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OTHER CHANGE MANAGEMENT FEE REDUCTION $1,758,110 SCHEDULE D, PART XI, LINE 8 OTHER CHANGES TO NET ASSETS RETROSPECTIVE PREMIUM CREDIT $ 328,422 SCHEDULE D, PART XII, LINE 4B OTHER CHANGE GAIN ON ASSET DISPOSITION $ 1,000 Central America and the Caribbean Program Services INVESTMENT 5483174 5483174 5483174 true false true false false false true IMMUNIZATION COLLABORATION PO BOX 100192 FORT WORTH TX 76185 752541065 501(C)(3) 9000 COLLABORATION MENTAL HEALTH CONNECTION OF TEXAS 3131 SANGUINET ST FORT WORTH TX 76107 752659610 501(C)(3) 25000 SPONSORSHIP MARCH OF DIMES 6815 MANHATTAN BLVD 102 FORT WORTH TX 76102 131846366 501(C)(3) 20000 SPONSORSHIP MAKE A WISH FOUNDATION OF TEXAS 6655 DESEO IRVING TX 75039 751889666 501(C)(3) 16500 SPONSORSHIP EPILEPSY FOUNDATION OF TEXAS 3629 WOSLEY DR FORT WORTH TX 76133 520856660 501(C)(3) 11400 SPONSORSHIP AMERICAN CANCER SOCIETY 2433 RIDGEPOINT DRIVE AUSTIN TX 78754 741185665 501(C)(3) 15000 SPONSORSHIP CITY OF MANSFIELD 106 S WISTERIA ST MANSFIELD TX 76063 756000594 501(C)(3) 10000 SPONSORSHIP MICHAEL YOUNG FAMILY FDN 1800 CENTURY PARK E STE 914 LOS ANGELES CA 90067 452623056 501(C)(3) 10000 SPONSORSHIP COWTOWN MARATHON INC PO BOX 11565 FORT WORTH TX 76110 752198418 501(C)(3) 20000 SPONSORSHIP 9 SCHOLARSHIPS FOR INDIVIDUALS 11 45000 PROCEDURE FOR MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES SCHEDULE I, PART I, LINE 2 THE ORGANIZATION USES PUBLIC AND PRIVATE DATA TO MONITOR THE USE OF FUNDS, AS NEEDED. IN ORDER TO BE ELIGIBLE FOR THE PRESIDENT'S SCHOLARSHIP AWARD THE APPLICANTS MUST MEET THE FOLLOWING REQUIREMENTS: 1) BE A CHILD OF A FULL TIME EMPLOYEE WITH ONE YEAR FULL TIME EXPERIENCE 2) BE A FULL TIME STUDENT IN A BACCALAUREATE PROGRAM & 3) PURSUING A DEGREE APPLICABLE TO THE HEALTHCARE WORKFORCE. THE SCHOLARSHIP RECIPIENTS ARE SELECTED BY THE SCHOLARSHIP COMMITTEE. THE SELECTION IS BASED ON ESSAYS SUBMITTED BY THE APPLICANTS, AS WELL AS GRADES. THE MINIMUM AWARD IS $5,000, $2,500 FOR REPEAT RECIPIENTS. SCHOLARSHIP PAYMENTS ARE ISSUED DIRECTLY TO THE UNIVERSITIES. X X X X X X true true false false false false false false false KIMBERLY D AARON MD 360999 24425 1388 18375 13188 418375 MICHAEL J DEITCHMAN MD 262160 1360 11518 275038 FRANK MCGEHEE MD 694239 3884 14149 712272 JAMES P MILLER MD 1054107 0 17742 17619 14303 1103771 JASON V TERK MD 363429 0 1440 18375 11537 394781 M SUZANNE WHITWORTH MD 151839 0 1716 7051 3546 164152 KEVIN D WYLIE DO 229291 19797 795 10775 15538 276196 LINDA S CHAPPELL 179226 74359 40846 18375 9201 322007 JAMES C CUNNINGHAM MD 411785 126610 17223 0 14082 569700 RICHARD P GOODE 96419 289257 40292 120876 28027 84082 3828 11485 3900 11697 172466 517397 TIMOTHY M HANNERS 200317 75816 6583 5740 11743 300199 BILLY R KENNEDY 273806 118888 63755 9800 19399 485648 DAVID F LANCASTER 157088 51794 11933 16844 13251 250910 JOHN W MCNEY 300823 114381 30915 16751 462870 RICK W MERRILL 256978 437560 156325 266174 56929 96932 55870 95130 5742 9776 531844 905572 66000 198000 GEORGE B MONTAGUE 206653 67135 19620 15313 11766 320487 FRANK J ROSSI 312682 112764 53444 18375 17715 514980 LARRY L TUBB 223434 85066 59162 0 7208 374870 CORY RHOADES 174270 57393 1582 9235 18139 260619 ERIC H HUBLI 425333 15000 18942 9800 15052 484127 JAMES D MARSHALL 445907 65371 2010 15313 18344 546945 JOANN M SANDERS MD 292535 50025 3414 18375 12922 377271 JOSEPH GALLAGHER 175120 55666 4982 10337 7907 254012 GRETCHEN EAMES MD 295000 0 3133 13877 454 312464 ANGEL W HERNANDEZ-MULERO MD 499028 0 19363 15313 21773 555477 SAMUEL E KLEINMAN MD 624941 1500 2142 15313 14745 658641 DONALD K MURPHEY MD 263901 5000 2047 16499 14207 301654 LINDA THOMPSON MD 247856 0 34 10528 5366 263784 DEBORAH A SCHUTTE MD 478114 0 1735 15313 13588 508750 JAMES R STALDER 165379 0 