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 752705881 COOK CHILDREN'S HEALTH CARE SYSTEM 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 RICK W MERRILL 801 SEVENTH AVE FORT WORTH TX 76104 95974993 false X WWW.COOKCHILDRENS.ORG X 1996 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. X 25 13 484 51 0 0 906905 1639175 84566527 89340108 6727104 324974 3000329 4670736 95200865 95974993 266650 297375 0 0 33428600 32112286 0 0 0 55868974 63047624 89564224 95457285 5636641 517708 444792606 76398015 26418834 26477289 418373772 49920726 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 76306144 247375 94010844 Cook Children's Health Care System is one of the country's leading, vertically integrated pediatric healthcare organizations that represents an award-winning, not-for-profit system of seamless healthcare designed exclusively for children. It is comprised of nine entities - the Medical Center, Physician Network, Home Health Company, Northeast Hospital, Pediatric Surgery Center, Health Plan, Indemnity Company, Health Care System Company and Health Foundation. CONTINUED ON SCHEDULE O 76306144 true true false true false false false false false true false false false false true false true false false true false false false false false false true true true false false false false true false false true false false false true false true true true false false true 130 0 true 484 true false true CJ false false false false false false false false false X 25 13 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 KIMBERLY D AARON MD 1.0 X 0 386877 23349 R JEFFREY ALEXANDER 2.0 X X 0 0 0 G THOMAS BOSWELL 1.0 X 0 0 0 MICHAEL J DEITCHMAN MD 1.0 X 0 276938 11026 JAMES R DUNAWAY JR 2.0 X X 0 0 0 RICHARD F GARVEY 1.0 X 0 0 0 RAFAEL G GARZA 2.0 X X 0 0 0 JAMES F HERD SR MD 1.0 X 0 0 0 NANCY KAY HOWARD 1.0 X 0 0 0 HOWARD M KELFER MD 2.0 X X 0 518629 34075 JEFFREY B KING 1.0 X 0 0 0 G MALCOLM LOUDEN 1.0 X 0 0 0 FRANK MCGEHEE MD 1.0 X 0 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X 278703 0 26894 FRANK J ROSSI 40.0 X 416525 0 31497 LARRY L TUBB 40.0 X 313084 0 25724 TRACY T WALLER 40.0 X 323879 0 17563 CORY RHOADES 40.0 X 181121 0 22676 THERESA ZAK MEADOWS 40.0 X 116646 0 13693 HARRY I SHUMAN 40.0 X 219340 0 14378 COLEMAN D SKINNER 40.0 X 156807 0 23200 ERIC H HUBLI 40.0 X 452582 0 24115 GREGORY K JIMERSON 40.0 X 210375 0 19981 JAMES D MARSHALL 40.0 X 538838 0 29246 JOANN M SANDERS MD 40.0 X 346541 0 30701 JOSEPH GALLAGHER 40.0 X 220122 0 20974 6394955 7320465 1012825 75 false true false DELOITTE CONSULTING LLP CONSULTING 2691719 UNITED MARKETING COMMUNICATIONS INC MARKETING 1763164 AETNA INC ADMIN SERVICES 1534801 BEACON PARTNERS INC CONSULTING 775903 SHARED TECHNOLOGIES REPAIR & MAINTENANCE 602289 28 1187524 451651 1639175 SHARED SERVICES 900099 79628517 79628517 HUMAN RESOURCES 900099 4874947 4874947 RENT 900099 2447252 2447252 COMMUNITY HEALTH OUTREACH 900099 1178859 1178859 ANSWERING SVC 900099 631627 631627 578906 578906 89340108 320474 320474 0 0 4500 4500 4500 4500 0 0 0 REBATES 900099 3543771 3543771 CONCIERGE 900099 584147 584147 LEGAL 900099 515618 515618 27200 27200 4670736 95974993 94010844 324974 247375 247375 50000 50000 0 0 5613981 565719 5048262 0 21306521 17554418 3752103 0 5191784 3836530 1355254 0 0 679471 341858 337613 