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        <Explanation>MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING COMBINED BALANCE SHEETS AS OF SEPTEMBER 30, 2013.</Explanation>
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      <CompBasedNetEarningsRelateOrgs>false</CompBasedNetEarningsRelateOrgs>
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        <Title>CFO</Title>
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        <BonusFilingOrg>0</BonusFilingOrg>
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        <CompReportPrior990RelatedOrgs>486974</CompReportPrior990RelatedOrgs>
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        <NamePerson>DACE REINHOLDS</NamePerson>
        <Title>ASSISTANT SECRETARY</Title>
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      <Form990ScheduleJPartII>
        <NamePerson>MARK A WALLACE</NamePerson>
        <Title>BOARD MEMBER / PRESIDENT / CEO</Title>
        <BaseCompensationFilingOrg>0</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>1119218</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>2660707</BonusRelatedOrgs>
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      <Form990ScheduleJPartIII>
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        <ReturnReference>Schedule J, Part I, Line 3</ReturnReference>
        <Explanation>COMPENSATION FOR THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL IS ESTABLISHED BY TEXAS CHILDREN'S AND TEXAS CHILDREN'S HOSPITAL, USING THE FOLLOWING METHODS: * COMPENSATION COMMITTEE * INDEPENDENT COMPENSATION CONSULTANT * COMPENSATION SURVEY OR STUDY * APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE</Explanation>
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      <Form990ScheduleJPartIII>
        <Identifier>Supplemental nonqualified retirement plan</Identifier>
        <ReturnReference>Schedule J, Part I, Line 4b</ReturnReference>
        <Explanation>CY 2012 457(F) PLAN: PAID/DEFERRED MARK A WALLACE 2,376,413 / 283,464 BENJAMIN MELSON 1,485,474 / 160,887 DIRECTOR INCENTIVE PLAN: PAID/DEFERRED DACE REINHOLDS 24,311 / 0 457(F): THE 457(F) PLAN IS A DEFERRED COMPENSATION PLAN THAT ALLOWS ELIGIBLE EXECUTIVES, FROM THE ASSISTANT VICE PRESIDENT LEVEL TO CHIEF EXECUTIVE OFFICER, TO CONTRIBUTE MONEY ON A PRE-TAX BASIS. FUNDS MAY BE DEFERRED INTO THIS ACCOUNT FROM ANY OF FOUR SOURCES: BASE SALARY, ANNUAL INCENTIVE PLAN, LONG-TERM INCENTIVE PLAN, AND CAPITAL ACCUMULATION ACCOUNT FROM A FLEXIBLE BENEFIT ACCOUNT SURPLUS. THESE VEST AFTER THREE YEARS IN THE 457(F) WITH THE EXCEPTION OF THE CAPITAL ACCUMULATION ACCOUNT WHICH VESTS AFTER FIVE YEARS IN THE 457(F) PLAN. DIRECTOR INCENTIVE PLAN: THE DIRECTOR INCENTIVE PLAN IS AN ANNUAL INCENTIVE PLAN IN WHICH ELIGIBLE DIRECTORS PARTICIPATE. THE PLAN SHARES GOALS WITH THE EXECUTIVE ANNUAL INCENTIVE PLAN, FOCUSING ON FACTORS SUCH AS FINANCIAL PERFORMANCE, QUALITY GOALS, AND PATIENT SATISFACTION. IN ADDITION, THERE ARE INDIVIDUAL COMPONENTS FOR EACH DIRECTOR WHICH VARY DEPENDING ON THE EXPECTED OUTCOMES FOR THAT AREA AND/OR YEAR.</Explanation>
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    </IRS990ScheduleJ>
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      <GeneralExplanation>
        <Identifier>Classes of members or stockholders</Identifier>
        <ReturnReference>Form 990, Part VI, Section A, Line 6</ReturnReference>
        <Explanation>TEXAS CHILDREN'S IS THE SOLE CORPORATE MEMBER OF TEXAS CHILDREN'S HOSPITAL FOUNDATION.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Members or stockholders electing members of governing body</Identifier>
        <ReturnReference>Form 990, Part VI, Section A, Line 7a</ReturnReference>
        <Explanation>TEXAS CHILDREN'S ANNUALLY APPOINTS THE ORGANIZATION'S BOARD OF DIRECTORS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Decisions requiring approval by members or stockholders</Identifier>
