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        <Identifier>INTENDED USE OF ENDOWMENT FUNDS</Identifier>
        <ReturnReference>SCHEDULE D PART V QUESTION 4</ReturnReference>
        <Explanation>COOK CHILDREN'S HAS ADOPTED INVESTMENT AND SPENDING POLICIES FOR ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO PROGRAMS AND OTHER ITEMS SUPPORTED BY ITS ENDOWMENT WHILE SEEKING TO MAINTAIN THE PURCHASING POWER OF THE ENDOWMENT. UNDER COOK CHILDREN'S POLICIES, ENDOWMENT ASSETS ARE INVESTED IN A MANNER THAT IS INTENDED TO PRODUCE AN AMOUNT THAT IS EQUAL TO A RETURN HURDLE DEFINED AS THE SPENDING RATE, INFLATION RATE AND THE MANAGEMENT COST OF THE ENDOWMENT ON AN ANNUAL BASIS WHILE ASSUMING A PRUDENT LEVEL OF INVESTMENT RISK. ACTUAL RETURNS IN ANY GIVEN YEAR MAY VARY FROM THIS AMOUNT. TO SATISFY ITS LONG-TERM RATE OF RETURN OBJECTIVES, COOK CHILDREN'S RELIES ON A TOTAL RETURN STRATEGY IN WHICH INVESTMENT RETURNS ARE ACHIEVED THROUGH BOTH CURRENT YIELD (INVESTMENT INCOME SUCH AS DIVIDENDS AND INTEREST) AND CAPITAL APPRECIATION (BOTH REALIZED AND UNREALIZED). COOK CHILDREN'S TARGETS A DIVERSIFIED ASSET ALLOCATION THAT PLACED A GREATER EMPHASIS ON EQUITY-BASED INVESTMENTS TO ACHIEVE ITS LONG-TERM RETURN OBJECTIVES WITHIN PRUDENT RISK CONSTRAINTS. COOK CHILDREN'S HAS A POLICY (THE SPENDING POLICY) OF APPROPRIATING FOR EXPENDITURE EACH YEAR 5% OF THE FOUNDATION'S INVESTMENTS AVERAGE FAIR VALUE OVER THE PRIOR 5 YEARS ENDED JUNE 30 PRECEDING THE YEAR IN WHICH EXPENDITURE IS PLANNED. IN ESTABLISHING THIS POLICY, COOK CHILDREN'S CONSIDERED THE LONG-TERM EXPECTED RETURN ON ITS ENDOWMENT. ACCORDINGLY, OVER THE LONG TERM, COOK CHILDREN'S EXPECTS THE CURRENT SPENDING POLICY TO ALLOW ITS ENDOWMENT TO GROW AT THE RETURN HURDLE. THIS IS CONSISTENT WITH COOK CHILDREN'S OBJECTIVE TO MAINTAIN THE PURCHASING POWER OF ENDOWMENT ASSETS HELD IN PERPETUITY OR FOR A SPECIFIED TERM, AS WELL AS TO PROVIDE ADDITIONAL REAL GROWTH THROUGH NEW GIFTS AND INVESTMENT RETURN.</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>SCHEDULE D, PART XI, LINE 8</Identifier>
        <ReturnReference>OTHER CHANGE</ReturnReference>
        <Explanation>CONTRIBUTIONS RECORDED TO NET ASSETS ($14,178,763) DONATIONS RECORDED FROM NET ASSETS $51,479,819 --------------- $37,301,056</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>SCHEDULE D, PART XII, LINE 4B</Identifier>
        <ReturnReference>OTHER CHANGE</ReturnReference>
        <Explanation>CONTRIBUTIONS RECORDED TO NET ASSETS $14,178,763 RECLASSIFICATION OF INVESTMENT DEPT EXPENSES $ 928,660 -------------- $15,107,423</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>SCHEDULE D, PART XIII, LINE 4B</Identifier>
        <ReturnReference>OTHER CHANGE</ReturnReference>
        <Explanation>RECLASSIFICATION OF INVESTMENT DEPT EXPENSES $ 928,660 DONATIONS FROM NET ASSETS $ 51,479,819 --------------- $ 52,408,479</Explanation>
      </Form990ScheduleDPartXIV>
    </IRS990ScheduleD>
    <IRS990ScheduleF documentId="IRS990ScheduleF">
      <AcctsActvsOutUSTable>
        <Region>Central America and the Caribbean</Region>
        <TypeOfActivitiesConducted>Program Services</TypeOfActivitiesConducted>
        <SpecificServicesProvided>INVESTMENTS</SpecificServicesProvided>
        <TotalExpenditures>217712076</TotalExpenditures>
      </AcctsActvsOutUSTable>
      <AcctsActvsOutUSTable>
        <Region>Europe (Including Iceland and Greenland)</Region>
        <TypeOfActivitiesConducted>Program Services</TypeOfActivitiesConducted>
        <SpecificServicesProvided>INVESTMENTS</SpecificServicesProvided>
        <TotalExpenditures>61741608</TotalExpenditures>
      </AcctsActvsOutUSTable>
      <AcctsActvsOutUSTable>
        <Region>East Asia and the Pacific</Region>
        <TypeOfActivitiesConducted>Program Services</TypeOfActivitiesConducted>
        <SpecificServicesProvided>INVESTMENTS</SpecificServicesProvided>
        <TotalExpenditures>4444998</TotalExpenditures>
      </AcctsActvsOutUSTable>
      <AcctsActvsOutUSTable>
        <Region>Sub-Saharan Africa</Region>
        <TypeOfActivitiesConducted>Program Services</TypeOfActivitiesConducted>
        <SpecificServicesProvided>INVESTMENTS</SpecificServicesProvided>
        <TotalExpenditures>6503876</TotalExpenditures>
      </AcctsActvsOutUSTable>
      <SubtotalAmountSpent>290402558</SubtotalAmountSpent>
      <TotalAmountSpent>290402558</TotalAmountSpent>
      <TransferToForeignCorp>true</TransferToForeignCorp>
