2014-08-14T15:34:40-05:00 2013-09-30 BKD LLP 2800 Post Oak Blvd Ste 3200 HOUSTON TX 77056 990 2012-10-01 752485366 COOK CHILDREN'S PHYSICIAN NETWORK % CORY RHOADES COOK 6828854000 801 SEVENTH AVENUE Suite FORT WORTH TX 76104 CORY RHOADES 6828854480 2014-08-15 true M Paige Gerich 7134994600 2012 2015-11-30 17:44:51Z W BRITT NELSON MD 801 SEVENTH AVE FORT WORTH TX 76104 216957509 false X WWW.COOKCHILDRENS.ORG X 1992 TX KNOWING THAT EVERY CHILD'S LIFE IS SACRED, IT IS THE PROMISE OF COOK CHILDREN'S TO IMPROVE THE HEALTH OF EVERY CHILD IN OUR REGION THROUGH THE PREVENTION AND TREATMENT OF ILLNESS, DISEASE, AND INJURY. 13 0 999 9 0 0 41651749 46740845 161752152 170206589 4456 4000 1046085 6075 204454442 216957509 0 1000 0 0 160652263 171292004 0 0 0 43518770 42363251 204171033 213656255 283409 3301254 35649158 40276365 23080789 24406742 12568369 15869623 X KNOWING THAT EVERY CHILD'S LIFE IS SACRED, IT IS THE PROMISE OF COOK CHILDREN'S TO IMPROVE THE HEALTH OF EVERY CHILD IN OUR REGION THROUGH THE PREVENTION AND TREATMENT OF ILLNESS, DISEASE, AND INJURY. false false 192404848 1000 170212664 Cook Children's Physician Network (CCPN) is the largest pediatric multi-specialty physician group in North Texas. The network includes more than 320 physicians and 160 mid-level providers in addition to thousands of other caring employees. During 2013, CCPN's provider count grew by 36 providers: including 24 physicians (four primary care, three hospitalists and 17 specialists) and 12 midlevel providers (three pediatric nurse practitioners, six physician assistants and three certified registered nurse anesthetists). CCPN provides medical care in 60 locations at more than 30 primary care and subspecialty practices. Additionally, we offer access to nine specialties via telemedicine: Endocrinology, Gastroenterology, Genetics, Hematology and Oncology, Infectious Disease, Nephrology, Neurology, Neuropsychology, and Psychiatry. These specialists hosted 1,351 visits via telemedicine in 2013 (an increase of 49 percent over 2012) offering immediate care and patient education. This helped save many hours of travel for patient families. The network's physicians and specialists have offices in Tarrant, Denton and Hood counties and provide a primary care home in economically disadvantaged neighborhoods and areas where access to pediatric health care is difficult to come by. The physician network has also increased access to pediatric specialty care through outreach clinics in many communities in North, West and Central Texas. Each month, physicians travel to provide services in several areas that are not large enough to support full-time specialty care. Patients continue to benefit from the CCPN on-line patient portal, called mycookchildrens. To date, more than 65,000 patients, or their families, have registered for the portal (representing an increase of 33 percent from 2012), which provides families on-demand access to prior visit summaries, medication lists, vaccine records, lab results and appointment requests. 192404848 true true false false false false false false false false true false false false true false false true false false false false false false false false false false false true false false false false false false true false false false false false false true false false false true 83 0 true 999 true false false false false false false false false false false X 13 0 false false false false true true true true true false false true true true true true true true true false X CORY RHOADES 6828854000 801 SEVENTH AVENUE FORT WORTH TX 76104 X FRANK MCGEHEE MD 41.0 1.0 X 846441 14474 JAMES P MILLER MD 41.0 1.0 X 925597 14574 DEBORAH SCHUTTE MD 42.0 1.0 X X 502488 31299 JASON V TERK MD 41.0 1.0 X 402868 30824 JAMES C WHEELER MD 41.0 0.0 X 608957 42597 KEVIN D WYLIE DO 42.0 2.0 X X 254465 36374 BARRY BZOSTEK MD 41.0 0.0 X 262078 7641 MARK MAZADE MD 41.0 0.0 X 250953 12958 AUDREY ROGERS MD 41.0 0.0 X 251688 9995 SANDRA ARCA MD 42.0 0.0 X X 208107 32398 LINDA M THOMPSON MD 42.0 2.0 X X 322465 17403 TODD WOLF MD 41.0 