND RICK W. MERRILL HAVE A BUSINESS RELATIONSHIP. MARY CARA MARTZ AND PETER L. PHILPOTT HAVE A BUSINESS RELATIONSHIP. VARIOUS OFFICERS AND TRUSTEES HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER DUE TO THEIR EMPLOYMENT OR BOARD SERVICE WITH OTHER ORGANIZATIONS WITHIN THE SYSTEM. FORM 990, PART VI, SECTION B, LINE 11B REVIEW PROCESS FOR FORM 990: The organization engages an outside independent accounting firm to assist in the preparation of the Form 990 and related filings. All information provided to the outside accounting firm is gathered by key company employees and executives. Once the Form 990 is prepared, it is reviewed by company Finance, Legal and Compliance staff and then provided to the Board of Trustees for review and comment. In addition, it is 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, SECTION B, LINE 12C CONFLICT OF INTEREST: 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 IS PROVIDED TO THE SYSTEM AUDIT COMMITTEE FOR REVIEW AND FOLLOW-UP. FURTHER, THE AUDIT COMMITTEE OF COOK CHILDREN'S HEALTH CARE SYSTEM IS RESPONSIBLE FOR MONITORING THE IMPLEMENTATION AND ENFORCEMENT OF THE CONFLICT OF INTEREST POLICY THAT IS APPLICABLE TO ALL AFFILIATED COMPANIES OF THE COOK CHILDREN'S HEALTH CARE SYSTEM. THE AUDIT COMMITTEE IS ALSO RESPONSIBLE FOR OVERSIGHT OF THE COMPLIANCE DEPARTMENT OF COOK CHILDREN'S HEALTH CARE SYSTEM. THE COMPLIANCE DEPARTMENT MAINTAINS A HOTLINE TO RECEIVE REPORTS OF INAPPROPRIATE ACTIVITIES INCLUDING ACTIVITIES THAT MIGHT CONSTITUTE A CONFLICT OF INTEREST. INTERNAL AUDIT AND COMPLIANCE ALSO CONDUCT RANDOM AUDITS OF CORPORATE ACTIVITIES SUCH AS EXPENSE REIMBURSEMENTS AND ACCOUNTS PAYABLE TO DETERMINE IF ANY INAPPROPRIATE PAYMENTS ARE BEING MADE TO INDIVIDUALS, SOME OF WHICH COULD BE EVIDENCE OF A CONFLICT OF INTEREST. ANY CORRECTIVE ACTION RELATED TO CONFLICTS OF INTEREST WOULD BE REPORTED TO THE AUDIT COMMITTEE FOR REVIEW, APPROVAL, AND MODIFICATION, AS NECESSARY, WITH FURTHER REPORTING TO THE SYSTEM BOARD OF TRUSTEES AS APPROPRIATE. FORM 990, PART VI, SECTION B, LINE 15A REVIEW AND APPROVAL OF COMPENSATION: COOK CHILDREN'S HEALTH CARE SYSTEM HAS ESTABLISHED A COMPENSATION COMMITTEE WITH OVERSIGHT OF EXECUTIVE AND PHYSICIAN COMPENSATION, WHICH INCLUDES THE ORGANIZATION'S CEO AND OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. THE COMPENSATION COMMITTEE APPROVES COMPENSATION ARRANGEMENTS IN ADVANCE, WHICH INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT COMMITTEE MEMBERS, USING COMPARABLE MARKET DATA RELATING TO COMPENSATION, WHICH IS PROVIDED BY SULLIVAN COTTER AND ASSOCIATES, INC. FOR EXECUTIVE COMPENSATION AND BY ECG MANAGEMENT CONSULTANTS FOR PHYSICIAN COMPENSATION, BOTH OF WHICH ARE INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANTS. THE COMPENSATION COMMITTEE DOCUMENTS THE BASIS FOR ITS DETERMINATIONS FOLLOWING CONTEMPORANEOUS SUBSTANTIATION OF THE COMPENSATION COMMITTEE'S DELIBERATIONS AND DECISIONS. THE COMPENSATION COMMITTEE REQUIRES THE COMPENSATION CONSULTANT TO UPDATE MARKET DATA PERIODICALLY, USUALLY EVERY TWO YEARS, WITH INTERIM REVIEWS BEING CONDUCTED AS NEEDED. WITH REGARD TO PHYSICIAN COMPENSATION, THE COMPENSATION COMMITTEE ALSO RETAINED SULLIVAN COTTER AND ASSOCIATES, INC. IN 2022 TO ISSUE A REASONABLENESS OPINION