Form990
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Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
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OMB No. 1545-0047
2021
Open to Public Inspection
A For the 2021 calendar year, or tax year beginning 10-01-2021 , and ending 09-30-2022
BCheck if applicable:
CName of organization
Cook Children's Medical Center
 
% CORY RHOADES
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
801 Seventh Avenue
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Fort Worth, TX76104
D Employer identification number

75-2051646
E Telephone number

G Gross receipts $ 1,773,582,757
F Name and address of principal officer:
NANCY CYCHOL
801 SEVENTH AVENUE
FORT WORTH,TX76104
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.COOKCHILDRENS.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. See instructions.
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1985
M State of legal domicile: TX
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: KNOWING THAT EVERY CHILD'S LIFE IS SACRED OUR PROMISE IS TO IMPROVE THE HEALTH OF EVERY CHILD IN OUR REGION THROUGH THE PREVENTION AND TREATMENT OF ILLNESS, DISEASE and INjury.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 13
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 12
5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) ...... 5 5,478
6 Total number of volunteers (estimate if necessary) ............. 6 584
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 11,463
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 6,642
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 49,806,055 17,108,404
9 Program service revenue (Part VIII, line 2g) ......... 1,463,493,299 1,754,264,051
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 302,271 108,029
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 58,522 592,351
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 1,513,660,147 1,772,072,835
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 73,422,672 83,326,957
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 402,390,436 490,600,737
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 679,291,913 776,859,354
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,155,105,021 1,350,787,048
19 Revenue less expenses. Subtract line 18 from line 12....... 358,555,126 421,285,787
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,871,901,068 1,720,011,003
21 Total liabilities (Part X, line 26)............. 624,234,763 656,624,458
22 Net assets or fund balances. Subtract line 21 from line 20..... 1,247,666,305 1,063,386,545
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
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Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2021)
Form 990 (2021)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: KNOWING THAT EVERY CHILD'S LIFE IS SACRED, OUR PROMISE IS TO IMPROVE THE HEALTH OF EVERY CHILD IN OUR REGION THROUGH THE PREVENTION AND TREATMENT OF ILLNESS, DISEASE AND INJURY.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 929,689,482 including grants of $ 83,326,957 ) (Revenue $ 1,754,932,548 )
Cook Children's Medical Center is the cornerstone of Cook Children's Health Care System. This 444-bed facility is home to top medical minds, advanced technologies, family-centered treatments and leading-edge clinical research, all designed to fulfill the System's Promise to improve the health and well-being of every child. Nationally recognized services such as the Level IV Neonatal Intensive Care Unit, the Jane and John Justin Neurosciences Center and the hematology and oncology center are leading the way in providing the highest level of care to families who travel to the medical center from all across Texas and the United States, as well as internationally. From complicated surgeries and Level II trauma care to physical therapy and behavioral health services, the medical center offers a variety of services and amenities to meet the unique needs of every patient and family. It is one of only 10 freestanding children's hospitals in the world to achieve Magnet designation with three consecutive re-designations from the American Nursing Credentialing Center, most recently in February 2021. Viral Surge On the heels of the COVID-19 pandemic, the country experienced an unseasonal round of respiratory syncytial virus (RSV) followed by the return of influenza and other seasonal viruses that hit children hard and, subsequently, strained pediatric hospitals. The medical center had to be nimble, flexible and quick to adjust to each new viral surge. To reduce the spread of illness, Cook Children's maintained safety protocols put into place early in the pandemic, such as masking, limiting visitors and instituting work-from-home plans. The medical center released weekly RSV and flu numbers to the public and held press conferences with Cook Children's physicians. It also asked for the community's help in limiting the spread of illness, taking children to the appropriate provider based on their condition (e.g. pediatrician versus urgent care versus ER) and encouraged patience during long wait times in busy ERs and urgent care centers. Telehealth remains a critical resource for the hospital, especially during times of intense viral spread. In the early days of COVID-19, Cook Children's took steps to increase its bandwidth to support the explosive growth in virtual health visits. The year's virtual health visits totaled approximately 67,000 across all of Cook Children's Health Care System. Pandemic Inspires Improvement Out of the challenges of the pandemic emerged a stronger organization better equipped for the future. In early FY22, Cook Children's opened a new six-bed Infectious Disease Unit designed to treat the sickest patients while also protecting staff and the community from the spread of illness. It includes private patient rooms with private bathrooms, specialized air ventilation systems, dedicated areas for visitors and staff to put on and take off personal protective equipment and technology that allows technicians to closely monitor a patient without having to be directly by the patient's bedside. The expansion includes a 24-hour solutions center inspired by lessons learned from the pandemic. This center will operate year-round to serve as a one-stop shop for requesting assistance with a facility or operations issue at Cook Children's Health Care System. Raising Joy Cook Children's 2021 JOY campaign-an ongoing series of articles that addressed and educated readers on children's rising mental health care needs-grew to include a new podcast featuring honest conversations about the mental well-being of kids and teens. The Raising Joy Podcast premiered in March 2022, and aired a total of 35 episodes throughout the year. Topics covered everything from child trafficking to drug use to body image to parents sharing their personal experience losing a child to suicide. The podcast is hosted by Cook Children's senior vice president and chief communication, inclusion, diversity and equity officer, and Cook Children's medical director of psychiatry outpatient services and partial hospitalization program. Safety Saves Lives By April 2022, 17 children had been treated for drownings at Cook Children's since the start of the year. That includes three fatalities. This was an alarming increase in the number of drownings compared to January through May in the previous five years. In response, Cook Children's communications team, together with the Center for Children's Health, led by Cook Children's, ramped up its drowning prevention education efforts in tandem with its ongoing Lifeguard Your Child water safety program. Several articles about drowning prevention, the importance of swim lessons, proper fit of life vests and water safety resources were published to Cook Children's Checkup Newsroom and social media accounts. In May, the medical center erected a powerful display outside on its north lawn as a visual reminder to Lifeguard Your Child. Fifteen swimsuits and five rubber duckies hung on a clothesline, representing children who were treated for drowning injuries at the hospital since the beginning of 2022. Each swimsuit matched the age and gender of the swimming pool drowning patients treated up to that point in the year. The rubber duckies represented the five children who drowned in bathtubs. Cook Children's Aim for Safety program zeroed in on a new way to educate families on gun safety using an interactive kiosk that teaches children what to do if they discover a firearm in a home - all while reinforcing safe-storage techniques for adult gun owners. The mobile kiosk, which stands more than 7-feet high and resembles a giant smartphone, rolled out in December 2021 at Defender Outdoors, a sports shooting and outdoors equipment retailer in Fort Worth. As part of a first-time collaboration with Cook Children's, the kiosk was placed near the check-out registers in hopes it attracts the attention of parents and children alike. The Aim for Safety educational kiosk - activated by touch - uses advanced technology to engage and teach children as they progress through four levels, stumbling upon unsecured guns hidden in places such as cabinets and drawers while moving through a virtual home. If they find a gun, they must correctly answer questions on how to safely handle the situation in order to progress through the program. Other gun safety-related questions are asked as objects in the rooms are found and touched. The program emphasizes three steps: Safe Storage. Safe Children. Safe Play. New and Improved Cook Children's Medical Center announced its development of a clinical care model that brings together specialties for more seamless health care. The Jane and John Justin Institute for Mind Health will bring Cook Children's Jane and John Justin Neurosciences Center, Cook Children's Division of Behavioral Health and the Child Study Center under one collaborative roof to provide easily accessible, well-coordinated and comprehensive care for children with disorders affecting the nervous system. The Justin Institute will be located in the Dodson Specialty Building on the medical center campus and is slated to open Spring 2023. Exceeding Expectations Even while operating under the cloud of the pandemic and challenging viral seasons, CCMC continued to pursue quality, safety and communication. Patient experience scores exceeded the Children's Hospital Association (CHA) average, earning employees a performance bonus. Cook Children's was one of five children's hospitals from across the country selected to present its success in improving workplace safety at the 2022 Solutions for Patient Safety (SPS) Fall National Learning Conference. Over the past five years, with collaboration from SPS, Cook Children's has worked to reduce the number and severity of employee injuries in three focus areas-slips, trips and falls; patient behavior events; and overexertion injuries caused by handling patients, soiled linen and trash. At the conference, several Cook Children's executives, board members, leaders and clinical staff reported on the health system's journey to a safer and healthier workplace. In February 2022, Jill Koss, Cook Children's director of Family Support Services, was honored by Crown Council, an organization associated with Teammates for Kids, for her work championing Child Life Zones at Cook Children's and other hospitals throughout the country. At the recognition event, Koss was surprised with a recorded video message from Country music singer and songwriter Garth Brooks, who delivered an emotional thank you for Koss' tireless work advocating for interactive spaces designed to foster the creative arts for pediatric patients and siblings.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet929,689,482
Form 990 (2021)
Form 990 (2021)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Rev. Proc. 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
6
Yes
 
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D, Part IIIClick to see attachment..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X, as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D, Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XIIClick to see attachment......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I. See instructions. ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I .... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part IIClick to see attachment...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part IIIClick to see attachment.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................Click to see attachment
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
28b
Yes
 
c
A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? If "Yes," complete Schedule L, Part IV..................... Click to see attachment
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in box 3 of Form 1096. Enter -0- if not applicable ..
1a
147
b
Enter the number of Forms W-2G included on line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
5,478
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. See instructions.
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
No
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
No
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
No
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see the instructions and file Form 4720, Schedule N.
15
Yes
 
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
17
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2021)
Form 990 (2021)
Page 6
Part VI
Governance, Management, and Disclosure. For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
13
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
12
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
Yes
 