0.0 X 423881 32397 VANESSA CHARETTE MD 42.0 2.0 X X 260557 16983 BRYAN STEINMANN MD 41.0 0.0 X 250011 29847 DEBORAH VERT DO 41.0 0.0 X 280016 24519 RYAN CHAMPLIN 40.0 0.0 X 472863 35706 JANELL MASON-BRISCOE 40.0 0.0 X 308866 13549 RICHARD P GOODE 4.0 36.0 X 94771 766781 32851 RICK W MERRILL 4.0 36.0 X 225799 1826920 86679 W BRITT NELSON MD 40.0 0.0 X 764049 34417 ROBERT GOODWILL 40.0 0.0 X VINCENT TAM MD 40.0 0.0 X 1715955 32424 CHAD HAMNER MD 40.0 0.0 X 781753 29074 JOSE L IGLESIAS MD 40.0 0.0 X 828518 21965 KYRIACOS PANAYIDES MD 40.0 0.0 X 851642 15324 SAMI HADEED MD 40.0 0.0 X 776355 33524 12871143 2593701 689796 401 false true false JESSE A CLAUDIA L ROCHA 1413 HEIDI COURT FORT WORTH TX 76108 JANITORIAL 197032 SULLIVAN COTTER AND ASSOC 62272 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 CONSULTING 119492 2 46506952 179338 54555 46740845 NET PATIENT FEES 621110 150697160 150697160 CONTRACTED FEES 621110 2796331 2796331 MANAGEMENT FEES 900099 15720313 15720313 OTHER INCOME 621110 924438 924438 RESEARCH 900099 68347 68347 170206589 0 0 0 0 0 0 4000 4000 4000 4000 0 0 0 OTHER INCOME 900099 6075 6075 6075 216957509 170212664 4000 1000 1000 0 0 0 7984925 6425596 1559329 137607 137607 142044107 137940146 4103961 0 21125365 19709284 1416081 0 3497296 3497296 56999 56999 0 0 0 0 0 1680111 1288447 391664 59376 30287 29089 11821327 12252407 -431080 0 5396398 5080672 315726 223114 194445 28669 0 34851 29551 5300 3723 3723 0 562632 527364 35268 1568200 1566559 1641 BAD DEBT EXPENSE 6209042 6209042 REPAIR & MAINTENANCE EXPENSE 246635 236873 9762 COLLECTION EXPENSE 10078726 -792 10079518 TELEPHONE TRIAGE 316274 316274 0 0 608547 456363 152184 213656255 192404848 21251407 0 9576 8431 20240947 23543093 0 0 10817313 11898732 0 0 0 0 0 0 1072746 1137648 1113770 1001698 7764088 5169790 2034709 2594298 0 0 0 0 0 0 0 0 360097 92465 35649158 40276365 3113666 3831154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19967123 20575588 23080789 24406742 X 12568369 15869623 0 0 0 0 12568369 15869623 35649158 40276365 3301254 X false true X true false X false false false RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1958786 1314701 644085 2464127 1763815 700312 2921954 2075127 846827 419221 16147 403074 2594298 0 ACCRUED PAYROLL 1017621 ACCRUED PHYSICIAN RECONS 8054118 DUE TO AFFILIATES 4385101 ACCRUED PTO LIABILITY 2689925 ACCRUED EXECUTIVE BONUS 493932 ACCRUED EIB LIABILITY 3889341 CAPITAL LEASE OBLIGATION 45550 20575588 210744467 -6209042 -6209042 216953509 4000 4000 216957509 207443213 -4000 -4000 207447213 6209042 6209042 213656255 RECONCILIATION OF REVENUE & EXPENSES PER RETURN TO AUDITED FINANCIAL STMTS PART XI, LINE 2D BAD DEBT EXPENSE: ($ 6,209,042) PART XI, LINE 4B GAIN ON ASSET DISPOSITION: $ 4,000 RECONCILIATION OF REVENUE & EXPENSES PER RETURN TO AUDITED FINANCIAL STMTS PART XII, LINE 2D GAIN ON ASSET DISPOSITION:($ 4,000) PART XII, LINE 4B BAD DEBT EXPENSE: $ 6,209,042 false true false false false false false false false FRANK MCGEHEE MD 837621 8820 14474 860915 JAMES P MILLER MD 899054 26543 14574 940171 DEBORAH SCHUTTE MD 487817 10000 4671 15625 15674 533787 JASON V TERK MD 398981 3887 18750 12074 433692 JAMES C WHEELER MD 604736 4221 18750 23847 651554 KEVIN D WYLIE DO 226594 25388 2483 18740 17634 290839 RYAN CHAMPLIN 264681 181687 26495 15625 20081 508569 JANELL MASON-BRISCOE 187246 119636 1984 8600 4949 322415 RICHARD P GOODE 40379 326700 37269 301538 17123 138543 1719 13906 1896 15330 98386 796017 RICK W MERRILL 77897 630256 43285 350219 104617 846445 7837 63412 1698 13732 235334 1904064 45650 369350 VINCENT TAM MD 1337796 370000 8159 15625 16799 1748379 BARRY BZOSTEK MD 226224 30000 5854 7641 269719 MARK MAZADE MD 246428 4525 12958 263911 AUDREY ROGERS MD 246795 4893 9995 261683 SANDRA ARCA MD 204565 3542 7545 24853 240505 LINDA M THOMPSON MD 319420 3045 12977 4426 339868 TODD WOLF MD 254843 166655 2383 15625 16772 456278 W BRITT NELSON MD 355462 297769 110818 18750 15667 798466 CHAD HAMNER MD 774676 7077 10000 19074 810827 JOSE L IGLESIAS MD 803847 24671 10000 11965 850483 