Form990


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)
Do not enter social security numbers on this form as it may be made public.
Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2024
Open to Public Inspection
A For the 2024 calendar year, or tax year beginning 10-01-2024 , and ending 09-30-2025
BCheck if applicable:
CName of organization
COOK CHILDREN'S MEDICAL CENTER
 
 
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 $ 2,269,822,319
F Name and address of principal officer:
NANCY CYCHOL
801 SEVENTH AVENUE
FORT WORTH,TX76104
I
Tax-exempt status: (   ) (insert no.) or
J
Website:
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  
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
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 13
5 Total number of individuals employed in calendar year 2024 (Part V, line 2a) ...... 5 5,692
6 Total number of volunteers (estimate if necessary) ............. 6 890
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 14,637
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 9,938
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 22,942,471 12,247,041
9 Program service revenue (Part VIII, line 2g) ......... 2,195,940,423 2,252,070,978
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 2,770,914 1,080,121
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 222,910 2,997,491
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 2,221,876,718 2,268,395,631
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 100,455,428 110,683,116
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 574,668,377 609,975,340
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) 0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 988,635,221 1,025,475,554
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,663,759,026 1,746,134,010
19 Revenue less expenses. Subtract line 18 from line 12....... 558,117,692 522,261,621
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 2,486,656,392 3,427,865,062
21 Total liabilities (Part X, line 26)............. 814,134,605 1,224,546,562
22 Net assets or fund balances. Subtract line 21 from line 20..... 1,672,521,787 2,203,318,500
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
Signature of officer Date
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name

Firm's EIN
Firm's address



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 (2024)
Form 990 (2024)
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 $ 1,352,770,479 including grants of $ 110,683,116 ) (Revenue $ 2,254,758,346 )
COOK CHILDREN'S MEDICAL CENTER (CCMC) - FORT WORTH REMAINS THE CORNERSTONE OF COOK CHILDREN'S HEALTH CARE SYSTEM. THIS 461-BED FACILITY BRINGS TOGETHER NATIONALLY RECOGNIZED CLINICIANS, ADVANCED TECHNOLOGY, FAMILY-CENTERED CARE AND LEADING-EDGE CLINICAL RESEARCH - ALL WITH THE SYSTEM'S PROMISE IN MIND. 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. NATIONALLY RECOGNIZED SERVICES SUCH AS THE LEVEL IV NEONATAL INTENSIVE CARE UNIT (NICU), THE JANE AND JOHN JUSTIN INSTITUTE FOR MIND HEALTH, AND THE HEMATOLOGY AND ONCOLOGY CENTER LEAD THE WAY IN PROVIDING THE HIGHEST LEVEL OF CARE TO FAMILIES WHO TRAVEL FROM ACROSS TEXAS, THE UNITED STATES AND INTERNATIONALLY. (CONTINUED ON SCHEDULE O)
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 expenses1,352,770,479
Form 990 (2024)
Form 990 (2024)
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
List of Attached Documents:
// Content
.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. Click to see attachment
List of Attached Documents:
// Content
...
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 I.............
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
List of Attached Documents:
// Content
.........
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
List of Attached Documents:
// Content
..
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
List of Attached Documents:
// Content
.........................
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 II....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D, Part III..............
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 IV..............
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
List of Attached Documents:
// Content
......
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
List of Attached Documents:
// Content
...................
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 VII.......
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 VIII.......
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
List of Attached Documents:
// Content
............
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
List of Attached Documents:
// Content
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 X
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII......................
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
21
Yes
 
Form 990 (2024)
Form 990 (2024)
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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 list of attachments
List of Attached Documents:
// Content
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 ....
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.......................
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 II...........
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 III.........................
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......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
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.....................
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............
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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.............
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 VI
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
182
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 (2024)
Form 990 (2024)
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
5,692
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
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:
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, or any disqualified or other person 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 (2024)
Form 990 (2024)
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
13
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
 
No
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 filed
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:
CORY RHOADES801 SEVENTH AVENUE   FORT WORTH,TX76104 (682) 885-4000
Form 990 (2024)
Form 990 (2024)
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, box 6 of 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) ANDREW S WAYNE......................................................................
TRUSTEE - VICE CHAIRMAN
 2.0
.................
2.0 		X   X       0 0 0
(2) JOHN P BOSWELL......................................................................
TRUSTEE - CHAIRMAN/SECRETARY/TREASURER
 2.0
.................
3.0 		X   X       0 0 0
(3) RYAN B DICKERSON......................................................................
TRUSTEE - CHAIRMAN/SECRETARY/TREASURER
 2.0
.................
4.0 		X   X       0 0 0
(4) BONNIE PETSCHE......................................................................
TRUSTEE
 1.0
.................
1.0 		X           0 0 0
(5) EDWIN S WIN RYAN......................................................................
TRUSTEE
 1.0
.................
3.0 		X           0 0 0
(6) JUDGE JEFFREY L CURETON......................................................................
TRUSTEE
 1.0
.................
1.0 		X           0 0 0
(7) LAURA MILLER......................................................................
TRUSTEE
 1.0
.................
1.0 		X           0 0 0
(8) LEAH M KING......................................................................
TRUSTEE - END 5/31/25
 1.0
.................
2.0 		X           0 0 0
(9) MICHAEL A LAGATTA......................................................................
TRUSTEE
 1.0
.................
1.0 		X           0 0 0
(10) NA'IM R MOSES......................................................................
TRUSTEE
 1.0
.................
1.0 		X           0 0 0
(11) PEGGY L CASSIDY......................................................................
TRUSTEE
 1.0
.................
2.0 		X           0 0 0
(12) TERRI VON LEHMDEN......................................................................
TRUSTEE
 1.0
.................
1.0 		X           0 0 0
(13) THOMAS BRECKINRIDGE RAY......................................................................
TRUSTEE
 1.0
.................
2.0 		X           0 0 0
(14) WALLY JONES......................................................................
TRUSTEE
 1.0
.................
2.0 		X           0 0 0
(15) CORY R RHOADES......................................................................
CHIEF FINANCIAL OFFICER
 1.0
.................
43.0 		    X       0 973,129 160,463
(16) JAMES C CUNNINGHAM MD......................................................................
EVP, CMO - END 1/3/25
 1.0
.................
41.0 		    X       0 1,353,775 912,444
(17) JONATHAN NEDRELOW MD......................................................................
EVP, CHIEF MEDICAL OFFICER
 1.0
.................
41.0 		    X       0 739,840 121,739
Form 990 (2024)
Form 990 (2024)
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) JOSEPH M GALLAGHER........................................................................
SVP, CHIEF LEGAL OFFICER
 1.0
.......................42.0 		    X       0 1,031,188 161,529
(19) MARY CARA MARTZ........................................................................
SECRETARY
 1.0
.......................40.0 		    X       0 193,688 26,567
(20) NANCY C CYCHOL........................................................................
EVP, HOSPITAL SERVICES
 26.0
.......................15.0 		    X       855,341 460,568 369,282
(21) RICK W MERRILL........................................................................
CEO
 10.0
.......................32.0 		    X       792,573 2,377,721 427,841
(22) SPENCER D SEALS........................................................................
SVP CONSTRUCTION & REAL ESTATE
 1.0
.......................43.0 		    X       0 473,682 97,738
(23) STANLEY E DAVIS........................................................................
PRESIDENT
 40.0
.......................1.0 		    X       1,026,034 0 718,638
(24) STEPHEN W KIMMEL........................................................................
EVP, SYSTEM FINANCE
 14.0
.......................29.0 		    X       496,418 882,522 517,619
(25) THERESA Z MEADOWS........................................................................
SVP, CHIEF INFORMATION OFFICER - END 6/1/25
 1.0
.......................41.0 		    X       0 949,722 64,282
(26) ALDRENA HEAD........................................................................
AVP, HIM
 40.0
.......................0 		      X     228,558 0 50,198
(27) CHERYL PETERSEN........................................................................
SVP NURSING/ CHIEF NURSING CNO
 40.0
.......................0 		      X     610,846 0 128,743
(28) DEBORAH BOUDREAUX........................................................................
VP, NURSING & PATIENT SVC
 40.0
.......................0 		      X     357,289 0 76,761
(29) ELIA VALENCIA-STOKES........................................................................
VP, FINANCE
 40.0
.......................0 		      X     459,499 0 101,646
(30) JACK SOSEBEE........................................................................
SVP OPERATIONS
 40.0
.......................2.0 		      X     628,404 0 107,739
(31) MEGAN CHAVEZ........................................................................
VP, COOK CHILDREN'S EXPERIENCE
 40.0
.......................0.0 		      X     497,439 0 83,275
(32) NATALIE WILKINS........................................................................
VP, OPERATIONS
 40.0
.......................0 		      X     486,264 0 71,369
(33) NICHOLAS MARKHAM........................................................................
VP CAMPUS FAC, SUPP SERVICES
 40.0
.......................0.0 		      X     327,931 0 70,363
(34) ORLANDO CHAPA........................................................................
VP, NURSING & PATIENT SVC
 40.0
.......................0 		      X     361,419 0 76,085
(35) OZIOMA OLOWU........................................................................
AVP, PHARMACY
 40.0
.......................0 		      X     348,680 0 66,499
(36) RAMONDA BUSBY........................................................................
AVP, CASE MANAGEMENT SERVICES
 40.0
.......................0 		      X     251,645 0 36,090
(37) TAMMY THOMLISON........................................................................
AVP, REVENUE CYCLE
 40.0
.......................0 		      X     322,540 0 36,755
(38) TIFFANY EPPERSON........................................................................
AVP, NURSING
 40.0
.......................0 		      X     215,059 0 41,349
(39) GINA HERNANDEZ........................................................................
DIRECTOR, NURSING ADMIN
 40.0
.......................0 		        X   231,899 0 29,369
(40) JESSACA SIBR........................................................................
PHARMACIST
 40.0
.......................0 		        X   246,422 0 42,029
(41) NATALIE CARPENTER........................................................................
AVP, NURSING
 40.0
.......................0 		        X   227,912 0 35,052
(42) ROBERT TUCKER........................................................................
DIRECTOR, FINANCE
 40.0
.......................0 		        X   228,087 0 39,238
(43) TOMMIE MOSS........................................................................
PHARMACIST
 40.0
.......................0 		        X   261,139 0 55,939
(44) KEVIN GREENE........................................................................
VP, PROSPER MEDICAL CENTER
 0.0
.......................40.0 		          X 0 343,582 81,639
1b Sub-Total..............
c Total from continuation sheets to Part VII, Section A..
d Total (add lines 1b and 1c)......... 9,461,398 9,779,417 4,808,280
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 929
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
Yes
 
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 24,260,845
DAVID M SCHWARZ ARCHITECTS INC

