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        <PersonNm>TIMOTHY MCCAVIT MD</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>MATTHEW DZURIK MD</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
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        <ReportableCompFromOrgAmt>1008083</ReportableCompFromOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>RICK W MERRILL</PersonNm>
        <TitleTxt>CEO</TitleTxt>
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        <ReportableCompFromRltdOrgAmt>2821562</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>ROBERT GOODWILL</PersonNm>
        <TitleTxt>SVP, COO</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>SHERI KANTNER</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>STEPHEN W KIMMEL</PersonNm>
        <TitleTxt>EVP, SYSTEM FINANCE - TREASURER</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>ALMA TOLLEY</PersonNm>
        <TitleTxt>VP, PRIMARY &amp; SPEC SERVICES</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>ASHTEN FLEMING</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>CORWIN WARMINK MD</PersonNm>
        <TitleTxt>CHIEF CLINICAL OFFICER</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>KEVIN BRISCOE</PersonNm>
        <TitleTxt>VP, FINANCE</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>SHANNA WALKER</PersonNm>
        <TitleTxt>AVP, REVENUE CYCLE</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>TARA ALLEN</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>TERESA BAKER</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID LODWICK MD</PersonNm>
        <TitleTxt>PHYSICIAN, OP/C</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>ELDAD EREZ MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>JOHNNIE HONEYCUTT MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>KIRK PINTO MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>VINCENT TAM</PersonNm>
        <TitleTxt>MEDICAL DIRECTOR</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>MATTHEW CARROLL MD</PersonNm>
        <TitleTxt>FORMER VP, ASSOC CHIEF QUALITY OFFICER</TitleTxt>
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        <ReportableCompFromRltdOrgAmt>533542</ReportableCompFromRltdOrgAmt>
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      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>BRASFIELD &amp; GORRIE LLC</BusinessNameLine1Txt>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 11407</AddressLine1Txt>
            <CityNm>BIRMINGHAM</CityNm>
            <StateAbbreviationCd>AL</StateAbbreviationCd>
            <ZIPCd>352460351</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONSTRUCTION</ServicesDesc>
        <CompensationAmt>1651996</CompensationAmt>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>SKILES GROUP LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1810 N GREENVILLE AVE</AddressLine1Txt>
            <CityNm>RICHARDSON</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>75081</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONSTRUCTION</ServicesDesc>
        <CompensationAmt>1146015</CompensationAmt>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ROYER &amp; SCHUTTS INC</BusinessNameLine1Txt>
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        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>200 BAILEY AVE</AddressLine1Txt>
            <AddressLine2Txt>STE 300</AddressLine2Txt>
            <CityNm>FORT WORTH</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>76107</ZIPCd>
          </USAddress>
        </ContractorAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>MICHAEL WALKER CONSTRUCTION</BusinessNameLine1Txt>
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        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>14901 QUORUM DR</AddressLine1Txt>
            <AddressLine2Txt>STE 475</AddressLine2Txt>