311378 67063 244315 131000 131000 0 0 4143990 3177853 966137 3233919 231460 3002459 1138654 713426 425228 32992778 32992778 0 4709084 4709084 797913 601610 196303 0 210752 177093 33659 171893 2580 169313 0 5326544 5326544 809152 809152 MINOR EQUIPMENT 2379576 2361356 18220 0 PHYSICIAN REMUNERATIONS 3236350 343127 2893223 0 DUES & SUBSCRIPTIONS 926709 367313 559396 0 RECRUITMENT 922382 828864 93518 0 MAINTENANCE & REPAIR 370519 370519 0 0 555560 499422 56138 0 95457285 76306144 19151141 0 8400 8400 3514286 11730031 599682 409874 2500121 13823896 13444 14199 0 248651 59861528 13246929 40097098 46614599 385289538 0 12770037 3548365 444792606 76398015 26132089 26115833 286745 361456 26418834 26477289 X 418373772 49920726 418373772 49920726 444792606 76398015 X 517708 -368970754 X false true true X true true X X X false false false CC MED CENTER 752051646 03 true true true 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 131000 131000 95326285 95457285 1000000 250000 false 1000000 1000000 1000000 1000000 4000000 6000000 109914 311106 221049 131000 773069 250000 250000 250000 250000 1000000 1500000 14614839 14614839 15601328 4921673 10679655 2240638 1590172 650466 26901900 6401461 20500439 502823 333623 169200 46614599 0 0 95974993 95457285 517708 -481215 -481215 36493 97092960 1917967 1917967 95174993 800000 800000 95974993 97051967 1594682 1594682 95457285 95457285 SCHEDULE D, PART XII, LINE 2D OTHER CHANGE MANAGEMENT FEE REDUCTION $1,599,182 CCIC PREMIUM $318,785 ---------- $1,917,967 SCHEDULE D, PART XIII, LINE 2D OTHER CHANGE MANAGEMENT FEE REDUCTION $1,599,182 GAIN ON ASSET DISPOSITION (4,500) --------- $1,594,682 UNCERTAIN TAX POSITIONS UNDER FIN 48 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. SCHEDULE D, PART XI, LINE 8 OTHER CHANGES TO NET ASSETS CONTRIBUTION FROM HF RECORDED TO NET ASSETS (800,000) PREMIUM CREDIT 318,785 ---------- TOTAL (481,215) SCHEDULE D, PART XII, LINE 4B OTHER AMOUNT INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1 CONTRIBUTION FROM CCHF $800,000 Central America and the Caribbean Program Services INVESTMENT 5862412 5862412 5862412 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 3131 SANGUINET ST FORT WORTH TX 76107 752659610 501(C)(3) 45150 SPONSORSHIP MARCH OF DIMES 6815 MANHATTAN BLVD 102 FORT WORTH FORT WORTH TX 76120 131846366 501(C)(3) 25000 SPONSORSHIP GOODWILL INDUSTRIES OF FORT WORTH PO BOX 1408 FORT WORTH TX 76101 750868393 501(C)(3) 8000 SPONSORSHIP MAKE A WISH FOUNDATION OF TX 6655 DESEO IRVING TX 75039 751889666 501(C)(3) 10000 SPONSORSHIP EPILEPSY FOUNDATION OF TEXAS 3629 WOSLEY DR FORT WORTH TX 76133 520856660 501(C)(3) 11400 SPONSORSHIP WESTLAKE ACADEMY FOUNDATION 2600 OTTINGER RD WESTLAKE TX 76262 200033926 501(C)(3) 10000 SPONSORSHIP AMERICAN CANCER SOCIETY 2433 RIDGEPOINT DRIVE AUSTIN TX 78754 741185665 501(C)(3) 12500 SPONSORSHIP CJ WILSON CHILDREN'S CHARITIES 100 BALLPARK WAY STE 212 ARLINGTON TX 76011 271301635 501(C)(3) 12000 SPONSORSHIP DFW HOSPITAL COUNCIL 250 DECKER DR IRVING TX 75062 237004426 501(C)(3) 5500 SPONSORSHIP FORT WORTH OBGYN SOCIETY 1325 PENNSYLVANIA AVE SUITE 600 FORT WORTH TX 76101 752345400 501(C)(3) 6500 EDUCATIONAL GRANT HOPE WALK FOUNDATION 21515 RIDGETOP CIRCLE SUITE 260 STERLING VA 20165 273719584 501(C)(3) 10000 SPONSORSHIP SOUTHLAKE CHAMBER OF