2013-08-14T11:57:29-05:00 2012-09-30 BKD LLP 2800 Post Oak Blvd Ste 3200 HOUSTON TX 77056 990 2011-10-01 752485366 COOK CHILDREN'S PHYSICIAN NETWORK % CORY RHOADES COOK 6828854480 801 SEVENTH AVENUE FORT WORTH TX 76104 CORY RHOADES 2013-08-15 true M Paige Gerich 7134994600 2011 2016-02-25 16:41:14Z W BRITT NELSON MD 801 SEVENTH AVE FORT WORTH TX 76104 204462236 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 0 980 23 887181 752694 42965376 41651749 143331135 161752152 0 4456 1599572 1046085 187896083 204454442 0 0 0 0 145972094 160652263 0 0 0 41801348 43518770 187773442 204171033 122641 283409 34104541 35649158 21819581 23080789 12284960 12568369 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 181603771 161911056 Cook Children's Physician Network (CCPN) is the largest pediatric multi-specialty physician group in North Texas. The network includes more than 300 physicians and thousands of other caring employees who provide medical care in 60 locations to more than 30 primary care and subspecialty practices. In 2012, CCPN grew by 20 providers: 14 physicians (five primary care, one primary care locum, two hospitalists and six specialists) and six midlevel providers (two physician assistants and four certified registered nurse anesthetists). Additionally, we offer access to seven specialties via telemedicine: Endocrinology, Genetics, Hematology and Oncology, Infectious Disease, Nephrology, Neurology and Psychiatry. These specialists hosted 875 visits via telemedicine in 2012 - saving 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. The San Angelo Specialty Clinic was relocated to a larger facility which allows more than double the exam room space to accommodate more specialties. Also, Southlake Urgent Care and Pediatric Specialties celebrated one year anniversaries in 2012. In its first year, the clinic had 9,902 total visits, compared to 7,502 projected, which is an average of 200 more monthly visits than anticipated. Patients benefited from a new patient Internet portal in 2012, call mycookchildrens. To date, more than 46,000 patients have registered for the portal, which provides families on-demand access to prior visit summaries, medication lists, vaccine records, lab results and appointment requests. 181603771 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 false true 91 0 true 980 true true true 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 6828854480 801 SEVENTH AVENUE FORT WORTH TX 76104 X MICHAEL J DEITCHMAN MD 41.0 X 263520 11518 FRANK MCGEHEE MD 42.0 X X 698123 14149 JAMES P MILLER MD 41.0 X 1071849 31922 DEBORAH SCHUTTE MD 42.0 X X 479849 28901 JASON V TERK MD 42.0 X X 364869 29912 JAMES C WHEELER MD 41.0 X 472534 39643 M SUZANNE WHITWORTH MD 41.0 X 153555 10597 KEVIN D WYLIE DO 42.0 X X 249883 26313 BARRY BZOSTEK MD 41.0 X 228541 7488 MARK MAZADE MD 41.0 X 267843 23836 AUDREY ROGERS MD 41.0 X 238463 21126 SANDRA ARCA MD 41.0 X 242963 23066 VANESSA CHARETTE MD 41.0 X 242868 15374 LINDA M THOMPSON MD 42.0 X X 247890 15894 TODD WOLF MD 41.0 X 384301 34467 RYAN CHAMPLIN 40.0 X 373079 32242 JANELL MASON-BRISCOE 38.0 X 229038 12972 RICHARD P GOODE 4.0 X 72485 586468 30910 RICK W MERRILL 4.0 X 139799 1131099 166518 W BRITT NELSON MD 40.0 X 596389 30977 NICHOLAS A OGUNMOLA MD 40.0 X 821200 19513 VINCENT TAM MD 40.0 X 1244714 31661 PATRICK THOMAS MD 40.0 X 806161 27902 CHAD HAMNER MD 40.0 X 811780 28898 JOSE L IGLESIAS MD 40.0 X 793020 22891 THEODORE MATTHEWS 0.0 X 132205 11777 11626921 1717567 750467 365 true 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 41408120 202126 41503 41651749 NET PATIENT FEES 621110 143010603 143010603 CONTRACTED FEES 621110 2631536 2631536 MANAGEMENT FEES 900099 14703482 14703482 OTHER INCOME 621110 1363988 1363988 RESEARCH 900099 42543 42543 161752152 0 0 0 12250 7794 4456 4456 4456 0 0 0 GROUP PURCH SALES 561439 887181 887181 OTHER INCOME 900099 158904 158904 1046085 204454442 161911056 887181 4456 0 0 0 0 7966038 6306481 1659557 103617 103617 133158426 129032501 4125925 0 19424182 17569334 1854848 0 2960514 2960514 102767 102767 0 0 0 0 1499184 1177572 321612 78966 40574 38392 11788493 11528446 260047 0 0 5912873 5077075 835798 301247 263429 37818 0 170986 150723 20263 1775 1775 0 571038 554237 16801 1781930 1779792 2138 BAD DEBT EXPENSE 5348651 5367830 -19179 0 PHYSICIAN EXPENSES 1225215 1222506 2709 COLLECTION EXPENSE 10193308 -7060 10200368 TELEPHONE TRIAGE 348462 348462 1233361 1086477 