2012-08-14T18:39:06-05:00 2011-09-30 BKD LLP 2800 Post Oak Blvd Ste 3200 HOUSTON TX 77056 990 2010-10-01 752051646 Cook Children's Medical Center COOK 6828854000 801 Seventh Avenue Fort Worth TX 76104 CORY RHOADES 2012-08-15 true M Paige Gerich 7134994600 2010 2016-02-24 21:20:13Z NANCY CYCHOL 801 SEVENTH AVENUE FORT WORTH TX 76104 657673218 false X WWW.COOKCHILDRENS.ORG X 1985 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. 18 14 3551 1192 37046 5735863 5788048 561457980 646232800 1962612 79302 7023290 3885405 576179745 655985555 36628234 42862351 0 0 215700718 236534786 0 0 0 232016571 245457158 484345523 524854295 91834222 131131260 761990272 717528502 404033064 414633348 357957208 302895154 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 397030619 42862351 648847942 Cook CHILDREN'S MEDICAL CENTER IS RANKED IN THE TOP 6 PERCENT OF THE NATION'S hospitals for its nursing excellence and has a distinguished international reputation for providing extraordinary care and achieving positive outcomes in its neurology, neurosurgery, cardiology, cardiothoracic surgery, hematology and oncology, neonatology, and pulmonology programs. The medical center accounted for 81% of Tarrant County's pediatric admissions in 2008. CONTINUED ON SCHEDULE O 397030619 true true false false false false false false true true false false false true true false true false false false false false false false false true true true true true true false false false false false false false false false false false false false false false true false false false false true 172 0 true 3551 true true true false false false false false false false false false X 18 14 false true false false true true true true true false false true true true true true true true true true true X CORY RHOADES 6828854480 801 SEVENTH AVENUE FORT WORTH TX 76104 X CORLISS BALDWIN 1.0 X 0 0 0 JAMES F HERD SR MD 1.0 X 0 0 0 MARSHA HILCHER 2.0 X X 0 0 0 CHRISTOPHER M HUCKABEE 1.0 X 0 0 0 WM MACK LAWHON 1.0 X 0 0 0 PATTI MCCONNELL 1.0 X 0 0 0 ROGER NOBER 1.0 X 0 0 0 BONNIE PETSCHE 1.0 X 0 0 0 PETER L PHILPOT 2.0 X X 0 0 0 G DOUGLAS TATUM MD 1.0 X 0 0 0 ANDREW S WAYNE 2.0 X X 0 0 0 JOHN P BOSWELL 1.0 X 0 0 0 JAMES R DUNAWAY JR 1.0 X 0 0 0 GRETCHEN EAMES MD 1.0 X 0 296710 12156 SHARON S MAYES 1.0 X 0 0 0 JOHN M RICHARDSON MD 1.0 X 0 0 0 JOANN M SANDERS MD 1.0 X 0 346541 30701 DONALD K MURPHEY MD 1.0 X 0 297404 32461 ANGEL W HERNANDEZ-MULERO MD 1.0 X 0 512850 35949 WILLIAM H CRAIG 40.0 X 107988 0 2853 NANCY C CYCHOL 40.0 X 615305 0 26678 STANLEY E DAVIS 40.0 X 215130 0 26385 RICHARD P GOODE 20.0 X 272138 283246 30985 CARA MARTZ 1.0 X 0 95216 7326 RICK W MERRILL 11.0 X 344839 886728 156115 GEORGE B MONTAGUE 2.0 X 0 278703 26894 PAULA J WEBB 40.0 X 264613 0 20452 TERESA J CLARK 40.0 X 182567 0 14427 JANELL P MASON-BRISCOE 38.0 X 167751 0 11196 ERIC PRESSON 40.0 X 40278 0 3072 KEVIN L DAHLE 40.0 X 183209 0 24727 EDWIN VIRGIL EASON 40.0 X 170692 0 24920 MIKE SMITH 40.0 X 183627 0 19606 DONALD K FAISON 40.0 X 168776 0 20302 MARY L HICKS 40.0 X 167916 0 17075 3084829 2997398 544280 186 false true false LINBECK GROUP LLC 201 MAIN ST STE 1801 FORT WORTH TX 76102 CONST. CONTRACTOR 89954150 FKP ARCHITECTS INC 8 GREENWAY PLAZE 300 HOUSTON TX 77046 CONST. ARCHITECTS 4580969 PRO ACTION FIRE ALARM INC 1933 SILVER CREEK ROAD AZLE TX 76020 PROFESSIONAL SERVICE 1401370 SIEMENS MEDICAL SOLUTIONS PO BOX 120001 DEPT 0733 DALLAS TX 75312 CONTR SERVICES/R&M 1319128 NATIONAL MARROW DONOR PROGRAM NW 8428 PO BOX 1450 MINNEAPOLIS MN 55485 REFERAL LAB 1112709 64 4598757 288649 900642 5788048 PATIENT SERVICES 621110 603633096 603633096 OTHER OPERATING REVENUE 621110 28623729 28623729 JOINT VENTURE REVENUE 621110 13938929 13938929 LAB REFERRALS 621500 37046 37046 646232800 0 0 0 2931782 1661519 1270263 1270263 1270263 105446 26144 79302 79302 79302 0 0 0 CCIC RETRO PREMIUM 900099 2615142 2615142 2615142 655985555 648810896 37046 1349565 42788659 42788659 73692 73692 0 0 2669058 2669058 0 184501255 165408266 19092989 0 49364473 44332100 5032373 0 75316675 2569627 72747048 121411 121411 0 0 0 0 19200833 13214172 5986661 59845 49046 10799 61724044 60096652 1627392 0 0 4798107 3752268 