            <CityNm>DALLAS</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>75254</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONSTRUCTION</ServicesDesc>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PRIM CONSTRUCTION</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>252 ROBERTS CUT OFF</AddressLine1Txt>
            <CityNm>FORT WORTH</CityNm>
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            <ZIPCd>76114</ZIPCd>
          </USAddress>
        </ContractorAddress>
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      <CntrctRcvdGreaterThan100KCnt>76</CntrctRcvdGreaterThan100KCnt>
      <RelatedOrganizationsAmt>135314273</RelatedOrganizationsAmt>
      <TotalContributionsAmt>135314273</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>NET PATIENT FEES</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>315073668</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>315073668</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>CONTRACTED FEES</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>7162971</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>7162971</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MANAGEMENT FEES</Desc>
        <BusinessCd>561000</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>93818981</RelatedOrExemptFuncIncomeAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>OTHER OPERATING INCOME</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>6695556</TotalRevenueColumnAmt>
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        <RealAmt>54461</RealAmt>
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        <ManagementAndGeneralAmt>24993623</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>1144853</ProgramServicesAmt>
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        <ManagementAndGeneralAmt>481407</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>730314</ProgramServicesAmt>
        <ManagementAndGeneralAmt>120571</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>247304</ProgramServicesAmt>
        <ManagementAndGeneralAmt>20881</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>397989</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2215</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>4251823</ProgramServicesAmt>
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        <ProgramServicesAmt>156911</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3591500</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>43688561</ProgramServicesAmt>
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        <ProgramServicesAmt>1173419</ProgramServicesAmt>
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        <Desc>COLLECTION EXPENSE</Desc>
        <TotalAmt>1176957</TotalAmt>
        <ProgramServicesAmt>1176957</ProgramServicesAmt>
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        <ProgramServicesAmt>350881</ProgramServicesAmt>
        <ManagementAndGeneralAmt>383</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>415184</ProgramServicesAmt>
        <ManagementAndGeneralAmt>96001</ManagementAndGeneralAmt>
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        <NontaxableBenefitsRltdOrgsAmt>31414</NontaxableBenefitsRltdOrgsAmt>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TARA ALLEN</PersonNm>
        <TitleTxt>AVP, PRIMARY/SPECIALTY SERVICES</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TERESA BAKER</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KEVIN BRISCOE</PersonNm>
        <TitleTxt>VP, FINANCE</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ASHTEN FLEMING</PersonNm>
        <TitleTxt>AVP, PRIMARY/SPEC SERVICES</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ALMA TOLLEY</PersonNm>
        <TitleTxt>VP, PRIMARY &amp; SPEC SERVICES</TitleTxt>