COVERING THE PHYSICIAN COMPENSATION PLAN FOR COOK CHILDREN'S PHYSICIAN NETWORK. FORM 990, PART VI, SECTION C, LINE 19 PROCESS OF MAKING GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC: THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC, EXCEPT TO THE EXTENT THEY ARE ON FILE WITH THE SECRETARY OF STATE OF TEXAS. THE CONFLICT OF INTEREST POLICY IS POSTED ON THE ORGANIZATION'S INTERNAL WEBSITE AND AVAILABLE TO ALL EMPLOYEES AND BOARD MEMBERS OF COOK CHILDREN'S HEALTH CARE SYSTEM ENTITIES. CONSOLIDATED FINANCIAL STATEMENTS ARE REPORTED ELECTRONICALLY FOR ALL COOK CHILDREN'S HEALTH CARE SYSTEM ENTITIES VIA THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEB SITE. FORM 990, PART XI, LINE 9 OTHER CHANGES TO NET ASSETS: CHANGE IN BENEFICIAL INTEREST IN TRUSTS $ (2,978,631) NET TRANSFERS BETWEEN AFFILIATES $209,873,798 RESTRICTED INVESTMENT INCOME $ 3,926,605 ------------- TOTAL $210,821,772 JEFFERSON STREET INVESTORS BLUE LLC 801 SEVENTH AVE FORT WORTH TX 76104 830910401 INVEST TX -164407 27895437 CCHF COOK CHILDREN'S HEALTH PLAN 801 SEVENTH AVE FORT WORTH TX 76104 760585240 INSURANCE TX 501(C)(3) 10 CCHCS true COOK CHILDREN'S HEALTH CARE SYSTEM 801 SEVENTH AVE FORT WORTH TX 76104 752705881 HLTH CARE SUP TX 501(C)(3) 12C CCHF true COOK CHILDREN'S PHYSICIAN NETWORK 801 SEVENTH AVE FORT WORTH TX 76104 752485366 PHYSICIAN SVC TX 501(C)(3) 3 CCHCS true COOK CHILDREN'S MEDICAL CENTER 801 SEVENTH AVE FORT WORTH TX 76104 752051646 HOSPITAL TX 501(C)(3) 3 CCHCS true COOK CHILDREN'S HOME HEALTH 801 SEVENTH AVE FORT WORTH TX 76104 752896983 HEALTHCARE TX 501(C)(3) 10 CCHCS true ROSEDALE OFFICE BUILDING INC 1500 W ROSEDALE FORT WORTH TX 76104 460866421 TITLE HOLDING TX 501(C)(2) N/A CCHF true CHILD STUDY CENTER 1300 W LANCASTER FORT WORTH TX 76102 751099536 HLTHCARE SRVC TX 501(C)(3) 7 CCMC true COOK CHILDREN'S HEALTH ENTERPRISES 801 SEVENTH AVE FORT WORTH TX 76104 842625990 HLTHCRE SUPPT TX 501(C)(3) 12B 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 11221 ROE AVE SUITE 320 LEAWOOD KS 66211 470871718 ASC TX NA N/A COOK CHILDREN'S SURGERY CENTER 11221 ROE AVE SUITE 320 LEAWOOD KS 66211 205227064 ASC TX NA N/A CENTER FOR PEDIATRIC SURGERY 11221 ROE AVE SUITE 320 LEAWOOD KS 66211 470871715 ASC TX NA N/A SPLIT INTEREST TRUSTS (2) PO BOX 830269 DALLAS TX 75283 SPLIT INT TRUST TX NA TRUST false COOK CHILDREN'S HEALTH SERVICES INC 801 7TH AVENUE FORT WORTH TX 76104 454024843 HEALTH SERVICE TX CCHCS C CORPORATION true SPLIT INTEREST TRUST 270 PARK AVE NEW YORK NY 100172014 SPLIT INT TRUST TX NA TRUST false COOK CHILDREN'S INDEMNITY COMPANY 878 WEST BAY RD GRAND CAYMAN CJ KY1-1102 980424041 SELF INSURANCE CJ NA C CORPORATION true true true false false false false false false false true false false false true true true true true true COOK CHILDREN'S HEALTH CARE SYSTEM B 2267654 FMV CHILD STUDY CENTER B 4794879 FMV COOK CHILDREN'S MEDICAL CENTER B 11128505 FMV COOK CHILDREN'S PHYSICIAN NETWORK B 1031306 FMV CHILD STUDY CENTER R 3997776 FMV COOK CHILDREN'S MEDICAL CENTER P 181083 FMV COOK CHILDREN'S MEDICAL CENTER R 1409089 FMV COOK CHILDREN'S MEDICAL CENTER S 210000000 FMV COOK CHILDREN'S HEALTH CARE SYSTEM P 4356208 FMV COOK CHILDREN'S HEALTH CARE SYSTEM R 1100668 FMV COOK CHILDREN'S PHYSICIAN NETWORK P 8402989 FMV