        <ReturnReference>Form 990, Part VI, Section A, Line 7b</ReturnReference>
        <Explanation>PER THE ORGANIZATION'S BYLAWS, THE MEMBER HAS CERTAIN RESERVED POWERS: -APPROVE, INTERPRET OR CHANGE THE PURPOSE OF THE CORPORATION. -FIX THE NUMBER, APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, ANY DIRECTOR OF THE CORPORATION. -APPROVE THE MERGER, DISSOLUTION OR CONSOLIDATION OR REORGANIZATION OF THE CORPORATION. -APPROVE THE ACQUISITION, SALE, LEASE, TRANSFER, OR OTHER ALIENATION OF PROPERTY OF THE CORPORATION, OTHER THAN IN THE USUAL AND REGULAR COURSE OF THE CORPORATION'S BUSINESS, WHEN SUCH ACQUISITION, SALE, LEASE, TRANSFER OR OTHER ALIENATION IS ABOVE SPECIFIC FINANCIAL LEVELS SET IN ACCORDANCE WITH POLICIES ESTABLISHED FROM TIME TO TIME BY THE MEMBER. -APPROVE CAPITAL AND OPERATING BUDGETS OF THE CORPORATION. -ADOPTION OR AMENDMENT OF SALARIES OR OTHER COMPENSATION (INCLUDING THE AWARDING OF ANY INCENTIVE COMPENSATION) OF THE OFFICERS OF THE CORPORATION, PHYSICIAN EMPLOYEES OF THE CORPORATION, IF ANY. -APPROVE DEBT INCURRED BY THE CORPORATION, WHICH IS IN EXCESS OF SUCH LIMITS AS ARE ESTABLISHED BY THE MEMBER. -APPROVE THE DISPOSITION OF ASSETS OF THE CORPORATION AT THE TIME OF ITS DISSOLUTION. -APPROVE ANY LONG-RANGE FINANCIAL OR STRATEGIC PLANS FOR THE CORPORATION. -SELECTION OF THE CORPORATION'S AUDITORS. -DESIGNATION OF ADDITIONAL OR SUCCESSOR MEMBER(S). -TAKE ANY ACTION WHICH WOULD BE INCONSISTENT WITH THE GOVERNING DOCUMENTS OR POLICIES OF TEXAS CHILDREN'S.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Documentation of meetings held by committees of governing body</Identifier>
        <ReturnReference>Form 990, Part VI, Section A, Line 8b</ReturnReference>
        <Explanation>NO SUCH COMMITTEES EXIST.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Review of form 990 by governing body</Identifier>
        <ReturnReference>Form 990, Part VI, Section B, Line 11b</ReturnReference>
        <Explanation>PER A RESOLUTION APPROVED BY THE MEMBER'S BOARD OF DIRECTORS, THE MEMBER BOARD'S AUDIT AND COMPLIANCE COMMITTEE HAS THE DELEGATED AUTHORITY TO REVIEW THE ORGANIZATION'S COMPLETED FORM 990 PRIOR TO FILING. FOLLOWING THE COMMITTEE'S REVIEW, THE COMPLETED FORM 990 IS DISTRIBUTED TO THE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Conflict of interest policy</Identifier>
        <ReturnReference>Form 990, Part VI, Section B, Line 12c</ReturnReference>
        <Explanation>THE ORGANIZATION CONSISTENTLY MONITORS AND ENFORCES THE CONFLICT OF INTEREST POLICY THROUGH TWO SEPARATE PROCESSES, ONE THAT APPLIES TO THE BOARD MEMBERS, AND A SECOND THAT APPLIES TO OFFICERS AND KEY EMPLOYEES. 1) BOARD MEMBERS: PER THE ORGANIZATION'S BOARD-APPROVED CONFLICTS REVIEW PROCESS, RESPONSES TO THE ANNUAL CONFLICTS QUESTIONNAIRE ARE REVIEWED BY THE MEMBER'S BOARD LEADERSHIP AND PRESENTED TO THE MEMBER'S AUDIT &amp; COMPLIANCE COMMITTEE. IF THE COMMITTEE DEEMS THERE ARE ANY SIGNIFICANT ISSUES, THE RESPONSES ARE THEN REVIEWED BY THE MEMBER BOARD'S EXECUTIVE COMMITTEE AND ANY REQUIRED ACTION (RECUSEMENT FROM BOARD DELIBERATIONS RELATED TO THE CONFLICT, ETC.) IS TAKEN IN ACCORDANCE WITH THE ORGANIZATION'S BOARD-APPROVED CODE OF CONDUCT. 2) OFFICERS / KEY EMPLOYEES: PER THE ORGANIZATION'S BOARD APPROVED CONFLICTS REVIEW PROCESS, RESPONSES TO THE ANNUAL CONFLICTS QUESTIONNAIRE ARE REVIEWED BY THE COMPLIANCE SERVICES DEPARTMENT. IF THE DEPARTMENT DEEMS THERE ARE ANY SIGNIFICANT ISSUES, REQUIRED ACTION IS TAKEN IN ACCORDANCE WITH THE ORGANIZATION'S BOARD-APPROVED CODE OF CONDUCT AND THE BOARD IS NOTIFIED OF SUCH ACTIONS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Governing documents, conflict of interest policy and financial statements available to the public</Identifier>
        <ReturnReference>Form 990, Part VI, Section C, Line 19</ReturnReference>