1045839 1015337 821503 193834 0 463914 343335 120579 6244610 6244610 0 23556593 16866520 6690073 2746500 2746500 PHYSICIAN REMUNERATION 8950056 7765974 1184082 0 BAD DEBT EXPENSE 17920430 17920430 0 0 MINOR EQUIPMENT 8645179 2456767 6188412 0 REPAIRS & MAINTENANCE 3693603 1906618 1786985 0 FOOD/LINENS 3522735 3236964 285771 0 7477286 4436916 3040370 0 524854295 397030619 127823676 0 8887 10832 112756159 170399587 52427080 59005895 4840500 4666661 980061 980061 594316890 186169847 290360263 408147043 277460608 48874181 7424990 7424990 15731724 18019252 761990272 717528502 60258395 81960202 590 310673876 307668911 33100793 25003645 404033064 414633348 X 357957208 302895154 357957208 302895154 761990272 717528502 X 131131260 -186193314 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 80357260 18935 2595270 433103 82538362 70947601 3803664 5976642 370647 80357260 65867824 7205558 -1698302 427479 70947601 0.54000 0.46000 false true true 11234574 11234574 245824436 103200356 142624080 4497023 1924177 2572846 111700345 76768252 34932093 221060512 4277062 216783450 408147043 0 EST. PAYABLE (THIRD PARTY) 22986369 DUE TO AFFILIATES 2017276 25003645 655985555 524854295 131131260 10345206 10345206 141476466 697196432 41363949 41363949 655832483 153072 153072 655985555 555719966 30865671 30865671 524854295 524854295 SCHEDULE D, PART XI, LINE 8 OTHER CHANGE INTEREST RATE SWAP ADJUSTMENT ($1,793,056) CONTR. FROM HF RECORDED TO NET ASSETS ($ 138,843) CONTR. FROM HS RECORDED TO NET ASSETS ($ 14,229) MINORITY INTEREST $12,291,334 ----------- TOTAL $10,345,206 SCHEDULE D, PART XII, LINE 2D OTHER CHANGE JOINT VENTURE ACCOUNTS NOT INCLUDED ON 990 $41,606,076 INTEREST RATE SWAP ADJUSTMENT ($ 1,793,056) NE GAIN ON SALE OF ASSET (IN AUDIT EXP) ($ 31,290) GAIN ON SALE/DISPOSAL OF ASSET (IN AUDIT EXP) ($ 79,300) Rental Expense $ 1,661,519 ------------- TOTAL OTHER CHANGE $ 41,363,949 SCHEDULE D, PART XII, LINE 4B OTHER CHANGE CONTRIBUTION FROM HS RECORDED TO NET ASSETS $ 138,843 CONTRIBUTION FROM HF RECORDED TO NET ASSETS $ 14,229 ------------- TOTAL OTHER CHANGE $ 153,072 SCHEDULE D, PART XIII, LINE 2D OTHER CHANGE JOINT VENTURE ACCOUNTS NOT INCLUDED ON 990 $41,606,076 MINORITY INTEREST ($12,291,334) NE GAIN ON SALE OF ASSET (IN AUDIT EXP) ($ 31,290) RENTAL EXPENSE $ 1,661,519 GAIN ON SALE/DISPOSAL OF ASSET (IN AUDIT EXP)($ 79,300) ------------- TOTAL OTHER CHANGE $30,865,671 UNCERTAIN TAX POSITIONS SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. INTENDED USE OF ENDOWMENT FUNDS SCHEDULE D, PART V, QUESTION 4 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. true true X true X 400. true X 500. true false true true 2414460 0 2414460 0.00450 274987634 255531254 19456380 0.03630 277402094 255531254 21870840 0.04080 2905016 6222 2898794 0.00540 295312 115147 180165 0.00030 823934 0 823934 0.00150 43069548 0 43069548 0.08040 47093810 121369 46972441 0.08760 324495904 255652623 68843281 0.12840 20000 0 20000 0.00000 8071 0 8071 0.00000 47402 0 47402 0.00010 129480 0 129480 0.00020 1114 0 1114 0.00000 206067 0 206067 0.00030 true 8277880 0 2346591 4243327 -1896736 X true true CC NORTHEAST HOSP FREESTANDING SURGICAL HOSP 0.55140 0.00000 0.32960 2 1 COOK CHILDREN'S MEDICAL CENTER

801 SEVENTH AVENUE FORT WORTH TX 76104

X 2 COOK CHILDREN'S NORTHEAST HOSPITAL

6316 Precinct Line Rd Hurst TX 76054

X COOK CHILDREN'S MEDICAL CENTER 1 COOK CHILDREN'S NORTHEAST HOSPITAL 2 1 CENTER FOR PEDIATRIC SURGERY

7000 W PLANO PARKWAY SUITE 100 PLANO TX 75093

AMBULATORY SURGERY CENTER PART I, LINE 3C COOK CHILDREN'S USES FPG TO DETERMINE ELIGIBILITY FOR FREE AND DISCOUNTED CARE. PART I, LINE 6A THE ANNUAL REPORT AND COMMUNITY BENEFITS ARE LOCATED ON THE COOK CHILDREN'S WEB SITE (WWW.COOKCHILDRENS.ORG). A HARD COPY OF THE REPORT IS ALSO AVAILABLE IN THE PUBLICATION "KEEPING OUR PROMISE". PART I, LINE 7G NOT APPLICABLE PART I, LINE 7, COLUMN F BAD DEBT EXPENSE OF $17,920,430 WAS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT WAS SUBTRACTED FROM TOTAL EXPENSE FOR THE CALCULATION OF "PERCENT OF TOTAL EXPENSE" IN THIS COLUMN. PART I, LINE 7 COSTS FOR LINE 7 WERE CALCULATED USING AN OVERALL COST TO CHARGE RATIO CALCULATED