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe on Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe on Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process on Schedule O. See instructions.
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
TX
18
Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletCORY RHOADES801 SEVENTH AVENUE   FORT WORTH,TX76104 (682) 885-4000
Form 990 (2021)
Form 990 (2021)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See the instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (box 5 of Form W-2, Form 1099-MISC, and/or box 1 of Form 1099-NEC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See the instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) RICK W MERRILL......................................................................
Chief Executive Officer
 11.0
.................
29.0 		    X       674,193 1,733,639 255,556
(2) STEPHEN W KIMMEL......................................................................
EVP, SYS FINANCE
 16.0
.................
24.0 		    X       417,068 625,601 162,506
(3) James C Cunningham MD......................................................................
EVP, CMO
 1.0
.................
40.0 		    X       0 1,079,736 45,761
(4) Nancy C Cychol......................................................................
President/Chief Hospital Svcs
 40.0
.................
2.0 		    X       1,054,983 0 33,010
(5) JOSEPH M GALLAGHER......................................................................
SR. VP, CHIEF LEGAL OFFICER
 1.0
.................
41.0 		    X       0 748,085 137,524
(6) CORY R RHOADES......................................................................
CFO
 1.0
.................
43.0 		    X       0 740,482 133,681
(7) THERESA Z MEADOWS......................................................................
Sr. VP, Chief Info Officer
 1.0
.................
41.0 		    X       0 736,107 54,863
(8) STANLEY E DAVIS......................................................................
Sr. Vice President, COO
 40.0
.................
1.0 		    X       619,089 0 124,319
(9) CHERYL PETERSEN......................................................................
VP Nursing, CNO
 40.0
.................
0.0 		      X     428,381 0 94,077
(10) SPENCER D SEALS......................................................................
VP Construction & Real Estate
 1.0
.................
43.0 		    X       0 376,149 86,425
(11) JACK SOSEBEE......................................................................
Vice President
 40.0
.................
2.0 		      X     374,615 0 71,818
(12) ELIA VALENCIA-STOKES......................................................................
AVP Finance
 40.0
.................
0.0 		      X     325,574 0 46,358
(13) ORLANDO CHAPA......................................................................
AVP Nursing
 40.0
.................
0.0 		      X     297,273 0 38,829
(14) DEBORAH BOUDREAUX......................................................................
AVP Nursing
 40.0
.................
0.0 		      X     288,512 0 46,341
(15) TAMMY THOMLISON......................................................................
AVP Revenue
 40.0
.................
0.0 		      X     279,789 0 12,262
(16) OZIOMA OLOWU......................................................................
Director of Pharmacy
 40.0
.................
0.0 		        X   228,879 0 49,176
(17) Gary Munford......................................................................
Day/Wknd Administrator
 40.0
.................
0.0 		        X   221,591 0 36,776
Form 990 (2021)
Form 990 (2021)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) NICHOLAS MARKHAM........................................................................
AVP Facilities/Campus Svcs
 40.0
.......................0.0 		      X     206,073 0 37,508
(19) Tamara Sims........................................................................
RN, Staff
 40.0
.......................0.0 		        X   212,829 0 27,361
(20) KEVIN GREENE........................................................................
AVP NORTH CAMPUS
 40.0
.......................0.0 		      X     194,913 0 42,629
(21) Jessica Sibr........................................................................
Pharmacist
 40.0
.......................0.0 		        X   197,117 0 38,887
(22) MARGIE DORMAN-O'DONNELL........................................................................
Director, Case Management
 40.0
.......................0.0 		        X   205,673 0 26,220
(23) MARY CARA MARTZ........................................................................
Secretary
 1.0
.......................40.0 		    X       0 169,553 23,484
(24) Frank A Anderson........................................................................
Trustee
 1.0
.......................1.0 		X           0 0 0
(25) ANNE M CARVALHO........................................................................
Trustee
 1.0
.......................3.0 		X           0 0 0
(26) Judge Jeffrey L Cureton........................................................................
Trustee
 1.0
.......................3.0 		X           0 0 0
(27) RYAN B DICKERSON........................................................................
Trustee
 1.0
.......................2.0 		X           0 0 0
(28) WALLY JONES........................................................................
TRUSTEE START: 06/22
 1.0
.......................2.0 		X           0 0 0
(29) LEAH M KING........................................................................
Trustee - Secretary/Treasurer
 2.0
.......................2.0 		X   X       0 0 0
(30) MICHAEL A LAGATTA........................................................................
Trustee
 1.0
.......................1.0 		X           0 0 0
(31) JOSEPH LAMARCA JR........................................................................
Trustee End: 05/22
 1.0
.......................1.0 		X           0 0 0
(32) LAURA MILLER........................................................................
Trustee Start: 06/22
 1.0
.......................1.0 		X           0 0 0
(33) BONNIE PETSCHE........................................................................
Trustee
 1.0
.......................1.0 		X           0 0 0
(34) BILLIE R PUGH JR MD........................................................................
Trustee
 1.0
.......................2.0 		X           0 0 0
(35) ANDREW S WAYNE........................................................................
Trustee - Vice Chairman
 2.0
.......................2.0 		X   X       0 0 0
(36) JAMES E WEBB........................................................................
Trustee End: 05/22
 1.0
.......................5.0 		X           0 0 0
(37) ROBERT J BATTON........................................................................
Trustee
 1.0
.......................2.0 		X           0 0 0
(38) JOHN P BOSWELL........................................................................
Trustee - Chairman
 2.0
.......................3.0 		X   X       0 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 6,226,552 6,209,352 1,625,371
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet519
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
LINBECK GROUP LLC,
1263 W ROSEDALE STE 202
FORT WORTH,TX76104 		CONSTRUCTION 37,483,024
HKS INC,
PO BOX 731121
DALLAS,TX75373 		PROFESSIONAL SVCS 4,431,948
DYNAMIC SYSTEMS INC,
2315 EAST LOOP 820 NORTH
FORT WORTH,TX76118 		CONSTRUCTION 6,761,054
FISK ELECTRIC CO,
1617 W CROSBY RD 120
CARROLLTON,TX75006 		CONSTRUCTION 3,206,849
CURA REVENUE CYCLE MANAGEMENT,
2202 N WEST SHORE BLVD STE 200
TAMPA,FL33607 		COLLECTION SVCS 1,068,154
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet82
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 11,128,505
e Government grants (contributions)1e 5,979,899
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 17,108,404
Program Service RevenueAmt Business Code
2a Patient Services 621110 1,597,346,460 1,597,346,460    
b Other Operating Revenue 621110 140,123,885 140,123,885    
c Joint Venture Revenue 621110 16,782,243 16,782,243    
d LAB REFERRALS 621500 11,463   11,463  
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 1,754,264,051
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 17,502     17,502
4 Income from investment of tax-exempt bond proceedsMediumBullet 0      
5 Royalties...........MediumBullet 0      
(ii) Personal (i) Real
6a Gross rents   1,363,595 6a
b Less: rental expenses   1,451,204 6b
c Rental income or (loss) 0 -87,609 6c
d Net rental income or (loss).......MediumBullet -87,609     -87,609
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 149,245   7a
b Less: cost or other basis and sales expenses 58,718   7b
c Gain or (loss) 90,527   7c
d Net gain or (loss).........MediumBullet 90,527     90,527
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a 0
b Less: direct expenses ... 8b 0
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a 0
b Less: direct expenses ... 9b 0
c Net income or (loss) from gaming activities..MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances ..
10a 0
b Less: cost of goods sold .. 10b 0
c Net income or (loss) from sales of inventory..MediumBullet 0      
Business Code Miscellaneous Revenue
11a CCIC Retro Premium 900099 679,960 679,960    
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 679,960
12 Total revenue. See instructions.....MediumBullet 1,772,072,835 1,754,932,548 11,463 20,420
Form 990 (2021)
Form 990 (2021)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 82,691,540 82,691,540
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 635,417 635,417
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. ............. 0  
4 Benefits paid to or for members ....... 0  
5 Compensation of current officers, directors, trustees, and key employees ........... 6,353,542 1,475,993 4,877,549  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ......... 91,990 91,990    
7 Other salaries and wages........ 366,801,380 337,900,095 28,901,285  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 17,730,798 16,286,776 1,444,022  
9 Other employee benefits ....... 72,603,907 67,559,724 5,044,183  
10 Payroll taxes ........... 27,019,120 25,119,816 1,899,304  
11 Fees for services (non-employees):        
a Management ...... 238,664,520   238,664,520  
b Legal ......... 2,082,872   2,082,872  
c Accounting ........... 0      
d Lobbying ........... 0      
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 0      
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 33,861,423 24,445,779 9,415,644  
12 Advertising and promotion .... 61,801 61,801    
13 Office expenses ....... 5,957,639 4,780,339 1,177,300  
14 Information technology ...... 0      
15 Royalties .. 0      
16 Occupancy ........... 10,274,236 8,783,946 1,490,290  
17 Travel ............ 590,915 504,108 86,807  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 0      
19 Conferences, conventions, and meetings .... 423,311 360,747 62,564  
20 Interest ........... 10,614,730 10,614,641 89  
21 Payments to affiliates ....... 9,289,525 9,271,249 18,276  
22 Depreciation, depletion, and amortization .. 52,725,189 39,035,723 13,689,466  
23 Insurance ... 2,063,461 2,063,461    
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a Medical Supplies 165,243,296 165,241,546 1,750  
b Bad Debt Expenses 80,633,206 80,633,206    
c LPPF SUPPLEMENTAL PAYMENTS 95,575,081   95,575,081  
d PHYSICIAN REMUNERATION 34,134,220 33,855,495 278,725  
e All other expenses 34,663,929 18,276,090 16,387,839  
25 Total functional expenses. Add lines 1 through 24e 1,350,787,048 929,689,482 421,097,566 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2021)
Form 990 (2021)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 16,350 1 16,501
2 Savings and temporary cash investments ......... 813,189,653 2 634,351,404
3 Pledges and grants receivable, net ...... 0 3 0
4 Accounts receivable, net ............. 210,785,197 4 257,360,190
5 Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
0 6 0
7 Notes and loans receivable, net ........... 6,464,746 7 7,144,706
8 Inventories for sale or use ............ 14,491,511 8 15,091,349
9 Prepaid expenses and deferred charges ...... 643,447 9 264,129
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,330,112,679
b Less: accumulated depreciation 10b 662,723,580 603,566,875 10c 667,389,099
11 Investments—publicly traded securities . 6,212,941 11 7,924,814
12 Investments—other securities. See Part IV, line 11 ..... 0 12 0
13 Investments—program-related. See Part IV, line 11 .. 0 13 0
14 Intangible assets ............... 6,682,491 14 5,939,992
15 Other assets. See Part IV, line 11 ........... 209,847,857 15 124,528,819
16 Total assets. Add lines 1 through 15 (must equal line 33)... 1,871,901,068 16 1,720,011,003
Liabilities 17 Accounts payable and accrued expenses ..... 89,834,410 17 110,185,596
18 Grants payable ... 0 18 0
19 Deferred revenue ......... 150,545 19 116,392
20 Tax-exempt bond liabilities ......... 494,289,995 20 481,113,684
21 Escrow or custodial account liability. Complete Part IV of Schedule D 0 21 0
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .. 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 39,959,813 25 65,208,786
26 Total liabilities. Add lines 17 through 25.. 624,234,763 26 656,624,458
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 1,247,666,305 27 1,063,386,545
28 Net assets with donor restrictions ........... 0 28 0
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 1,247,666,305 32 1,063,386,545
33 Total liabilities and net assets/fund balances ........ 1,871,901,068 33 1,720,011,003
Form 990 (2021)
Form 990 (2021)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
1,772,072,835
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
1,350,787,048
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
421,285,787
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
1,247,666,305
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-605,565,547
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
1,063,386,545
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain on
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2021)
Form 990 (2021)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
Cook Children's Medical Center
 