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        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SHANNA WALKER</PersonNm>
        <TitleTxt>AVP, REVENUE CYCLE</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <OtherCompensationFilingOrgAmt>11708</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>12347</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>24879</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
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        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CORWIN WARMINK MD</PersonNm>
        <TitleTxt>CHIEF CLINICAL OFFICER</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>85179</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>25660</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>795039</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ELDAD EREZ MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>2015021</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>29459</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>2097814</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JOHNNIE HONEYCUTT MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>1264703</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>46875</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>22837</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>1392387</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DAVID LODWICK MD</PersonNm>
        <TitleTxt>PHYSICIAN, OP/C</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>16105</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>13800</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
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        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KIRK PINTO MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>1443496</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <OtherCompensationFilingOrgAmt>27490</OtherCompensationFilingOrgAmt>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>1542749</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>VINCENT TAM</PersonNm>
        <TitleTxt>MEDICAL DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>2139788</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>32713</OtherCompensationFilingOrgAmt>
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        <DeferredCompensationFlngOrgAmt>1021250</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>3236965</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 1A FIRST-CLASS OR CHARTER TRAVEL</FormAndLineReferenceDesc>
        <ExplanationTxt>AIR TRAVEL FOR KIRK PINTO, MD, JEFF PUGACH, MD, DEBORAH SCHUTTE, MD, ALMA TOLLEY, TIMOTHY MCCAVIT, MD, TARA ALLEN, ROBERT GOODWILL, AND MATHEW DZURIK, MD WAS PROVIDED TO PROVIDE MEDICAL SERVICES IN THEIR CAPACITIES AS PHYSICIANS FOR COOK CHILDREN'S PHYSICIAN NETWORK AND/OR FOR COOK CHILDREN'S PHYSICIAN NETWORK RELATED BUSINESSES IN THEIR CAPACITIES AS SENIOR MANAGEMENT EXECUTIVES. THIS IS NOT INCLUDED IN THEIR W-2 TAXABLE COMPENSATION AS IT IS 100% BUSINESS RELATED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 1A TAX INDEMNIFICATION AND GROSS-UP PAYMENTS</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FOLLOWING INDIVIDUALS RECEIVED CME AND OTHER GROSS UP PAYMENTS IN THEIR W-2 AS TAXABLE WAGES: VINCENT TAM, ELDAD EREZ, DAVID LODWICK, KIRK PINTO, JOHNNIE HONEYCUTT, JEFF PUGACH, ERIN BRIDGEWATER, ANTHONY ANANI, DIANE ARNAOUT, DEBORAH SCHUTTE, CHRISTINA ATEEK, TIMOTHY MCCAVIT, FRANK MCGEHEE, ERIK TEMPLETON, KARA STARNES, JASON V. TERK, RANDA RAZZOUK, DAPHNE SHAW, BIANKA SORIA-OLMOS, HEATHER MILLER</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 1B WRITTEN POLICY REGARDING PAYMENT OR REIMBURSEMENT OF EXPENSES</FormAndLineReferenceDesc>