      <InterestInForeignTrust>false</InterestInForeignTrust>
      <OwnForeignCorp>true</OwnForeignCorp>
      <PassiveForeignInvestCo>false</PassiveForeignInvestCo>
      <ForeignPartnership>true</ForeignPartnership>
      <BoycottCountries>false</BoycottCountries>
    </IRS990ScheduleF>
    <IRS990ScheduleI documentId="IRS990ScheduleI">
      <RecordsMaintained>true</RecordsMaintained>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>COOK CHILDREN'S MEDICAL CENTER</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>801 SEVENTH AVENUE</AddressLine1>
          <City>FORT WORTH</City>
          <State>TX</State>
          <ZIPCode>76104</ZIPCode>
        </AddressUS>
        <EINOfRecipient>752051646</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
        <AmountOfCashGrant>50778304</AmountOfCashGrant>
        <PurposeOfGrant>FINANCIAL ASSISTANCE</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>COOK CHILDREN'S PHYSICIAN NETWORK</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>801 SEVENTH AVENUE</AddressLine1>
          <City>FORT WORTH</City>
          <State>TX</State>
          <ZIPCode>76104</ZIPCode>
        </AddressUS>
        <EINOfRecipient>752485366</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
        <AmountOfCashGrant>141820</AmountOfCashGrant>
        <PurposeOfGrant>FINANCIAL ASSISTANCE</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>COOK CHILDREN'S HEALTH CARE SYSTEM</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>801 SEVENTH AVENUE</AddressLine1>
          <City>FORT WORTH</City>
          <State>TX</State>
          <ZIPCode>76104</ZIPCode>
        </AddressUS>
        <EINOfRecipient>752705881</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
        <AmountOfCashGrant>559050</AmountOfCashGrant>
        <PurposeOfGrant>FINANCIAL ASSISTANCE</PurposeOfGrant>
      </RecipientTable>
      <TotalNbrOf501C3AndGovtGrants>3</TotalNbrOf501C3AndGovtGrants>
      <Form990ScheduleIPartIV>
        <Identifier>PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS</Identifier>
        <ReturnReference>SCHEDULE I PART I QUESTION 2</ReturnReference>
        <Explanation>FUNDS ARE PLACED IN THE APPROPRIATE DESIGNATED ACCOUNTS WITH NOTIFICATION FROM DEVELOPMENT STAFF TO THE AUTHORIZED SIGNER. AUTHORIZED SIGNERS AND OTHER APPROPRIATE INDIVIDUALS ARE NOTIFIED OF ANY RESTRICTIONS ON THE FUNDS. DEVELOPMENT STAFF FOLLOW UP WITH AUTHORIZED SIGNERS TO OBTAIN INFORMATION ON THE USE OF FUNDS AND THE IMPACT MADE TO THE PROGRAM. IMPACT REPORTS ARE THEN PREPARED BY DEVELOPMENT STAFF AND SENT TO THE DONOR ON AN ANNUAL BASIS OR AS REQUIRED BY THE DONOR AGREEMENT.</Explanation>
      </Form990ScheduleIPartIV>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ">
      <CompensationCommittee>X</CompensationCommittee>
      <IndependentConsultant>X</IndependentConsultant>
      <Form990OfOtherOrganizations>X</Form990OfOtherOrganizations>
      <WrittenEmploymentContract>X</WrittenEmploymentContract>
      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>true</SeverancePayment>
      <SupplementalNonqualRetirePlan>true</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>false</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>false</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>false</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>false</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>false</AnyNonFixedPayments>
      <InitialContractException>false</InitialContractException>
      <Form990ScheduleJPartII>
        <NamePerson>GARY M COLE</NamePerson>
        <BaseCompensationFilingOrg>10765</BaseCompensationFilingOrg>
        <BonusFilingOrg>0</BonusFilingOrg>
        <OtherCompensationFilingOrg>99924</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>1161</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>448</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>112298</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>ROBERT K FEATHER</NamePerson>
        <BaseCompensationFilingOrg>245900</BaseCompensationFilingOrg>
        <BonusFilingOrg>102941</BonusFilingOrg>
        <OtherCompensationFilingOrg>73220</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>18375</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>14338</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>454774</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>RICHARD P GOODE</NamePerson>