Employer identification number

75-2051646
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose            
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge            
6 Total. Add lines 1 through 5            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    
Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by 0.035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes 1  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity 		2  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations 3  
4 Amounts paid to acquire exempt-use assets 4  
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) 5  
6 Other distributions (describe in Part VI). See instructions 6  
7Total annual distributions. Add lines 1 through 6. 7  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions 		8  
9 Distributable amount for 2021 from Section C, line 6 9  
10 Line 8 amount divided by Line 9 amount 10  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions 		(ii)
Underdistributions
Pre-2021 		(iii)
Distributable
Amount for 2021
1 Distributable amount for 2021 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI).
See instructions.		  
3 Excess distributions carryover, if any, to 2021:
a From 2016.......  
b From 2017.......  
c From 2018.......  
d From 2019.......  
e From 2020.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2021 distributable amount  
i Carryover from 2016 not applied (see
instructions) 		 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2021 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2021 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2021, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions. 		 
6 Remaining underdistributions for 2021. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions. 		 
7 Excess distributions carryover to 2022. Add lines
3j and 4c. 		 
8 Breakdown of line 7:
a Excess from 2017.....  
b Excess from 2018.....  
c Excess from 2019.....  
d Excess from 2020.....  
e Excess from 2021.....  
Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990) 2021


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Name of the organization
Cook Children's Medical Center
 
Employer identification number

75-2051646
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990) (2021)
Schedule B (Form 990) (2021) Page 2
Name of organization
Cook Children's Medical Center
  		Employer identification number
75-2051646
Part I
Contributors
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)
Schedule B (Form 990) (2021)
Page 3
Name of organization
Cook Children's Medical Center
  		Employer identification number

75-2051646
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
Schedule B (Form 990) (2021)
Schedule B (Form 990) (2021)
Page 4
Name of organization
Cook Children's Medical Center
  		Employer identification number

75-2051646
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990) (2021)
Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet Complete if the organization is described below. SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
Cook Children's Medical Center
 
Employer identification number

75-2051646
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

2
Political campaign activity expenditures. See instructions ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities. See instructions ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990) 2021

Schedule C (Form 990) 2021
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).Click to see attachment
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ...................... 0 0
b Total lobbying expenditures to influence a legislative body (direct lobbying) ........................ 0 203,050
c Total lobbying expenditures (add lines 1a and 1b) ............................................................ 0 203,050
d Other exempt purpose expenditures ............................................................................... 1,350,787,048 3,058,073,223
e Total exempt purpose expenditures (add lines 1c and 1d) .................................................. 1,350,787,048 3,058,276,273
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		 1,000,000 8,223,544
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) ................................................. 250,000 2,055,887
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) Total
2a Lobbying nontaxable amount     1,000,000 1,000,000 2,000,000
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		3,000,000
c Total lobbying expenditures     0 0 0
d Grassroots nontaxable amount     250,000 250,000 500,000
e Grassroots ceiling amount
(150% of line 2d, column (e))		 750,000
f Grassroots lobbying expenditures     0 0 0
Schedule C (Form 990) 2021


Schedule C (Form 990) 2021
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes|No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
 
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
 
c
Media advertisements? ...................................................................................................
 
 
 
d
Mailings to members, legislators, or the public? .............................................................................
 
 
 
e
Publications, or published or broadcast statements? ...........................................................
 
 
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
 
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
 
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
 
 
i
Other activities? ...................................................................................................................
 
 
 
j
Total. Add lines 1c through 1i ....................................................................................................
 
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
 
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures. See Instructions .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Schedule C (Form 990) 2021


Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
Cook Children's Medical Center
 
Employer identification number

75-2051646
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year ......... 1  
2 Aggregate value of contributions to (during year) 7,550  
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........ 266,669  
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance .... 145,006,389 111,257,225 116,417,669 111,568,298 95,010,517
b Contributions ... 777,244 503,149 1,190,873 545,683 9,396,884
c Net investment earnings, gains, and losses 4,022,829 35,878,832 4,368,488 5,290,113 8,367,517
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		1,647,900 2,632,817 10,719,805 986,425 1,206,620
f Administrative expenses ....          
g End of year balance ...... 148,158,562 145,006,389 111,257,225 116,417,669 111,568,298
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet40.210 %
b
Permanent endowment SchDMd Bullet52.950 %
c
Term endowment SchDMd Bullet6.840 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
No
(ii) Related organizations .................
3a(ii)
Yes
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment) 		(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....   21,503,546 21,503,546
b Buildings ....   880,972,616 431,448,604 449,524,012
c Leasehold improvements   0   0
d Equipment ....   256,247,615 218,923,578 37,324,037
e Other .....   171,388,902 12,351,398 159,037,504
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 667,389,099
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 3
Part VII
Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Financial derivatives.........    
(2) Closely-held equity interests........    
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)Assets Limited to Use 29,414,751
(2)Other Receivables 3,036,084
(3)Supplemental Assets 83,672,876
(4)Rights of Use Assets 8,368,960
(5)Intercompany Receivables 36,148
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 124,528,819
Part X
Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes 0
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 65,208,786
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 1,726,411,513
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d -44,149,025
e Add lines 2a through 2d ..................... 2e -44,149,025
3 Subtract line 2e from line 1.................. 3 1,770,560,538
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b 1,512,297
c Add lines 4a and 4b.................... 4c 1,512,297
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 1,772,072,835
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 1,288,611,046
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d 18,457,204
e Add lines 2a through 2d.................... 2e 18,457,204
3 Subtract line 2e from line 1................... 3 1,270,153,842
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b 80,633,206
c Add lines 4a and 4b..................... 4c 80,633,206
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 1,350,787,048
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
SCHEDULE D, PART V, LINE 4 INTENDED USE OF ENDOWMENT FUNDS: 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 plus inflation over a rolling seven-year period, as well as show favorable performance characteristics relative to other market indiCES weighted for asset allocations as well as similarly managed funds. 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 PLACES A GREATER EMPHASIS on public and private EQUITY-BASED INVESTMENTS TO ACHIEVE ITS LONG-TERM RETURN OBJECTIVES WITHIN PRUDENT RISK CONSTRAINTS. COOK CHILDREN'S HAS A POLICY (THE SPENDING POLICY) in where W.I. Cook Foundation, Inc. may make available EACH YEAR OF UP TO 5% OF THE FOUNDATION'S INVESTMENTS AVERAGE FAIR VALUE OVER THE PRIOR 5 YEARS ENDED JUNE 30 PRECEDING THE YEAR IN WHICH THE EXPENDITURE IS PLANNED AND/OR ACCORDING TO THE DONOR REQUIREMENTS AS SET FORTH IN EACH ENDOWMENT DOCUMENT. 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.
SCHEDULE D, PART XI, LINE 2d Reconciliation of audited revenue to form 990 revenue: Bad Debt expense: (80,633,206) Interest Rate SWAP Adjustment: 4,434,453 joint venture revenue: 32,049,728 --------------- (44,149,025)
Schedule D, Part XI, Line 4b RECONCILIATION OF AUDITED revenue to form 990 revenue: Additional Gain on Disposal of Asset: 90,527 Additional Contributions from Foundation: 2,872,974 Direct Rent Expenses: (1,451,204) ------------ 1,512,297
Schedule D, Part XII, Line 2D Reconciliation of audited expenses to form 990 expenses: direct rent expenses: 1,451,204 Additional gain on Disposal of Asset (90,527) Joint Venture Expenses 17,096,527 ----------------- 18,457,204
SCHEDULE D, PART XII, LINE 4B Reconciliation of audited expenses to form 990 expenses: Bad Debt Expense: 80,633,206
Schedule D, Part X, Line 2 ASC 740 Footnote: 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 (Form 990) 2021


Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
Cook Children's Medical Center
 
Employer identification number

75-2051646
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

 

No
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    11,010,358 2,353,201 8,657,157 0.680 %
b Medicaid (from Worksheet 3, column a) . . . . .     665,761,692 643,355,002 22,406,690 1.760 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     676,772,050 645,708,203 31,063,847 2.440 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     6,336,734 19,644 6,317,090 0.500 %
f Health professions education (from Worksheet 5) . . .     293,807 159,146 134,661 0.010 %
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .     431,011 431,011    
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     82,606,901   82,606,901 6.500 %
j Total. Other Benefits . .     89,668,453 609,801 89,058,652 7.010 %
k Total. Add lines 7d and 7j .     766,440,503 646,318,004 120,122,499 9.450 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing     20,000   20,000  
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building     38,825   38,825  
7 Community health improvement advocacy     491,003   491,003 0.040 %
8 Workforce development            
9 Other            
10 Total     549,828   549,828 0.040 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
80,633,206
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
7,773,811
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
8,889,710
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-1,115,899
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1CC PEDIATRIC SURGERY
  		SURGERY CENTER 54.663 %   3.146 %
2CC SURGERY CENTER
  		SURGERY CENTER 51.256 %   32.161 %
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 COOK CHILDREN'S MEDICAL CENTER
801 SEVENTH AVE
FORT WORTH,TX76104
WWW.COOKCHILDRENS.ORG
000332 		    X              
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
COOK CHILDREN'S MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 21
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 21
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V, SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
COOK CHILDREN'S MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE PART V, SECTION C
b
SEE PART V, SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 6
Part VFacility Information (continued)