        <ExplanationTxt>THERE IS NO WRITTEN POLICY REGARDING PAYMENT OR REIMBURSEMENT OF TAX INDEMNIFICATION AND GROSS-UP PAYMENTS BECAUSE THE COMPANY DOES NOT GENERALLY ALLOW FOR GROSS-UP PAYMENTS EXCEPT IN SPECIFIC CIRCUMSTANCES AND THEN ONLY IF APPROVED BY SENIOR MANAGEMENT FOLLOWED BY REVIEW OF THE COMPANY'S COMPLIANCE AND LEGAL DEPARTMENTS. THESE TYPE OF REIMBURSEMENTS GENERALLY RELATE TO TAXES OWED BY INDIVIDUALS WHO RECEIVE NOMINAL INCENTIVE PAYMENTS FOR SERVICE AWARDS OR QUALITY IMPROVEMENT PROGRAMS, AND THE GROSS-UP PAYMENTS USUALLY ARE IMMATERIAL, $250 OR LESS. IN ADDITION TO THE GIFT CARD AND INCENTIVE BONUSES DESCRIBED ABOVE, THERE IS NO WRITTEN POLICY REGARDING PAYMENT OR REIMBURSEMENT OF TAX INDEMNIFICATION AND GROSS-UP PAYMENTS FOR CONTINUING MEDICAL EDUCATION ALLOWANCES PAID TO EMPLOYED PHYSICIANS OF COOK CHILDREN'S PHYSICIAN NETWORK. THESE TYPE OF EXPENSES ARE USUALLY HANDLED AS NON TAXABLE ACCOUNTABLE PLAN BUSINESS EXPENSES UNDER THE INTERNAL REVENUE CODE, BUT THE COMPANY HAS ELECTED TO TREAT THESE PAYMENTS AND THE GROSS-UP PAYMENTS AS TAXABLE INCOME TO THE AFFECTED INDIVIDUALS. THESE PAYMENTS ARE APPROVED IN ADVANCE BY SENIOR MANAGEMENT AND REVIEWED BY THE COMPANY'S COMPLIANCE AND LEGAL DEPARTMENTS. FURTHER, THESE EXPENSES ARE INCLUDED IN THE BENEFITS CALCULATION FOR SUCH PHYSICIANS WHICH ARE REVIEWED BY THE COMPANY'S COMPENSATION COMMITTEE TO VERIFY THAT SUCH PAYMENTS ARE PAID AT FAIR MARKET VALUE AND COMMERCIALLY REASONABLE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 3 ARRANGEMENT USED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION</FormAndLineReferenceDesc>
        <ExplanationTxt>METHODS USED BY CCHCS TO ESTABLISH COMPENSATION OF THE COMPANY'S PRESIDENT: COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT WRITTEN EMPLOYMENT CONTRACT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN</FormAndLineReferenceDesc>
        <ExplanationTxt>RICK W MERRILL - PAID BY SYSTEM - $366,668 DEFERRED, $0 W-2 STEPHEN W KIMMEL - PAID BY SYSTEM - $463,384 DEFERRED, $154,217 W-2 KEVIN BRISCOE - PAID BY CCPN - $36,841 DEFFERED, $0 W-2 MATTHEW DZURIK - PAID BY CCPN - $105,936 DEFERRED, $50,922 W-2 ROBERT C GOODWILL - PAID BY CCPN - $68,327 DEFERRED, $77,225 W-2 MATTHEW CARROLL - PAID BY SYSTEM - $49,386 DEFERRED, $0 W-2 ALMA TOLLEY - PAID BY CCPN - $31,829 DEFERRED, $0 W-2 CORWIN WARMINK - PAID BY CCPN - $61,738 DEFERRED, $0 W-2 VINCENT TAM - PAID BY CCPN - $995,375 DEFERRED, $0 W-2</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART II ALLOCATION OF CEO &amp; CFO SALARIES</FormAndLineReferenceDesc>
        <ExplanationTxt>SALARIES FOR THE CEO AND EVP, SYSTEM FINANCE ARE ALLOCATED PRO-RATA BASED ON THE AMOUNT OF TIME THEY SPEND WITH EACH OF THE FOLLOWING COMPANIES: COOK CHILDREN'S MEDICAL CENTER COOK CHILDREN'S HEALTH FOUNDATION COOK CHILDREN'S HOME HEALTH COOK CHILDREN'S HEALTH CARE SYSTEM COOK CHILDREN'S HEALTH PLAN COOK CHILDREN'S PHYSICIAN NETWORK COOK CHILDREN'S MEDICAL CENTER - PROSPER CHILD STUDY CENTER</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="24020961" softwareVersionNum="2024v5.1">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 4A PROGRAM SERVICE DESCRIPTION</FormAndLineReferenceDesc>
        <ExplanationTxt>THIRTY OF CCPN'S BOARD-CERTIFIED PEDIATRICIANS PROVIDE SERVICES IN NINE NEIGHBORHOOD HEALTH CENTERS (NHC), TWO OF WHICH OPENED THIS SUMMER 2025. ALL NHCS ARE LOCATED IN ECONOMICALLY DISADVANTAGED AREAS WITHIN TARRANT COUNTY. THE PROFESSIONAL STAFF OF THE NHCS ALSO INCLUDE TWO DENTISTS AND 16 ADVANCED PRACTICE PROVIDERS. THE NHCS PROVIDE PRIMARY CARE SERVICES AND SERVE AS MEDICAL HOMES PREDOMINANTLY FOR CHILDREN INSURED UNDER GOVERNMENT-FUNDED PROGRAMS SUCH AS THE CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP), MEDICAID AND MEDICAID MANAGED CARE PLANS. IN A FIRST-OF-ITS-KIND PRIVATE, PUBLIC PARTNERSHIP, COOK CHILDREN'S AND JPS HEALTH NETWORK ARE PROVIDING SERVICES AT THE LAS VEGAS TRAIL (LVT) NEIGHBORHOOD HEALTH CENTER. THE CENTER PROVIDES PEDIATRIC AND ADULT MEDICAL