COMMERCE PO BOX 92611 SOUTHLAKE TX 76092 751919765 501(C)(3) 10000 SPONSORSHIP 13 SCHOLARSHIPS FOR INDIVIDUALS 10 50000 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 A MINIMUM OF ONE YEAR OF FULL TIME SERVICE 2)BE A FULL TIME STUDENT SEEKING THEIR FIRST DEGREE IN A BACCALAUREATE PROGRAM & 3)PURSUE A DEGREE APPLICABLE TO THE HEALTHCARE WORKFORCE. THE SCHOLARSHIP RECIPIENTS ARE SELECTED BY THE SCHOLARSHIP COMMITTEE. EVALUATION OF ALL APPLICANTS WILL FOCUS ON ACADEMIC ACHIEVEMENT AND ALIGNMENT WITH COOK CHILDREN'S VALUES. 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 0 276537 0 108630 0 1710 0 15313 0 8036 0 410226 0 0 MICHAEL J DEITCHMAN MD 0 275578 0 0 0 1360 0 0 0 11026 0 287964 0 0 HOWARD M KELFER MD 0 514165 0 0 0 4464 0 18375 0 15700 0 552704 0 0 FRANK MCGEHEE MD 0 572961 0 2000 0 8012 0 18375 0 12473 0 613821 0 0 JAMES P MILLER MD 0 884122 0 0 0 17742 0 18375 0 13136 0 933375 0 0 JASON V TERK MD 0 326781 0 0 0 1440 0 18375 0 10636 0 357232 0 0 PAUL S THORNTON MD 0 424215 0 6388 0 2036 0 15313 0 20636 0 468588 0 0 M SUZANNE WHITWORTH MD 0 146512 0 200 0 1244 0 9303 0 1742 0 159001 0 0 KEVIN D WYLIE DO 0 184767 0 38453 0 795 0 15970 0 14864 0 254849 0 0 LINDA S CHAPPELL 181861 0 56148 0 24983 0 18375 0 8997 0 290364 0 0 0 JAMES C CUNNINGHAM MD 399999 0 102971 0 15813 0 0 0 14533 0 533316 0 0 0 RICHARD P GOODE 87080 261238 27683 83048 24083 72253 3298 9895 4448 13344 146592 439778 0 0 TIMOTHY M HANNERS 188369 54804 6098 4900 4541 258712 0 BILLY R KENNEDY 261094 0 99751 0 67431 0 9800 0 17515 0 455591 0 0 0 DAVID F LANCASTER 153577 0 38626 0 11474 0 15575 0 13171 0 232423 0 0 0 JOHN W MCNEY 254505 0 89544 0 71390 0 18375 0 17869 0 451683 0 0 0 RICK W MERRILL 166779 500340 94912 284735 46201 138600 35450 106350 3579 10736 346921 1040761 33000 99000 GEORGE B MONTAGUE 202686 0 57069 0 18948 0 15313 0 11581 0 305597 0 0 0 FRANK J ROSSI 255819 0 85620 0 75086 0 18375 0 13122 0 448022 0 0 0 LARRY L TUBB 197880 0 64836 0 50368 0 18375 0 7349 0 338808 0 0 0 TRACY T WALLER 123113 0 53040 0 147726 0 7876 0 9687 0 341442 0 0 0 CORY RHOADES 169553 0 10000 0 1568 0 7239 0 15437 0 203797 0 0 0 ERIC H HUBLI 419072 0 15000 0 18510 0 9800 0 14315 0 476697 0 0 0 GREGORY K JIMERSON 167244 0 41402 0 1729 0 8527 0 11454 0 230356 0 0 0 JAMES D MARSHALL 456417 0 80411 0 2010 0 15313 0 13933 0 568084 0 0 0 JOANN M SANDERS MD 283921 0 59286 0 3334 0 18375 0 12326 0 377242 0 0 0 JOSEPH GALLAGHER 165470 0 49808 0 4844 0 10151 0 10823 0 241096 0 0 0 GRETCHEN EAMES MD 0 295000 0 0 0 1710 0 12156 0 0 0 308866 0 0 ANGEL W HERNANDEZ-MULERO MD 0 495632 0 0 0 17218 0 15313 0 20636 0 548799 0 0 SAMUEL E KLEINMAN MD 0 616269 0 0 0 2142 0 15313 0 13430 0 647154 0 0 DONALD K MURPHEY MD 0 275504 0 20000 0 1900 0 18375 0 14086 0 329865 0 0 DEBORAH A SCHUTTE MD 0 453054 0 0 0 1710 0 15313 0 11836 0 481913 0 0 HARRY I SHUMAN 219340 0 0 0 0 0 8512 0 5866 0 233718 0 0 0 COLEMAN D SKINNER 136417 0 18904 0 1486 0 8655 0 14545 0 180007 0 0 0 PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J PART I LINE 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. SEVERENCE PAYMENTS RECEIVED FROM ORGANIZATION SCHEDULE J PART I LINE 4A TRACY T. WALLER RECEIVED A SEVERANCE PAYMENT OF $131,258 DURING CALENDAR YEAR 2010. SEAN WYLIE SEE PART V 5000 SCHOLARSHIP JP MORGAN SEE PART V 169612 