Billing and Collections
COOK CHILDREN'S MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
COOK CHILDREN'S MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
SCHEDULE H, PART V, SECTION B, LINE 5 Input from representatives of the community: The initial Cook Children's Community-Wide Children's Health Assessment and Planning Survey (CCHAPS) was conducted in 2009 and every three years thereafter (2012, 2015, 2018 and 2021). Our methodology varies slightly among assessment years but always includes gathering data from multiple sources representing our community. Overall, our Community Health Needs Assessment (CHNA) methodology includes a survey of parents of children ages 0-17, a community leader survey, and focus groups outlined in the table below. We also gather feedback from community coalition members through facilitated discussions at regular meetings and at eight child health summits that we host to present the data to our various communities. In addition, Cook Children's collects data from publicly available sources to supplement perceptions of children's health obtained through the parent and community leader surveys, focus groups and/or community meetings. The 2021 CHNA parent survey was administered through an outside vendor (ETC Institute) to a statistically representative sample of parents with children ages 0-17 living in our primary service region (Collin, Denton, Grayson, Hood, Johnson, Parker, Tarrant, and Wise counties). The large sample size (5,715 completed surveys) provides statistically representative results applicable to all eight counties individually and collectively with a low margin of error (+/- 1.3%; 95% CI). The survey is administered through mail, telephone, and internet communications and ETC monitors responses to ensure that representation is similar to general population demographics in terms of total population in each geographic area, race/ethnicity, marital status, income, and education level. In order to assess the health of children living in families that are traditionally underrepresented in mail and telephone surveys, a research team from the Evaluation and Outcomes Division of My Health My Resources of Tarrant County (MHMRTC) administered the parent survey to an intentional sample of caregivers within families experiencing homelessness in shelters or within families with at least one undocumented member at several Tarrant County homeless shelters (229 completed surveys). A team from University of North Texas Health Science Center at Fort Worth's School of Public Health conducted six virtual focus groups and one interview with parents (total of 22 parents/caregivers) across the eight-county service area. Community partners and program staff within the Center for Children's Health helped advertise and refer participants via email. These focus groups provided an opportunity for parents and caregivers to share additional information beyond questions within in the parent survey. Priority topics within these focus groups included asthma, oral health, mental health, healthy lifestyles, injury prevention, parenting support, COVID-19 and equitable access to care. The Center for Transforming Lives conducted a survey of families with children from birth to age 17 who were living within motels or extended-stay properties throughout Tarrant County from February to October 2021. Seventy families completed the anonymous surveys on-site at the motel locations. ETC Institute also conducted a survey with community leaders to obtain their feedback about the status of children's health. Surveys were mailed to 1,881 community leaders representing city and county governments, public agencies, not-for-profit organizations, independent school districts, faith based/clergy, and health care professionals. We received 306 responses (16% response rate). A complete list of who received the opportunity to participate in the leader survey is available upon request. Virtual interviews with 20 community leaders across the eight-county service area were also conducted. Leaders were recruited based on their expertise and diverse roles within the community. Interviewees discussed pressing issues or concerns in the community, providing additional context for the community leader and parent survey findings. Priority topics discussed during the interviews included the impact of COVID-19, mental health, ACEs, housing and food security, healthy lifestyles, injury prevention, and equitable access to health care. Based on the 2009 initial assessment results, Cook Children's Board of Trustees prioritized children's health issues identified by parents and community leaders and findings from subsequent CHNA processes in 2012, 2015, 2018, and 2021 confirmed the importance of these issues for continuing focused intervention: - Equitable access to health care - Oral Health - Mental Health - Healthy Lifestyles (obesity prevention) - Parenting and Family Support (abuse and neglect prevention) - Injury Prevention - Asthma Cook Children's continues to use the 2021 CHNA findings to assess parent and community leader perceptions of children's health needs and to inform our community health outreach and community engagement efforts. The 2024 CHNA is currently in development and will be completed and posted by September 30, 2025.
Schedule H, Part V, Section B, Line 6a CHNA CONDUCTED WITH OTHER HOSPITAL FACILITIES: This 2021 Community Health Needs Assessment report is intended to serve as a joint assessment for the main Cook Children's Medical Center in Fort Worth and the new Cook Children's Medical Center in Prosper, opening in the fall of 2022. The Fort Worth Medical Center's primary service area encompasses Denton, Hood, Johnson, Parker, Tarrant and Wise counties. The Prosper Medical Center serves the primary counties of Collin, Denton and Grayson. Our 2021 assessment intentionally collected data in Collin and Grayson counties to represent those communities in the Prosper service area. Denton County falls within both the Fort Worth and Prosper service areas.
SCHEDULE H, Part V, Section B, Line 6b Other Organizations other than Hospital Facilities: External vendors used to conduct the parent and community leader surveys included The Center for Transforming Lives, ETC Institute, Inc., My Health My Resources of Tarrant County, and University of North Texas Health Science Center. No other organizations were involved other than these contracted surveyor entities and no other organizations are able to use this assessment to fulfill CHNA requirements.
SCHEDULE H, PART V, SECTION B, LINE 11 HOW WE ARE ADDRESSING SIGNIFICANT NEEDS: Cook Children's created the Center for Children's Health in 2011 to provide an infrastructure for using children's health assessment data to guide community programs and stakeholder collaborations that prevent illness, disease and injuries for children. The center oversees a regular community health needs assessment, community research and community health outreach. All three categories of Center activities are focused on increasing access to preventive services for underserved populations. The Center for Children's Health develops strategies for addressing targeted children's health priorities through research and an infrastructure that supports effective delivery of community and family services. Our services are data driven, evidence-informed and provided using high standards of community practice and service delivery. Recognizing that Cook Children's cannot solve complex children's health needs alone, we lead coalitions and support partnerships in every county within our primary service region to involve community partners in identifying health needs, and developing and implementing sustainable solutions. Collaborations are structured according to principles that research indicates are effective characteristics for successful community collaborations, including a commitment to using strategic plans to guide implementation of strategies, diverse representation within each community, and facilitating decisions guided by members according to formal coalition bylaws and meeting guidelines. Collaborations led by the Center for Children's Health include: - ACEs Task Force - Children's Oral Health Coalition - Lifeguard Your Child (Drowning Prevention Campaign) - Healthy Children Coalition of Parker County - Hood County for Healthy Children - Johnson County Alliance for Healthy Kids - Safe Baby Sleep Council - Safe Kids North Texas-Fort Worth - SaVe a Smile - Wise Coalition for Healthy Children - Wellness Alliance for Total Children's Health of Denton County 2021 CHNA parent and community leader survey findings support Cook Children's continued focus on family outreach programs that address the children's health issues identified in our initial parent survey process in 2009. The family services addressing priority children's health needs are provided using evidence-based/informed practices, including strict adherence to regulatory requirements, implementing proven program designs, obtaining appropriate staff certifications or licensures, providing adequate supervision, practicing accurate and confidential record-keeping, and conducting ongoing formal evaluation. Recognizing the need to improve access to care for vulnerable populations, the Center for Children's Health focuses all programming listed in the following sections to families identified as high-risk either due to low income or high prevalence of health risk factors. Equitable Access to Health Care Goal: Improve overall health for children and increase equitable access to quality health care - Ensure that C4CH programs and community involvement exemplify Cook Children's Promise. Community Strategies - Monitor and identify priority children's health issues in Cook Children's 6-county FWSA/3-county PSA to guide equitable service delivery program designs > Held 6 local and 2 regional CHNA Summits to share findings from the 2021 CHNA. > Rolling data collection is in progress for the 2024 CHNA by administering the parent survey among a purposeful sample of caregivers and families across the 8-county region. - Draw on the power of community partnerships to increase the reach for equitable health care information and services to disproportionally impacted populations (C4CH Coalitions) > The Homeless Initiative addresses unmet health and psycho-social needs of children living in three shelters in Tarrant County by providing a medical home and a case management model to coordinate health and social services. > Cook Children's is regularly represented at community initiatives throughout our region addressing various child health issues. > The Center for Children's Health distributed 332,529 educational resources and 181,567 prevention tools through community events and community partners in FY22. - Lead community coalitions with multi-sector, geographically diverse membership. > The Center for Children's Health led over 800 community events and engaged over 600 community partners to promote the health and safety of children. - Maintain focus of C4CH service delivery programs designs on the principles of community collaboration, evidence-based information and practices, and reducing health disparities and inequities. - The Center for Children's Health contributes funding to the Immunization Collaboration of Tarrant County to provide easy access to immunizations for children from low-income families in Tarrant County. The collaboration hosts a multi-week event during August and September, with the help of nearly 100 volunteers to immunize approximately 6,000+ children each year. - The Center for Children's Health provides regular communication about health information to families and community partners through Checkup Magazine, YouTube videos, and presentations. - The Center maximizes the power of Cook Children's integrated health system by developing close partnerships with Neighborhood Clinics, Cook Children's Health Plan, and other departments offering case management services to distribute health and wellness messages and prevention tools. - The Center for Children's Health and Cook Children's Health Plan expanded their partnership with the addition of a C4CH/CCHP Liaison. This liaison has held multiple stakeholder meetings, educated children and families on prevention efforts to help keep their children healthy and safe, and assisted with resource distributions. In FY22, CCHP staff distributed 19,714 C4CH resources to members and potential members and provided 168 hours of support at C4CH meetings and events. - Community Health Workers (CHWs) are an integral piece to the success of several C4CH programs including Build-a-Bridge, Save-A-Smile, and Healthy Homes by connecting families to needed resources and support services to increase access to care. In FY22, CHWs provided 5,660 social services to families to help them meet basic needs and address social determinants of health and were responsible for 477 community referrals provided to families connecting them to basic needs and health services. CHWs, along with other C4CH staff, served 21,616 children, families, and partners. Additional information related to increasing access to care is also addressed throughout each of the remaining six focus areas discussed below. Oral Health Goal: Improve child oral health - Respond to the urgent needs of children at increased risk of poor oral health Community Strategies - Lead and sustain the Save a Smile Advisory Committee; and the Children's Oral Health Coalition (COHC) to plan and implement oral health collaborative interventions. The coalition's Legislative Advocacy committee monitors state and national legislative issues, especially those supporting expanded access to dental care for low-income children. - Develop and distribute evidence-informed oral health resources to educate families, medical/dental providers and other community partners. - Continue Save a Smile programming to conduct limited oral health evaluations for low-income children; identify those with acute dental problems in targeted schools; and provide comprehensive social and dental treatment services. - Provide evidence-based training to caregivers and children; pregnant women; school nurses; medical/dental providers; and other community partners. - Facilitate and track community-level oral health screening outcomes. - Reduce barriers to oral health care for pregnant teens and women. - Explore potential partnership with Renaissance Dental Clinic to expand patient family education opportunities. - Support community awareness campaigns and events to encourage good oral health Mental Health Goal: Increase access to services for child mental health and well-being - Respond to the increasing critical need for mental health services to serve children Community Strategies - Lead and sustain the Wellness Alliance for Total Children's Health (WATCH) to plan and implement mental health collaborative interventions, targeting high-risk populations. - Sustain a strong community network of quality mental health services to support mental health services and treatment (Mental Health Connection). - Provide professional development opportunities for mental health providers who will share skills, knowledge, and tools with colleagues and caregivers within their reach (Wellness Workshops). - Develop and implement evidence-informed education and interventions for caregivers, children and adolescents to expand the reach of mental health messaging and strengthen connections to health care and commun