BY THE HOSPITAL'S COST ACCOUNTING SYSTEM. PART III, LINE 4 We record self pay accounts at the full expected amount. Each account goes through the collection process as necessary. An allowance is established based on historical experience. Bad debt expense at cost was calculated using an overall cost to charge ratio calculated by the hospital's cost accounting system. We are unable to calculate an accurate estimate for this category. Footnote disclosure regarding the treatment of bad debts is as follows: Cook Children's reports patient accounts receivable for services rendered at net realizable amounts from government payors, managed care plans, patients and others. Amounts due from patients include both amounts due from fully uninsured patients and co-payments and deductibles for which insured patients are responsible. As a service to the patient, Cook Children's bills third-party payors directly and bills the patient when the patient's liability is determined. Patient accounts receivable are due in full when billed. Cook Children's provides an allowance for doubtful accounts based upon a review of outstanding receivables, historical collection information and existing economic conditions. Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluation and specific circumstances of the account. Bad debt, in whole or in part, should be included in community benefit given the tangible and measurable benefit of the underlying services provided to, primarily, underserved members of our community. For instance, we have a significant non-insured, undocumented worker population that may not participate in the charity or medical indigent discount qualification process due to concerns about their immigration status. We provide critical inpatient, emergency room, and outpatient services to this demographic for little or no reimbursement and without regard for their ability to pay, but receive no community benefit consideration. At minimum, hospitals should have the opportunity to delineate how much bad debt stems from non-insured patients and then be given community benefit consideration for the cost burden associated with providing these needed services knowing that we have already done all we can with regard to screening patients for charity and medical indigent discounts and written the patients' balances off as such. PART III, LINE 8 The Medicare shortfall should be considered community benefit since it is representative of the non-covered cost of patient care that hospitals are using to justify the need for their tax exempt status. Presenting the Medicare shortfall in the community benefit section allows regulators and the public to see the unfunded costs of services that hospitals provide to community members. This presentation would help the community better understand that in the absence of a tax exempt status (which in effect is granted to them by the public), the hospitals would have to look to the community to fund the shortfall or risk losing valued hospital services. The ratio of cost to charges used in the calculation of costs for Medicare was taken from the Medicare Cost Report. PART III, LINE 9B The hospital does not pursue collection of amounts determined to qualify as charity care. NEEDS ASSESSMENT In 2009 Cook Children's completed the first community-wide children's health assessment and planning survey. This random household survey of families with a child aged 0 - 14 years generated 7,439 responses to 200 questions about their child's health. The CCHAPS effort is the first known project of its kind in this state to focus solely on the overall health status of children. Cook Children's is committed to the health and well-being of our children, which can only be achieved through actions based on solid information. While a great amount of medical information exists about children, there are large gaps in understanding and measurement of children's health. CCHAPS fills that void and helps us honor our commitment. The data gathered through CCHAPS allows our community to: -Evaluate children's health needs within the region by reviewing measures of health status, as well as factors that