INVESTMENT MGMT FEES false GRANT OR ASSISTANCE BENEFITING INTERESTED PERSONS SCHEDULE L, PART III SEAN WYLIE IS THE SON OF KEVIN D. WYLIE, A BOARD MEMBER. RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION SCHEDULE L, PART IV JEFFREY B. KING, BOARD MEMBER, IS A MANAGING DIRECTOR FOR JP MORGAN. CASH 2011-09-30 369289538 BOOK VALUE 752051649 WI COOK FOUNDATION 801 SEVENTH AVE FORT WORTH TX 76104 501(C)(3) false false false false SALE, EXCHANGE, DISPOSITION, OR OTHER TRANSFER OF MORE THAN 25% ASSETS SCHEDULE N, PART II THE ORGANIZATION HAS COMPLETED SCHEDULE N, PART II FOR TRANSFERS OF MORE THAN 25% OF THE ORGANIZATION"S ASSETS. THE ORGANIZATION HAS TRANSFERRED ASSETS TO THE SYSTEM'S RELATED FOUNDATION FOR THE EFFICIENT MANAGEMENT OF THE INVESTMENT PORTFOLIO FOR THE AFFILIATED HEALTH CARE SYSTEM. PROGRAM SERVICE ACTIVITY CONTINUED FORM 990 PART III QUESTION 4A 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 more than half the state. With a population of over 6.7 million, the Dallas-Fort Worth-Arlington metro area is the nation's fastest growing region and in 2011, Tarrant County alone added over 21,000 people. Economic development projections indicate that by 2020, the population of Fort Worth will increase by 800,000 over 2005 levels. In fact, "All roads lead to Cook Children's," as its community extends outside Texas to the rest of the United States, beyond borders, and across the seas. Patients and their families often travel great distances when making Cook Children's their destination for the best possible pediatric care. Many of their stories are published in Cook Children's annual report. 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 4,468 employees commit to keep every day--to improve the health of every child in its region through the prevention and treatment of illness, disease, and injury. Cook Children's is a promise-driven organization and lives up to that pledge by combining the art of caring with strong, 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 reinvestment of hundreds of millions of dollars in community benefits. Cultivating and maintaining a pediatric care system based on this promise is at the core of all Cook Children's long and short-term business strategies. As such, rating agencies have cited Cook Children's market dominance in Tarrant County because of its successful expansion efforts, robust growth in revenue and liquidity, and stellar operating margins. The commitment and expertise of the system's trustees, physicians, and Cook Children's staff combined with its vast resources enable this institution to be recognized as sustainable and among the best for positive clinical outcomes. This is evidenced by its double-A bond rating and the growing and impressive list of awards and acknowledgments the system receives every year. Cook Children's records approximately one million patient encounters each year through its hospitals, specialty clinics, neighborhood clinics, physician offices, outpatient settings, and home care business. SOLE MEMBER FORM 990 PART VI, QUESTION 6 W.I. COOK FOUNDATION, INC., 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 W.I. COOK 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 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 OF THE 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 