Schedule H, Part V, Section B, lines 7a & 10a CHNA & Implementation strategy availability: The CHNA and implementation strategy are available upon request and at the following address: www.cookchildrens.org/about/community-outreach/pages/community-health-need s-assessment.aspx
Schedule H, Part V, Section B, lines 16a, 16b & 16c Financial assistance documents: The financial assistance policy, application and plain language summary are available at the following address: https://www.cookchildrens.org/patients/billing-insurance/pages/financial-a ssistance.aspx
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?2
Name and address Type of Facility (describe)
1 CENTER FOR PEDIATRIC SURGERY
4200 W UNIVERSITY DRIVE STE 110
PROSPER,TX75078 		AMBULATORY SURGERY CENTER
2 COOK CHILDREN'S SURGERY CENTER
6313 PRECINCT LINE RD
HURST,TX76054 		AMBULATORY SURGERY CENTER
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
SCHEDULE H, PART III, SECTION A, LINE 2 Bad debt expense: 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.
SCHEDULE H, PART III, SECTION A, LINE 3 Bad debt as a community benefit: 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 medically 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 a 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 medically indigent discounts and written the patients' balances off as such.
SCHEDULE H, PART III, SECTION A, LINE 4 Bad debt footnote: Footnote disclosure regarding the treatment of bad debts is located on page 20 of the most recent audited financial statements attached to this form.
SCHEDULE H, PART III, SECTION B, LINE 8 Medicare shortfall and cost reported: 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.
SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION PRACTICES: THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE.
SCHEDULE H, PART VI, LINE 2 Needs assessment: Although various departments within Cook Children's periodically conduct patient needs assessments for specific medical specialties, the parent survey for our Community Health Needs Assessment, also known as the Community-wide Children's Health Assessment & Planning Survey (CCHAPS) as reported in Part V, Section B-is the only community-wide children's health needs assessment conducted by our health system.
SCHEDULE H, PART VI, LINE 3 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, urgent care, 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. A financial counselor will assist all self-pay inpatients, observation stays and scheduled procedures, screening them for various government programs, such as Medicaid and Chip. In addition, a financial counselor will assist any patient that presents to registration for financial assistance, providing them with a Medicaid application and reviewing the charity policy. Patient representatives and Case Management personnel also direct families to the patient registration staff when they need financial assistance. In addition, the financial assistance policy, explanation of amounts generally billed and the charity application are posted on the Cook Children's website at www.cookchildrens.org. The charity application is posted in both English and Spanish versions.
SCHEDULE H, PART VI, LINE 4 Community Information: Cook Children's eight-county service region is based in North Central Texas and comprises Collin, Denton, Grayson, Hood, Johnson, Parker, Tarrant, and Wise Counties. Cook Children's evaluates the statistics describing our community and representing our population served with every Community Health Needs Assessment (CHNA). For Fiscal Year 2022, all information provided is in response to our 2021 CHNA. Furthermore, the statistics described within this section reflect those reported in our 2021 CHNA. Please note: Our 2024 CHNA is currently in development and will be approved and posted by September 30, 2025. The U.S. Census Bureau classifies these counties as follows: Collin County-mostly urban, 5% rural; Denton County-mostly urban, 7% rural; Grayson County-rural 43%; Hood County-mostly urban, 33% rural; Johnson County-mostly urban, 38% rural; Parker County-rural 56%; Tarrant County-mostly urban, 1% rural and Wise County-mostly rural 72% (1). The FWSA total population of 3,309,223 includes 972,470 children from birth to age 17, while the PSA total population of 1,938,813 includes 512,680 children from birth to age 17. Overall, this eight-county region is home to a diverse population of 4,414,214 people, and 1,269,810 (28%) are children 17 years and younger (2). Of those 1,269,810 children ages 0-17, there are 265,400 children living in Collin County; 215,340 in Denton County; 31,940 in Grayson County; 12,230 in Hood County; 145,140 in Johnson County; 36,070 in Parker County; 547,340 in Tarrant County; and 16,350 in Wise County (2). The annual median income for families with children under age 18 range between $63,311 in Grayson County to $117,935 in Collin County (2). Of the 1,269,810 children under age 18 living in the region, nearly 150,000 (12%) live in households with income below the poverty level, and children in households that receive Supplemental Security Income (SSI), cash public assistance or food stamps/SNAP benefits ranges from 8% in Collin County to 27% in Grayson County. Of the 1,269,810 children under age 18 living in the region, between 8%-27% live in households that receive Supplemental Security Income (SSI), cash public assistance, or Food Stamps/SNAP benefits (2). The information below reflects race and ethnicity by county within our region. 2021 U.S. Census Estimates of Race and Ethnicity (Children under 18 years) (2) . Asian: Collin 16.2%; Denton 9.6%; Grayson 1.7%; Hood 0.7%; Johnson 5.2%; Parker 0.7%; Tarrant 5.6%; Wise 0.6% . Black/African American: Collin 10.3%; Denton 9.9%; Grayson 6%; Hood 0.8%; Johnson 4.7%; Parker 1.0%; Tarrant 16.8%; Wise 1.3% . Other Race/Two or More Races: Collin 0.5%; Denton 0.5%; Grayson 0.5%; Hood 1.0%; Johnson 0.2%; Parker 0.5%; Tarrant 0.8%; Wise 0.6% . White: Collin 55.0%; Denton 57.6%; Grayson 74.6%; Hood 84.2%; Johnson 79.3%; Parker 82.6%; Tarrant 45.2%; Wise 76.8% . Hispanic or Latino (Any Race): Collin 15.5%; Denton 19.6%; Grayson 14.2%; Hood 12.4%; Johnson 7.9%; Parker 13.0%; Tarrant 29.5%; Wise 19.3% The Cook Children's eight-county service region contains three medically underserved areas and two medically underserved populations as defined by the Health Resources & Services Administration. These areas are: Medically Underserved Areas (3) . Denton County: Known as Poverty Population by Service Area Name, Medical Underservice Score is 0 (Governor's Exception), Rural Status is Non-Rural . Tarrant County: Known as Diamond Hill Service Area by Service Area Name, Medical Underservice Score is 57.5, Rural Status is Non-Rural . Tarrant County: Known as Fort Worth-North by Service Area Name, Medical Underservice Score is 58, Rural Status is Non-Rural Medically Underserved Population (3) . Grayson County: Known as Low Income-Grayson County by Service Area Name, Medical Underserved Score is 61, Rural Status is Partially Rural . Tarrant County: Known as Low Inc-East Side by Service Area Name, Medical Underserve Score is 59.8, Rural Status is Non-Rural
SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: In FY2022, the Center for Children's Health led 812 health outreach events serving over 33,000 children, families, and community partners. These outreach events include education or activities around the prioritized health issues identified in the findings from our first formal community health needs assessment in 2009, which include: - Equitable access to health care - Oral Health - Mental Health - Healthy Lifestyles (obesity prevention) - Parenting and Family Support (abuse and neglect prevention) - Injury Prevention - Asthma In FY2022 our community partners and volunteers gave over 4,200 hours of volunteer support to the Center for Children's Health, totaling a value of $130,000. Out of our 812 health outreach events, over 650 were coalition, workgroup, and stakeholder meetings, trainings, and workshops that we led through our collaborations below: - ACEs Task Force - Children's Oral Health Coalition - Lifeguard Your Child (Drowning Prevention Campaign) - Healthy Children Coalition of Parker County - Hood County for Healthy Children - Johnson County Alliance for Healthy Kids - Safe Baby Sleep Council - Safe Kids North Texas - Save a Smile - Wise Coalition for Healthy Children - Wellness Alliance for Total Children's Health of Denton County Selected highlights of our work in FY2022 to improve the health of children and families in the community include: - Over 6,600 children received a limited oral health evaluation and over 1,800 dental procedures were provided to children with dental disease for a total value of $255,000. - Provided over 355 car seat checks to families in need - Provided 452 continued education credits to over 255 community professionals at our mental health education workshops. - Coordinated and engaged 545+ volunteers and collaboration members. - Provided 5,660 support services and over 470 community referrals to families, meeting needs for food, rent and utilities assistance, school supplies, and mental health. - Distributed 514,096 prevention and educational resources at a value of $652,902 to families and community partners. - Supported 358 events coordinated by community partners.
SCHEDULE H, PART VI, LINE 6 Affiliated Health Care System: Cook Children's also operates seven 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 outpatient settings subsidized by Cook Children's. Cook Children's Health Plan is a contracted intermediary for Medicaid managed care and Chip, providing an open provider panel for all eligible children in the six-county primary service area. Cook Children's Home Health offers pediatric-specific home care to assure care is provided in the most appropriate and lowest cost setting.
SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: Texas
Schedule H, Part I, Line 7, Column (F) Bad debt expense of $80,633,206 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.
Schedule H, Part II, Lines 1-10 Community Building Activities: 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 the area. Coalition Building: Cook Children's is the lead organization for the Wellness Alliance for Total Children's Health of Denton County ("WATCH"). WATCH of Denton County is a collaboration of both public and private organizations and individuals who are invested in the total wellness of Denton County's children. WATCH currently works to increase awareness of and access to mental health services in Denton County. Cook Children's is also a participant in the Denton County Behavioral Health Leadership Team which advocates and facilitates a collaborative person-centered behavioral health system to repair and restore lives by ensuring behavioral health services are available to meet the needs of all, assessing data for continuous outcome measurements, prioritizing data driven recommendations, and providing a continuum of care in Denton County. Cook Children's is also a participant in the Intellectual and Developmental Disabilities Council of Tarrant County which is a community coalition of providers, public officials, families, and self-advocates who have come together to increase opportunities for people with intellectual disabilities in our community. Community Health Improvement Advocacy: Advocacy efforts by Cook Children's are enhanced through membership in various local, state, and national organizations. Issues addressed include community needs assessment, access to health care and insurance for underserved populations, and advocacy for specific health issues such as child abuse and neglect and preventable injuries. Over 1,000 hours were contributed to multiple coalitions, committees, and councils for FYE 2022.
Schedule H, Part I, Line 7 Financial Assistance & Certain Community Benefits at Cost: Line 7a is calculated using worksheet 1 and the cost to charge ratio. Line 7b Medicaid Shortfall is calculated using worksheet 3 and the cost to charge ratio. Lines 7e - i are calculated using the hospital's internal activity reports.
Schedule H, Part I, Line 3C Cook Children's also uses asset level, medical indigency, insurance status, underinsurance status, and residency in determining eligibility for free or discounted care.
SCHEDULE H, PART I, LINE 6A & 6B Cook Children's conducts a CHNA and prepares a summary report every three years. The most recent CHNA was conducted in 2021, and the written CHNA report was posted in 2022. The 2021 CHNA report is available to the public on our website: (https://www.cookchildrens.org/about/community-outreach/community-health-n eeds-assessment/). The next CHNA (2024) is currently in development and will be posted by September 30, 2025.
Schedule H (Form 990) 2021
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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
Cook Children's Medical Center
 