1707 L STREET NW
SUITE 400
WASHINGTON,DC20036 		ARCHITECTURE DESIGN 3,925,386
HKS INC

PO BOX 731121
DALLAS,TX75373 		PROFESSIONAL SERVICES 3,273,253
BOTTOM LINE SYSTEMS LLC

541 BUTTERMILK PIKE
STE 401
CRESCENT SPRINGS,KY41017 		PROFESSIONAL SERVICES 2,732,120
DUNAWAY ASSOCIATES LLC

550 BAILEY AVE
SUITE 400
FORT WORTH,TX76107 		CONSTRUCTION 1,702,887
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 109
Form 990 (2024)
Form 990 (2024)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 12,099,488
e Government grants (contributions)1e 147,553
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f....... 12,247,041
Program Service RevenueAmt Business Code
2a PATIENT SERVICES 622310 2,088,394,363 2,088,394,363    
b OTHER OPERATING REVENUE 622310 140,452,082 140,452,082    
c JOINT VENTURE REVENUE 622310 23,209,896 23,209,896    
d LAB REFERRALS 621511 14,637   14,637  
e
f All other program service revenue. 0 0 0 0
g Total. Add lines 2a–2f ..... 2,252,070,978
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ...... 949,450     949,450
4 Income from investment of tax-exempt bond proceeds        
5 Royalties...........        
(i) Real (ii) Personal
6a Gross rents 6a 1,653,336  
b Less: rental expenses 6b 1,357,850  
c Rental income or (loss) 6c 295,486 0
d Net rental income or (loss)....... 295,486     295,486
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 7a   199,509
b Less: cost or other basis and sales expenses 7b   68,838
c Gain or (loss) 7c 0 130,671
d Net gain or (loss)......... 130,671     130,671
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..        
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..        
OtherRevenueMiscAmt
Business Code
11a GAIN ON DEFEASANCE 900099 2,702,005 2,702,005    
b            
c            
d All other revenue .... 0 0 0 0
e Total. Add lines 11a–11d ...... 2,702,005
12 Total revenue. See instructions..... 2,268,395,631 2,254,758,346 14,637 1,375,607
Form 990 (2024)
Form 990 (2024)
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 .... 110,112,991 110,112,991
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 570,125 570,125
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 11,278,336 2,178,497 9,099,839  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........        
7 Other salaries and wages........ 429,794,299 413,727,553 16,066,746  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 22,290,766 21,174,832 1,115,934  
9 Other employee benefits ....... 114,404,472 109,285,149 5,119,323  
10 Payroll taxes ........... 32,207,467 30,667,127 1,540,340  
11 Fees for services (non-employees):        
a Management ...... 322,906,855   322,906,855  
b Legal ......... 31,819   31,819  
c Accounting ...........        
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 54,319,672 46,082,156 8,237,516 0
12 Advertising and promotion .... 123,294 118,294 5,000  
13 Office expenses ....... 16,123,308 15,125,844 997,464  
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 10,567,320 7,466,783 3,100,537  
17 Travel ............ 1,140,957 1,054,969 85,988  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 660,114 624,621 35,493  
20 Interest ........... 47,187 30,288 16,899  
21 Payments to affiliates ....... 1,956,235 1,956,235    
22 Depreciation, depletion, and amortization .. 66,789,871 50,909,771 15,880,100  
23 Insurance ... 6,153,250 6,153,250    
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 230,692,780 230,692,780    
b LPPF SUPPLEMENTAL PAYMENTS 172,890,192 172,890,192    
c PHYSICIAN REMUNERATION 73,283,842 73,283,842    
d MINOR/COMPUTER EQUIPMENT 23,265,609 23,265,609    
e All other expenses 44,523,249 35,399,571 9,123,678 0
25 Total functional expenses. Add lines 1 through 24e 1,746,134,010 1,352,770,479 393,363,531 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 if following SOP 98-2 (ASC 958-720).        
Form 990 (2024)
Form 990 (2024)
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 ........ 16,486 1 16,421
2 Savings and temporary cash investments ......... 1,216,988,006 2 1,844,701,567
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 320,616,591 4 314,577,802
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 ........... 4,806,246 7 3,508,282
8 Inventories for sale or use ............ 20,825,319 8 19,215,711
9 Prepaid expenses and deferred charges ...... 574,843 9 574,463
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,555,802,062
b Less: accumulated depreciation 10b 830,392,814 677,505,071 10c 725,409,248
11 Investments—publicly traded securities .   11  
12 Investments—other securities. See Part IV, line 11 ..... 0 12  
13 Investments—program-related. See Part IV, line 11 .. 9,500,076 13 9,267,686
14 Intangible assets ............... 4,517,494 14 3,762,495
15 Other assets. See Part IV, line 11 ........... 231,306,260 15 506,831,387
16 Total assets. Add lines 1 through 15 (must equal line 33)... 2,486,656,392 16 3,427,865,062
Liabilities 17 Accounts payable and accrued expenses ..... 130,863,370 17 139,337,676
18 Grants payable ...   18  
19 Deferred revenue ......... 164,344 19 181,161
20 Tax-exempt bond liabilities ......... 457,651,530 20 793,448,624
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
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 ..   23  
24 Unsecured notes and loans payable to unrelated third parties ..   24  
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 225,455,361 25 291,579,101
26 Total liabilities. Add lines 17 through 25.. 814,134,605 26 1,224,546,562
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 1,672,521,787 27 2,203,318,500
28 Net assets with donor restrictions ...........   28  
Organizations that do not follow FASB ASC 958, check here right arrow 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 ........... 1,672,521,787 32 2,203,318,500
33 Total liabilities and net assets/fund balances ........ 2,486,656,392 33 3,427,865,062
Form 990 (2024)
Form 990 (2024)
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
2,268,395,631
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
1,746,134,010
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
522,261,621
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
1,672,521,787
5
Net unrealized gains (losses) on investments ...............
5
8,087,978
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
447,114
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
2,203,318,500
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 Uniform Guidance, 2 C.F.R. Part 200, Subpart F?
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 (2024)
Form 990 (2024)
Additional Data


Software ID: 24020961
Software Version: 2024v5.1
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
2024
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) 2024

Schedule A (Form 990) 2024
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) 2020 (b) 2021 (c) 2022 (d) 2023 (e) 2024 (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) 2020 (b) 2021 (c) 2022 (d) 2023 (e) 2024 (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
33 1/3% support test—2024. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization .......................right arrow
b
33 1/3% support test—2023. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow
17a
10%-facts-and-circumstances test—2024. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow
b
10%-facts-and-circumstances test—2023. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow
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) 2024

Schedule A (Form 990) 2024
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) 2020 (b) 2021 (c) 2022 (d) 2023 (e) 2024 (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) 2020 (b) 2021 (c) 2022 (d) 2023 (e) 2024 (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
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
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
33 1/3% support tests-2024. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow
b
33 1/3 % support tests—2023. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow
20
Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow
Schedule A (Form 990) 2024

Schedule A (Form 990) 2024
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) 2024

Schedule A (Form 990) 2024
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) 2024

Schedule A (Form 990) 2024
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) 2024

Schedule A (Form 990) 2024
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 2024 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-2024 		(iii)
Distributable
Amount for 2024
1 Distributable amount for 2024 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2024 (reasonable cause required-- explain in Part VI).
See instructions.		  
3 Excess distributions carryover, if any, to 2024:
a From 2019.......  
b From 2020.......  
c From 2021.......  
d From 2022.......  
e From 2023.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2024 distributable amount  
i Carryover from 2019 not applied (see
instructions) 		 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2024 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2024 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2024, 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 2024. 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 2025. Add lines
3j and 4c. 		 
8 Breakdown of line 7:
a Excess from 2020.....  
b Excess from 2021.....  
c Excess from 2022.....  
d Excess from 2023.....  
e Excess from 2024.....  
Schedule A (Form 990) (2024)

Schedule A (Form 990) 2024
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) 2024


Additional Data


Software ID: 24020961
Software Version: 2024v5.1
Schedule B
(Form 990)
(Rev. January 2025)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

right arrow Attach to Form 990, 990-EZ, or 990-PF.
right arrow Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
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
501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization


Form 990-PF
501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation
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
For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.
Special Rules
For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 331/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.
For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.
For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Right Arrow $  
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) (Rev. 1-2025)
Schedule B (Form 990) (Rev. 1-2025) Page 2
Name of organization
COOK CHILDREN'S MEDICAL CENTER
  		Employer identification number
75-2051646
Part I
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) (Rev. 1-2025)
Schedule B (Form 990) (Rev. 1-2025)
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) (Rev. 1-2025)
Schedule B (Form 990) (Rev. 1-2025)
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.) $  
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) (Rev. 1-2025)
Additional Data


Software ID: 24020961
Software Version: 2024v5.1
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

right arrow Complete if the organization is described below. right arrow Attach to Form 990 or Form 990-EZ.
right arrowGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2024
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 ....................................................................right arrow
$  
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 ................................right arrow
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................right arrow
$  
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 ..... right arrow
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................right arrow

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

$  
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) 2024

Schedule C (Form 990) 2024
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 right arrowexpenses, and share of excess lobbying expenditures).Click to see attachment
List of Attached Documents:
// Content

B Check right arrow
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) ........................ 0 427,090
c Total lobbying expenditures (add lines 1a and 1b) ............................................................ 0 427,090
d Other exempt purpose expenditures ............................................................................... 1,746,134,010 3,967,971,363
e Total exempt purpose expenditures (add lines 1c and 1d) .................................................. 1,746,134,010 3,968,398,453
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		 1,000,000 1,000,000
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) ................................................. 250,000 250,000
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................ 0 0
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................ 0 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) 2021 (b) 2022 (c) 2023 (d) 2024 (e) Total
2a Lobbying nontaxable amount 1,000,000 1,000,000 1,000,000 1,000,000 4,000,000
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		6,000,000
c Total lobbying expenditures 203,050 225,096 218,773 427,090 1,074,009
d Grassroots nontaxable amount 250,000 250,000 250,000 250,000 1,000,000
e Grassroots ceiling amount
(150% of line 2d, column (e))		 1,500,000
f Grassroots lobbying expenditures 0 0 0 0 0
Schedule C (Form 990) 2024


Schedule C (Form 990) 2024
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) 2024


Additional Data


Software ID: 24020961
Software Version: 2024v5.1

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
right arrow 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.
right arrow Attach to Form 990.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
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) 2,300  
3 Aggregate value of grants from (during year) 0  
4 Aggregate value at end of year ........ 355,586  
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 July 25, 2006, 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 right arrow  
4
Number of states where property subject to conservation easement is located right arrow  
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
right arrow  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow $  
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 .........................right arrow $  
(ii)
Assets included in Form 990, Part X ...............................right arrow $  
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 ..........................right arrow $  
b
Assets included in Form 990, Part X ...............................right arrow $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) (Rev. 1-2025)

Schedule D (Form 990) (Rev. 1-2025)
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 .... 167,539,202 150,274,073 147,891,893 144,754,164 111,066,541
b Contributions ... 395,391 573,248 556,006 769,694 503,149
c Net investment earnings, gains, and losses 17,608,406 17,653,678 3,075,768 4,015,935 35,817,291
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		6,512,874 961,797 1,249,594 1,647,900 2,632,817
f Administrative expenses ....          
g End of year balance ...... 179,030,125 167,539,202 150,274,073 147,891,893 144,754,164
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment right arrow38.56 %
b
Permanent endowment right arrow53.08 %
c
Term endowment right arrow8.36 %
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 .....   16,179,074 16,179,074
b Buildings ....   1,093,292,495 562,316,937 530,975,558
c Leasehold improvements   4,710,222 4,563,555 146,667
d Equipment ....   322,367,882 247,551,503 74,816,379
e Other .....   119,252,389 15,960,819 103,291,570
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..right arrow 725,409,248
Schedule D (Form 990) (Rev. 1-2025)

Schedule D (Form 990) (Rev. 1-2025)
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.)right arrow  
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.)right arrow  
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 359,675,982
(2)OTHER RECEIVABLES 4,388,123
(3)SUPPLEMENTAL ASSETS 116,511,540
(4)RIGHTS OF USE ASSETS 15,929,973
(5)INTERCOMPANY RECEIVABLES 10,325,769
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........right arrow 506,831,387
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  
FEDERAL INCOME TAXES  
INTERCOMPANY PAYABLES 174,515,907
ESTIMATED DUE TO THIRD PARTIES 102,122,402
RIGHT OF USE LIABILITY 14,940,792





Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)right arrow 291,579,101
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) (Rev. 1-2025)

Schedule D (Form 990) (Rev. 1-2025)
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 2,273,034,567
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a 8,087,978
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ........... 2d 1,804,955
e Add lines 2a through 2d ..................... 2e 9,892,933
3 Subtract line 2e from line 1.................. 3 2,263,141,634
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 5,253,997
c Add lines 4a and 4b.................... 4c 5,253,997
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 2,268,395,631
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 1,746,063,225
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 1,357,850
e Add lines 2a through 2d.................... 2e 1,357,850
3 Subtract line 2e from line 1................... 3 1,744,705,375
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 1,428,635
c Add lines 4a and 4b..................... 4c 1,428,635
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 1,746,134,010
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 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, PART V, LINE 4 INTENDED USES 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. THE INTENDED USE OF THE HIGHEST AMOUNTS OF ENDOWMENTS IS CHARITY CARE, OPERATIONAL NEEDS OF THE CHILD LIFE DEPARTMENT, OPERATIONS OF THE HOSPITAL, TO SUPPORT THE FACILITY DOG PROGRAM, SUPPORT THE OPERATIONAL NEEDS OF THE PASTORAL CARE DEPARTMENT AND NURSING RESEARCH.
SCHEDULE D, PART XI, LINE 2(D) OTHER REVENUES IN AUDITED FINANCIAL STATEMENTS NOT IN FORM 990 INTEREST RATE SWAP ADJUSTMENT - 447105 RENT EXPENSE - 1357850
SCHEDULE D, PART XI, LINE 4(B) OTHER REVENUES IN FORM 990 NOT IN AUDITED FINANCIAL STATEMENTS ADDITIONAL CONTRIBUTIONS FROM FOUNDATION - 3677809 CCIC RETRO PREMIUM - 1297964 GOVERNMENT GRANTS - 147553 GAIN ON DISPOSAL OF ASSETS - 130671
SCHEDULE D, PART XII, LINE 2(D) OTHER EXPENSES IN AUDITED FINANCIAL STATEMENTS NOT IN FORM 990 RENT EXPENSE - 1357850
SCHEDULE D, PART XII, LINE 4(B) OTHER EXPENSES IN FORM 990 NOT IN AUDITED FINANCIAL STATEMENTS GAIN ON DISPOSAL OF ASSETS - 130671 CCIC RETRO PREMIUM - 1297964
Schedule D (Form 990) (Rev. 1-2025)