        <Explanation>THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Other changes in net assets or fund balances</Identifier>
        <ReturnReference>Form 990 , Part XI, Line 9</ReturnReference>
        <Explanation>TRANSFER FROM HOSPITAL - 27787411; TRANSFER FROM TEXAS CHILDREN'S HEALTH PLAN - 47300000;</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>FORM 5471 DISCLOSURE STATEMENT</Identifier>
        <ReturnReference>SCHEDULE O</ReturnReference>
        <Explanation>UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, AS A CATEGORY 5 FILER WITH RESPECT TO CERTAIN CONTROLLED FOREIGN CORPORATIONS (CFCS). THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 FOR THESE CFCS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT: TEXAS CHILDREN'S EIN: 76-0461578 1919 S. BRAESWOOD BLVD, 4TH FL HOUSTON, TX 77030</Explanation>
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          <AddressLine1>6621 FANNIN STREET</AddressLine1>
          <City>HOUSTON</City>
          <State>TX</State>
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          <AddressLine1>PO BOX 300630</AddressLine1>
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          <State>TX</State>
          <ZIPCode>77230</ZIPCode>
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          <AddressLine1>6621 FANNIN STREET</AddressLine1>
          <City>HOUSTON</City>
          <State>TX</State>
          <ZIPCode>77030</ZIPCode>
        </AddressUS>
        <PrimaryActivities>HEALTH CARE</PrimaryActivities>
        <LegalDomicileState>TX</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>9</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>TEXAS CHILDREN'S</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>true</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>TCH PEDIATRIC ASSOCIATES</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>PO BOX 300630</AddressLine1>
          <City>HOUSTON</City>
          <State>TX</State>
          <ZIPCode>77230</ZIPCode>
        </AddressUS>
        <PrimaryActivities>HEALTH CARE</PrimaryActivities>
        <LegalDomicileState>TX</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>9</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>TEXAS CHILDREN'S</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>true</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>TEXAS CHILDREN'S HEALTH PLAN</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>2450 HOLCOMBE SUITE 34L</AddressLine1>
          <City>HOUSTON</City>
          <State>TX</State>
          <ZIPCode>77021</ZIPCode>
        </AddressUS>
        <PrimaryActivities>HEALTH CARE</PrimaryActivities>
        <LegalDomicileState>TX</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>9</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>TEXAS CHILDREN'S</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>true</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>TEXAS CHILDREN'S HEALTH PLAN - THE CENTER</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>6621 FANNIN STREET</AddressLine1>
          <City>HOUSTON</City>
          <State>TX</State>
          <ZIPCode>77030</ZIPCode>
        </AddressUS>
        <PrimaryActivities>HEALTH CARE</PrimaryActivities>
        <LegalDomicileState>TX</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>11 - Type I</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>TEXAS CHILDREN'S HEALTH PLAN</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>true</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartIII>
        <NameOfRelatedOrg>
          <BusinessNameLine1>QUINTANA ENERGY FUND I COINVESTOR-PRZ LP</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>601 JEFFERSON STREET SUITE 3600</AddressLine1>
          <City>HOUSTON</City>
          <State>TX</State>
          <ZIPCode>77002</ZIPCode>
        </AddressUS>
        <EIN>263190589</EIN>
        <PrimaryActivity>INVESTMENT</PrimaryActivity>
