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      <Desc>Cook Childrens Home Health is another not-for-profit company within the continuum of the Cook Children's Health Care System. It began operating as a company in 2001 and is the areas largest and most comprehensive pediatric home health care provider. As a one-stop alternative to hospitalization or nursing home care, it meets the diverse needs of children who are able to continue their recovery and rehabilitation in the comfort and convenience of their own home. Research verifies that children who require long-term care usually feel better and recover more quickly when treated in the familiar surroundings of home, accompanied by family. Cook Childrens Home Health provides services through Cook Children's employees rather than by contracting with outside providers, allowing patients and their families the opportunity for greater continuity of care and convenience, while significantly lowering costs. The staff develops individualized care plans for patients and works with them on a monthly, weekly or daily basis. Company divisions include skilled nursing services and rehabilitation, infusion pharmacy, durable medical equipment, specialty biotechnology drugs, PHS 340b contract pharmacy, rehabilitation and orthotics and prosthetics. They offer clinical services like initial discharge planning, patient assessment, home care instruction and ongoing treatments and/or evaluation. Cook Childrens Home Health has offices in Dallas, Fort Worth, Austin and San Antonio, which allows Cook Childrens to better serve patients at home. Cook Childrens Home Health pharmacists, nurses, social workers, respiratory therapists, orthotics and prosthetics practitioners orthotists and prosthetists and physical, occupational, and speech therapists and dietician, are trained in pediatric home care. All submit to an intensive interview process and receive thorough background checks. Nurses are required to be PALS (Pediatric Advanced Life Support) certified with pediatric experience. Each patient is assigned a Cook Childrens Home Health Care Coordinator, who is a registered nurse, to ensure that every family is treated with respect, coordinate care and see that communication between the family and the providers is timely and accurate. Patients and their families may call on a pediatric home care nurse 24 hours a day, 7 days a week. Cook Childrens Home Health provides products and services for patients needing orthotics and prosthetics, including ankle-foot orthotics, scoliosis bracing, cranial helmets, prosthetic limbs, upper extremity orthotics, shoe inserts and more. Children in need of custom orthotics receive help with design and fit.</Desc>
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        <PersonNm>Rick W Merrill</PersonNm>
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        <PersonNm>Dionne CRIGLER</PersonNm>
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        <PersonNm>SHANNON ROGERS</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>VINH PHAN</PersonNm>
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        <PersonNm>Carolyn Bruno</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Sandra Manning</PersonNm>
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      <ContractorCompensationGrp>
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      <ContractorCompensationGrp>
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      <FeesForServicesLobbyingGrp>
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      <PublicSupportTotal509Amt>228306789</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
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      <Post1975UBTIGrp>
        <TotalAmt>0</TotalAmt>
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      <InvestmentIncomeAndUBTIGrp>
        <TotalAmt>0</TotalAmt>
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      <NetIncomeFromOtherUBIGrp>
        <TotalAmt>0</TotalAmt>
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        <TotalAmt>0</TotalAmt>
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      <PublicSupportCY509Pct>0.87638</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>1.00000</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00000</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00000</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
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    <IRS990ScheduleB documentId="IRS990ScheduleB">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
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        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
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      <HeldWorksArtGrp />
      <CYMinus3YrEndwmtFundGrp />
      <CYMinus4YrEndwmtFundGrp />
      <LandGrp />
      <BuildingsGrp />
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>267889</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>219446</DepreciationAmt>
        <BookValueAmt>48443</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
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        <DepreciationAmt>2791676</DepreciationAmt>
        <BookValueAmt>1560058</BookValueAmt>
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      <OtherLandBuildingsGrp>
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        <DepreciationAmt>67889</DepreciationAmt>
        <BookValueAmt>366310</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>1974811</TotalBookValueLandBuildingsAmt>