1515 7049 17797 191740 THERESA ZAK MEADOWS 210529 0 23475 9337 16829 260170 HARRY I SHUMAN 221825 59675 2069 9800 9265 302634 COLEMAN D SKINNER 144450 47291 1504 12464 14561 220270 FLORENCE BROWN 91123 11229 113470 0 5789 221611 PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J PART I LINE 4B RICK W. MERRILL-PARTICIPATES, BUT RECEIVED $0 PAYMENT DURING CALENDAR YEAR 2011. ALLOCATION OF CEO AND CFO SALARIES SCHEDULE J PART II COOK CHILDREN'S HEALTH CARE SYSTEM IS COMPRISED OF 9 COMPANIES, INCLUDING A MEDICAL CENTER, PHYSICIAN NETWORK, HEALTH PLAN, HOME HEALTH COMPANY, INDEMNITY COMPANY, HEALTH FOUNDATION, NORTHEAST HOSPITAL, PEDIATRIC SURGERY CENTER, AND HEALTH CARE SYSTEM COMPANY. THE CEO AND CFO ARE RESPONSIBLE FOR THE OVERSIGHT OF ALL FOREMENTIONED COMPANIES. AS A RESULT, THEIR SALARIES ARE ALLOCATED PRO-RATA, BASED ON THE AMOUNT OF TIME THEY SPEND WITH EACH COMPANY. SEVERANCE PAYMENT SCHEDULE J PART I LINE 4A FLORENCE BROWN RECEIVED $92,963 AS A SEVERANCE PAYMENT DURING CALENDAR YEAR 2011. SOLE MEMBER FORM 990, PART VI, QUESTION 6 Cook Children's Health Foundation, 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 Foundation 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 Foundation has the exclusive 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. REVIEW PROCESS FOR FORM 990 FORM 990, PART VI, QUESTION 11B The organization engages an outside 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. In addition, it is presented to the Cook Children's Health Care System Audit Committee for review. Subsequent to Audit Committee review, the Form 990 is filed with the Internal Revenue Service and made available to the public for review. 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 deliberation and decision. 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. PROCESS OF MAKING GOVERNING DOCUMENTS AVAILABLE TO THE 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. CONFLICT OF INTEREST 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. OTHER CHANGES IN NET ASSETS OF FUND BALANCES FORM 990, PART XI, LINE 5 TRANSFERS BETWEEN AFFILIATES $3,497,999 RETROPECTIVE PREMIUM CREDIT 328,422 UNREALIZED MARKET CHANGE (275,020) ------------ 3,551,401 PROGRAM SERVICE ACTIVITY FORM 990, PART III, QUESTION 4A Cook Children's Health Care System is one of the country's leading vertically integrated pediatric healthcare organizations. Cook Children's represents an award-winning, not-for-profit system of seamless heathcare designed to fulfill our promise for children. The system has eight integrated companies designed to meet children's health care needs across the continuum of care -the Medical Center, Physician Network, Home Health Company, Northeast Hospital, Pediatric Surgery Center, Health Plan, Health Services, Inc. and Health Foundation. Based in Fort Worth, Texas, Cook Children's has significant reach with more than 60 primary and specialty care offices and clinics throughout North Texas. Its service region includes Denton, Hood, Johnson, Parker, Tarrant and Wise counties, with an additional referral area encompassing approximately half the state. The area's growth is substantial. In Fort Worth alone, the 2012 total population was 838,207, and over the next five years that number is expected to increase by nearly 60,000. Cook Children's sustainable heritage dates back to 1918, and throughout the decades since, it has been a leader in pediatric healthcare by fostering continual change and robust growth while always embracing its abiding promise- that all 5,401 employees commit to keep every day. Cook Children's lives up to that pledge by combining the art of caring with integrity-led, interdisciplinary collaboration, a commitment to evidence-based practice, ensuring the highest levels of safety and security, leading