Additional Data


Software ID: 24020961
Software Version: 2024v5.1




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
Medium right arrow Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow Attach to Form 990.
Medium right arrow Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2024
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) . . . 		    19,333,187 2,051,351 17,281,836 0.990 %
b Medicaid (from Worksheet 3, column a) . . . . .     987,380,575 837,429,758 149,950,817 8.588 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .         0 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 0 0 1,006,713,762 839,481,109 167,232,653 9.577 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     10,715,902 32,569 10,683,333 0.612 %
f Health professions education (from Worksheet 5) . . .         0 0 %
g Subsidized health services (from Worksheet 6) . . . .     13,989,579   13,989,579 0.801 %
h Research (from Worksheet 7) .     12,542,967 3,443,939 9,099,028 0.521 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     110,258,496   110,258,496 6.314 %
j Total. Other Benefits . . 0 0 147,506,944 3,476,508 144,030,436 8.249 %
k Total. Add lines 7d and 7j . 0 0 1,154,220,706 842,957,617 311,263,089 17.826 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2024
Schedule H (Form 990) 2024
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 0.001 %
2 Economic development         0 0 %
3 Community support         0 0 %
4 Environmental improvements         0 0 %
5 Leadership development and
training for community members		         0 0 %
6 Coalition building     38,613   38,613 0.002 %
7 Community health improvement advocacy     497,700   497,700 0.029 %
8 Workforce development         0 0 %
9 Other         0 0 %
10 Total 0 0 556,313 0 556,313 0.032 %
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
131,618,519
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
6,427,373
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
6,067,380
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
359,993
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 %
1COOK CHILDRENS SURGERY CENTER
  		SURGERY CENTER 51 % 0 % 30.03 %
2CENTER FOR PEDIATRIC SURGERY LTD
  		SURGERY CENTER 52.03 % 0 % 14.29 %
3CPS PEDIATRICS LLC
  		PEDIATRIC CARE 52.55 % 0 % 14.29 %
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2024
Schedule H (Form 990) 2024
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 and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research 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) 2024
Schedule H (Form 990) 2024
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 24
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 24
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): WWW.COOKCHILDRENS.ORG/ABOUT/COMMUNITY-OUTREACH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/
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) 2024
Schedule H (Form 990) 2024
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 Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 400.0%
and FPG family income limit for eligibility for discounted care of 500.0%
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 Described the information the hospital facility may require an individual to provide as part of his or her application
b Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application
c Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process
d Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications
e Other (describe in Section C)
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
WWW.COOKCHILDRENS.ORG/PATIENTS-FAMILIES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/
b
WWW.COOKCHILDRENS.ORG/PATIENTS-FAMILIES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2024
Schedule H (Form 990) 2024
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) 2024
Schedule H (Form 990) 2024
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) 2024
Schedule H (Form 990) 2024
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 FACILITY , 1 FACILITY , 1 - COOK CHILDRENS MEDICAL CENTER. 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 2021, AND 2024). 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 CAREGIVERS OF CHILDREN AGES 0-17, A COMMUNITY LEADER SURVEY, AND FOCUS GROUPS OUTLINED IN THE TABLE BELOW. WE ALSO GATHER FEEDBACK FROM COMMUNITY PARTNERS THROUGH FACILITATED DISCUSSIONS AT REGULAR MEETINGS AND AT 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 CAREGIVER AND COMMUNITY LEADER SURVEYS, FOCUS GROUPS AND/OR COMMUNITY MEETINGS. THE 2024 CHNA PARENT/CAREGIVER SURVEY WAS ADMINISTERED THROUGH AN OUTSIDE VENDOR (ETC INSTITUTE) TO A STATISTICALLY REPRESENTATIVE SAMPLE OF CAREGIVERS WITH CHILDREN AGES 0-17 LIVING IN OUR PRIMARY SERVICE AREA (COLLIN, DENTON, GRAYSON, HOOD, JOHNSON, PARKER, TARRANT, AND WISE COUNTIES). THE LARGE SAMPLE SIZE (6,877 COMPLETED SURVEYS) PROVIDES STATISTICALLY REPRESENTATIVE RESULTS APPLICABLE TO ALL EIGHT COUNTIES INDIVIDUALLY AND COLLECTIVELY WITH A LOW MARGIN OF ERROR (+/- 1.2%; 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/CAREGIVER SURVEY TO AN INTENTIONAL SAMPLE OF CAREGIVERS WITH FAMILIES EXPERIENCING HOMELESSNESS IN SHELTERS OR FAMILIES WITH AT LEAST ONE UNDOCUMENTED MEMBER AT SEVERAL TARRANT COUNTY HOMELESS SHELTERS (227 COMPLETED SURVEYS). COMMUNITY HEALTH WORKERS (CHWS) FROM THE CENTER CONDUCTED 27 INTERVIEWS WITH ENGLISH AND SPANISH-SPEAKING CAREGIVERS, TOTALING APPROXIMATELY 540 MINUTES SPENT WITH FAMILIES. CHWS WHO HAD ALREADY BUILT TRUST WITH THE FAMILY/CAREGIVER LED THE INTERVIEWS. THIS PROVIDED AN OPPORTUNITY FOR CAREGIVERS TO SHARE ADDITIONAL INFORMATION BEYOND QUESTIONS ON THE PARENT/CAREGIVER SURVEY. A COOK CHILDREN'S PHYSICIAN SUPPORTED INTERVIEWS WITH 4 CAREGIVERS OF CHILDREN SEEKING HEALTH CARE IN THE SERVICE AREA AND WHO SPEAK A LANGUAGE OTHER THAN ENGLISH AND SPANISH, TOTALING APPROXIMATELY 140 MINUTES SPENT WITH FAMILIES. THESE INTERVIEWS OFFERED AN IMPORTANT OPPORTUNITY FOR CAREGIVERS TO SHARE THEIR EXPERIENCES NAVIGATING THE NORTH TEXAS HEALTH CARE SYSTEM, IDENTIFY OBSTACLES TO QUALITY CARE, AND PROVIDE INFORMATION ON WAYS TO ENHANCE FAMILY-CENTERED CARE, PARTICULARLY FOR IMMIGRANT FAMILIES. ETC INSTITUTE ALSO CONDUCTED A SURVEY WITH COMMUNITY LEADERS TO OBTAIN THEIR FEEDBACK ABOUT THE STATUS OF CHILDREN'S HEALTH. SURVEYS WERE MAILED TO 1,002 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 239 RESPONSES (24% RESPONSE RATE). A COMPLETE LIST OF WHO RECEIVED THE OPPORTUNITY TO PARTICIPATE IN THE LEADER SURVEY IS AVAILABLE UPON REQUEST. VIRTUAL INTERVIEWS WITH 12 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/CAREGIVER SURVEY FINDINGS. PRIORITY TOPICS DISCUSSED INCLUDED MENTAL HEALTH, ACES, HOUSING AND FOOD SECURITY, HEALTHY LIFESTYLES, INJURY PREVENTION, AND ACCESS TO HEALTH CARE FOR ALL CHILDREN. BASED ON THE 2009 INITIAL ASSESSMENT RESULTS, COOK CHILDREN'S BOARD OF TRUSTEES REPRIORITIZED CHILDREN'S HEALTH ISSUES IDENTIFIED BY PARENTS AND COMMUNITY LEADERS AND FINDINGS FROM SUBSEQUENT CHNA PROCESSES IN 2012, 2015, 2018, 2021, AND 2024 CONFIRMED THE IMPORTANCE OF THESE ISSUES FOR CONTINUING FOCUSED INTERVENTION: - EQUITABLE ACCESS TO HEALTH CARE - ORAL HEALTH - MENTAL HEALTH - HEALTHY LIFESTYLES (OBESITY PREVENTION) - CAREGIVER AND FAMILY SUPPORT (ABUSE AND NEGLECT PREVENTION) - INJURY PREVENTION - ASTHMA COOK CHILDREN'S CONTINUES TO USE THE 2024 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 2027 CHNA IS CURRENTLY IN DEVELOPMENT AND WILL BE COMPLETED AND POSTED BY SEPTEMBER 30, 2028.
SCHEDULE H, PART V, SECTION B, LINE 6A FACILITY , 1 FACILITY , 1 - COOK CHILDRENS MEDICAL CENTER. THIS 2024 COMMUNITY HEALTH NEEDS ASSESSMENT REPORT IS INTENDED TO SERVE AS A JOINT ASSESSMENT FOR THE MAIN COOK CHILDREN'S MEDICAL CENTER-FORT WORTH AND COOK CHILDREN'S MEDICAL CENTER-PROSPER, WHICH OPENED IN JANUARY 2023. 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 2024 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 FACILITY , 1 FACILITY , 1 - COOK CHILDRENS MEDICAL CENTER. EXTERNAL VENDORS USED TO CONDUCT THE PARENT AND COMMUNITY LEADER SURVEYS INCLUDED ETC INSTITUTE, INC., MY HEALTH MY RESOURCES OF TARRANT COUNTY, AND UNIVERSITY OF NORTH TEXAS HEALTH - FORT WORTH. 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 FACILITY , 1 FACILITY , 1 - COOK CHILDRENS MEDICAL CENTER. COOK CHILDREN'S CENTER FOR COMMUNITY HEALTH (THE CENTER), FORMERLY THE CENTER FOR CHILDREN'S HEALTH, WAS CREATED IN 2011 TO PROVIDE AN INFRASTRUCTURE FOR CONDUCTING THE TRIENNIAL CHNA, LEAD COMMUNITY RESEARCH, AND GUIDE COMMUNITY PROGRAMS AND STAKEHOLDER COLLABORATIONS. THESE COMBINED ACTIVITIES FOCUS ON INCREASING ACCESS TO PREVENTIVE SERVICES FOR UNDER-RESOURCED POPULATIONS. THE CENTER 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 COLLABORATIONS AND SUPPORT PARTNERSHIPS IN EVERY COUNTY WITHIN OUR EIGHT-COUNTY 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 COLLABORATIVE BYLAWS AND MEETING GUIDELINES. COLLABORATIONS LED BY THE CENTER INCLUDE: - CAREGIVER AND FAMILY SUPPORT ACTION TEAM - CHILDREN'S ORAL HEALTH COLLABORATIVE - HEALTH ACCESS ACTION TEAM - HEALTHY LIFESTYLES ACTION TEAM - INJURY PREVENTION COLLABORATIVE - LIFEGUARD YOUR CHILD CAMPAIGN - THRIVING COMMUNITIES COLLABORATIVE - SCHOOL-BASED ORAL HEALTH ACTION TEAM - SAVE A SMILE - SAFE BABY SLEEP COUNCIL - MENTAL HEALTH & RESILIENCY ACTION TEAM 2024 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 AND FRAMEWORKS SUCH AS THE SPECTRUM OF PREVENTION, 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 UNDER-RESOURCED POPULATIONS, THE CENTER 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: INCREASE ACCESS TO OVERALL HEALTH & WELL-BEING FOR ALL CHILDREN - ENSURE THAT C4CH PROGRAMS AND COMMUNITY INVOLVEMENT EXEMPLIFY COOK CHILDREN'S PROMISE. COMMUNITY STRATEGIES - MONITOR AND ADDRESS CHILDREN'S HEALTH ISSUES IN COOK CHILDREN'S 6-COUNTY FWSA TO GUIDE PROGRAM DESIGN AND PRIORITIZATION 1. HOSTED TWO REGIONAL CHILD HEALTH SUMMITS TO SHARE FINDINGS FROM THE 2024 CHNA. 2. COMPLETED ROLLING DATA COLLECTION FOR YEAR 1 OF THE 2027 CHNA BY ADMINISTERING THE PARENT/CAREGIVER SURVEY ANNUALLY AMONG A PURPOSEFUL SAMPLE OF CAREGIVERS AND FAMILIES ACROSS THE 8-COUNTY SERVICE AREA. - LEVERAGE COMMUNITY PARTNERSHIPS TO EXPAND HEALTHCARE SERVICES AND RESOURCES 1. 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. 2. COOK CHILDREN'S IS REGULARLY REPRESENTED AT COMMUNITY INITIATIVES THROUGHOUT THE 8-COUNTY SERVICE AREA ADDRESSING VARIOUS CHILD HEALTH ISSUES. 3. HOSTED 15 COLLABORATIVE MEETINGS WITH COMMUNITY PARTNERS AND ENGAGED OVER 860 COMMUNITY ORGANIZATIONS, SHARING KEY MESSAGING AND EDUCATIONAL RESOURCES. 4. PROVIDED 379,970 MINUTES OF DIRECT EDUCATION AND TRAINING TO OVER 40,000 CHILDREN, CAREGIVERS, AND COMMUNITY PARTNERS, ACHIEVING A 99% PARTICIPANT SATISFACTION RATE ON TRAIN THE TRAINERS. 