influence health status. -Identify children's health priorities within our community. -Promote and support community collaborations that identify and implement solutions to specifically targeted children's health priorities. -Create and monitor community benchmarks to measure progress. Access to the children's health data provides a valuable community tool to support planning and fundraising efforts on behalf of children. Health status data can be used by community planning organizations to develop initiatives for action on children's issues, by foundations for determining funding priorities where children are affected and by faith-based organizations to focus outreach ministry efforts. The data is instrumental in helping to identify any disparities in children's healthcare. Cook Children's has identified a group of "top-line" children's health issues in its six-county service region which will be the focus of Cook Children's initial efforts to act on the data: abuse/neglect, accidental injury, access to healthcare, asthma, dental health, mental health and obesity. Asthma and obesity proved to be especially prevalent in the survey findings. As stewards of the data, which was gathered for the benefit of the community, Cook Children's wants to be sure the data is not only widely available, but also that additional resources accompany it for those individuals and organizations that want to put the information to use. Cook Children's will continue its in-depth analysis of the CCHAPS data to better understand and communicate children's health issues and potential solutions in our area. Cook Children's will focus its efforts over the next 10 years to realize our promise ... "to improve the health of every child in our region through the prevention and treatment of illness, disease and injury." CCHAPS offers the potential of regional collaboration on children's health issues. Cook Children's recognizes this and calls on the community to participate in a joint effort. The plan is to partner with the community and the various organizations that embrace children's health. Cook Children's wants to play the role in those efforts that is most appropriate for helping improve children's health - be that leader, partner, collaborator, follower or supporter. The hope is to join with many allies and partners in the quest to be one of the healthiest areas to raise a child in the coming decade. The goal of improving children's health can only become a reality if communities, collaborations and coalitions work together to use CCHAPS to set and achieve realistic, quantitative goals to improve children's health in areas of specific concerns or interest to that group. Cook Children's will continue to offer support as needed in efforts to research data, foster sharing information and build a solid enduring foundation that continues the work of improving the lives of children. A public Web site launched on January 15, 2010 that allows anyone direct access to the data from the Community-wide Children's Health Assessment and Planning Survey. www.cchaps.org deliberately places the data into the hands of each community where it can be best understood and used for planning actions. Cook Children's Health Care System employed three additional community outreach workers specifically assigned to counties to foster the use of the data and coordinate child health summits in each county. During 2010, the CCHAPS team presented data and information in each of the five-outlying counties to diverse members from each community. Each, daylong summit, co-hosted by one or more local community sponsors, foreshadowed individual strategic planning efforts at the local community level to improve the health of children in each community planned during 2011. The CCHAPS data continues to be a source of new information. In 2010, the team calculated the age and gender specific BMI percentiles and reported this new information in a "CCHAPS Special Report on Childhood Obesity" available on the Web site. To give strategic focus to community-planning efforts, a novel Ecosystem Model for Children's Health provides a way TO identify the relevant factors and interaction affecting each child health issue. A "think-tank" provided participants from a wide-range of backgrounds the opportunity to understand the complex systems and interactions involved in childhood asthma. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE English and Spanish versions of a one-page document explaining the charity care offered at Cook Children's are posted in each of the patient registration areas, the Emergency Room, night clinic, and Medical Office Building. This document includes information on the following: 1)how one might qualify for financial assistance 2)explains qualification is determined by family size and income, and 3)guides families to contact the Patient Accounting department to apply for financial assistance. In all areas of Patient Registration, registration clerks offer a Medicaid application to all self pay registrations. Patient Registration staff will assist the family with the application for Medicaid, and then Charity if Medicaid is denied. Patient Representatives and Case Management personnel also direct families to the Patient Registration staff when they need financial assistance. COMMUNITY INFORMATION The Medical Center provides primary, secondary, tertiary, and quaternary levels of pediatric care in Tarrant and contiguous counties and appropriate specialty care regionally throughout Texas. The Medical Center defines its 132-county service area into the major markets listed below: Six-County Area: The Six-County Area consists of Denton, Hood, Johnson, Parker, Tarrant, and Wise Counties. In 2010, the population of the Six-County Area was reported to be 2,820,112, approximately 23% of which are ages 0 to 14. Within the six counties, Tarrant County serves as Cook Children's Primary Service Area (PSA) generating approximately 75% of the Medical Center's inpatients each year. Referral Market: The Outlying Referral Markets stretch northwest from the panhandle, southward through Midland/Odessa into central Texas and the Killeen-Temple area, east to Tyler and due north to the Oklahoma/Texas border (126-COUNTIES TO THE SOUTH AND WEST OF THE DFW METROPLEX). For fiscal year 2010, 2,517 inpatient discharges originateD from this area. Regional outpatient pediatric specialty clinics are staffed in several locations in this area with multi-specialty clinics located in Abilene, Brownwood, Midland/Odessa, San Angelo and Waco. Other Markets: As a result of aggressive and targeted marketing, new volume comes from Other Markets outside the Referral Markets (OUTSIDE OF THE TRADITIONAL 132-COUNTIES AND INCLUDES OUT OF STATE PATIENTS). Some larger markets with tertiary, commercial referral potential (Houston, San Antonio, etc.) are marketed for referral volume, particularly quaternary care. Patient volume from these areas is significantly smaller than from the Six-County Area and Referral Markets due to the presence of other children's hospitals. The hospitals that serve the pediatric population and compete with the Medical Center for market share differ for each of the markets. PROMOTION OF COMMUNITY HEALTH: Cook Children's maintains an open medical staff and the governing bodies of the various companies are made up (unless constrained by the Texas Medical Practice Act) of voluntary community members along with physicians. The organization cares for all children regardless of their ability to pay and proactively seeks to enroll all eligible children into appropriate programs to improve access to care. AFFILIATED HEALTH CARE SYSTEM ROLES Cook Children's also operates five Neighborhood Clinics providing primary care to underserved populations around the city's perimeter and inner city to help assure care is provided in the most appropriate setting. Both preventive and therapeutic dental health care are provided to underserved populations. Mental and behavioral health is provided in both inpatient and outpatients settings subsidized by Cook Children's. Cook Children's Health Plan is a contracted intermediary for Medicaid Managed Care and sCHIP, providing an open provider panel for all eligible children in the six-county primary service area. Cook