Employer identification number
75-2051646
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
(if applicable)		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) COOK CHILDREN'S PHYSICIAN NETWORK
801 SEVENTH AVENUE
FORT WORTH,TX76104 		75-2485366 501(C)(3) 82,531,217       SUBSIDIZE OPERATIONS
(2) JUNIOR LEAGUE OF FORT WORTH
255 BAILEY AVE
FORT WORTH,TX76107 		75-6022377 501(C)(3) 35,000       SPONSOR
(3) WARM PLACE
809 LIPSCOMB STREET
FORT WORTH,TX76104 		75-2220859 501(C)(3) 25,000       SPONSOR
(4) MARCH OF DIMES
po box 18819
ATLANTA,GA31126 		13-1846366 501(C)(3) 15,000       SPONSOR
(5) RONALD MCDONALD HOUSE
1001 8TH AVENUE
FORT WORTH,TX76104 		75-1754490 501(C)(3) 10,000       SPONSOR
(6) WINDSONG RANCH COMMUNITY
1001 WINDSONG PARKWAY SOUTH
PROSPER,TX75078 		46-5352001 501(C)(3) 10,000       SPONSOR
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
6
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2021

Schedule I (Form 990) 2021
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1) Medication 1845 236,741      
(2) Transportation 1810 75,906      
(3) LODGING 583 66,690      
(4) Gift Cards 570 58,182      
(5) UTILITIES 21 4,144      
(6) MEALS 873 20,256      
(7) MEDICAL EQUIPMENT 42 11,600      
(8) BABY SUPPLIES 427 39,966      
(9) Funeral services 133 120,445      
(10) miscellaneous 11 1,487      
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING THE USE OF THE GRANT FUNDS IN THE US: THE ORGANIZATION USES PUBLIC AND PRIVATE DATA TO MONITOR THE USE OF FUNDS, AS NEEDED.
Schedule I (Form 990) 2021



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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
Cook Children's Medical Center
 
Employer identification number

75-2051646
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....
1b
 
No
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2021

Schedule J (Form 990) 2021
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1DEBORAH BOUDREAUX
AVP Nursing 		(i)

(ii)		 219,517
-------------
0 		53,852
-------------
0 		15,143
-------------
0 		8,639
-------------
0 		37,702
-------------
0 		334,853
-------------
0 		0
-------------
0
2ORLANDO CHAPA
AVP Nursing 		(i)

(ii)		 229,270
-------------
0 		54,265
-------------
0 		13,738
-------------
0 		21,750
-------------
0 		17,079
-------------
0 		336,102
-------------
0 		0
-------------
0
3James C Cunningham MD
EVP, CMO 		(i)

(ii)		 0
-------------
629,003 		0
-------------
296,290 		0
-------------
154,443 		0
-------------
21,750 		0
-------------
24,011 		0
-------------
1,125,497 		0
-------------
0
4Nancy C Cychol
President/Chief Hospital Svcs 		(i)

(ii)		 621,692
-------------
0 		290,193
-------------
0 		143,098
-------------
0 		21,750
-------------
0 		11,260
-------------
0 		1,087,993
-------------
0 		0
-------------
0
5STANLEY E DAVIS
Sr. Vice President, COO 		(i)

(ii)		 388,649
-------------
0 		169,422
-------------
0 		61,018
-------------
0 		85,128
-------------
0 		39,191
-------------
0 		743,408
-------------
0 		43,697
-------------
0
6MARGIE DORMAN-O'DONNELL
Director, Case Management 		(i)

(ii)		 167,495
-------------
0 		24,341
-------------
0 		13,837
-------------
0 		11,200
-------------
0 		15,020
-------------
0 		231,893
-------------
0 		0
-------------
0
7JOSEPH M GALLAGHER
SR. VP, CHIEF LEGAL OFFICER 		(i)

(ii)		 0
-------------
509,871 		0
-------------
220,899 		0
-------------
17,315 		0
-------------
103,168 		0
-------------
34,356 		0
-------------
885,609 		0
-------------
0
8KEVIN GREENE
AVP NORTH CAMPUS 		(i)

(ii)		 156,487
-------------
0 		35,617
-------------
0 		2,809
-------------
0 		8,081
-------------
0 		34,548
-------------
0 		237,542
-------------
0 		0
-------------
0
9STEPHEN W KIMMEL
EVP, SYS FINANCE 		(i)

(ii)		 251,317
-------------
376,973 		119,415
-------------
179,122 		46,336
-------------
69,506 		52,562
-------------
78,840 		12,443
-------------
18,661 		482,073
-------------
723,102 		0
-------------
82,928
10NICHOLAS MARKHAM
AVP Facilities/Campus Svcs 		(i)

(ii)		 158,811
-------------
0 		38,108
-------------
0 		9,154
-------------
0 		15,156
-------------
0 		22,352
-------------
0 		243,581
-------------
0 		0
-------------
0
11MARY CARA MARTZ
Secretary 		(i)

(ii)		 0
-------------
131,942 		0
-------------
31,642 		0
-------------
5,969 		0
-------------
7,810 		0
-------------
15,674 		0
-------------
193,037 		0
-------------
0
12THERESA Z MEADOWS
Sr. VP, Chief Info Officer 		(i)

(ii)		 0
-------------
452,928 		0
-------------
193,410 		0
-------------
89,769 		0
-------------
21,750 		0
-------------
33,113 		0
-------------
790,970 		0
-------------
0
13RICK W MERRILL
Chief Executive Officer 		(i)

(ii)		 357,589
-------------
919,515 		206,971
-------------
532,212 		109,633
-------------
281,912 		60,970
-------------
156,781 		10,586
-------------
27,219 		745,749
-------------
1,917,639 		0
-------------
0
14Gary Munford
Day/Wknd Administrator 		(i)

(ii)		 209,588
-------------
0 		4,000
-------------
0 		8,003
-------------
0 		12,774
-------------
0 		24,002
-------------
0 		258,367
-------------
0 		0
-------------
0
15OZIOMA OLOWU
Director of Pharmacy 		(i)

(ii)		 188,058
-------------
0 		29,276
-------------
0 		11,545
-------------
0 		12,288
-------------
0 		36,888
-------------
0 		278,055
-------------
0 		0
-------------
0
16CHERYL PETERSEN
VP Nursing, CNO 		(i)

(ii)		 314,677
-------------
0 		107,282
-------------
0 		6,422
-------------
0 		54,975
-------------
0 		39,102
-------------
0 		522,458
-------------
0 		0
-------------
0
17CORY R RHOADES
CFO 		(i)

(ii)		 0
-------------
475,794 		0
-------------
204,726 		0
-------------
59,962 		0
-------------
97,819 		0
-------------
35,862 		0
-------------
874,163 		0
-------------
42,740
18SPENCER D SEALS
VP Construction & Real Estate 		(i)

(ii)		 0
-------------
279,522 		0
-------------
94,063 		0
-------------
2,564 		0
-------------
52,284 		0
-------------
34,141 		0
-------------
462,574 		0
-------------
0
19Tamara Sims
RN, Staff 		(i)

(ii)		 191,983
-------------
0 		15,500
-------------
0 		5,346
-------------
0 		15,951
-------------
0 		11,410
-------------
0 		240,190
-------------
0 		0
-------------
0
20JACK SOSEBEE
Vice President 		(i)

(ii)		 278,738
-------------
0 		92,089
-------------
0 		3,788
-------------
0 		51,643
-------------
0 		20,175
-------------
0 		446,433
-------------
0 		0
-------------
0
21TAMMY THOMLISON
AVP Revenue 		(i)