        <BaseCompensationFilingOrg>19285</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>366391</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>8058</BonusFilingOrg>
        <BonusRelatedOrgs>153110</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>5605</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>106504</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>766</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>14547</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>780</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>14817</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>34494</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>655369</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>RICK W MERRILL</NamePerson>
        <BaseCompensationFilingOrg>138908</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>555630</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>84500</BonusFilingOrg>
        <BonusRelatedOrgs>337999</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>30772</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>123089</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>37750</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>113250</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>3880</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>11638</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>295810</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>1141606</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>84480</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>179520</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>GEORGE B MONTAGUE</NamePerson>
        <CompBasedOnRelatedOrgs>206653</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>67135</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>19620</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>15313</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>11766</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>320487</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>PATRICK B O'CONNOR</NamePerson>
        <BaseCompensationFilingOrg>176096</BaseCompensationFilingOrg>
        <BonusFilingOrg>48821</BonusFilingOrg>
        <OtherCompensationFilingOrg>1525</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>9115</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>7447</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>243004</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>LESLEY ATKINSON</NamePerson>
        <BaseCompensationFilingOrg>127060</BaseCompensationFilingOrg>
        <BonusFilingOrg>18673</BonusFilingOrg>
        <OtherCompensationFilingOrg>1826</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>5265</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>11481</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>164305</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>JENNIFER JOHNSON</NamePerson>
        <BaseCompensationFilingOrg>129325</BaseCompensationFilingOrg>
        <BonusFilingOrg>28861</BonusFilingOrg>
        <OtherCompensationFilingOrg>3606</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>10986</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>2270</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>175048</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>TIMOTHY PLOCICA</NamePerson>
        <BaseCompensationFilingOrg>129212</BaseCompensationFilingOrg>
        <BonusFilingOrg>18726</BonusFilingOrg>
        <OtherCompensationFilingOrg>1577</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>11485</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>161000</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>GRANT HARRIS</NamePerson>
        <BaseCompensationFilingOrg>122963</BaseCompensationFilingOrg>
        <BonusFilingOrg>13803</BonusFilingOrg>
        <OtherCompensationFilingOrg>6737</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>6015</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>15317</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>164835</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <Identifier>PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN</Identifier>
        <ReturnReference>SCHEDULE J PART I LINE 4B</ReturnReference>
        <Explanation>RICK W. MERRILL PARTICIPATES, BUT RECEIVED $0 PAYMENT DURING CALENDAR YEAR 2011.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>ALLOCATION OF CEO AND CFO SALARIES</Identifier>