SERVICES, BEHAVIORAL HEALTH SERVICES AND SOCIAL SERVICES SUPPORT SUCH AS FOOD INSECURITY IN THE FORM OF FOOD PANTRY, COMMUNITY EDUCATION AND ONSITE JOB TRAINING. IN ADDITION TO NUMEROUS PROVIDER LOCATIONS IN TARRANT, DENTON, HOOD AND COLLIN COUNTIES, CCPN HAS INCREASED ACCESS TO PEDIATRIC SUBSPECIALTY CARE THROUGH OUTREACH IN WEST TEXAS WHERE SPECIALTY CARE IS LIMITED. EACH MONTH, NUMEROUS CCPN SPECIALTY PHYSICIANS AND SURGEONS TRAVEL TO SEVEN WEST TEXAS MARKETS THAT LACK THE FULL SPECTRUM OF PEDIATRIC SPECIALTY CARE TO SERVE PATIENTS CLOSE TO THEIR HOMES. THE NEED FOR THESE OUTREACH SERVICES IN UNDERSERVED MARKETS IS EXPECTED TO GROW AS THE PHYSICIAN SHORTAGE WORSENS OVER TIME. CCPN CONTINUES TO GROW ITS PRESENCE IN PLANO, FRISCO, MCKINNEY, ALLEN, AUBREY, CELINA, LEWISVILLE, LITTLE ELM AND PROSPER, WHICH HAS GROWN TO INCLUDE 18 PRIMARY CARE LOCATIONS AND 50 GENERAL PEDIATRICIANS. IN ADDITION, CCPN HAS APPROXIMATELY 60 PEDIATRIC SUBSPECIALISTS WORKING IN THE PROSPER MEDICAL OFFICE BUILDING AND AT COOK CHILDREN'S MEDICAL CENTER - PROSPER. SPECIALTY PROGRAMS IN OUR QUEST TO BE THE PREEMINENT PEDIATRIC HEALTHCARE SYSTEM, COOK CHILDREN'S IS COMMITTED TO TREATING MEDICALLY COMPLEX CHILDREN THROUGH OUR MULTIDISCIPLINARY CLINICS (MDCS). OUR MDCS, BRING TOGETHER MULTIPLE SPECIALTIES AND ANCILLARY PROFESSIONALS TO SERVE VARIOUS CONDITIONS SUCH AS PRADER-WILLI SYNDROME, DIGEORGE SYNDROME, GENETIC ONCOLOGY AND METABOLIC AND GENETIC BONE HEALTH. THE MDCS MEET THROUGHOUT THE YEAR TO PROVIDE A SYNERGISTIC OPPORTUNITY FOR PATIENTS TO SEE MULTIPLE PROVIDERS AND ANCILLARY PROFESSIONALS IN A SPACE DESIGNED FOR THIS PURPOSE WITHIN ONE COORDINATED VISIT. THIS APPROACH HAS PROVEN TO IMPROVE PATIENT OUTCOMES, ENHANCE THE FAMILY AND TEAM EXPERIENCE, AND DECREASE THE TRAVEL BURDEN FOR OUR FAMILIES. CCPN CLINICIANS HAVE ALSO IMPLEMENTED PROGRAMS FOR SPECIFIC PATIENT POPULATIONS DESIGNED TO DELIVER THE RIGHT CARE AT THE RIGHT TIME IN A PATIENT'S LIFETIME. EXAMPLES OF THESE PROGRAMS INCLUDE COMPLEX CARE CLINIC, ADULT CONGENITAL HEART DISEASE PROGRAM, AND HIGH-RISK ASTHMA CLINIC. OUR COMPLEX CARE CLINIC IS LED BY A PRIMARY CARE PHYSICIAN AND A DEDICATED GROUP OF ANCILLARY PROFESSIONALS, SERVING PATIENTS 5 DAYS A WEEK THROUGHOUT THE YEAR. THE COMPLEX CARE CLINIC SERVES CHILDREN WHO HAVE ONE OR MORE CHRONIC CONDITION THAT TOGETHER AFFECT THREE OR MORE ORGAN SYSTEMS, SEVERELY REDUCING COGNITIVE/PHYSICAL FUNCTIONING AND REQUIRES THE USE OF MEDICATION, DURABLE MEDICAL EQUIPMENT (DME), THERAPY, SURGERY OR OTHER TREATMENTS OR ONE LIFE-THREATENING ILLNESS OR RARE PEDIATRIC DISEASE. OUR GOAL IS TO ASSIST THE PATIENT'S PRIMARY CARE PHYSICIAN IN COORDINATING CARE, AS WELL AS PROVIDING A MEDICAL HOME, THEREBY DECREASING EMERGENCY ROOM VISITS AND PROVIDING CONVENIENT SUPPORTIVE CARE. THE ADULT CONGENITAL HEART DISEASE PROGRAM AT COOK CHILDREN'S MEDICAL CENTER BECAME AN ACHA ACCREDITED COMPREHENSIVE CARE CENTER IN NOVEMBER 2025. THE ACHA ACCREDITATION PROGRAM IS ENDORSED BY THE AMERICAN ACADEMY OF PEDIATRICS, AMERICAN COLLEGE OF CARDIOLOGY AND THE AMERICAN HEART ASSOCIATION AMONG OTHERS. THE ACCREDITATION FROM THE ADULT CONGENITAL HEART ASSOCIATION (ACHA) PUTS COOK CHILDREN'S IN THE TOP TIER OF PROGRAMS ACROSS THE COUNTRY. CRITERIA INCLUDE PERSONNEL REQUIREMENTS, SPECIALIZED EQUIPMENT, SPECIFIC MEDICAL SERVICES AND THE POLICIES AND PROCEDURES THAT ENSURE THE HIGHEST LEVEL OF CARE. THE ACHA SEAL OF APPROVAL GIVES PATIENTS THE PEACE OF MIND THEY'RE RECEIVING THE BEST CARE POSSIBLE FROM LEADING EXPERTS IN THE FIELD. IN ADDITION TO OUTPATIENT VISITS, THE ACHD PROGRAM PROVIDED A TOTAL OF 247 INPATIENT CONSULTS/FOLLOW-UP VISITS BETWEEN COOK CHILDREN'S MEDICAL CENTER AND LOCAL ADULT FACILITIES (THR HARRIS FORT WORTH AND BAYLOR ALL SAINTS). THE ACHD TEAM CONTINUES TO SUPPORT THE CARDIOTHORACIC SURGERY TEAM WITH POST-OPERATIVE PATIENT CARE AT THR HARRIS AS PART OF A