(ii)		 222,277
-------------
0 		49,945
-------------
0 		7,567
-------------
0 		8,542
-------------
0 		3,720
-------------
0 		292,051
-------------
0 		0
-------------
0
22ELIA VALENCIA-STOKES
AVP Finance 		(i)

(ii)		 252,426
-------------
0 		61,543
-------------
0 		11,605
-------------
0 		8,304
-------------
0 		38,054
-------------
0 		371,932
-------------
0 		0
-------------
0
23Jessica Sibr
Pharmacist 		(i)

(ii)		 193,946
-------------
0 		0
-------------
0 		3,171
-------------
0 		13,312
-------------
0 		25,575
-------------
0 		236,004
-------------
0 		0
-------------
0
Schedule J (Form 990) 2021

Schedule J (Form 990) 2021
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
SCHEDULE J, PART I, LINE 4B PARTICIPATION IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: PARTICIPANTS IN SERP IN W-2 DEF COMP PAID BY ----------------------- --------- ------------ ------------ RICK W. MERRILL NONE 196,000 System STEPHEN W. KIMMEL $82,928 113,277 System Stanley Davis $43,697 63,378 ccmc JOSEPH M. GALLAGHER NONE 81,912 System CORY R. RHOADES $42,740 76,429 System CHERYL PETERSEN NONE 34,825 CCMC SPENCER D. SEALS NONE 30,534 SYSTEM JACK SOSEBEE NONE 29,893 CCMC
SCHEDULE J, PART II ALLOCATION OF CEO AND CFO SALARIES: SALARIES FOR THE CEO AND CFO 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 CHILD STUDY CENTER
SCHEDULE J, PART I, Line 1A & 1B GENERAL GROSS UP PAYMENTS DISCLOSURE 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. CY 2021 GROSS UP PAYMENTS INCLUDED IN TAXABLE COMPENSATION: Margie Dorman-O'Donnell GARY MUNFORD TAMARA SIMS Ozioma Olowu
SCHEDULE J, PART I, Line 3 METHODS USED BY CCHCS TO ESTABLISH COMPENSATION OF THE CEO/EXEC DIRECTOR: COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT WRITTEN EMPLOYMENT CONTRACT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
Schedule J (Form 990) 2021

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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet Attach to Form 990.
SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
Cook Children's Medical Center
 
Employer identification number
75-2051646
Part Ⅰ
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer		 (i) Pool
financing
Yes No Yes No Yes No
A TARRANT COUNTY CULTURAL EDUCATION FACILITIES
  		75-1181060 875906NY1 02-24-2010 231,948,097 DEVELOPMENT, CONST, EQUIPMENT   X   X   X
B Tarrant County Cultural Education Facilities
  		04-3833551 87638QJC4 08-01-2013 71,222,592 REFUNDING PORTION OF 2010 BOND   X   X   X
C Tarrant County Cultural Education Facilities
  		04-3833551 87638QKX6 02-02-2014 176,767,688 CONSTRUCTION & EQUIPMENT COSTS   X   X   X
D TARRANT COUNTY CULTURAL EDUCATION FACILITIES FINAN
  		04-3833551 87638QQq5 02-25-2020 241,629,204 REFUNDING AND CONSTRUCTION AND EQU   X   X   X
Part Ⅱ
Proceeds
A B C D
1 Amount of bonds retired .................. 199,770,000 0 21,865,000 7,780,000
2 Amount of bonds legally defeased .............. 0 0 0 0
3 Total proceeds of issue .................. 231,948,097 71,222,592 176,767,688 241,629,204
4 Gross proceeds in reserve funds ............. 0 0 0 0
5 Capitalized interest from proceeds ............. 0 0 0 0
6 Proceeds in refunding escrows ............... 0 70,145,003 0 90,712,257
7 Issuance costs from proceeds ............... 2,686,446 1,077,553 1,755,350 2,221,088
8 Credit enhancement from proceeds ............. 0 0 0 0
9 Working capital expenditures from proceeds ............. 0 0 0 0
10 Capital expenditures from proceeds ............. 230,119,470 0 176,023,031 122,400,517
11 Other spent proceeds ............. 0 0 0 0
12 Other unspent proceeds ............. 0 0 0 26,295,342
13 Year of substantial completion ............. 2011 2013 2016
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2020, a current refunding issue)? ........ 		  X X     X X  
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2020, an advance refunding issue)? ........ 		  X   X   X   X
16 Has the final allocation of proceeds been made? .......... X   X   X     X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 2
Part Ⅲ
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X     X   X   X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............   X   X   X   X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? .............   X   X   X   X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0.184 % 0.184 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet        
6 Total of lines 4 and 5 ............. 0.184 % 0.184 % 0 %  
7 Does the bond issue meet the private security or payment test? ... X   X   X   X  
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........ 		X   X   X   X  
Part Ⅳ
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X X  
b Exception to rebate? ........   X   X   X   X
c No rebate due? ......... X   X   X     X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X     X   X   X
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 3
Part Ⅳ
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue? X     X   X   X
b Name of provider .......... Bank of America
  		0
  		0
  		0
 
c Term of hedge ......... 21.3 %      
d Was the hedge superintegrated? ......   X            
e Was the hedge terminated? ........   X            
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider .......... 0
  		0
  		0
  		0
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part Ⅴ
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part Ⅵ
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
Part IV, Column A, Line 2C No Rebate Due The final rebate computation was performed as of 2/4/2014
Part IV, Column B, Line 2C No rebate due The final rebate computation was performed as of 2/4/2014.
Part IV, Column C, Line 2C No rebate due the final rebate computation was performed as of 03/22/2017.
Part III, line 7, Columns A, B, & C FOR THE PURPOSES OF CALCULATING THE PRIVATE SECURITY OR PAYMENT TEST, COOK CHILDREN'S MEDICAL CENTER (CCMC) HAS INCLUDED GROSS RECEIPTS FROM CERTAIN ACTIVITIES THAT CCMC HAS CONCLUDED GENERATE PRIVATE PAYMENTS. CALCULATED IN THAT MANNER, CCMC HAS CONCLUDED THAT THE PRIVATE PAYMENT TEST HAS BEEN MET WITH RESPECT TO THE BOND ISSUES DESCRIBED IN COLUMNS A, B & C. HOWEVER, THE AMOUNT OF PRIVATE BUSINESS USE WITH RESPECT TO THE BOND ISSUES DESCRIBED IN COLUMNS A, B & C IS LESS THAN 5%, IN EACH CASE, SO THAT EACH OF THOSE BOND ISSUES FAILS THE PRIVATE BUSINESS USE TEST AND CONTINUES TO MEET THE REQUIREMENTS IMPOSED ON "QUALIFIED 501(C)(3) BONDS."
Part II, Column A & C, Line 3 Total Proceeds include investment earnings.
Schedule K (Form 990) 2021

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Schedule L
(Form 990)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
Cook Children's Medical Center
 
Employer identification number

75-2051646
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e) Original principal amount (f) Balance due (g) In default? (h) Approved by board or committee? (i) Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990) 2021
Schedule L (Form 990) 2021
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) KATHARINE CARVALHO DAUGHTER OF BOARD MEMBER 91,990 COMPENSATION   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990) 2021


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SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
Cook Children's Medical Center
 
Employer identification number

75-2051646
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIPS: VARIOUS OFFICERS AND TRUSTEES HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER DUE TO THEIR EMPLOYMENT OR BOARD SERVICE WITH OTHER ORGANIZATIONS WITHIN THE SYSTEM.
FORM 990, PART VI, SECTION A, LINE 3 DELEGATION OF MANAGEMENT AUTHORITY: A MANAGEMENT COMPANY MANAGES THE DAY TO DAY OPERATIONS OF THE JOINT VENTURES.
FORM 990, PART VI, SECTION A, LINE 6 SOLE MEMBER: COOK CHILDREN'S HEALTH CARE SYSTEM, A TEXAS NON-PROFIT CORPORATION, IS THE SOLE MEMBER OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7A MEMBER ELECTION ABILITIES: 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.
FORM 990, PART VI, SECTION A, LINE 7B MEMBER DECISION ABILITIES: AS THE SOLE MEMBER OF THE ORGANIZATION, COOK CHILDREN'S HEALTH CARE SYSTEM HAS THE EXCLUSIVE POWER AND RESERVED POWER TO DO ANY OF THE FOLLOWING: A. AMEND, ALTER OR REPEAL THE BYLAWS; B. AMEND THE CERTIFICATE OF FORMATION OF THE ORGANIZATION; C. DETERMINE THE NUMBER OF MEMBERS OF THE BOARD OF TRUSTEES AND TO ELECT THE MEMBERS OF THE BOARD OF TRUSTEES; D. APPROVE ANY MERGER, ACQUISITION, LIQUIDATION, WINDING UP, TERMINATION OR CONSOLIDATION OF THE ORGANIZATION; E. APPROVE THE SALE, GIFT OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OF THE ORGANIZATION; AND, F. APPROVE THE CREATION OF, OR INVESTMENT IN, ANY SUBSIDIARY ENTITY.
FORM 990, PART VI, SECTION B, LINE 11B REVIEW PROCESS FOR FORM 990: 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.
FORM 990, PART VI, SECTION B, LINE 12C WRITTEN CONFLICT OF INTEREST POLICY: EVERY YEAR THE LEGAL DEPARTMENT OF THE COOK CHILDREN'S HEALTH CARE SYSTEM (SYSTEM) SENDS OUT A FORM 990 QUESTIONNAIRE/CONFLICT OF INTEREST DISCLOSURE STATEMENT TO OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES OF ALL SYSTEM COMPANIES, 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 ARE PROVIDED TO THE SYSTEM AUDIT COMMITTEE FOR REVIEW AND FOLLOW-UP. FURTHER, THE AUDIT COMMITTEE OF COOK CHILDREN'S HEALTH CARE SYSTEM IS RESPONSIBLE FOR MONITORING THE IMPLEMENTATION AND ENFORCEMENT OF THE CONFLICT OF INTEREST POLICY 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.
FORM 990, PART VI, SECTION B, LINE 15A & 15B REVIEW AND APPROVAL OF COMPENSATION: 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 RETAINED SULLIVAN COTTER AND ASSOCIATES, INC. IN 2022 to issue a reasonableness opinion covering the physician compensation plan for Cook Children's Physician Network.
FORM 990, PART VI, SECTION C, LINE 19 PROCESS OF MAKING GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC: 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 THE STATE OF TEXAS. THE CONFLICT OF INTEREST POLICY IS POSTED ON THE ORGANIZATION'S INTERNAL WEBSITE AND AVAILABLE TO ALL EMPLOYEES AND BOARD MEMBERS OF COOK CHILDREN'S HEALTH CARE SYSTEM ENTITIES. CONSOLIDATED FINANCIAL STATEMENTS ARE REPORTED ELECTRONICALLY FOR ALL COOK CHILDREN'S HEALTH CARE SYSTEM ENTITIES VIA THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEB SITE.
Form 990, Part XI, Line 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES: NET Fund Balance Transfers Between Affiliates: (610,000,000) Change in FV of SWAP: 4,434,453 ------------- (605,565,547)
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