clinical research, utilizing the best available technology, effective financial stewardship and the re-investment of hundreds of millions of dollars in community benefits. Cultivating and maintaining a pediatric care system is at the core of all Cook Children's long and short-term business strategies. Most notably is the recent expansion of the medical center which nearly doubles the size of our campus. The services we provide increased with our Urgent Care and Pediatric Specialty facility in Southlake, Texas. Because we expanded our programs, services and amenities, we've augmented our capacity to meet the growing need for our services and transformed how we are caring for generations to come. The commitment and expertise of the system's trustees, physicians and staff, combined with Cook Children's vast resources, enable this institution to be recognized as sustainable and among the best for positive clinical outcomes. As such, rating agencies have cited Cook Children's market leadership in Tarrant County because of its successful expansion efforts, robust growth in revenue and liquidity, and stellar operating margins. Additionally, this is evidenced by its double-A bond rating and the growing and impressive list of awards and acknowledgments the system receives every year. In 2012, Cook Children's recorded 1,187,104 patient encounters through its hospitals, specialty clinics, neighborhood clinics, physician offices, outpatient settings and home care business. In 2012, a total of 127,941 Emergency/Urgent Care visits occurred at Cook Children's. In 2012, Cook Children's proudly announced an endowed chair program for our physicians. Thanks to generous donors, two doctors, Warren Marks, M.D., and Paul Thornton, M.D., can intensify their work and develop more innovative treatments for kids. Dr. Marks is developing a comprehensive clinical center for pediatric movement disorders. This will build on the highly successful programs that are already in place within the Jane and John Justin Neurosciences Center at Cook Children's, with deep brain stimulation (DBS) serving as the centerpiece. The DBS program enjoys an international reputation and our rehabilitation services are recognized regionally. By establishing a comprehensive movement disorder, Cook Children's will further enhance our regional, national and international reputation as a destination for care in neurosciences. The scope of service will stretch from the earliest diagnosis to the last stage of rehabilitation and return to normal function. Dr. Thornton will help further the work of Cook Children's Congenital Hyperinsulinism Center, which has a national reputation and continues to gain prominence with his endowed chair. As one of only two such centers in the country, it positions Cook Children's program as a leader in clinical research in hypoglycemia. This endowed chair will also enable the development of the latest diagnostic and therapeutic interventions for patients with hyperinsulinism in Texas, the south and the United States. At Cook Children's, we believe it's not just about the bottom line. It's about keeping our promise. As much as we take pride in the rewards and recognition we receive for our work, we measure our success by the improved health of children in our region. That is why our Cook Children's team continues to work collaboratively with our community partners to address identified pediatric health needs in our area. These accomplishments can be seen in our 2012 annual report "A Tradition of Champions." HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KIMBERLY D. AARON, MD TITLE:TRUSTEE HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:R. JEFFREY ALEXANDER TITLE:TRUSTEE HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:G. THOMAS BOSWELL TITLE:TRUSTEE HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOHN P. BOSWELL TITLE:TRUSTEE HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MICHAEL J. DEITCHMAN, MD TITLE:TRUSTEE HOURS:41 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JAMES R. DUNAWAY, JR. TITLE:TRUSTEE HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:RICHARD F. GARVEY TITLE:TRUSTEE HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:RAFAEL G. GARZA TITLE:TRUSTEE-SECRETARY/TREASURER HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:NANCY KAY HOWARD TITLE:TRUSTEE-CHAIRMAN HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:FRANK MCGEHEE, MD TITLE:TRUSTEE HOURS:42 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JAMES P. MILLER, MD TITLE:TRUSTEE HOURS:41 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MICHAEL R. PAVELL TITLE:TRUSTEE HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOSEPH C. PENSHORN TITLE:TRUSTEE HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:PETER L. PHILPOTT TITLE:TRUSTEE HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JASON V. TERK, MD TITLE:TRUSTEE HOURS:42 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:GARY G. WALSH TITLE:TRUSTEE HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JAMES E. WEBB TITLE:TRUSTEE HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:M. SUZANNE WHITWORTH, MD TITLE:TRUSTEE HOURS:43 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KEVIN D. WYLIE, DO TITLE:TRUSTEE-VICE CHAIRMAN HOURS:42 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:GRETCHEN EAMES, MD TITLE:TRUSTEE HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ANGEL W. HERNANDEZ-MULERO, MD TITLE:TRUSTEE HOURS:43 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MARSHA A. HILCHER TITLE:TRUSTEE HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:CHRISTOPHER M. HUCKABEE TITLE:TRUSTEE HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DONALD K. MURPHEY, MD TITLE:TRUSTEE HOURS:43 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:LINDA THOMPSON, MD TITLE:TRUSTEE HOURS:43 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DEBORAH A. SCHUTTE, MD TITLE:TRUSTEE HOURS:42 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:RICHARD P. GOODE TITLE:CFO HOURS:30 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:CARA MARTZ TITLE:SECRETARY HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:RICK W. MERRILL TITLE:PRESIDENT & CEO HOURS:25 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:GEORGE B. MONTAGUE TITLE:VP, REAL ESTATE HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOANN M. SANDERS, MD TITLE:PATIENT SAFETY OFFICER HOURS:1 COOK CHILDREN'S HEALTH PLAN 801 SEVENTH AVE FORT WORTH TX 76104 760585240 INSURANCE TX 501(C)(3) 11C CCHCS true COOK CHILDREN'S PHYSICIAN NETWORK 801 SEVENTH AVE FORT WORTH TX 76104 752485366 PHYSICIAN SVC TX 501(C)(3) 3 CCHCS true WI COOK FOUNDATION 801 SEVENTH AVE FORT WORTH TX 76104 752051649 FUNDRAISING TX 501(C)(3) 11D NA false 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) 11C CCHCS true COOK CHILDREN'S HEALTH SERVICES 801 7TH AVENUE FORT WORTH TX 76104 454024843 HEALTHCARE TX CCHCS C CORPORATION 181315 756565 1.00000 true true true false false false false false false false false false false false true true true true COOK CHILDREN'S HOME HEALTH A 172844 FMV COOK CHILDREN'S HEALTH FOUNDATION C 559050 FMV COOK CHILDREN'S HEALTH FOUNDATION P 1332322 FMV COOK CHILDREN'S HOME HEALTH P 4181660 FMV COOK CHILDREN'S HEALTH PLAN A 208674 FMV COOK CHILDREN'S HEALTH PLAN P 2902836 FMV COOK CHILDREN'S MEDICAL CENTER Q 1176788 FMV COOK CHILDREN'S MEDICAL CENTER P 152067899 FMV COOK CHILDREN'S PHYSICIAN NETWORK A 1469623 FMV COOK CHILDREN'S PHYSICIAN NETWORK Q 286172 FMV COOK CHILDREN'S PHYSICIAN NETWORK O 6914051 FMV COOK CHILDREN'S PHYSICIAN NETWORK P 6439143 FMV