COLLABORATIVE APPROACH TO THE CARE OF ACHD PATIENTS. THIS CONTINUES TO BE A FOCUS WITHIN THE PROGRAM AS THE NEED FOR INPATIENT CARE INCREASES. OUR HIGH-RISK ASTHMA CLINIC COMPREHENSIVELY ADDRESSES THE HIGH-RISK ASTHMA POPULATION, RESULTING IN REDUCED ASTHMA-RELATED HOSPITALIZATIONS AND IMPROVED PATIENT OUTCOMES. THE CLINIC OFFERS ONE-ON-ONE PHYSICIAN SUPPORT WITH PERSONALIZED TREATMENT PLANNING, EDUCATION AND SELF-MANAGEMENT TRAINING AND COMMUNITY EDUCATION AND TRAINING FOR EDUCATORS AND COACHES IN SCHOOLS TO BETTER MANAGE ASTHMA IN CHILDREN. THIS CENTER OF EXCELLENCE FOR ASTHMA MANAGEMENT HAS ENHANCED EMERGENCY DEPARTMENT AND INPATIENT ASTHMA PATHWAYS TO ENSURE PROVIDERS DELIVER EVIDENCE-BASED MEDICINE TO EVERY PATIENT WITH ASTHMA. IT HAS CREATED SYSTEM-WIDE ASTHMA EDUCATION PROGRAMING FOR PATIENTS AND FAMILIES EXTENDING FROM INPATIENT SERVICES IN BOTH FORT WORTH AND PROSPER TO URGENT CARE AND OUTPATIENT SERVICES. ASTHMA EDUCATION INCLUDES ONLINE RESOURCES WITH HELPFUL LINKS AND VIDEOS FOR FAMILIES TO LEARN AT THEIR OWN PACE AS WELL AS ONE-ON-ONE ASTHMA EDUCATION WITH CERTIFIED ASTHMA EDUCATORS. A LIBRARY OF ASTHMA RESOURCES IS AVAILABLE FOR PHYSICIANS, PROVIDERS, NURSES, PHARMACISTS, AND RTS TO STAY UP TO DATE ON STANDARD OF CARE FOR ASTHMA TREATMENT. IN ADDITION, THE NELSON KU PROJECT (SCHOOL PROGRAM) AND ASTHMA 411 PROVIDES ASTHMA EDUCATION FOR TEACHERS, COACHES, AND SCHOOL NURSES. SCHOOL ASTHMA PATHWAY TO GUIDE ASTHMA TREATMENT AT SCHOOL INCLUDES PROCESSES FOR INFORMING PARENTS OF ASTHMA TREATMENTS THAT WERE ADMINISTERED AT SCHOOL AND HOW TO ESCALATE CARE IN EMERGENCIES. IN AN EFFORT TO EXPAND ACCESS TO BEHAVIORAL HEALTH SERVICES ACROSS OUR COMMUNITIES, CCPN OFFERS REACH TRAINING TO OUR NETWORK OF PEDIATRICIANS. THE TRAINING HAS BEEN COMPLETED BY 120 PEDIATRICIANS AND HELPS THEM MANAGE THE MOST COMMON MENTAL HEALTH CONDITIONS THEY SEE IN THEIR PRACTICES, SAVING REFERRALS TO BEHAVIORAL HEALTH SPECIALISTS FOR THE MORE COMPLEX CASES. CCPN PRIMARY CARE IS ALSO PILOTING AN INTEGRATED BEHAVIORAL HEALTH MODEL IN FIVE OF OUR PRIMARY CARE PRACTICES. THE PILOT INCLUDES AN EMBEDDED THERAPIST PROVIDING DIRECT THERAPY TO PATIENTS AT TWO LOCATIONS AND A BEHAVIORAL HEALTH COORDINATOR CONNECTING PATIENTS TO COMMUNITY THERAPISTS FOR CLOSED LOOP REFERRALS. IN 2025, THIS PILOT PROGRAM ASSISTED WITH OVER 700 REFERRALS, ENSURING PATIENTS ACCESS BEHAVIORAL HEALTH CARE BEFORE THEY ARE AT THE POINT OF CRISIS. PHYSICIAN WELLNESS PHYSICIAN BURNOUT REMAINS A GROWING PROBLEM. COVID-19 EXACERBATED THE PROBLEM BY PUTTING A SIGNIFICANT STRAIN ON PHYSICIAN PRACTICES AND MEDICAL PROVIDERS EVERYWHERE. SINCE THE PANDEMIC, HEALTH CARE'S TYPICAL SEASONALITY WHERE MONTHS OF HIGH DEMAND ARE FOLLOWED BY LULLS IS A THING OF THE PAST. THIS UNREMITTING TOIL WEARS ON PROVIDERS AND FURTHER WORSENS THE BURNOUT OF PHYSICIANS WITH POOR WORK/LIFE INTEGRATION. IN 2022, CCPN ESTABLISHED AN OFFICE OF PHYSICIAN WELL-BEING, STAFFED BY A GENERAL PEDIATRICIAN AND A PEDIATRIC SPECIALIST. THEIR ROLE IS TO FOSTER THE WELL-BEING OF PHYSICIANS, THROUGH SYSTEM-LEVEL INTERVENTIONS, ADDRESSING ACTIVITIES THAT CONTRIBUTE TO BURNOUT. IN 2025, COOK CHILDREN'S WAS AWARDED THE BRONZE LEVEL OF RECOGNITION FROM THE AMERICAN MEDICAL ASSOCIATION JOY IN MEDICINE HEALTH SYSTEM RECOGNITION PROGRAM BASED UPON THESE EFFORTS. WE CONTINUE TO STRIVE TOWARD HELPING OUR PHYSICIANS REMAIN CONNECTED TO THE JOY AND MEANING IN THEIR WORK.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 4A PROGRAM SERVICE DESCRIPTION - CONTINUED</FormAndLineReferenceDesc>