5. THE CENTER DISTRIBUTED 177,097 PREVENTION TOOLS AND 308,529 EDUCATIONAL RESOURCES THROUGH COMMUNITY EVENTS AND COMMUNITY PARTNERS IN FY25. - ALIGN C4CH PROGRAMS WITH COOK CHILDREN'S PROMISE WHILE FOCUSING ON COLLABORATION, EVIDENCE-BASED PRACTICES, AND ADDRESSING HEALTH DISPARITIES. 1. THE CENTER PROVIDES REGULAR COMMUNICATION ABOUT HEALTH INFORMATION TO FAMILIES AND COMMUNITY PARTNERS THROUGH ONLINE EDUCATIONAL RESOURCES, CHECKUP MAGAZINE, YOUTUBE VIDEOS, EVENTS, AND PRESENTATIONS. IN FY25, C4CH REACHED OVER 3.3 MILLION UNIQUE COMMUNITY MEMBERS THROUGH TARGETED DIGITAL AWARENESS CAMPAIGNS ACROSS PRIORITY GEOGRAPHIES, REFLECTING 48,000 HOURS OF ENGAGEMENT. 2. THE CENTER MAXIMIZES THE POWER OF COOK CHILDREN'S INTEGRATED HEALTH SYSTEM BY DEVELOPING CLOSE PARTNERSHIPS WITH NEIGHBORHOOD HEALTH CENTERS, COOK CHILDREN'S HEALTH PLAN, AND OTHER DEPARTMENTS OFFERING CASE MANAGEMENT SERVICES TO DISTRIBUTE HEALTH AND WELLNESS MESSAGES AND PREVENTION TOOLS. 3. 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 FY25, CHWS PROVIDED OVER 10,680 SOCIAL SERVICES TO FAMILIES TO HELP THEM MEET BASIC NEEDS AND ADDRESS SOCIAL DETERMINANTS OF HEALTH AND WERE RESPONSIBLE FOR 2,290 COMMUNITY REFERRALS PROVIDED TO FAMILIES CONNECTING THEM TO BASIC NEEDS AND HEALTH SERVICES. CHWS, ALONG WITH OTHER C4CH STAFF, SERVED NEARLY 28,000 CHILDREN, FAMILIES, AND PARTNERS. - SERVE AS AN ACTIVE PARTNER ON COLLABORATIONS LED BY OTHER COMMUNITY ORGANIZATIONS TO ADVOCATE FOR AND IMPROVE THE SYSTEM OF CARE FOR CHILDREN WITH DISPARITIES. 1. SUPPORTED 389 PARTNER EVENTS AND MEETINGS INCLUDING PRESENTATIONS. ADDITIONAL INFORMATION RELATED TO INCREASING ACCESS TO CARE IS ALSO ADDRESSED THROUGHOUT EACH OF THE REMAINING SIX FOCUS AREAS DISCUSSED BELOW. 2. THE CENTER 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 7,000+ CHILDREN EACH YEAR. 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 ORAL HEALTH COLLABORATIVE AND ASSOCIATED ACTION TEAMS TO PLAN AND IMPLEMENT ORAL HEALTH COLLABORATIVE INTERVENTIONS. - DEVELOP AND DISTRIBUTE EVIDENCE-INFORMED ORAL HEALTH RESOURCES TO EDUCATE FAMILIES, MEDICAL/DENTAL PROVIDERS, AND OTHER COMMUNITY PARTNERS. - CONTINUE IMPLEMENTING SAVE A SMILE: A) CONDUCT LIMITED ORAL HEALTH EVALUATIONS FOR LOW-INCOME CHILDREN. B) IDENTIFY THOSE WITH ACUTE DENTAL PROBLEMS IN IDENTIFIED SCHOOLS. C) PROVIDE COMPREHENSIVE DENTAL TREATMENT AND COORDINATED CARE CONNECTING FAMILIES TO COMMUNITY RESOURCES MEETING IMMEDIATE SOCIAL SERVICE NEEDS. - BUILD ORGANIZATIONAL CAPACITY AND 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 OBSTACLES TO ORAL HEALTH CARE FOR PREGNANT TEENS AND WOMEN AND COORDINATE WITH OTHER C4CH SERVICES/PROGRAMMING FOR BROADER 4TH TRIMESTER SUPPORT. - EXPLORE MEDICAL/DENTAL INTEGRATION OPPORTUNITIES WITHIN COOK CHILDREN'S AND BEYOND TO ENHANCE COORDINATED CARE SERVICES. - SUPPORT COMMUNITY AWARENESS CAMPAIGNS, EVENTS, AND ADVOCACY EFFORTS TO ENCOURAGE GOOD ORAL HEALTH (E.G., NATIONAL CHILDREN'S DENTAL HEALTH MONTH). CONTINUED ON NEXT DISCLOSURE
SCHEDULE H, PART V, SECTION B, LINE 11 FACILITY , 2 FACILITY , 2 - COOK CHILDRENS MEDICAL CENTER. CONTINUED FROM PRIOR DISCLOSURE MENTAL HEALTH GOAL: IMPROVE CHILD MENTAL HEALTH, RESILIENCY, AND WELL-BEING - RESPOND TO THE URGENT AND GROWING NEED FOR MENTAL HEALTH SERVICES FOR CHILDREN AND YOUTH BY SUPPORTING COMMUNITY PARTNERS WHO PROVIDE ESSENTIAL MENTAL HEALTH CARE COMMUNITY STRATEGIES - LEAD AND SUSTAIN THRIVING COMMUNITIES COLLABORATIVE AND ASSOCIATED ACTION TEAMS TO PLAN AND IMPLEMENT MENTAL HEALTH COLLABORATIVE INTERVENTIONS, TARGETING HIGH-RISK POPULATIONS. - SUPPORT ORGANIZATIONS IN CAPACITY BUILDING TO FORM IMPACTFUL AND SUSTAINABLE MENTAL HEALTH PRACTICES AND POLICIES (E.G., HEALTHY MINDS. RESILIENT COMMUNITIES., MENTAL HEALTH CONNECTION).* 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 COMMUNITY RESOURCES (E.G., CHILDREN'S FEELINGS ARE A WORK OF ART, ROADMAP FOR CHILDREN'S MENTAL HEALTH). - PROVIDE PROFESSIONAL DEVELOPMENT OPPORTUNITIES FOR MENTAL HEALTH PROVIDERS TO SHARE SKILLS, KNOWLEDGE, AND TOOLS WITH COLLEAGUES AND CAREGIVERS WITHIN THEIR REACH (E.G., WELLNESS WORKSHOPS, TRAUMA INFORMED CARE TRAINING, QPR TRAINING (SUICIDE PREVENTION), YOUTH MENTAL HEALTH FIRST AID TRAINING). - SUPPORT COMMUNITY CAMPAIGNS AND EVENTS TO REDUCE STIGMA AND PROMOTE AWARENESS ABOUT MENTAL HEALTH AND WELL-BEING (E.G., MENTAL HEALTH AWARENESS MONTH, SUICIDE PREVENTION AND AWARENESS MONTH). HEALTHY LIFESTYLES (OBESITY PREVENTION) GOAL: IMPROVE ACCESS TO NUTRITIOUS FOOD AND PHYSICAL ACTIVITY FOR CHILDREN - RESPOND TO THE GENERAL HEALTH AND WELLNESS NEEDS OF FAMILIES COMMUNITY STRATEGIES - LEAD AND SUSTAIN THRIVING COMMUNITIES COLLABORATIVE AND ASSOCIATED ACTION TEAMS TO PLAN AND IMPLEMENT FAMILY WELLNESS COLLABORATIVE INTERVENTIONS. -INCREASE ACCESS TO FOOD RESOURCES THROUGH COMMUNITY PARTNERSHIPS AND EDUCATION (E.G., NOURISHING COMMUNITIES EFFORTS, LVT NHC DEMONSTRATION KITCHEN) - EXPLORE AND PROVIDE TRAUMA-INFORMED CARE TRAINING AND PRACTICES REGARDING FOOD INSECURITY SCREENING AND FOOD RESOURCE CONNECTION. - DEVELOP AND DISTRIBUTE EVIDENCE-INFORMED EDUCATION AND INTERVENTIONS FOR CHILDREN TO PROMOTE HEALTHY LIFESTYLES, NUTRITIOUS FOOD CONSUMPTION, AND PHYSICAL ACTIVITY (E.G., 5210+ EVERY DAY, GARDENING). - PROVIDE HEALTHY LIFESTYLES TRAINING TO PROVIDERS AND COMMUNITY MEMBERS TO EQUIP THEM WITH KNOWLEDGE AND TOOLS TO SUPPORT CAREGIVERS WITHIN THEIR REACH (E.G., 5210+ EVERY DAY FACILITATOR TRAINING, GARDEN WORKSHOPS). - SUPPORT CAPACITY-BUILDING EFFORTS FOR ORGANIZATIONS TO ESTABLISH SUSTAINABLE, IMPACTFUL PRACTICES AND POLICIES. - SUPPORT COMMUNITY AWARENESS CAMPAIGNS AND EVENTS TO ENCOURAGE HEALTHY LIFESTYLES (E.G., HEALTHY LIFESTYLES AWARENESS MONTH). CAREGIVER AND FAMILY SUPPORT (ABUSE NEGLECT AND PREVENTION) GOAL: IMPROVE FAMILY RESILIENCY THROUGH CAREGIVER AND FAMILY SUPPORT -RESPOND TO THE URGENT NEEDS OF FAMILIES RAISING CHILDREN FACING SERIOUS ADVERSITIES, INCLUDING ADVERSE CHILDHOOD EXPERIENCES (ACES), BY PROVIDING SUPPORT TO STRENGTHEN PARENTING SKILLS. COMMUNITY STRATEGIES - LEAD AND SUSTAIN THRIVING COMMUNITIES COLLABORATIVE AND ASSOCIATED ACTION TEAMS TO PLAN AND IMPLEMENT INTERVENTIONS THAT PROTECT CHILDREN'S WELL-BEING AND BUILD FAMILY RESILIENCE. - DEVELOP AND DISTRIBUTE EVIDENCE-INFORMED EDUCATION, RESOURCES, AND INTERVENTIONS THAT PROVIDE NETWORKS OF SUPPORT FOR PARENTS AND CAREGIVERS (E.G., BUILD-A-BRIDGE, CAREGIVER ALLIANCE, DIAPER HUB, AND PARENT CAFES). - CONTINUE IMPLEMENTING BUILD-A-BRIDGE TO: A) CONNECT FAMILIES WITH COORDINATED CARE AND COMMUNITY RESOURCES TO ADDRESS IMMEDIATE SOCIAL NEEDS. B) PROMOTE HEALTHY CAREGIVER AND CHILD ATTACHMENT AND CONNECTION WITH A MEDICAL HOME. - BUILD ORGANIZATIONAL CAPACITY AND PROVIDE EVIDENCE-INFORMED EDUCATION TO PROVIDERS AND COMMUNITY MEMBERS (E.G., PARENT CAFE FACILITATOR TRAINING, SCHOOL COUNSELOR ROUNDTABLES, EARLY DETECTION OF CHILD ABUSE AND NEGLECT, ACES 101 AND PCE TRAININGS). - CONNECT FAMILIES TO MATERNAL AND INFANT HEALTH SERVICES, INCLUDING POSTPARTUM MENTAL HEALTH SUPPORT AND LOCAL RESOURCES ADDRESSING THE NON-MEDICAL DRIVERS OF HEALTH, AND COORDINATE WITH OTHER C4CH SERVICES/PROGRAMMING FOR BROADER 4TH TRIMESTER SUPPORT. (E.G., PARENT PASS, COORDINATION AMONG C4CH SERVICES, SUPPORT SERVICES FOR TEEN PARENTS, EDUCATIONAL VIDEOS). - COLLABORATE WITH MATERNAL/INFANT HEALTH COALITIONS TO EXPAND ACCESS TO CRITICAL RESOURCES FOR POSTPARTUM MOTHERS AND FAMILIES (E.G., HEAL, TARRANT CO. MATERNAL-INFANT HEALTH COALITION). - SUPPORT COMMUNITY CAMPAIGNS AND EVENTS TO INCREASE AWARENESS ABOUT THE IMPORTANCE OF CAREGIVER AND FAMILY SUPPORT (E.G., CHILD ABUSE PREVENTION MONTH). INJURY PREVENTION GOAL: INCREASE SAFETY PRACTICES TO REDUCE UNINTENTIONAL INJURIES TO CHILDREN -RESPOND TO THE URGENT NEEDS OF FAMILIES WITH UNSAFE SLEEP ENVIRONMENTS, WHERE DROWNINGS ARE MORE LIKELY TO OCCUR, WHO DO NOT HAVE PROPERLY INSTALLED CAR SEATS, RECENTLY PRESCRIBED MEDICATION, RISK FOR ACCIDENTAL INGESTION/OVERDOSE, OR ARE MORE LIKELY TO HAVE GUN-RELATED INJURY IN THE HOME. COMMUNITY STRATEGIES - LEAD AND SUSTAIN INJURY PREVENTION COLLABORATIVE AND ASSOCIATED ACTION TEAMS TO PLAN AND IMPLEMENT COLLABORATIVE INTERVENTIONS - PROVIDE EVIDENCE-INFORMED EDUCATION AND INTERVENTIONS FOR PARENTS AND CAREGIVERS THAT ENCOURAGE SAFER HABITS (PLANNED VS UNPLANNED WATER SAFETY, CHILD PASSENGER SAFETY IN THE CAR AND ON THE ROAD, MEDICATION STORAGE, GUN STORAGE, AND SAFE SLEEP) - ENHANCE ORGANIZATIONAL CAPACITY BY EQUIPPING PROVIDERS AND COMMUNITY MEMBERS WITH THE KNOWLEDGE AND TOOLS TO ADVOCATE FOR SAFER HABITS WITH CAREGIVERS WITHIN THEIR REACH (TRAIN THE TRAINER EVENTS, CAR SEAT TECHNICIAN TRAINING EVENTS, AND SAFE BABY SLEEP SYMPOSIUM) - DEVELOP AND DISTRIBUTE EVIDENCE-BASED RESOURCES AND TOOLS TO PROMOTE SAFE PRACTICES FOR WATER SAFETY, CHILD PASSENGER SAFETY, POISON PREVENTION, GUN SAFETY, AND SAFE INFANT SLEEP - SUPPORT COMMUNITY AWARENESS CAMPAIGNS AND EVENTS TO ENCOURAGE SAFE PRACTICES FOR WATER SAFETY, CHILD PASSENGER SAFETY, POISON PREVENTION, GUN SAFETY, AND SAFE INFANT SLEEP ASTHMA GOAL: IMPROVE CONTROL OF CHILDHOOD ASTHMA - RESPOND TO THE URGENT NEEDS OF CHILDREN WITH INCREASED RISK OF UNCONTROLLED ASTHMA COMMUNITY STRATEGIES - HEALTHY HOMES 1. COACH FAMILIES TO IDENTIFY AND ADDRESS POTENTIAL ASTHMA TRIGGERS IN THEIR HOME ENVIRONMENT 2. EQUIP FAMILIES AND PARTNERS WITH EDUCATIONAL MATERIALS AND PRACTICAL TOOLS TO MITIGATE ASTHMA TRIGGERS. 3. CONNECT FAMILIES WITH CLINICAL ASTHMA CARE MANAGEMENT SERVICES AND COMMUNITY RESOURCES TO MEET IMMEDIATE SOCIAL SERVICE NEEDS (HEALTH CARE, FOOD, ETC.). - ASTHMA 411: SUPPORT PREVENTION-ORIENTED CARE IN SCHOOL SETTINGS 1. EQUIP SCHOOL NURSES WITH TRAINING AND MEDICATION NEEDED TO REDUCE MISSED SCHOOL AND EMERGENCY DEPARTMENT VISITS. 2. PROVIDE PHARMACY SERVICES AND TECHNICAL ASSISTANCE TO BUILD SCHOOL DISTRICTS' CAPACITY TO PROVIDE PREVENTION-ORIENTED CARE 3. PROVIDE GUIDANCE ON STANDING DELEGATED ORDERS AND OTHER CLINICAL ASPECTS THROUGH THE ASTHMA 411 MEDICAL ADVISORY COMMITTEE - EXPLORE ADDITIONAL SUPPORT OF COOK CHILDREN'S CLINICAL ASTHMA EFFORTS FOR HIGH-RISK ASTHMA POPULATIONS. - LEAD AND SUSTAIN THE THRIVING COMMUNITIES COLLABORATIVE AND SUPPORT OTHER COLLECTIVE COMMUNITY EFFORTS TO PLAN AND IMPLEMENT PREVENTIVE ASTHMA INTERVENTIONS, PRIORITIZING HIGH-RISK POPULATIONS. - PROVIDE ASTHMA-RELATED TRAINING TO PROVIDERS AND COMMUNITY MEMBERS WHO WILL SHARE SKILLS, KNOWLEDGE, AND TOOLS WITH COLLEAGUES AND CAREGIVERS WITHIN THEIR REACH. - SUPPORT COMMUNITY AWARENESS CAMPAIGNS AND EVENTS TO INCREASE AWARENESS ABOUT UNCONTROLLED ASTHMA
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2024
Schedule H (Form 990) 2024
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,TX75075 		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) 2024
Schedule H (Form 990) 2024