VANESSA CHARETTE MD 183506 75248 1803 11316 5667 277540 BRYAN STEINMANN MD 245873 4138 18418 11429 279858 DEBORAH VERT DO 276802 3214 18442 6077 304535 KYRIACOS PANAYIDES MD 840774 10868 15324 866966 SAMI HADEED MD 768912 7443 18750 14774 809879 PARTICIPATION IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PART I, QUESTION 4B PARTICIPANTS IN SERP REPORTED IN W-2 DEFERRED COMPENSATION -------------------- --------------- --------------------- RICK W. MERRILL $755,000 $ 61,249 ALLOCATION OF CEO AND CFO SALARIES PART II 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 PHYSICIAN NETWORK COOK CHILDREN'S HEALTH FOUNDATION COOK CHILDREN'S HOME HEALTH COOK CHILDREN'S HEALTH CARE SYSTEM COOK CHILDREN'S HEALTH PLAN METHODS USED BY CCHCS TO ESTABLISH COMPENSATION OF THE CEO/EXEC DIRECTOR PART I, QUESTION 3 COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT WRITTEN EMPLOYMENT CONTRACT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TOM ROGERS JR MD A. ROGERS FATHER-IN-LAW 137607 COMPENSATION false MEMBERS OR STOCKHOLDERS FORM 990, PART VI, QUESTION 6 Cook Children's Health Care System, a Texas non-profit corporation, is the sole member of the organization. MEMBER ELECTION ABILITIES FORM 990, PART VI, QUESTION 7A As the sole member of the organization, Cook Children's Health Care System has the power to determine the number of members of the board of trustees and to elect the members of the board of trustees. MEMBER DECISION ABILITIES FORM 990, PART VI, QUESTION 7B As the sole member of the organization, Cook Children's Health Care System has the exclusive 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. PROCESS FOR REVIEW OF THE 990 FORM 990, PART VI, QUESTION 11B 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. WRITTEN CONFLICT OF INTEREST POLICY FORM 990, PART VI, QUESTION 12C 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. The responses are reviewed by the Legal, Finance, and Compliance Departments. Follow up and/or corrective action is taken as needed with respect to responses that indicate the existence of actual or potential conflicts of interest. The responses to the questionnaires 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 in force for 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 hot-line 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. REVIEW AND APPROVAL OF COMPENSATION FORM 990, PART VI, QUESTION 15A & 15B Cook Children's Health Care System has established a Compensation Committee with oversight of executive and physician compensation. The Compensation Committee approves compensation arrangements in advance, which includes a review and approval by independent persons, using comparable market data relating to compensation, which is provided by Sullivan Cotter and Associates, Inc., 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. MAKING GOVERNING DOCUMENTS PUBLIC FORM 990, PART VI, QUESTION 19 The organization does not make its governing documents or conflict of interest policy available to the public, except to the extent they are on file with the Secretary of State of Texas. 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. COOK CHILDREN'S MEDICAL CENTER 801 SEVENTH AVE FORT WORTH TX 76104 752051646 HOSPITAL TX 501(C)(3) 3 CCHCS false WI COOK FOUNDATION 801 SEVENTH AVENUE FORT WORTH TX 76104 752051649 FUNDRAISING TX 501(C)(3) 11D NA false COOK CHILDREN'S HOME HEALTH 801 SEVENTH AVENUE FORT WORTH TX 76104 752896983 HEALTHCARE TX 501(C)(3) 11C CCHCS false COOK CHILDREN'S HEALTH CARE SYSTEM 801 SEVENTH AVE FORT WORTH TX 76104 752705881 SUPPORT TX 501(C)(3) 11C CCHF false COOK CHILDREN'S HEALTH PLAN 801 SEVENTH AVE FORT WORTH TX 76104 760585240 INSURANCE TX 501(C)(3) 11C CCHCS false ROSEDALE OFFICE BUILDING INC 1500 W ROSEDALE FORT WORTH TX 76104 460866421 TITLE HOLDING TX 501(C)(2) N/A CCHF false COOK CHILDREN'S HEALTH SERVICES 801 7TH AVENUE FORT WORTH TX 76104 454024843 HEALTHCARE TX CCHCS C CORPORATION false false false true false false false false false true true true false false false false true true true true