        <ExplanationTxt>IN THE SPOTLIGHT EACH YEAR, LOCAL PUBLICATIONS HIGHLIGHT THE REGION'S BEST PHYSICIANS AS CHOSEN BY THEIR PEERS. VOTES ARE TALLIED AND SORTED BY THE EDITORIAL STAFF, AND THE REMAINING VOTES ARE VETTED BY AN ANONYMOUS PANEL OF ESTEEMED DOCTORS. IN 2025, 24 OF CCPN'S PHYSICIANS WERE NAMED TO D MAGAZINE'S LIST OF BEST DOCTORS AND PEDIATRIC SPECIALISTS. JOHN ROBERTSON, M.D., PULMONOLOGIST, WAS NAMED A FINALIST FOR THE "OUTSTANDING HEALTHCARE INNOVATOR" AWARD IN THE D CEO 2025 EXCELLENCE IN HEALTHCARE AWARDS - ACKNOWLEDGING LEADERSHIP AND INNOVATION IN HEALTH CARE DELIVERY. THIS ACHIEVEMENT, OUT OF 150 NOMINATIONS, SPEAKS VOLUMES ABOUT THE INNOVATIVE, PATIENT-FIRST APPROACH THAT IS THE CORE OF COOK CHILDREN'S. FACULTY DEVELOPMENT COOK CHILDREN'S IN OCTOBER 2024 CREATED A NEW ROLE OF CCPN VICE PRESIDENT OF FACULTY DEVELOPMENT. M. SCOTT PERRY, M.D., WHO SERVES AS MEDICAL DIRECTOR OF THE JANE AND JOHN JUSTIN INSTITUTE FOR MIND HEALTH AT COOK CHILDREN'S, BECAME THE FIRST TO HOLD THE TITLE. THE ROLE PROVIDES GUIDANCE FOR PHYSICIANS IN MEDICAL EDUCATION, AS WELL AS SUPPORT FOR STRATEGIC AND VISIONARY PLANNING AND PROPOSALS. IN ADDITION, DR. PERRY OVERSEES THE ENDOWED CHAIR PROGRAM, WHICH RECOGNIZES PHYSICIANS WHOSE GROUNDBREAKING INNOVATIONS ADVANCE PEDIATRIC CARE AND ENHANCE COOK CHILDREN'S RESEARCH REPUTATION. A $10 MILLION ENDOWMENT FROM THE COOK CHILDREN'S HEALTH FOUNDATION ESTABLISHED THE PROGRAM TO SUPPORT CLINICAL RESEARCH, TEACHING, PROGRAM DEVELOPMENT, PUBLICATIONS AND OTHER WORK. SIXTEEN PHYSICIANS HAVE RECEIVED AN ENDOWED CHAIR TO FURTHER ELEVATE THE REGIONAL, NATIONAL AND GLOBAL PROMINENCE OF THEIR MEDICAL EXPERTISE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, LINE 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS</FormAndLineReferenceDesc>
        <ExplanationTxt>VARIOUS TRUSTEES &amp; OFFICERS EMPLOYED OR SERVING BOARDS WITHIN THE SYSTEM - BUSINESS RELATIONSHIP</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS</FormAndLineReferenceDesc>
        <ExplanationTxt>COOK CHILDREN'S HEALTH CARE SYSTEM, A TEXAS NON-PROFIT CORPORATION, IS THE SOLE MEMBER OF THE ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, LINE 7A MEMBERS OR STOCKHOLDERS ELECTING MEMBERS OF GOVERNING BODY</FormAndLineReferenceDesc>
        <ExplanationTxt>AS THE SOLE MEMBER OF THE ORGANIZATION, COOK CHILDREN'S HEALTH CARE SYSTEM HAS THE ABSOLUTE RIGHT TO APPOINT OR APPROVE MEMBERSHIP ON THE BOARD OF DIRECTORS OF THE ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, LINE 7B DECISIONS REQUIRING APPROVAL BY MEMBERS OR STOCKHOLDERS</FormAndLineReferenceDesc>
        <ExplanationTxt>AS THE SOLE MEMBER OF THE ORGANIZATION, COOK CHILDREN'S HEALTH CARE SYSTEM HAS THE EXCLUSIVE AND RESERVED POWER TO DO ANY OF THE FOLLOWING: A. APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE ORGANIZATION AND THE LONG-RANGE FINANCIAL AND STRATEGIC PLANS FOR THE CORPORATION; B. APPROVE DEVIATIONS FROM ANNUAL OPERATING AND CAPITAL BUDGETS IN EXCESS OF SUCH LIMITS AS ESTABLISHED BY THE MEMBER; C. APPROVE THE PURCHASE OR ACQUISITION OF ANY PROPERTY, REAL, PERSONAL, OR MIXED, BY THE ORGANIZATION IN EXCESS OF SUCH LIMITS AS ESTABLISHED BY THE MEMBER; D. APPROVE THE SALE, GIFT OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OF THE ORGANIZATION; E. APPROVE THE MORTGAGE OR OTHER ENCUMBRANCE OF ANY PROPERTY, REAL, PERSONAL, OR MIXED, OF THE ORGANIZATION IN EXCESS OF SUCH LIMITS AS ESTABLISHED BY THE MEMBER; F. APPROVE THE ACQUISITION, LIQUIDATION, MERGER, WINDING UP, TERMINATION, OR CONSOLIDATION OF THE ORGANIZATION; G. APPROVE THE CREATION OF, OR INVESTMENT IN, ANY SUBSIDIARY ENTITY, JOINT VENTURE, ACCOUNTABLE CARE ORGANIZATION OR SIMILAR ENTITIES; H. APPROVE THE ADOPTION, AMENDMENT OR REPEAL OF THE CERTIFICATE OF FORMATION OF THE ORGANIZATION AND THESE BYLAWS; I. APPROVE INCURRING DEBT WHICH WOULD EXCEED SUCH LIMITS ESTABLISHED BY THE MEMBER; J. APPROVE THE SETTLEMENT OF CLAIMS AND LITIGATION OF THE ORGANIZATION; AND K. SUBSEQUENT TO THE ORGANIZING AND INCORPORATING PHYSICIAN'S SELECTION OF THE INITIAL BOARD OF DIRECTORS, APPROVE THE APPOINTMENT OR ELECTION OF DIRECTORS IN ACCORDANCE WITH SECTION 3.2 OF THE ORGANIZATION'S BYLAWS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, LINE 11B REVIEW OF FORM 990 BY GOVERNING BODY</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION ENGAGES AN OUTSIDE INDEPENDENT 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 AND COMMENT. IN ADDITION, IT IS PROVIDED TO THE COOK CHILDREN'S HEALTH CARE SYSTEM AUDIT COMMITTEE FOR REVIEW AND COMMENT. SUBSEQUENT TO THE BOARD AND AUDIT COMMITTEE REVIEW, THE FORM 990 IS FILED WITH THE INTERNAL REVENUE SERVICE AND MADE AVAILABLE TO THE PUBLIC FOR REVIEW.