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 I, LINE 3C OTHER METHODS TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE 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 COMMUNITY BENEFIT REPORT COOK CHILDREN'S CONDUCTS A CHNA AND PREPARES A SUMMARY REPORT EVERY THREE YEARS. THE MOST RECENT CHNA WAS CONDUCTED IN 2024, AND THE WRITTEN CHNA REPORT WAS POSTED IN 2025. THE 2024 CHNA REPORT IS AVAILABLE TO THE PUBLIC ON OUR WEBSITE: (HTTPS://WWW.COOKCHILDRENS.ORG/ABOUT/COMMUNITY-OUTREACH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/). THE NEXT CHNA (2027) IS CURRENTLY IN DEVELOPMENT AND WILL BE POSTED BY SEPTEMBER 30, 2028.
SCHEDULE H, PART I, LINE 7 FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST COOK CHILDREN'S HEALTH CARE SYSTEM PROVIDES CRITICAL BENEFITS TO THE COMMUNITIES IT SERVES, MANY OF WHICH ARE FUNDED BY PARENT AND CHILD ORGANIZATIONS OF THE MEDICAL CENTERS. THE FOLLOWING CONTAINS A SUMMARY OF COMMUNITY BENEFITS THAT ARE NOT INCLUDED ON SCHEDULE H OF THE IRS FORM 990, BUT ARE AN IMPORTANT PART OF THE MISSION. COMMUNITY BENEFITS FUNDED BY NON-HOSPITAL COOK CHILDREN'S ORGANIZATIONS, FISCAL 2025: (9) NEIGHBORHOOD CLINICS - $11,394,081 - COMMUNITY BENEFITS FUNDED BY WI COOK FOUNDATION (10) ENDOWED CHAIRS - $1,000,000 - COMMUNITY BENEFITS FUNDED BY WI COOK FOUNDATION CHILD STUDY CENTER - $2,914,449 BEHAVIORAL HEALTH - $126,645 - COMMUNITY BENEFITS FUNDED BY WI COOK FOUNDATION TOTAL COMMUNITY BENEFITS FUNDED BY NON-HOSPITAL COOK CHILDREN'S ORGANIZATIONS - $15,435,175 NEIGHBORHOOD CLINICS - FREE-STANDING PEDIATRIC PRACTICE BUILT IN A NEIGHBORHOOD IDENTIFIED AS HAVING INADEQUATE ACCESS TO PRIMARY CARE FOR CHILDREN. THE PRACTICE IS STAFFED WITH DOCTORS, OTHER CLINICAL AND SUPPORT STAFF TO HELP MAINTAIN HEALTH AND PROMOTE HEALING FOR CHILDREN THROUGH WELL-CHILD EXAMINATIONS, VACCINES, AND SICK VISITS. ENDOWED CHAIRS - COOK CHILDREN'S FUNDED RESEARCH PERFORMED BY COOK CHILDREN'S PHYSICIANS FOR THE COMMUNITY-WIDE ADVANCEMENT OF PEDIATRIC CARE. CHILD STUDY CENTER - A NOT-FOR-PROFIT CORPORATION ORGANIZED TO PROVIDE DIAGNOSIS, TREATMENT, AND EDUCATION TO THE UNDER-SERVED POPULATION OF CHILDREN WITH COMPLEX DEVELOPMENTAL AND BEHAVIORAL DISABILITIES. BEHAVIORAL HEALTH - BEHAVIORAL HEALTH IS A GROWING NEED IDENTIFIED IN COOK CHILDREN'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). COOK CHILDREN'S HAS INVESTED IN PROVIDING THIS CARE FOR THE COMMUNITY, DESPITE LACK OF ADEQUATE REIMBURSEMENT FROM PAYORS. TOTAL COMMUNITY BENEFITS PROVIDED BY ALL COOK CHILDREN'S SUBSIDIARIES, FISCAL 2025: COOK CHILDREN'S MEDICAL CENTER - FORT WORTH - $311,263,089 (ALREADY INCLUDED IN COMMUNITY BENEFIT CALCULATION ON SCHEDULE H, PART I, LINE 7K) COOK CHILDREN'S MEDICAL CENTER - PROSPER - $49,752,846 (ALREADY INCLUDED IN COMMUNITY BENEFIT CALCULATION ON SCHEDULE H, PART I, LINE 7K) WI COOK FOUNDATION - $12,520,726 CHILD STUDY CENTER - $2,914,449 TOTAL COMMUNITY BENEFITS PROVIDED BY ALL COOK CHILDREN'S SUBSIDIARIES - $376,451,110
SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY USED TO CALCULATE FINANCIAL ASSISTANCE 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 II COMMUNITY BUILDING ACTIVITIES 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 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 1,090 HOURS WERE CONTRIBUTED TO MULTIPLE COALITIONS, COMMITTEES, AND COUNCILS FOR FYE 2025.
SCHEDULE H, PART III, LINE 2 BAD DEBT EXPENSE - METHODOLOGY USED TO ESTIMATE AMOUNT 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, LINE 3 BAD DEBT EXPENSE METHODOLOGY 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, LINE 4 BAD DEBT EXPENSE - FINANCIAL STATEMENT FOOTNOTE FOOTNOTE DISCLOSURE REGARDING THE TREATMENT OF BAD DEBTS IS LOCATED ON PAGE 16 OF THE MOST RECENT AUDITED FINANCIAL STATEMENTS ATTACHED TO THIS FORM.
SCHEDULE H, PART III, LINE 8 COMMUNITY BENEFIT & METHODOLOGY FOR DETERMINING MEDICARE COSTS 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, LINE 9B COLLECTION PRACTICES FOR PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE.
SCHEDULE H, PART V, SECTION B, LINE 16A FAP WEBSITE - COOK CHILDREN'S MEDICAL CENTER: LINE 16A URL: WWW.COOKCHILDRENS.ORG/PATIENTS-FAMILIES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/;
SCHEDULE H, PART V, SECTION B, LINE 16B FAP APPLICATION WEBSITE - COOK CHILDREN'S MEDICAL CENTER: LINE 16B URL: WWW.COOKCHILDRENS.ORG/PATIENTS-FAMILIES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/;
SCHEDULE H, PART V, SECTION B, LINE 16C FAP PLAIN LANGUAGE SUMMARY WEBSITE - COOK CHILDREN'S MEDICAL CENTER: LINE 16C URL: WWW.COOKCHILDRENS.ORG/PATIENTS-FAMILIES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/;
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 FORT WORTH SERVICE AREA (FWSA) IS BASED IN NORTH CENTRAL TEXAS AND COMPRISES DENTON, 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 2025, ALL INFORMATION PROVIDED IS IN RESPONSE TO OUR 2024 CHNA. PLEASE NOTE: OUR 2027 CHNA IS CURRENTLY IN DEVELOPMENT AND WILL BE APPROVED AND POSTED BY SEPTEMBER 30, 2028. THE U.S. CENSUS BUREAU CLASSIFIES THESE COUNTIES AS FOLLOWS: DENTON COUNTY-URBAN, HOOD COUNTY-MOSTLY URBAN, 41% RURAL; JOHNSON COUNTY-NEARLY MIXED, 54% URBAN AND 46% RURAL; PARKER COUNTY- MOSTLY RURAL, 36% URBAN; TARRANT COUNTY-URBAN AND WISE COUNTY-RURAL.(2) OVERALL, THE EIGHT-COUNTY REGION IS HOME TO A DIVERSE POPULATION OF 5,626,154 PEOPLE, AND 1,181,591 (25%) ARE CHILDREN 17 YEARS AND YOUNGER.(1) THE FWSA TOTAL POPULATION OF 3,495,123 INCLUDES 877,448 CHILDREN FROM BIRTH TO 17. OF THOSE CHILDREN AGES 0-17, THERE ARE 218,680 IN DENTON COUNTY; 12,922 IN HOOD COUNTY; 46,951 IN JOHNSON COUNTY; 37,266 IN PARKER COUNTY; 544,440 IN TARRANT COUNTY; AND 17,189 IN WISE COUNTY. (1) THE ANNUAL MEDIAN INCOME FOR FAMILIES WITH CHILDREN UNDER AGE 18 RANGE BETWEEN $86,236 IN TARRANT COUNTY TO $130,127 IN DENTON COUNTY.(1) OF THE 877,448 CHILDREN UNDER AGE 18 LIVING IN THE FWSA, NEARLY 116,000 (13%) 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 11% IN DENTON COUNTY TO 24% IN TARRANT COUNTY. (1) THE INFORMATION BELOW REFLECTS RACE AND ETHNICITY BY COUNTY WITHIN OUR REGION. 2022 U.S. CENSUS ESTIMATES OF RACE AND ETHNICITY (CHILDREN UNDER 18 YEARS).(2) * ASIAN: DENTON 10.2%; HOOD 0.5%; JOHNSON 1.4%; PARKER 0.8%; TARRANT 5%; WISE 0.3% * BLACK/AFRICAN AMERICAN: DENTON 10%; HOOD 1%; JOHNSON 4.8%; PARKER 1.6%; TARRANT 18.8%; WISE 1.7% * OTHER RACE: DENTON 3.8%; HOOD 1.3%; JOHNSON 4.5%; PARKER 1.9%; TARRANT 10%; WISE 5.5% * TWO OR MORE RACES: DENTON 16.2%; HOOD 14.3%; JOHNSON 12.7%; PARKER 11.9%; TARRANT 17.1%; WISE 9.3% * WHITE: DENTON 59%; HOOD 82.7%; JOHNSON 76.4%; PARKER 83.1%; TARRANT 48.4%; WISE 82.5% * HISPANIC OR LATINO (ANY RACE): DENTON 25.6%; HOOD 22.1%; JOHNSON 31.4%; PARKER 19.1%; TARRANT 38.6%; WISE 29% THE COOK CHILDREN'S FWSA CONTAINS THREE MEDICALLY UNDERSERVED AREAS AND ONE MEDICALLY UNDERSERVED POPULATION AS DEFINED BY THE HEALTH RESOURCES & SERVICES ADMINISTRATION. (3) 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, DISCIPLINE IS PRIMARY CARE * TARRANT COUNTY: KNOWN AS CENTRAL SERVICE AREA BY SERVICE AREA NAME, MEDICAL UNDERSERVICE SCORE IS 55.3, RURAL STATUS IS NON-RURAL, DISCIPLINE IS PRIMARY CARE * TARRANT COUNTY: KNOWN AS FORT WORTH-NORTH BY SERVICE AREA NAME, MEDICAL UNDERSERVICE SCORE IS 58, RURAL STATUS IS NON-RURAL, DISCIPLINE IS PRIMARY CARE MEDICALLY UNDERSERVED POPULATION (3) * TARRANT COUNTY: KNOWN AS LOW INC-EAST SIDE BY SERVICE AREA NAME, MEDICAL UNDERSERVE SCORE IS 59.8, RURAL STATUS IS NON-RURAL, DISCIPLINE IS PRIMARY CARE REFERENCES: (1) US CENSUS BUREAU. 2022 AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES. UNITED STATES CENSUS BUREAU. PUBLISHED DECEMBER 7, 2023. ACCESSED JANUARY 2026. HTTP://DATA.CENSUS.GOV (2) US CENSUS BUREAU. 2020 URBAN AREA TO 2020 COUNTY RELATIONSHIP FILE (2020_UA_COUNTY.XLSX). GEOGRAPHY DIVISION. DECEMBER 2022. ACCESSED JANUARY 30, 2026. HTTPS://WWW.CENSUS.GOV/GEOGRAPHIES/REFERENCE-FILES/TIME-SERIES/GEO/RELATIONSHIP-FILES.HTML (3) MEDICALLY UNDERSERVED AREA/POPULATION (MUA/P) FIND TOOL. HEALTH RESOURCES AND SERVICES ADMINISTRATION. ACCESSED JANUARY 30, 2025. HTTPS://DATA.HRSA.GOV/TOOLS/SHORTAGE-AREA/MUA-FIND (THE LOWEST SCORE (HIGHEST NEED) IS 0; THE HIGHEST SCORE (LOWEST NEED) IS 100. IN ORDER TO QUALIFY FOR DESIGNATION, THE IMU SCORE MUST BE LESS THAN OR EQUAL TO 62.0, EXCEPT FOR A GOVERNOR DESIGNATION, WHICH DOES NOT RECEIVE AN IMU SCORE.)
SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH IN FY2025, COOK CHILDREN'S CENTER FOR COMMUNITY HEALTH LED 819 HEALTH OUTREACH TRAININGS AND EVENTS SERVING OVER 22,000 CHILDREN, FAMILIES, AND COMMUNITY PARTNERS. THESE OUTREACH EVENTS INCLUDE EDUCATION OR ACTIVITIES AROUND THE REPRIORITIZED 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) CAREGIVER AND FAMILY SUPPORT (ABUSE AND NEGLECT PREVENTION) INJURY PREVENTION ASTHMA IN FY2025, OUR COMMUNITY PARTNERS AND VOLUNTEERS DONATED NEARLY 3,200 HOURS OF VOLUNTEER SUPPORT TO THE CENTER, TOTALING A VALUE OF $106,799. THE 819 HEALTH OUTREACH TRAININGS AND EVENTS LED BY THE CENTER WERE PROVIDED THROUGH OUR COLLABORATIONS BELOW. * CAREGIVER AND FAMILY SUPPORT ACTION TEAM * MENTAL HEALTH & RESILIENCY ACTION TEAM * CHILDREN'S ORAL HEALTH COLLABORATIVE * SAFE BABY SLEEP COUNCIL * HEALTH ACCESS ACTION TEAM * SAVE A SMILE * HEALTHY LIFESTYLES ACTION TEAM * SCHOOL-BASED ORAL HEALTH ACTION TEAM * INJURY PREVENTION COLLABORATIVE * THRIVING COMMUNITIES COLLABORATIVE * LIFEGUARD YOUR CHILD CAMPAIGN SELECTED HIGHLIGHTS OF OUR WORK IN FY2025 TO IMPROVE THE HEALTH OF CHILDREN AND FAMILIES IN THE COMMUNITY INCLUDE: * FACILITATED 9,800 LIMITED ORAL HEALTH EVALUATIONS AND DENTAL TREATMENT PROCEDURES FOR CHILDREN WITH DENTAL DISEASE FOR A TOTAL VALUE OF $643,590. * PROVIDED 532 CAR SEAT CHECKS TO FAMILIES IN NEED AND EDUCATED 133 CAREGIVERS ON PROPER INSTALLATION TO ENSURE THEIR CHILDREN'S SAFETY. NEARLY 3 IN 4 CAR SEATS ARRIVED INCORRECTLY INSTALLED AT OUR EVENTS. HOWEVER, THROUGH OUR HANDS-ON EDUCATION, 100% OF CAR SEATS LEAVE PROPERLY INSTALLED, PROVIDING CRITICAL SAFETY FOR CHILDREN AND FAMILIES. * DISTRIBUTED OVER 4,880 RESOURCES AND EDUCATIONAL ITEMS TO 321 FAMILIES. * PROVIDED 1,248 HOURS OF CONTINUED EDUCATION CREDITS TO OVER 710 COMMUNITY PROFESSIONALS AT OUR MENTAL HEALTH EDUCATION WORKSHOPS. * EXPANDED FOOD ACCESS ACROSS OUR COOK CHILDREN'S SYSTEM AND SERVICE AREA: HELPED SUPPORT THE DISTRIBUTION OF OVER 911,280 LBS. OF FOOD THROUGH C4CH, CCHP, NHCS, DODSON SPECIALTY CLINICS (INFECTIOUS DISEASE, NEPHROLOGY, CYSTIC FIBROSIS), VOLUNTEER SERVICES, AND PARTNER PANTRIES. * PROVIDED 10,680 SUPPORT SERVICES AND NEARLY 2,300 COMMUNITY REFERRALS TO FAMILIES, MEETING NEEDS FOR FOOD, RENT AND UTILITIES ASSISTANCE, SCHOOL SUPPLIES, AND MENTAL HEALTH. * DISTRIBUTED 177,097 PREVENTION TOOLS AND 308,529 EDUCATIONAL RESOURCES AT A VALUE OF $1,064,503 TO FAMILIES AND COMMUNITY PARTNERS. * OVER 3.3 MILLION UNIQUE COMMUNITY MEMBERS REACHED THROUGH TARGETED DIGITAL AWARENESS CAMPAIGNS, REFLECTING 48,000 HOURS OF ENGAGEMENT.
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 TX
Schedule H (Form 990) 2024
Additional Data