Children's offers pediatric specific home care to assure care is provided in the most appropriate and lowest cost setting. ALL STATES WHICH ORGANIZATION FILES A COMMUNITY BENEFIT REPORT TX COMMUNITY BUILDING ACTIVITIES PART II PHYSICAL IMPROVEMENTS AND HOUSING: COOK CHILDREN'S IS LOCATED IN THE NEAR SOUTH SIDE OF FORT WORTH WHICH INCLUDES THE MEDICAL DISTRICT AS WELL AS A DIVERSE MIX OF RESIDENTIAL NEIGHBORHOODS. TO ADDRESS NEIGHBORHOOD IMPROVEMENT NEEDS, COOK CHILDREN'S IS A MEMBER OF FORT WORTH SOUTH, INC., A NONPROFIT ORGANIZATION THAT PARTNERS WITH THE CITY OF FORT WORTH AND OTHER COMMUNITY ORGANIZATIONS TO ADVANCE EDUCATIONAL INITIATIVES, PUBLIC POLICIES, AND COMMUNITY PROGRAMS THAT FOSTER A REVITALIZED AND SAFE CENTRAL CITY. STRATEGIC PLANNING HAS RESULTED IN IMPROVED SECURITY, CODE ENFORCEMENT, AND TRANSPORTATION FOR RESIDENTS AND EMPLOYEES WHO WORK IN THIS AREA. COMMUNITY SUPPORT: MORE THAN 24 COOK CHILDREN'S EMPLOYEES PARTICIPATE AT A NEARBY ELEMENTARY SCHOOL AS MENTORS THROUGH THE JUNIOR ACHIEVEMENT PROGRAM. THESE EMPLOYEES SPENT 120 HOURS DURING WORK TIME TEACHING CLASSES TO HELP INSPIRE THE STUDENTS TO "DREAM BIG AND REACH THEIR POTENTIAL. THE EXPERIENTIAL PROGRAM DEVELOPS AND STRENGTHENS THE YOUTHS' ASSETS AS THE STUDENTS LEARN KEY CONCEPTS RELATED TO WORK READINESS, ENTREPRENEURSHIP, AND FINANCIAL LITERACY. COALITION BUILDING: COOK CHILDREN'S IS A CO-FOUNDING MEMBER OF THE INFANT MORTALITY NETWORK ORGANIZED TO ADDRESS THE HIGH RATES OF INFANT MORTALITY IN THE COUNTY. THE CURRENT CO-CHAIR OF THE NETWORK IS A NURSING DIRECTOR AT COOK CHILDREN'S. THE NETWORK HAS RAISED COMMUNITY AWARENESS OF THE PROBLEM AND WORKED WITH LEGISLATORS TO CREATE PUBLIC POLICY TO HELP ADDRESS THE PROBLEM. COOK CHILDREN'S IS ALSO AN ACTIVE MEMBER OF THE HEALTHY TARRANT COUNTY COLLABORATION - A HEALTH PROMOTION NETWORK OF NON-PROFIT HOSPITALS, PUBLIC HEALTH AND LOCAL UNIVERSITIES. THE COLLABORATION EFFORTS INCLUDE HEALTH EDUCATION AT A SUMMER CAMP FOR UNDERSERVED CHILDREN. THE CURRENT VICE-CHAIR OF THE INTELLECTUAL AND DEVELOPMENTAL DISABILITIES NEEDS COUNCIL OF TARRANT COUNTY IS A DIRECTOR OF PSYCHIATRIC SERVICES AT COOK CHILDREN'S. COMMUNITY HEALTH IMPROVEMENT ADVOCACY: ADVOCACY EFFORTS BY COOK CHILDREN'S ARE ENHANCED THROUGH MEMBERSHIP IN VARIOUS LOCAL, STATE, AND NATIONAL ORGANIZATIONS. ASSESSMENT OF COMMUNITY NEEDS, ACCESS TO HEALTH CARE AND INSURANCE FOR UNDERSERVED POPULATIONS AND ADVOCACY ON SPECIFIC HEALTH ISSUES SUCH AS CHILD ABUSE AND NEGLECT AND PREVENTABLE INJURIES ARE AMONG THE ISSUES ADDRESSED. WORKFORCE DEVELOPMENT: COOK CHILDREN'S HAS REPRESENTATION ON ADVISORY BOARDS AT LOCAL UNIVERSITIES AND COLLEGES TO PROVIDE GUIDANCE IN SPECIFIC AREAS OF STUDY. FACILITY INFORMATION SCHEDULE H, PART V, SECTION B THE ORGANIZATION HAS ELECTED NOT TO COMPLETE THE OPTIONAL SCHEDULE H, PART V, SECTION B FOR THE 2010 TAX YEAR FORM 990. true COOK CHILDREN'S PHYSICIAN NETWORK 801 SEVENTH AVENUE FORT WORTH TX 76104 752485366 501(C)(3) 42661100 subsidize operations AMERICAN HEART ASSOCIATION 2630 W FREEWAY 250 FORT WORTH TX 76104 135613797 501(C)(3) 70000 SPONSOR CAREITY FOUNDATION PO BOX 126038 FORT WORTH TX 76126 061704800 501(C)(3) 15000 SPONSOR ARTS COUNCIL OF NE- ARTS LEAGUE 2819 R D HURT PKY BEDFORD TX 76126 751586473 501(C)(3) 7000 SPONSOR 4 MEDICATIONS 216 31053 TRANSPORTATION 343 16505 RENT/MORTGAGE 22 12356 UTILITIES 14 5386 OTHER 66 6352 MEAL TICKETS 103 2040 PROCEDURES FOR MONITORING THE USE OF THE GRANT FUNDS IN THE US SCHEDULE I PART I QUESTION 2 THE ORGANIZATION USES PUBLIC AND PRIVATE DATA TO MONITOR THE USE OF FUNDS, AS NEEDED. X X X X X X true true false false false false false false false NANCY C CYCHOL 359887 0 151549 0 103869 0 18375 0 8303 0 641983 0 0 0 STANLEY E DAVIS 165450 0 47936 0 1744 0 8955 0 17430 0 241515 0 0 0 RICHARD P GOODE 170675 177643 54258 56473 47205 49130 6464 6729 8718 9074 287320 299049 0 0 RICK W MERRILL 186794 480325 106301 273346 51744 133057 39704 102096 4008 10307 388551 999131 36960 95040 GEORGE B MONTAGUE 0 202686 0 57069 0 18948 0 15313 0 11581 0 305597 0 0 PAULA J WEBB 207686 0 53802 0 3125 0 12513 0 7939 0 285065 0 0 0 TERESA J CLARK 151109 0 21291 0 10167 0 8451 