        <ReturnReference>SCHEDULE J PART II</ReturnReference>
        <Explanation>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.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>SEVERANCE PAYMENT RECEIVED FROM THE ORGANIZATION</Identifier>
        <ReturnReference>SCHEDULE J PART I QUESTION 4A</ReturnReference>
        <Explanation>GARY M. COLE RECEIVED A SEVERANCE PAYMENT OF $82,104 DURING CALENDAR YEAR 2011.</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="IRS990ScheduleL">
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>LUTHER KING CAPITAL MANAGEMENT</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>SEE PART V</Relationship>
        <AmountOfTransaction>321947</AmountOfTransaction>
        <DescriptionOfTransaction>INVESTMENT MGMT FEES</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>LUTHER KING CAPITAL MANAGEMENT</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>SEE PART V</Relationship>
        <AmountOfTransaction>321947</AmountOfTransaction>
        <DescriptionOfTransaction>INVESTMENT MGMT FEES</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>JP MORGAN CHASE</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>SEE PART V</Relationship>
        <AmountOfTransaction>283955</AmountOfTransaction>
        <DescriptionOfTransaction>INVT MGMT/OPERATING ACCT FEES</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartV>
        <Identifier>RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION</Identifier>
        <ReturnReference>PART IV</ReturnReference>
        <Explanation>GARY G. WALSH, BOARD MEMBER, IS A PRINCIPAL AND SHAREHOLDER FOR LUTHER KING CAPITAL MANAGEMENT. MASON D. KING, BOARD MEMEBER, IS A VICE PRESIDENT FOR LUTHER KING CAPITAL MANAGEMENT. TODD RITTERBUSCH, BOARD MEMBER, IS TARRANT COUNTY CHAIRMAN AND CEO FOR JP MORGAN CHASE.</Explanation>
      </Form990ScheduleLPartV>
    </IRS990ScheduleL>
    <IRS990ScheduleM documentId="IRS990ScheduleM">
      <WorksOfArt />
      <ArtHistoricalTreasures />
      <ArtFractionalInterest />
      <BooksAndPublications />
      <ClothingAndHouseholdGoods />
      <CarsAndOtherVehicles />
      <BoatsAndPlanes />
      <IntellectualProperty />
      <SecuritiesPubliclyTraded>
        <NonCashCheckbox>X</NonCashCheckbox>
        <NumberOfContributions>13</NumberOfContributions>
        <NoncashContribsRptdF990>556631</NoncashContribsRptdF990>
        <MethodOfDeterminingRevenues>AVG HIGH/LOW FOR DAY</MethodOfDeterminingRevenues>
      </SecuritiesPubliclyTraded>
      <SecuritiesCloselyHeldStock />
      <SecuritiesPrtnrshpTrustIntrsts />
      <SecuritiesMiscellaneous />
      <QualifiedContribHistStruct />
      <QualifiedContribOther />
      <RealEstateResidential />
      <RealEstateCommercial />
      <RealEstateOther />
      <Collectibles />
      <FoodInventory />
      <DrugsAndMedicalSupplies />
      <Taxidermy />
      <HistoricalArtifacts />
      <ScientificSpecimens />
      <ArchaeologicalArtifacts />
      <AnyPropertyThatMustBeHeld>false</AnyPropertyThatMustBeHeld>
      <ReviewProcessUnusualNCGifts>true</ReviewProcessUnusualNCGifts>
      <ThirdPartiesUsed>true</ThirdPartiesUsed>
      <Form990ScheduleMPartII>
        <Identifier>THIRD PARTY USED TO SELL NONCASH CONTRIBUTIONS</Identifier>
        <ReturnReference>QUESTION 32B</ReturnReference>
        <Explanation>STOCK CONTRIBUTIONS ARE SOLD BY OUR INVESTMENT MANAGER UPON RECEIPT.</Explanation>
      </Form990ScheduleMPartII>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <GeneralExplanation>
        <Identifier>REVIEW PROCESS FOR FORM 990</Identifier>
        <ReturnReference>FORM 990 PART VI QUESTION 11B</ReturnReference>
        <Explanation>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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>CONFLICT OF INTEREST</Identifier>
        <ReturnReference>FORM 990 PART VI QUESTION 12C</ReturnReference>
        <Explanation>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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>REVIEW &amp; APPROVAL OF COMPENSATION</Identifier>
        <ReturnReference>FORM 990 PART VI, QUESTION 15A &amp; 15B</ReturnReference>
        <Explanation>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 &amp; Emery of Chicago, Illinois, to issue a reasonableness opinion covering the physician compensation plan for Cook Children's Physician Network.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>PROCESS OF MAKING GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC</Identifier>