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Schedule I
(Form 990)
(Rev. January 2025)
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 instructions and the latest information.
OMB No. 1545-0047
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 CHILDRENS PHYSICIAN NETWORK
801 SEVENTH AVE
FORT WORTH,TX76107 		75-2485366 501(C)(3) 110,042,991       SUBSIDIZE OPERATIONS
(2) JUNIOR LEAGUE OF FORT WORTH
255 BAILEY AVE
FORT WORTH,TX76107 		75-6022377 501(C)(3) 35,000       SPONSORSHIP
(3) BREAKTHROUGH T1D NORTH TEXAS AND OKLAHOMA
PO BOX 5029
HAGERSTOWN,MD21741 		23-1907729 501(C)(3) 10,000       SPONSORSHIP
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
3
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) Rev. 1-2025

Schedule I (Form 990) Rev. 1-2025
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) BABY SUPPLIES 466 32,211      
(2) GIFT CARDS 506 25,869      
(3) LODGING 452 106,533      
(4) MEALS 568 15,294      
(5) MEDICAL EQUIPMENT 10 1,809      
(6) MEDICATION 2007 133,730      
(7) MISCELLANEOUS 7 202      
(8) TRANSPORTATION 1845 101,139      
(9) UTILITIES 14 4,928      
(10) FUNERAL SERVICES 149 124,727      
(11) HOLIDAY BENEVOLENCE GIFT CARDS 88 23,683      
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 USE OF GRANT FUNDS THE ORGANIZATION MAINTAINS RECORDS TO SUBSTANTIATE THE AMOUNT OF GRANTS OR ASSISTANCE AND HAS PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS.
Schedule I (Form 990) Rev. 1-2025



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Schedule J
(Form 990)
(Rev. January 2025)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic Attach to Form 990.
medium right arrow graphic Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
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) (Rev. 1-2025)

Schedule J (Form 990) (Rev. 1-2025)
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
1JAMES C CUNNINGHAM MD
EVP, CMO - END 1/3/25 		(i)

(ii)		 0
-------------
780,476 		0
-------------
385,606 		0
-------------
187,693 		0
-------------
873,037 		0
-------------
39,407 		0
-------------
2,266,219 		0
-------------
0
2NANCY C CYCHOL
EVP, HOSPITAL SERVICES 		(i)

(ii)		 496,024
-------------
267,089 		245,484
-------------
132,184 		113,833
-------------
61,295 		214,526
-------------
115,514 		25,507
-------------
13,735 		1,095,374
-------------
589,817 		0
-------------
0
3STANLEY E DAVIS
PRESIDENT 		(i)

(ii)		 622,211
-------------
0 		283,922
-------------
0 		119,901
-------------
0 		678,012
-------------
0 		40,626
-------------
0 		1,744,672
-------------
0 		85,949
-------------
0
4JOSEPH M GALLAGHER
SVP, CHIEF LEGAL OFFICER 		(i)

(ii)		 0
-------------
595,791 		0
-------------
300,421 		0
-------------
134,976 		0
-------------
123,663 		0
-------------
37,866 		0
-------------
1,192,717 		0
-------------
110,868
5STEPHEN W KIMMEL
EVP, SYSTEM FINANCE 		(i)

(ii)		 285,169
-------------
506,968 		141,101
-------------
250,846 		70,148
-------------
124,708 		174,581
-------------
310,366 		11,762
-------------
20,910 		682,761
-------------
1,213,798 		55,518
-------------
98,699
6MARY CARA MARTZ
SECRETARY 		(i)