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, LINE 12C CONFLICT OF INTEREST POLICY</FormAndLineReferenceDesc>
        <ExplanationTxt>EVERY YEAR THE LEGAL DEPARTMENT OF THE COOK CHILDREN'S HEALTH CARE SYSTEM (SYSTEM) SENDS OUT A CONFLICT OF INTEREST DISCLOSURE STATEMENT TO OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES OF ALL SYSTEM COMPANIES, AS WELL AS CERTAIN OTHER EMPLOYEES, INCLUDING PHYSICIANS, WHO ARE DETERMINED TO BE EMPLOYED IN POSITIONS THAT MIGHT BE SUBJECT TO THE SYSTEM'S CONFLICT OF INTEREST POLICY. 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. A SUMMARY OF THE RESPONSES TO THE QUESTIONNAIRES AND FOLLOW-UP INFORMATION IS 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 THAT IS APPLICABLE TO 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 HOTLINE 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, WITH FURTHER REPORTING TO THE SYSTEM BOARD OF TRUSTEES AS APPROPRIATE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, LINE 15A PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL</FormAndLineReferenceDesc>
        <ExplanationTxt>COOK CHILDREN'S HEALTH CARE SYSTEM HAS ESTABLISHED A COMPENSATION COMMITTEE WITH OVERSIGHT OF THE CEO. THE COMPENSATION COMMITTEE APPROVES COMPENSATION ARRANGEMENTS IN ADVANCE, WHICH INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT COMMITTEE MEMBERS, USING COMPARABLE MARKET DATA RELATING TO COMPENSATION, WHICH IS PROVIDED BY SULLIVAN COTTER AND ASSOCIATES, INC. , WHICH IS AN INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE DOCUMENTS THE BASIS FOR ITS DETERMINATIONS FOLLOWING CONTEMPORANEOUS SUBSTANTIATION OF THE COMPENSATION COMMITTEE'S DELIBERATIONS AND DECISIONS. THE COMPENSATION COMMITTEE REQUIRES THE COMPENSATION CONSULTANT TO UPDATE MARKET DATA PERIODICALLY, USUALLY EVERY TWO YEARS, WITH INTERIM REVIEWS BEING CONDUCTED AS NEEDED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, LINE 15B PROCESS TO ESTABLISH COMPENSATION OF OTHER EMPLOYEES</FormAndLineReferenceDesc>
        <ExplanationTxt>COOK CHILDREN'S HEALTH CARE SYSTEM HAS ESTABLISHED A COMPENSATION COMMITTEE WITH OVERSIGHT OF EXECUTIVE AND PHYSICIAN COMPENSATION, WHICH INCLUDES THE ORGANIZATION'S CEO AND OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. THE COMPENSATION COMMITTEE APPROVES COMPENSATION ARRANGEMENTS IN ADVANCE, WHICH INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT COMMITTEE MEMBERS, USING COMPARABLE MARKET DATA RELATING TO COMPENSATION, WHICH IS PROVIDED BY SULLIVAN COTTER AND ASSOCIATES, INC. FOR EXECUTIVE COMPENSATION AND PHYSICIAN COMPENSATION, WHICH IS AN INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE DOCUMENTS THE BASIS FOR ITS DETERMINATIONS FOLLOWING CONTEMPORANEOUS SUBSTANTIATION OF THE COMPENSATION COMMITTEE'S DELIBERATIONS AND DECISIONS. 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 JONES DAY OF CHICAGO, ILLINOIS, TO ISSUE A REASONABLENESS OPINION COVERING THE PHYSICIAN COMPENSATION PLAN FOR COOK CHILDREN'S PHYSICIAN NETWORK.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, LINE 19 REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC</FormAndLineReferenceDesc>
        <ExplanationTxt>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 TEXAS SECRETARY OF STATE. 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.</ExplanationTxt>
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