      <TotalRevEtcAuditedFinclStmtAmt>46931546</TotalRevEtcAuditedFinclStmtAmt>
      <OtherRevenueAmt>-3362301</OtherRevenueAmt>
      <RevenueNotReportedAmt>-3362301</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>50293847</RevenueSubtotalAmt>
      <OtherRevenuesNotIncludedAmt>41652</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>41652</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>50335499</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>46704296</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>-41652</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>-41652</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>46745948</ExpensesSubtotalAmt>
      <OtherExpensesNotIncludedAmt>3362301</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>3362301</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>50108249</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART XI, LINES 2D</FormAndLineReferenceDesc>
        <ExplanationTxt>RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS WITH RETURN: BAD DEBT TOTAL: $ (3,362,301)</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>sCHEDULE D, PART XI, LINE 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS WITH RETURN: GAIN ON DISPOSAL OF ASSETS: $ 41,652</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>sCHEDULE d, pART XII, LINE 2D</FormAndLineReferenceDesc>
        <ExplanationTxt>RECONCILIATION OF eXPENSES PER AUDITED FINANCIAL STATEMENTS WITH RETURN: GAIN ON DISPOSAL OF ASSETS: $ (41,652)</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>sCHEDULE D, PART XII, LINE 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>RECONCILIATION OF eXPENSES PER AUDITED FINANCIAL STATEMENTS WITH RETURN: BAD DEBT TOTAL: $3,362,301</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART X, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>ASC 740 Footnote: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INLUDES IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSIIONS TO BE RECORDED OR DISLOSED IN THE FINANCIAL STATEMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ">
      <FirstClassOrCharterTravelInd>X</FirstClassOrCharterTravelInd>
      <IdemnificationGrossUpPmtsInd>X</IdemnificationGrossUpPmtsInd>
      <WrittenPolicyRefTAndEExpnssInd>false</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>true</SubstantiationRequiredInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>true</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
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        <PersonNm>Jason Kennedy MD</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>579157</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>500</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>37225</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
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        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>659148</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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        <PersonNm>M Scott Perry MD</PersonNm>
        <TitleTxt>Vice Chairman</TitleTxt>
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        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Danny S Rafati MD</PersonNm>
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        <OtherCompensationRltdOrgsAmt>42564</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>2259</DeferredCompRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>15870</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>353623</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Michael R Simmons</PersonNm>
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        <BonusRelatedOrganizationsAmt>103273</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>110109</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>20625</DeferredCompRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>22105</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>478346</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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        <PersonNm>Michael Gendke</PersonNm>
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        <BonusRelatedOrganizationsAmt>55263</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>33456</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>18440</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>16621</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>288747</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Stephen W Kimmel</PersonNm>
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        <OtherCompensationRltdOrgsAmt>142321</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>4060</DeferredCompensationFlngOrgAmt>
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        <TotalCompensationFilingOrgAmt>48762</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>926475</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Cara Martz</PersonNm>
        <TitleTxt>Secretary</TitleTxt>
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        <NontaxableBenefitsRltdOrgsAmt>15369</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Rick W Merrill</PersonNm>
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        <OtherCompensationRltdOrgsAmt>28828</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>8917</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>20998</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>323663</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Carolyn Bruno</PersonNm>