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SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
Cook Children's Medical Center
 
Employer identification number

75-2051646
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity










Part II
Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1)COOK CHILDREN'S PHYSICIAN NETWORK
801 SEVENTH AVE

FORT WORTH,TX76104
75-2485366 		PHYSICIAN SVC TX 501(C)(3) 3 CCHCS
 
Yes
 
(2)WI COOK FOUNDATION
801 SEVENTH AVE

FORT WORTH,TX76104
75-2051649 		FUNDRAISING TX 501(C)(3) 7 NA
 
 
No
(3)COOK CHILDREN'S HOME HEALTH
801 SEVENTH AVE

FT WORTH,TX76104
75-2896983 		HEALTHCARE TX 501(C)(3) 10 CCHCS
 
Yes
 
(4)COOK CHILDREN'S HEALTH CARE SYSTEM
801 SEVENTH AVE

FORT WORTH,TX76104
75-2705881 		HLTH CARE SUP TX 501(C)(3) 12C CCHF
 
Yes
 
(5)COOK CHILDREN'S HEALTH PLAN
801 SEVENTH AVE

FORT WORTH,TX76104
76-0585240 		INSURANCE TX 501(C)(3) 10 CCHCS
 
Yes
 
(6)ROSEDALE OFFICE BUILDING INC
1500 W ROSEDALE

FORT WORTH,TX76104
46-0866421 		TITLE HOLDING TX 501(C)(2) N/A CCHF
 
Yes
 
(7)CHILD STUDY CENTER
1300 W LANCASTER

FORT WORTH,TX76102
75-1099536 		HLTHCARE SRVC TX 501(C)(3) 7 CCMC
 
Yes
 
(8)COOK CHILDREN'S HEALTH ENTERPRISES
801 SEVENTH AVE

FORT WORTH,TX76104
84-2625990 		HLTHCARE SUPP TX 501(C)(3) 12B CCHCS
 
Yes
 
(9)COOK CHILDRENS MEDICAL CENTER PROSPER
801 SEVENTH AVE

FORT WORTH,TX76104
85-2354189 		HOSPITAL TX 501(C)(3) 3 CCHCS
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) COOK CHILDREN'S SURGERY CENTER

11221 ROE AVE SUITE 320
LEAWOOD,KS66211
20-5227064 		ASC TX NA
  		RELATED 6,046,154 2,164,516   No 0   No 51.256 %
(2) CENTER FOR PEDIATRIC SURGERY

11221 ROE AVE SUITE 320
LEAWOOD,KS66211
47-0871715 		ASC TX NA
  		RELATED 6,218,847 13,566,632   No 0   No 54.398 %
(3) CPS PEDIATRICS LLC

11221 ROE AVE SUITE 320
LEAWOOD,KS66211
47-0871718 		ASC TX NA
  		RELATED 33,288 110,075   No 0   No 54.663 %








Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) COOK CHILDREN'S HEALTH SERVICES INC

801 7TH AVENUE
FORT WORTH,TX76104
45-4024843 		HEALTHCARE TX CCHCS
  		C CORPORATION       Yes  
(2) COOK CHILDREN'S INDEMNITY COMPANY

878 WEST BAY RD
GRAND CAYMAN,CJKY1-1102
CJ
98-0424041 		SELF INSURANCE CJ CCHCS
  		C CORPORATION       Yes  










Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
Yes
 
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
Yes
 
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) COOK CHILDREN'S PHYSICIAN NETWORK

 A 1,732,721 fmv
(2) COOK CHILDREN'S HEALTH CARE SYSTEM

 A 2,676,418 fmv
(3) COOK CHILDREN'S PHYSICIAN NETWORK

 B 82,531,217 FMV
(4) COOK CHILDREN'S SURGERY CENTER (NE)

 J 1,363,595 FMV
(5) COOK CHILDREN'S HEALTH ENTERPRISES

 N 5,998,682 FMV
(6) COOK CHILDREN'S PHYSICIAN NETWORK

 O 113,890,220 FMV
(7) CHILD STUDY CENTER

 O 154,240 FMV
(8) COOK CHILDREN'S HEALTH CARE SYSTEM

 O 1,074,393 FMV
(9) COOK CHILDREN'S HOME HEALTH

 P 195,613 FMV
(10) COOK CHILDREN'S HEALTH CARE SYSTEM

 P 306,801 FMV
(11) COOK CHILDREN'S PHYSICIAN NETWORK

 Q 581,090 FMV
(12) COOK CHILDREN'S HOME HEALTH

 Q 81,138 FMV
(13) COOK CHILDREN'S HEALTH CARE SYSTEM

 Q 318,996,455 FMV
(14) COOK CHILDREN'S PHYSICIAN NETWORK

 R 332,540 FMV
(15) COOK CHILDREN'S HOME HEALTH

 R 3,007,419 FMV
(16) COOK CHILDREN'S HEALTH CARE SYSTEM

 R 400,000,000 FMV
(17) COOK CHILDREN'S HEALTH PLAN

 S 222,081,506 FMV
(18) COOK CHILDREN'S HEALTH CARE SYSTEM

 S 1,315,126 FMV
(19) COOK CHILDREN'S SURGERY CENTER LLC

 S 4,656,499 FMV
(20) Center for Pediatric Surgery Ltd

 S 6,657,822 fmv
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference Explanation
Schedule R (Form 990) 2021

Additional Data


Software ID:  
Software Version:  






TY 2021 AffiliatedGroupSchedule
Name:
Cook Children's Medical Center
EIN:
75-2051646
Affiliated Group Business Name:
COOK CHILDREN'S MEDICAL CENT
Address. Either US or Foreign Type:
801 seventh ave
FORT WORTH, TX76104    
EIN:
75-2051646
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
1,350,787,048
Total Exempt Purpose Expenditures:
1,350,787,048
Lobbying Nontaxable Amount:
1,000,000
Grassroots Nontaxable Amount:
250,000
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
COOK CHILDREN'S HEALTH PLAN
Address. Either US or Foreign Type:
801 SEVENTH AVE
FORT WORTH, TX76104    
EIN:
76-0585240
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
22,478
Total Lobbying Expenditures:
22,478
Other Exempt Purpose Expenditures:
840,298,549
Total Exempt Purpose Expenditures:
840,321,027
Lobbying Nontaxable Amount:
1,000,000
Grassroots Nontaxable Amount:
250,000
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
COOK CHILDREN'S HEALTH CARE
Address. Either US or Foreign Type:
801 SEVENTH AVE
FORT WORTH, TX76104    
EIN:
75-2705881
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
180,572
Total Lobbying Expenditures:
180,572
Other Exempt Purpose Expenditures:
287,722,338
Total Exempt Purpose Expenditures:
287,902,910
Lobbying Nontaxable Amount:
1,000,000
Grassroots Nontaxable Amount:
250,000
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
COOK CHILDREN'S PHYSICIAN NE
Address. Either US or Foreign Type:
801 SEVENTH AVE
FORT WORTH, TX76104    
EIN:
75-2485366
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
432,113,954
Total Exempt Purpose Expenditures:
432,113,954
Lobbying Nontaxable Amount:
1,000,000
Grassroots Nontaxable Amount:
250,000
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
WI COOK FOUNDATION
Address. Either US or Foreign Type:
801 SEVENTH AVE
FORT WORTH, TX76104    
EIN:
75-2051649
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
46,656,091
Total Exempt Purpose Expenditures:
46,656,091
Lobbying Nontaxable Amount:
1,000,000
Grassroots Nontaxable Amount:
250,000
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
COOK CHILDREN'S HOME HEALTH
Address. Either US or Foreign Type:
801 SEVENTH AVE
FORT WORTH, TX76104    
EIN:
75-2896983
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
68,024,379
Total Exempt Purpose Expenditures:
68,024,379
Lobbying Nontaxable Amount:
1,000,000
Grassroots Nontaxable Amount:
250,000
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
ROSEDALE OFFICE BUILDING
Address. Either US or Foreign Type:
1500 W ROSEDALE
FORT WORTH, TX76104    
EIN:
46-0866421
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
2,316,032
Total Exempt Purpose Expenditures:
2,316,032
Lobbying Nontaxable Amount:
265,802
Grassroots Nontaxable Amount:
66,451
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
CHILD STUDY CENTER
Address. Either US or Foreign Type:
801 SEVENTH AVE
FORT WORTH, TX76104    
EIN:
75-1099536
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
9,401,256
Total Exempt Purpose Expenditures:
9,401,256
Lobbying Nontaxable Amount:
620,063
Grassroots Nontaxable Amount:
155,016
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
COOK CHILDREN'S HEALTH ENTER
Address. Either US or Foreign Type:
801 SEVENTH AVE
FORT WORTH, TX76104    
EIN:
84-2625990
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
7,200,844
Total Exempt Purpose Expenditures:
7,200,844
Lobbying Nontaxable Amount:
510,042
Grassroots Nontaxable Amount:
127,511
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
COOK CHILDREN'S MEDICAL CENT
Address. Either US or Foreign Type:
801 SEVENTH AVE
FORT WORTH, TX76104    
EIN:
85-2354189
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
13,552,732
Total Exempt Purpose Expenditures:
13,552,732
Lobbying Nontaxable Amount:
827,637
Grassroots Nontaxable Amount:
206,909
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0