        <ReturnReference>FORM 990 PART VI, QUESTION 19</ReturnReference>
        <Explanation>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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>OFFICER, DIRECTOR, TRUSTEE, OR KEY EMPLOYEE FAMILY/BUSINESS RELATIONSHIPS</Identifier>
        <ReturnReference>FORM 990 PART VI QUESTION 2</ReturnReference>
        <Explanation>MASON D. KING AND GARY G. WALSH HAVE A BUSINESS RELATIONSHIP. MASON D. KING AND GARY G. WALSH ARE EMPLOYEES OF LUTHER KING CAPITAL MANAGEMENT, WHICH PROVIDES INVESTMENT MANAGEMENT SERVICES TO THE FOUNDATION PURSUANT TO THE FIRM'S STANDARD FEE SCHEDULE. WIN RYAN AND GEORGE M. YOUNG HAVE A BUSINESS RELATIONSHIP.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>OTHER CHANGES IN NET ASSETS</Identifier>
        <ReturnReference>FORM 990, PART XI, LINE 5</ReturnReference>
        <Explanation>UNRESTRICTED NET ASSETS: TRANSFERS BETWEEN AFFILIATES $ 70,204,306 NET UNREALIZED GAINS ON INVESTMENTS 38,423,709 TEMPORARILY RESTRICTED NET ASSETS: CHANGE IN BENEFICIAL INTEREST IN LEAD TRUST 37,913 NET ASSETS RELEASED FROM RESTRICTIONS (152,160) INVESTMENT INCOME &amp; UNREALIZED GAIN(LOSSES) 1,076,488 PERMANENTLY RESTRICTED NET ASSETS: CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUSTS 640,751 INVESTMENT INCOME &amp; UNREALIZED GAIN(LOSSES) 2,873,475 ------------- TOTAL $113,104,482</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>PROGRAM SERVICE ACCOMPLISHMENTS</Identifier>
        <ReturnReference>FORM 990, PART III, LINE 4A</ReturnReference>
        <Explanation>In 2012, Cook Children's Health Foundation raised $16.3 million dollars in support of program development, clinical research and the recent expansion of Cook Children's Medical Center. The Fulfilling Our Promise capital campaign, which began in 2008 and ended October 2012, raised more than $88 million for expansion. In July 2009, Cook Children's broke ground on what would soon become the largest expansion in our history. In September 2011, the new north tower and single room Neonatal Intensive Care Unit opened. The Dodson Specialty Clinics building opened the following March and just two months later in May, the new Child Life Zone. As part of the fundraising efforts for the Fulfilling Our Promise capital campaign, Cook Children's employees funded the interactive, inpatient TV system, GetWellNetwork and the new indoor playground through our Employees Care program. Employee giving which totaled more than $1.2 million, funded these projects and also consisted of general gifts to help fund our most recent expansion. Through Employees Care, Cook Children's employees are given an opportunity to directly show the community that when employees join together, big things happen. At Cook Children's, children are helping other children ever day. Whether it's collecting art supplies for our Creative Artist in Residence Programme, spending their summers as Junior Volunteers at the medical center or decorating cards for patients, each of these young philanthropists is making a difference. When Haley Whatley was just 6 years old, she knew that something as small as a stuffed animal could comfort and soothe patients at Cook Children's. She wanted to bring a feeling of love and support during what could be a difficult time for them. Haley, with the help of her family and friends she called her "Bunny Ambassadors," organized what would be the first of 13 annual Bunny and Bear drives. Each spring she collected more stuffed animals than the last, donating every furry friend to Cook Children's, to be distributed to patients who had to stay overnight at the medical center. Cook Children's is fortunate to have the support of Jewel Charity. In 1953, two industrious Fort Worth women realized that Cook Children's required additional resources to provide the high levels of uncompensated care required by the region's neediest children. Working in tandem with the Cook Children's Health Foundation, Jewel Charity, a 501(c)(3) non-profit, has grown to more than 400 members governed by a board of directors. Since its inception, Jewel Charity has provided Cook Children's with more than $58 million dollars from special events fundraising.</Explanation>
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