0 5976 0 196994 0 0 0 KEVIN L DAHLE 172098 0 0 0 11111 0 10681 0 14046 0 207936 0 0 0 EDWIN VIRGIL EASON 150345 0 0 0 20347 0 11158 0 13762 0 195612 0 0 0 MIKE SMITH 163768 0 0 0 19859 0 12408 0 7198 0 203233 0 0 0 GRETCHEN EAMES MD 0 295000 0 0 0 1710 0 12156 0 0 0 308866 0 0 JOANN M SANDERS MD 0 283921 0 59286 0 3334 0 18375 0 12326 0 377242 0 0 DONALD K MURPHEY MD 0 275504 0 20000 0 1900 0 18375 0 14086 0 329865 0 0 ANGEL W HERNANDEZ-MULERO MD 0 495632 0 0 0 17218 0 15313 0 20636 0 548799 0 0 JANELL P MASON-BRISCOE 166210 0 0 0 1541 0 6679 0 4517 0 178947 0 0 0 DONALD K FAISON 133898 0 18333 0 16545 0 12812 0 7490 0 189078 0 0 0 MARY L HICKS 166167 0 0 0 1749 0 12136 0 4939 0 184991 0 0 0 PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J PART I QUESTION 4B RICK W. MERRILL PARTICIPATES, BUT RECEIVED 0 PAYMENT DURING CALENDAR YEAR 2010. 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 AFOREMENTIONED COMPANIES. AS A RESULT, THEIR SALARIES ARE ALLOCATED PRO-RATA, BASED ON THE AMOUNT OF TIME THEY SPEND WITH EACH COMPANY. SEVERANCE PAYMENTS RECEIVED FROM ORGANIZATION SCHEDULE J PART I QUESTION 4A WILLIAM H. CRAIG RECEIVED A SEVERANCE PAYMENT OF $94,640 DURING CALENDAR YEAR 2010. TARRANT COUNTY HEALTH FACILITIES DEVELOPMENT CORP 751881060 875906MV8 2007-06-27 52156976 REFUNDING BONDS 2000 & 2005 false false false BELL COUNTY HEALTH FACILITIES DEVELOPMENT CORP 742218760 078027HW2 2007-06-27 17523594 REFUNDING BONDS ISSUED 7/19/2000 false false false TARRANT COUNTY HEALTH FACILITIES DEVELOPMENT CORP 751881060 875906NY1 2010-02-04 231948097 DEVELOPMENT, CONSTR, EQUIP COST false false false 0 0 52156976 0 0 50833752 672932 650292 0 0 0 0 2007 true false true true 0 0 17523594 0 0 17116642 229475 177477 0 0 0 0 2007 false true true true 0 0 232664094 0 0 0 2691188 0 0 187884787 0 42088119 2013 false false false true false false false false true 0.00000 0.00000 0.00000 true false false false false false 0.00000 0.00000 0.00000 true false true false false true 0.00260 0.00000 0.00260 true false false false false false false false false false false false false false true false false false false SOLE MEMBER 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 corporation; c. Approve any merger, acquisition, liquidation, winding up, termination or consolidation of the corporation; d. Approve the persons who are to be elected by the corporation to fill any vacancies on the board of trustees; e. Approve the sale, gift, or other disposition of all or substantially all of the property of the corporation; f. Approve the creation of, or investment in, any subsidiary entity; and g. Approve the removal of a member of the board of trustees. REVIEW PROCESS FOR FORM 990 FORM 990 PART VI, QUESTION 11 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 FORMS ARE PREPARED, THEY ARE REVIEWED BY COMPANY EXECUTIVES AND THEN PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW. IN ADDITION, THEY ARE PRESENTED TO THE BOARD AUDIT COMMITTEE FOR REVIEW. SUBSEQUENT TO AUDIT COMMITTEE REVIEW, THE FORMS ARE 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 committee approves compensation arrangements in advance, relying upon comparable market data relating to compensation, which is provided by Mercer & Associates (executive compensation) and Sullivan Cotter (physician compensation), both independent, nationally recognized compensation consultants. The committee documents the basis for its determinations, and requires the compensation consultants to update market data periodically, usually every two years, with interim reviews being conducted as needed. With regard to physician compensation, the 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 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. EXEMPT PURPOSE ACHIEVEMENTS CONTINUED 990 PART III QUESTION 4A (CONT.) With the culmination of a historic building initiative that began in 2009, the medical center is now licensed for 429 beds, making it one of the largest children's hospitals in the country. The 530,000 square foot expansion includes a conversion to a private layout for the hospital's 106 Neonatal Intensive Care unit rooms, more rooms in