        <TitleTxt>AVP Finance</TitleTxt>
        <BaseCompensationFilingOrgAmt>127089</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>20903</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>22754</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>12644</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>19792</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>203182</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Sandra Manning</PersonNm>
        <TitleTxt>SR Director Operations</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>35307</BonusFilingOrganizationAmount>
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        <OtherCompensationFilingOrgAmt>12524</OtherCompensationFilingOrgAmt>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 1A</FormAndLineReferenceDesc>
        <ExplanationTxt>Gross up payments included in taxable compensation: SHANNON ROGERS $220 GROSS UP VINH PHAN $220 GROSS UP JASON KENNEDY $110 GROSS UP ERRIN NEWMAN $110 GROSS UP M. SCOTT PERRY $110 GROSS UP DANNY S. RAFATI $110 GROSS UP</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 1B</FormAndLineReferenceDesc>
        <ExplanationTxt>GENERAL GROSS UP PAYMENTS: 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 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. CME GROSS UP PAYMENTS: THERE IS NO WRITTEN POLICY REGARDING PAYMENT OR REIMBURSEMENT OF TAX INDEMNIFICATION AND GROSS-UP PAYMENTS FOR CONTINUING MEDICAL EDUCATION ALLOWANCES PAID TO EMPLOYED PHYSICIANS OF COOK CHILDREN'S PHYSICIAN NETWORK. THESE TYPES OF EXPENSES ARE USUALLY HANDLED AS NON-TAXABLE ACCOUNTABLE PLAN BUSINESS EXPENSES UNDER THE INTERNAL REVENUE CODE, BUT THE COMPANY HAS ELECTED TO TREAT THESE PAYMENTS AND THE GROSS-UP PAYMENTS AS TAXABLE INCOME TO THE AFFECTED INDIVIDUALS. THESE PAYMENTS ARE APPROVED IN ADVANCE BY SENIOR MANAGEMENT AND REVIEWED BY THE COMPANY'S COMPLIANCE AND LEGAL DEPARTMENTS. FURTHER, THESE EXPENSES ARE INCLUDED IN THE BENEFITS CALCULATION FOR SUCH PHYSICIANS WHICH ARE REVIEWED BY THE COMPANY'S COMPENSATION COMMITTEE TO VERIFY THAT SUCH PAYMENTS ARE PAID AT FAIR MARKET VALUE AND COMMERCIALLY REASONABLE. CME GROSS UPS: JASON KENNEDY $16,575 ERRIN NEWMAN, MD 5,000 M. SCOTT PERRY 9,750 DANNY S RAFATI, MD 3,000 CHARTER AIR TRAVEL PROVIDED TO DR. M. SCOTT PERRY FOR CLINICAL CARE AND OUTREACH IN HIS CAPACITY AS A PHYSICIAN FOR COOK CHILDREN'S PHYSICIAN NETWORK.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>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</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, Line 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>PARTICIPATION IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PARTICIPANTS IN SERP IN W-2 DEF COMP PAID BY -------------------- -------- ---------- --------- RICK W. MERRILL 126,903 196,000 CCHS STEPHEN KIMMEL 63,144 70,202 CCHS MICHAEL R. SIMMONS 41,133 NONE CCHH</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>SOLE MEMBER: COOK CHILDREN'S HEALTH CARE SYSTEM, A TEXAS NON-PROFIT CORPORATION, IS THE SOLE MEMBER OF THE ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBER ELECTION ABILITIES: 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBER DECISION ABILITIES: 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; F. APPROVE THE CREATION OF, OR INVESTMENT IN, ANY SUBSIDIARY ENTITY; G. APPROVE CAPITAL AND OPERATING BUDGETS OF THE ORGANIZATION; H. APPROVE DEBT TO BE INCURRED BY THE ORGANIZATION WHICH WOULD EXCEED SUCH LIMITS AS ESTABLISHED BY THE SOLE MEMBER; AND, I. APPROVE THE LONG-RANGE FINANCIAL AND STRATEGIC PLANS FOR THE ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>REVIEW PROCESS FOR FORM 990: THE ORGANIZATION ENGAGES AN OUTSIDE INDEPENDENT ACCOUNTING FIRM TO ASSIST IN THE PREPARATION OF THE FORM 990 AND RELATED FILINGS. ALL INFORMATION PROVIDED TO THE OUTSIDE ACCOUNTING FIRM IS GATHERED BY KEY COMPANY EMPLOYEES AND EXECUTIVES. ONCE THE FORM 990 IS PREPARED, IT IS REVIEWED BY COMPANY FINANCE, LEGAL AND COMPLIANCE STAFF AND THEN PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW AND COMMENT. IN ADDITION, IT IS PRESENTED TO THE COOK CHILDREN'S HEALTH CARE SYSTEM AUDIT COMMITTEE FOR REVIEW AND COMMENT. SUBSEQUENT TO AUDIT COMMITTEE REVIEW, THE FORM 990 IS FILED WITH THE INTERNAL REVENUE SERVICE AND MADE AVAILABLE TO THE PUBLIC FOR REVIEW.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>Written Conflict of Interest Policy: Every year the Legal Department of the Cook Childrens 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 Systems 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 Childrens 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 Childrens Health Care System. The Audit Committee is also responsible for oversight of the Compliance Department of Cook Childrens 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15A &amp; 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>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 RETAINS THE LAW FIRM OF MCDERMOTT, WILL AND EMERY OF CHICAGO, ILLINOIS, TO ISSUE A REASONABLENESS OPINION COVERING THE PHYSICIAN COMPENSATION PLAN FOR COOK CHILDREN'S PHYSICIAN NETWORK.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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          <ZIPCd>76104</ZIPCd>
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</Return>