        <LegalDomicileState>TX</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>TEXAS CHILDREN'S HOSPITAL FOUNDATION</BusinessNameLine1>
        </DirectControllingEntityName>
        <PredominantIncomeType>UNRELATED</PredominantIncomeType>
        <ShareOfTotalIncome>2933456</ShareOfTotalIncome>
        <ShareOfEOYAssets>63891</ShareOfEOYAssets>
        <DisproportionateAllocations>false</DisproportionateAllocations>
        <CodeVAmount>1534223</CodeVAmount>
        <GeneralOrManagingPartner>false</GeneralOrManagingPartner>
        <PercentageOwnership>0.7273</PercentageOwnership>
      </Form990ScheduleRPartIII>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>TCH INSURANCE COMPANY LTD</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressForeign>
          <AddressLine1>23 LIME TREE BAY AVENUE</AddressLine1>
          <ProvinceOrState>GRAND CAYMAN</ProvinceOrState>
          <Country>CJ</Country>
          <PostalCode>KY1-1102</PostalCode>
        </AddressForeign>
        <PrimaryActivity>INSURANCE</PrimaryActivity>
        <LegalDomicileForeignCountry>CJ</LegalDomicileForeignCountry>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C CORPORATION</TypeOfEntity>
        <ControlledOrg>true</ControlledOrg>
      </Form990ScheduleRPartIV>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>CVI GVF HOLDINGS 3 LTD</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressForeign>
          <AddressLine1>UGLAND HOUSE SOUTH CHURCH STREET</AddressLine1>
          <ProvinceOrState>GEORGE TOWN</ProvinceOrState>
          <Country>CJ</Country>
          <PostalCode>KY1-1104</PostalCode>
        </AddressForeign>
        <PrimaryActivity>INVESTMENT</PrimaryActivity>
        <LegalDomicileForeignCountry>CJ</LegalDomicileForeignCountry>
        <DirectControllingEntityName>
          <BusinessNameLine1>TEXAS CHILDREN'S HOSPITAL FOUNDATION</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C CORPORATION</TypeOfEntity>
        <ShareOfTotalIncome>3361071</ShareOfTotalIncome>
        <ShareOfEOYAssets>14152907</ShareOfEOYAssets>
        <PercentageOwnership>1</PercentageOwnership>
        <ControlledOrg>true</ControlledOrg>
      </Form990ScheduleRPartIV>
      <ReceiptOfIntAnnRentsRoyalties>false</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>false</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>false</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>false</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
      <DividendsRelatedOrganization>false</DividendsRelatedOrganization>
      <SaleOfAssetsToOtherOrg>false</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>false</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>false</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>false</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>false</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>false</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>true</SharingOfFacilities>
      <SharingOfPaidEmployees>true</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>false</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>false</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>false</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>true</OtherTransferFromOtherOrg>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>TEXAS CHILDREN'S HOSPITAL</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>S</TransactionType>
        <AmountInvolved>27787411</AmountInvolved>
        <MethodOfAmtDetermination>COST</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>TEXAS CHILDREN'S HEALTH PLAN</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>S</TransactionType>
        <AmountInvolved>47300000</AmountInvolved>
        <MethodOfAmtDetermination>COST</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
    </IRS990ScheduleR>
  </ReturnData>
</Return>