the HEMATOLOGY and Oncology unit and the Transitional Care and Rehabilitation Care units, two new helipads, a food court, a patient library and classrooms, a parent business center, an indoor/outdoor playground, and 1,300 additional parking spaces. This expansion has positioned Cook Children's to continue to provide the outstanding quality of care that is the cornerstone of its market dominance, in response to the challenges of an ever-growing population. The medical center offers advanced technological equipment, leading surgical techniques, rehabilitation facilities, and ancillary services designed to meet the special needs of children. Additionally, the campus boasts a professional and highly skilled staff of nurses, technologists, therapists, and other clinicians, as well as more than 500 physicians and dentists who provide primary, secondary, tertiary, and quaternary levels of pediatric care. Child Life staff, chaplains, teachers, social services coordinators, and translators help patients and families cope with the stressors that accompany a child's hospitalization. The medical center is home to Cook Children's Emergency Department and Urgent Care Center and the only EMS-designated pediatric trauma center in Tarrant County, Texas. More than 100,000 patients present to the Emergency Department and Urgent Care Center for treatment each year. Cook Children's Medical Center is supported by one of the nation's largest and award winning pediatric transport programs, which brings more than 2,200 children to the medical center annually, primarily for critical care. Services include ambulance, helicopter, and fixed-wing airplane transportation. During Hurricane Ike, in 2006, Cook Children's transport team helped to evacuate intensive care patients from a pediatric hospital in Corpus Christi, Texas. DELEGATION OF CONTROL OVER MANAGEMENT FORM 990 PART VI QUESTION 3 A MANAGEMENT COMPANY MANAGES THE DAY TO DAY OPERATIONS OF BOTH OF OUR JOINT VENTURES. WRITTEN CONFLICT OF INTEREST POLICY FORM 990 PART VI, QUESTION 12C Every year the Legal Department sends out a Form 990 questionnaire/Conflict of Interest Disclosure Statement to officers, directors, trustees and key employees. 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 are provided to the 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 entities 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 FORM 990, PART XI, LINE 5 TRANSFERS BETWEEN AFFILIATES ($184,662,972) AMORTIZATION OF BOND SWAP EFFECTIVENESS $ 262,714 INTEREST RATE SWAP ADJUSTMENT ($ 1,793,056) ---------------- TOTAL CHANGE IN NET ASSETS ($186,193,314) HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JAMES F. HERD, SR., MD TITLE:TRUSTEE HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MARSHA HILCHER TITLE:TRUSTEE-VICE CHAIRMAN HOURS:1 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:BONNIE PETSCHE TITLE:TRUSTEE HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:PETER L. PHILPOT TITLE:TRUSTEE-CHAIRMAN HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:G. DOUGLAS TATUM, MD TITLE:TRUSTEE HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOHN P. BOSWELL TITLE:TRUSTEE HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JAMES R. DUNAWAY, JR. TITLE:TRUSTEE HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:GRETCHEN EAMES, MD TITLE:TRUSTEE HOURS:41 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOHN M. RICHARDSON, MD TITLE:TRUSTEE HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOANN M. SANDERS, MD TITLE:TRUSTEE HOURS:40 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:ANGEL W. HERNANDEZ-MULERO, MD TITLE:TRUSTEE HOURS:43 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:RICHARD P. GOODE TITLE:CHIEF FINANCIAL OFFICER HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:CARA MARTZ TITLE:SECRETARY HOURS:39 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:RICK W. MERRILL TITLE:CHIEF EXECUTIVE OFFICER HOURS:29 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:GEORGE B. MONTAGUE TITLE:VP, REAL ESTATE HOURS:38 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JANELL P. 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