(ii)		 0
-------------
149,106 		0
-------------
38,234 		0
-------------
6,348 		0
-------------
9,339 		0
-------------
17,228 		0
-------------
220,255 		0
-------------
0
7THERESA Z MEADOWS
SVP, CHIEF INFORMATION OFFICER - END 6/1/25 		(i)

(ii)		 0
-------------
577,639 		0
-------------
260,293 		0
-------------
111,790 		0
-------------
25,875 		0
-------------
38,407 		0
-------------
1,014,004 		0
-------------
0
8RICK W MERRILL
CEO 		(i)

(ii)		 409,809
-------------
1,229,427 		268,858
-------------
806,577 		113,906
-------------
341,717 		98,136
-------------
294,408 		8,824
-------------
26,473 		899,533
-------------
2,698,602 		0
-------------
0
9JONATHAN NEDRELOW MD
EVP, CHIEF MEDICAL OFFICER 		(i)

(ii)		 0
-------------
498,211 		0
-------------
223,042 		0
-------------
18,587 		0
-------------
95,444 		0
-------------
26,295 		0
-------------
861,579 		0
-------------
0
10CORY R RHOADES
CHIEF FINANCIAL OFFICER 		(i)

(ii)		 0
-------------
586,487 		0
-------------
261,581 		0
-------------
125,061 		0
-------------
122,610 		0
-------------
37,853 		0
-------------
1,133,592 		0
-------------
103,601
11SPENCER D SEALS
SVP CONSTRUCTION & REAL ESTATE 		(i)

(ii)		 0
-------------
313,437 		0
-------------
111,805 		0
-------------
48,440 		0
-------------
61,013 		0
-------------
36,725 		0
-------------
571,420 		0
-------------
45,938
12KEVIN GREENE
VP, PROSPER MEDICAL CENTER 		(i)

(ii)		 0
-------------
251,951 		0
-------------
90,096 		0
-------------
1,535 		0
-------------
45,800 		0
-------------
35,839 		0
-------------
425,221 		0
-------------
0
13DEBORAH BOUDREAUX
VP, NURSING & PATIENT SVC 		(i)

(ii)		 257,999
-------------
0 		92,575
-------------
0 		6,715
-------------
0 		48,514
-------------
0 		28,247
-------------
0 		434,050
-------------
0 		0
-------------
0
14RAMONDA BUSBY
AVP, CASE MANAGEMENT SERVICES 		(i)

(ii)		 202,489
-------------
0 		44,600
-------------
0 		4,556
-------------
0 		10,219
-------------
0 		25,871
-------------
0 		287,735
-------------
0 		0
-------------
0
15ORLANDO CHAPA
VP, NURSING & PATIENT SVC 		(i)

(ii)		 263,446
-------------
0 		93,298
-------------
0 		4,675
-------------
0 		58,506
-------------
0 		17,579
-------------
0 		437,504
-------------
0 		0
-------------
0
16MEGAN CHAVEZ
VP, COOK CHILDREN'S EXPERIENCE 		(i)

(ii)		 324,345
-------------
0 		118,040
-------------
0 		55,054
-------------
0 		48,769
-------------
0 		34,506
-------------
0 		580,714
-------------
0 		52,501
-------------
0
17TIFFANY EPPERSON
AVP, NURSING 		(i)

(ii)		 175,490
-------------
0 		27,952
-------------
0 		11,617
-------------
0 		7,158
-------------
0 		34,191
-------------
0 		256,408
-------------
0 		0
-------------
0
18ALDRENA HEAD
AVP, HIM 		(i)

(ii)		 171,519
-------------
0 		46,054
-------------
0 		10,985
-------------
0 		14,520
-------------
0 		35,678
-------------
0 		278,756
-------------
0 		0
-------------
0
19NICHOLAS MARKHAM
VP CAMPUS FAC, SUPP SERVICES 		(i)

(ii)		 240,694
-------------
0 		85,303
-------------
0 		1,934
-------------
0 		47,171
-------------
0 		23,192
-------------
0 		398,294
-------------
0 		0
-------------
0
20OZIOMA OLOWU
AVP, PHARMACY 		(i)

(ii)		 243,453
-------------
0 		69,493
-------------
0 		35,734
-------------
0 		31,679
-------------
0 		34,820
-------------
0 		415,179
-------------
0 		0
-------------
0
21CHERYL PETERSEN
SVP NURSING/ CHIEF NURSING CNO 		(i)

(ii)		 369,661
-------------
0 		168,862
-------------
0 		72,323
-------------
0 		88,117
-------------
0 		40,626
-------------
0 		739,589
-------------
0 		52,394
-------------
0
22JACK SOSEBEE
SVP OPERATIONS 		(i)

(ii)		 391,630
-------------
0 		174,255
-------------
0 		62,519
-------------
0 		89,608
-------------
0 		18,131
-------------
0 		736,143
-------------
0 		44,974
-------------
0
23TAMMY THOMLISON
AVP, REVENUE CYCLE 		(i)

(ii)		 247,441
-------------
0 		61,452
-------------
0 		13,647
-------------
0 		14,423
-------------
0 		22,332
-------------
0 		359,295
-------------
0 		0
-------------
0
24ELIA VALENCIA-STOKES
VP, FINANCE 		(i)

(ii)		 330,140
-------------
0 		120,992
-------------
0 		8,367
-------------
0 		61,020
-------------
0 		40,626
-------------
0 		561,145
-------------
0 		0
-------------
0
25NATALIE WILKINS
VP, OPERATIONS 		(i)

(ii)		 325,951
-------------
0 		113,633
-------------
0 		46,680
-------------
0 		56,855
-------------
0 		14,514
-------------
0 		557,633
-------------
0 		44,159
-------------
0
26NATALIE CARPENTER
AVP, NURSING 		(i)

(ii)		 193,284
-------------
0 		28,981
-------------
0 		5,647
-------------
0 		17,019
-------------
0 		18,033
-------------
0 		262,964
-------------
0 		0
-------------
0
27GINA HERNANDEZ
DIRECTOR, NURSING ADMIN 		(i)

(ii)		 191,993
-------------
0 		27,350
-------------
0 		12,556
-------------
0 		17,090
-------------
0 		12,279
-------------
0 		261,268
-------------
0 		0
-------------
0
28TOMMIE MOSS
PHARMACIST 		(i)

(ii)		 257,769
-------------
0 		0
-------------
0 		3,370
-------------
0 		18,228
-------------
0 		37,711
-------------
0 		317,078
-------------
0 		0
-------------
0
29JESSACA SIBR
PHARMACIST 		(i)

(ii)		 243,052
-------------
0 		0
-------------
0 		3,370
-------------
0 		17,541
-------------
0 		24,488
-------------
0 		288,451
-------------
0 		0
-------------
0
30ROBERT TUCKER
DIRECTOR, FINANCE 		(i)

(ii)		 188,542
-------------
0 		27,127
-------------
0 		12,418
-------------
0 		11,876
-------------
0 		27,362
-------------
0 		267,325
-------------
0 		0
-------------
0
Schedule J (Form 990) (Rev. 1-2025)

Schedule J (Form 990) (Rev. 1-2025)
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 1A TAX INDEMNIFICATION AND GROSS-UP PAYMENTS GROSS UP PAYMENTS INCLUDED IN TAXABLE COMPENSATION: TOMMIE MOSS
SCHEDULE J, PART I, LINE 1B WRITTEN POLICY REGARDING PAYMENT OR REIMBURSEMENT OF EXPENSES 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
SCHEDULE J, PART I, LINE 3 ARRANGEMENT USED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION COOK CHILDREN'S HEALTH CARE SYSTEM, A RELATED ORGANIZATION, USES THE FOLLOWING METHODS TO DETERMINE CEO/EXECUTIVE DIRECTOR COMPENSATION: COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT WRITTEN EMPLOYMENT CONTRACT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN RICK W MERRILL - PAID BY SYSTEM - $366,668 DEFERRED, $NONE W-2 STEPHEN W KIMMEL - PAID BY SYSTEM - $463,384 DEFERRED, $154,217 W-2 JOSEPH GALLAGHER - PAID BY SYSTEM - $99,100 DEFERRED, $110,868 W-2 CORY R RHOADES - PAID BY SYSTEM - $96,735 DEFERRED, $103,601 W-2 SPENCER D SEALS - PAID BY SYSTEM - $39,192 DEFERRED, $45,938 W-2 STANLEY E. DAVIS - PAID BY CCMC - $653,100 DEFERRED, $85,949 W-2 JACK SOSEBEE - PAID BY CCMC - $63,733 DEFERRED, $44,974 W-2 CHERYL PETERSEN - PAID BY CCMC - $62,242 DEFERRED, $52,394 W-2 ELIA VALENCIA-STOKES - PAID BY CCMC - $42,350 DEFERRED, $NONE W-2 NATALIE WILKINS - PAID BY SYSTEM - $39,744 DEFERRED, $44,159 W-2 JONATHAN NEDRELOW - PAID BY SYSTEM - $81,644 DEFERRED, $NONE W-2 NICHOLAS MARKHAM - PAID BY CCMC - $29,835 DEFERRED, $NONE W-2 KEVIN GREENE - PAID BY PROSPER - $31,708 DEFERRED, $NONE W-2 ORLANDO CHAPA - PAID BY CCMC - $32,631 DEFERRED, $NONE W-2 DEBORAH BOUDREAUX - PAID BY CCMC - $32,378 DEFERRED, $NONE W-2 OZIOMA OLOWU - PAID BY CCMC - $17,214 DEFERRED, $NONE W-2 MEGAN CHAVEZ - PAID BY CCMC - $41,400 DEFERRED, $52,501 W-2 JAMES C CUNNINGHAM, MD - PAID BY SYSTEM - $847,163 DEFERRED, $NONE W-2 NANCY C. CYCHOL - PAID BY CCMC - $304,165 DEFERRED, $NONE W-2
SCHEDULE J, PART II ALLOCATION OF CEO & CFO SALARIES SALARIES FOR THE CEO AND EVP, SYSTEM FINANCE ARE ALLOCATED PRO-RATA BASED ON THE AMOUNT OF TIME THEY SPEND WITH EACH OF THE FOLLOWING COMPANIES: COOK CHILDREN'S MEDICAL CENTER COOK CHILDREN'S HEALTH FOUNDATION COOK CHILDREN'S HOME HEALTH COOK CHILDREN'S HEALTH CARE SYSTEM COOK CHILDREN'S HEALTH PLAN COOK CHILDREN'S PHYSICIAN NETWORK COOK CHILDREN'S MEDICAL CENTER - PROSPER CHILD STUDY CENTER
Schedule J (Form 990) (Rev. 1-2025)

Additional Data


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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
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 87638QKX6 02-02-2014 176,767,688 CONSTRUCTION & EQUIPMENT COSTS X     X   X
C TARRANT COUNTY CULTURAL EDUCATION FACILITIES
  		04-3833551 87638QQQ5 02-25-2020 241,629,204 REFUNDING AND CONSTRUCTION AND EQUIPMENT   X   X   X
D TARRANT COUNTY CULTURAL EDUCATION FACILITIES
  		04-3833551 000000000 09-05-2023 163,310,000 REFUNDING 2013 & 2014 BONDS   X   X   X
TARRANT COUNTY CULTURAL EDUCATION FACILITIES
  		04-3833551 87638QTK5 02-27-2025 400,041,204 REFUNDING 2014 AND CONSTRUCTION AND EQUIPMENT   X   X   X
Part Ⅱ
Proceeds
A B C D
1 Amount of bonds retired .................. 202,570,000 28,820,000 20,745,000 6,905,000
2 Amount of bonds legally defeased .............. 0 135,820,000    
3 Total proceeds of issue .................. 231,948,097 176,767,688 242,464,102 165,369,955
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ............... 46,772,072   90,712,257 162,599,938
7 Issuance costs from proceeds ............... 2,686,446 1,755,350 2,221,088 710,063
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 230,119,470 176,023,031 198,738,578  
11 Other spent proceeds .............       2,059,954
12 Other unspent proceeds ............. 350,000,000      
13 Year of substantial completion ............. 2011 2016 2023 2023
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) (Rev. 1-2025)

Schedule K (Form 990) (Rev. 1-2025)
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?   X   X   X   X
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?   X   X   X   X
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 .... 0.49 % 0 % 0.19 % 0.21 %
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 ......... 0 % 0 % 0 % 0 %
6 Total of lines 4 and 5 ............. 0.49 % 0 % 0.19 % 0.21 %
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. .. 0 % 0 % 0 % 0 %
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) (Rev. 1-2025)

Schedule K (Form 990) (Rev. 1-2025)
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
  		 
  		 
  		 
 
c Term of hedge ......... 20 % 0 % 0 % 0 %
d Was the hedge superintegrated? ......   X   X   X   X
e Was the hedge terminated? ........   X   X   X   X
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider ..........  
  		 