CONFILCT 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. CONFLICT OF INTEREST 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 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. THE AUDIT COMMITTEE IS ALSO RESPONSIBLE FOR OVERSIGHT OF THE COMPLIANCE DEPARTMENT OF COOK CHILDREN'S HEALTH CARE SYSTEM. ANY CORRECTIVE ACTION RELATED TO CONFLICTS OF INTEREST WOULD BE REPORTED TO THE AUDIT COMMITTEE FOR REVIEW, APPROVAL, AND MODIFICATION, AS NECESSARY. OTHER CHANGE PART XI, LINE 5 TRANSFER TO CCHF (369,289,538) RETROSPECTIVE PREMIUM CREDIT 318,785 ------------- TOTAL (368,970,753) 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-SECRETARY/TREASURER 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:MICHAEL J. DEITCHMAN, MD TITLE:TRUSTEE HOURS:42 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JAMES R. DUNAWAY, JR. TITLE:TRUSTEE-CHAIRMAN HOURS:5 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:3 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:NANCY KAY HOWARD TITLE:TRUSTEE HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:HOWARD M. KELFER, MD TITLE:TRUSTEE-VICE CHAIRMAN HOURS:41 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JEFFREY B. KING TITLE:TRUSTEE HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:G. MALCOLM LOUDEN TITLE:TRUSTEE HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:FRANK MCGEHEE, MD TITLE:TRUSTEE HOURS:41 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:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:PETER L. PHILPOT TITLE:TRUSTEE HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JASON V. TERK, MD TITLE:TRUSTEE HOURS:41 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:PAUL S. THORNTON, MD TITLE:TRUSTEE HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:GARY G. WALSH TITLE:TRUSTEE-CHAIRMAN HOURS:2 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:44 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KEVIN D. WYLIE, DO TITLE:TRUSTEE HOURS:42 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: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:SAMUEL E. KLEINMAN, 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: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:30 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 NA COOK CHILDREN'S PHYSICIAN NETWORK 801 SEVENTH AVE FORT WORTH TX 76104 752485366 PHYSICIAN SVC TX 501(C)(3) 3 NA WI COOK FOUNDATION 801 SEVENTH AVE FORT WORTH TX 76104 752051649 FUNDRAISING TX 501(C)(3) 11D NA COOK CHILDREN'S MEDICAL CENTER 801 SEVENTH AVE FORT WORTH TX 76104 752051646 HOSPITAL TX 501(C)(3) 3 NA COOK CHILDREN'S HOME HEALTH 801 SEVENTH AVE FORT WORTH TX 76104 752896983 HEALTHCARE TX 501(C)(3) 11C NA true true true false false false false false false false false false false false true true true true COOK CHILDREN'S HEALTH FOUNDATION C 1187524 COOK CHILDREN'S HEALTH FOUNDATION P 1170470 COOK CHILDREN'S HOME HEALTH A 180552 COOK CHILDREN'S HOME HEALTH P 3544927 COOK CHILDREN'S HEALTH PLAN A 207612 COOK CHILDREN'S HEALTH PLAN P 3144770 COOK CHILDREN'S MEDICAL CENTER B 943663 COOK CHILDREN'S MEDICAL CENTER P 123427979 COOK CHILDREN'S PHYSICIAN NETWORK A 1470288 COOK CHILDREN'S PHYSICIAN NETWORK B 486694 COOK CHILDREN'S PHYSICIAN NETWORK O 3258045 COOK CHILDREN'S PHYSICIAN NETWORK P 15138534