146884 204171033 181603771 22567262 0 10012 9576 19724374 20240947 0 0 10231799 10817313 0 0 0 0 0 0 846566 1072746 1223540 1113770 5762007 3727298 1825219 2034709 0 0 0 0 0 0 0 0 243031 360097 34104541 35649158 3276455 3113666 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18543126 19967123 21819581 23080789 X 12284960 12568369 0 0 0 0 12284960 12568369 34104541 35649158 283409 X false true true X false X false false false RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1138523 1045034 93489 1745561 823484 922077 2817373 1854743 962630 60550 4037 56513 2034709 0 ACCRUED PAYROLL 832159 ACCRUED PHYSICIAN RECONS 7932657 DUE TO AFFILIATES 4270889 ACCRUED PTO LIABILITY 2669076 ACCRUED EXECUTIVE BONUS 433970 ACCRUED EIB LIABILITY 3772076 CAPITAL LEASE OBLIGATION 56296 19967123 204454442 204171033 283409 283409 204449986 204449986 4456 4456 204454442 204166577 204166577 4456 4456 204171033 OTHER CHANGES PART VII, LINE 4B & PART VIII, LINE 4B GAIN ON ASSET DISPOSITION: $4,456 X X X X X X false true false false false false false false false MICHAEL J DEITCHMAN MD 262160 0 1360 0 11518 275038 FRANK MCGEHEE MD 694239 0 3884 0 14149 712272 JAMES P MILLER MD 1054107 0 17742 17619 14303 1103771 DEBORAH SCHUTTE MD 478114 0 1735 15313 13588 508750 JASON V TERK MD 363429 0 1440 18375 11537 394781 JAMES C WHEELER MD 470824 0 1710 18375 21268 512177 M SUZANNE WHITWORTH MD 151839 0 1716 7051 3546 164152 KEVIN D WYLIE DO 229291 19797 795 10775 15538 276196 RYAN CHAMPLIN 260042 88793 24244 15313 16929 405321 JANELL MASON-BRISCOE 171186 56302 1550 8320 4652 242010 THEODORE MATTHEWS 12445 44800 74960 9967 1810 143982 RICHARD P GOODE 42426 343250 17728 143440 12331 99778 1684 13629 1716 13881 75885 613978 RICK W MERRILL 76399 618139 46475 376024 16925 136936 16610 134390 1707 13811 158116 1279300 29040 234960 NICHOLAS A OGUNMOLA MD 819490 0 1710 15313 4200 840713 VINCENT TAM MD 1242572 0 2142 15313 16348 1276375 BARRY BZOSTEK MD 179400 46250 2891 0 7488 236029 MARK MAZADE MD 266135 400 1308 12201 11635 291679 AUDREY ROGERS MD 236261 0 2202 11519 9607 259589 SANDRA ARCA MD 240787 500 1676 0 23066 266029 VANESSA CHARETTE MD 240596 2066 206 9906 5468 258242 LINDA M THOMPSON MD 247856 0 34 10528 5366 263784 TODD WOLF MD 343084 40796 421 14086 20381 418768 W BRITT NELSON MD 437744 133876 24769 18375 12602 627366 PATRICK THOMAS MD 805621 0 540 9800 18102 834063 CHAD HAMNER MD 810394 0 1386 9800 19098 840678 JOSE L IGLESIAS MD 774810 0 18210 9800 13091 815911 NAMES, AMOUNTS, AND DETAILS OF ARRANGEMENTS PART 1, QUESTION 4 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. TOM ROGERS JR MD A. ROGERS FATHER-IN-LAW 103617 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 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 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. 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 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. 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. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MICHAEL J. DEITCHMAN, MD TITLE:TRUSTEE HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:FRANK MCGEHEE, MD TITLE:TRUSTEE-TREASURER HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JAMES P. MILLER, MD TITLE:TRUSTEE HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DEBORAH SCHUTTE, MD TITLE:TRUSTEE-VICE CHAIRMAN HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JASON V. TERK, MD TITLE:TRUSTEE - VICE CHAIRMAN HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:M. SUZANNE WHITWORTH, MD TITLE:TRUSTEE HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KEVIN D. WYLIE, DO TITLE:TRUSTEE-SECRETARY HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:VANESSA CHARETTE, MD TITLE:TRUSTEE HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:LINDA M. THOMPSON, MD TITLE:TRUSTEE-SECRETARY HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JANELL MASON-BRISCOE TITLE:INTERIM VP. OPERATIONS HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:RICHARD P. GOODE TITLE:CHIEF FINANCIAL OFFICER HOURS:36 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:RICK W. MERRILL TITLE:CHIEF EXECUTIVE OFFICER HOURS:36 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 COOK CHILDREN'S HEALTH SERVICES 801 7TH AVENUE FORT WORTH TX 76104 454024843 HEALTHCARE TX CCHCS C CORPORATION 0 0 0.00000 false false true false false false false false true true false false false false true true true true