  		 
  		 
 
c Term of GIC ......... 0 % 0 % 0 % 0 %
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........   X   X   X   X
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
SCHEDULE K, 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."
SCHEDULE K, PART II COLUMNS A-D TOTAL EXPENDITURES INCLUDE AMOUNTS SPENT AFTER INVESTMENT EARNINGS.
SCHEDULE K, PART IV, LINE 2C COLUMN A ISSUER NAME: TARRANT COUNTY CULTURAL EDUCATION FACILITIES THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 02/14/2014
SCHEDULE K, PART IV, LINE 2C COLUMN B ISSUER NAME: TARRANT COUNTY CULTURAL EDUCATION FACILITIES THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 03/22/2017
SCHEDULE K, PART IV, LINE 2C COLUMN C ISSUER NAME: TARRANT COUNTY CULTURAL EDUCATION FACILITIES THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 06/14/2021
Schedule K (Form 990) (Rev. 1-2025)

Additional Data


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Software Version: 2024v5.1


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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
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 87638QKX6 02-02-2014 176,767,688 CONSTRUCTION & EQUIPMENT COSTS X     X   X
C TARRANT COUNTY CULTURAL EDUCATION FACILITIES
  		04-3833551 87638QQQ5 02-25-2020 241,629,204 REFUNDING AND CONSTRUCTION AND EQUIPMENT   X   X   X
D TARRANT COUNTY CULTURAL EDUCATION FACILITIES
  		04-3833551 000000000 09-05-2023 163,310,000 REFUNDING 2013 & 2014 BONDS   X   X   X
TARRANT COUNTY CULTURAL EDUCATION FACILITIES
  		04-3833551 87638QTK5 02-27-2025 400,041,204 REFUNDING 2014 AND CONSTRUCTION AND EQUIPMENT   X   X   X
Part Ⅱ
Proceeds
A B C D
1 Amount of bonds retired .................. 202,570,000 28,820,000 20,745,000 6,905,000
2 Amount of bonds legally defeased .............. 0 135,820,000    
3 Total proceeds of issue .................. 231,948,097 176,767,688 242,464,102 165,369,955
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ............... 46,772,072   90,712,257 162,599,938
7 Issuance costs from proceeds ............... 2,686,446 1,755,350 2,221,088 710,063
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 230,119,470 176,023,031 198,738,578  
11 Other spent proceeds .............       2,059,954
12 Other unspent proceeds ............. 350,000,000      
13 Year of substantial completion ............. 2011 2016 2023 2023
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) (Rev. 1-2025)

Schedule K (Form 990) (Rev. 1-2025)
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?   X   X   X   X
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?   X   X   X   X
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 .... 0.49 % 0 % 0.19 % 0.21 %
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 ......... 0 % 0 % 0 % 0 %
6 Total of lines 4 and 5 ............. 0.49 % 0 % 0.19 % 0.21 %
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. .. 0 % 0 % 0 % 0 %
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) (Rev. 1-2025)

Schedule K (Form 990) (Rev. 1-2025)
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
  		 
  		 
  		 
 
c Term of hedge ......... 20 % 0 % 0 % 0 %
d Was the hedge superintegrated? ......   X   X   X   X
e Was the hedge terminated? ........   X   X   X   X
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider ..........  
  		 
  		 
  		 
 
c Term of GIC ......... 0 % 0 % 0 % 0 %
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........   X   X   X   X
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
SCHEDULE K, 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."
SCHEDULE K, PART II COLUMNS A-D TOTAL EXPENDITURES INCLUDE AMOUNTS SPENT AFTER INVESTMENT EARNINGS.
SCHEDULE K, PART IV, LINE 2C COLUMN A ISSUER NAME: TARRANT COUNTY CULTURAL EDUCATION FACILITIES THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 02/14/2014
SCHEDULE K, PART IV, LINE 2C COLUMN B ISSUER NAME: TARRANT COUNTY CULTURAL EDUCATION FACILITIES THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 03/22/2017
SCHEDULE K, PART IV, LINE 2C COLUMN C ISSUER NAME: TARRANT COUNTY CULTURAL EDUCATION FACILITIES THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 06/14/2021
Schedule K (Form 990) (Rev. 1-2025)

Additional Data


Software ID: 24020961
Software Version: 2024v5.1

SCHEDULE O
(Form 990)
(Rev. January 2025)
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.
Attach to Form 990 or 990-EZ.
 Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
Open to Public
Inspection
Name of the organization
COOK CHILDREN'S MEDICAL CENTER
 
Employer identification number

75-2051646
Return Reference Explanation
FORM 990, PART III, LINE 4A PROGRAM SERVICE DESCRIPTION FROM COMPLEX SURGICAL CARE AND LEVEL II TRAUMA SERVICES TO PHYSICAL THERAPY AND BEHAVIORAL HEALTH SERVICES, CCMC - FORT WORTH OFFERS COMPREHENSIVE SERVICES TAILORED TO THE NEEDS OF EVERY PATIENT AND FAMILY. COLLABORATION LEADS TO NEW CHAPTER FOR TWO NEIGHBORHOODS IN FY25, OUR GENEROUS DONORS MET THE GROWING NEED FOR ADDITIONAL NEIGHBORHOOD HEALTH CENTERS (NHC). BECAUSE OF THEIR GENEROSITY, TWO MORE NHCS WERE ADDED TO THE COOK CHILDREN'S ROSTER - MANHATTAN AND LAS VEGAS TRAIL - FOR A TOTAL OF NINE. THESE CENTERS PROVIDE PRIMARY HEALTH CARE, WELL-BEING SERVICES AND MORE TO FAMILIES LIVING IN AREAS WHERE RESIDENTS ARE MET WITH MULTIPLE BARRIERS TO ACCESSING CARE, INCLUDING LIMITED TRANSPORTATION, FOOD INSECURITY, LANGUAGE OR LITERACY BARRIERS, AND A LACK OF AWARENESS OF AVAILABLE RESOURCES. THE NHC LOCATED ON MANHATTAN BOULEVARD IN EAST FORT WORTH WAS PROVIDED BY THE HAPPY DAVIS FOUNDATION AND THE TEXAS RANGERS. THE NEW CENTER SHOWCASES THE COMMUNITY'S GENEROSITY AND COLLABORATIVE SPIRIT WITH ARTWORK FEATURING A LOCAL LEGEND-RANGERS CAPTAIN, THE TEXAS RANGERS MASCOT. THE LAS VEGAS TRAIL (LVT) HEALTH CENTER IS A FIRST-OF-ITS-KIND PARTNERSHIP BETWEEN JPS HEALTH NETWORK, COOK CHILDREN'S HEALTH CARE SYSTEM, THE CITY OF FORT WORTH, LVTRISE AND WESTAID. MORE THAN JUST A CLINIC, IT FUNCTIONS AS A COMPREHENSIVE HEALTHCARE HUB, CONNECTING INDIVIDUALS AND FAMILIES TO SERVICES THAT SUPPORT HOLISTIC WELL-BEING, INCLUDING PERSONAL SAFETY, MEDICAL CARE, FOOD SECURITY, FINANCIAL STABILITY AND STRONG FAMILY FOUNDATIONS. SINCE THE LVT HEALTH CENTER OPENED ITS DOORS, THOUSANDS HAVE RECEIVED HEALTHCARE SERVICES. PARTICIPANTS IN THE NEIGHBORHOOD HEALTH CENTER'S FIRST WORKFORCE DEVELOPMENT PROGRAM, TAUGHT BY TARRANT COUNTY COLLEGE, GRADUATED IN DECEMBER. NEARLY 100 COMMUNITY MEMBERS HAVE PARTICIPATED IN ONE OF 12 COOKING CLASSES OFFERED IN THE CENTER'S TEACHING KITCHEN, WHERE A COOK CHILDREN'S DIETITIAN DEMONSTRATES HOW TO PREPARE HEALTHY, BUDGET-FRIENDLY MEALS WITH LIMITED COOKING RESOURCES. HUNDREDS OF CONNECTIONS HAVE BEEN MADE THROUGH OUTREACH EVENTS. ADVANCING THE LEGACY OF HEALING AND HOPE IN SPRING 2025, COOK CHILDREN'S BROKE GROUND ON A NEW 700,000-SQUARE-FOOT BUILDING - THE WEST TOWER. THE ADDITION OF THE WEST TOWER WILL ENHANCE COOK CHILDREN'S HEART CENTER, ALREADY HOME TO THE NATION'S TOP PEDIATRIC CARDIOLOGISTS AND CARDIOVASCULAR SURGEONS. THE GROWTH, WHICH INCLUDES TWO NEW DEDICATED CARDIOVASCULAR OPERATING ROOMS, PAVES THE WAY FOR COOK CHILDREN'S SURGEONS TO PERFORM LIFE-SAVING HEART TRANSPLANTS. THE WEST TOWER ALSO MAKES WAY FOR THE EXPANSION AND REDESIGN OF COOK CHILDREN'S PEDIATRIC INTENSIVE CARE UNIT (PICU) AND NEONATAL INTENSIVE CARE UNIT (NICU). THE PICU WILL INCLUDE 56 PRIVATE PATIENT ROOMS AND BATHROOMS. DESIGNS FOR THE NEW PICU FOCUS ON TWO KEY ELEMENTS FOR SUPPORTING HEALING AND IMPROVING THE PATIENT AND FAMILY EXPERIENCE - SUNLIGHT AND PRIVACY. THE NICU WILL BE APPROXIMATELY 40,000 SQUARE FEET AND INCLUDE 143 PRIVATE ROOMS. THE WEST TOWER WILL BE A PLACE WHERE COOK CHILDREN'S CHARTS NEW FRONTIERS IN MEDICAL RESEARCH, ENSURING THAT EVERY STEP FORWARD IN PATIENT CARE IS DRIVEN BY CONTINUOUS INNOVATION AND EVIDENCE-BASED PRACTICE. FIGHTING FOR THE COOK CHILDREN'S HEALTH PLAN COOK CHILDREN'S HEALTH PLAN PROVIDES HEALTH CARE COVERAGE TO A VULNERABLE POPULATION THAT MAY NOT OTHERWISE BE ABLE TO ACCESS OR AFFORD CARE - LOW-INCOME FAMILIES WHO QUALIFY FOR MEDICAID AND THE CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP). MEMBERS ENROLLED IN CCHP ARE ASSURED OF TIMELY ACCESS TO NECESSARY MEDICAL CARE, INCLUDING PREVENTIVE SERVICES SUCH AS WELL-CHILD VISITS, IMMUNIZATIONS AND PRENATAL/POSTPARTUM CARE. THE TEXAS HEALTH AND HUMAN SERVICES COMMISSION (HHSC), ANNOUNCED IN MARCH 2024 ITS INTENT TO NOT RENEW CCHP'S MEDICAID STAR AND CHIP CONTRACT, INSTEAD AWARDING THOSE CONTRACTS TO NUMEROUS FOR-PROFIT HEALTH CARE COMPANIES. THE STATE'S DECISION, THE RESULT OF A FLAWED PROCESS, IGNORED COOK CHILDREN'S 20+ YEAR TRACK RECORD OF SUCCESS IN ADMINISTERING THESE PROGRAMS TO LOCAL FAMILIES. IN RESPONSE, COOK CHILDREN'S FORMALLY PROTESTED THAT THE SCORING PROCESS LACKED TRANSPARENCY, IGNORED LEGISLATIVELY MANDATED CONSIDERATIONS AND PREFERENCES, AND PUT NON-PROFIT COMMUNITY PLANS AT AN UNFAIR DISADVANTAGE. IN JUNE 2024, COOK CHILDREN'S HEALTH PLAN FILED A LAWSUIT ALLEGING THAT THE STATE'S PROCUREMENT WAS NOT CONDUCTED ACCORDING TO THE APPROPRIATE STATUTES. IN OCTOBER 2024, TRAVIS COUNTY DISTRICT COURT ISSUED A TEMPORARY INJUNCTION WHICH STOPS HHSC FROM IMPLEMENTING ANY NEW MEDICAID STAR/CHIP CONTRACTS, THEREBY PRESERVING THE STATUS QUO AND PROTECTING THE COOK CHILDREN'S HEALTH PLAN. THE TEXAS LEGISLATURE MET IN EARLY 2025 AND FAILED TO TAKE ANY ACTION THAT WOULD HAVE CLARIFIED OR IMPROVED THE STATE'S MEDICAID MANAGED CARE ORGANIZATION PROCUREMENT PROCESS. THEREFORE, THE LAWSUIT FILED BY COOK CHILDREN'S HEALTH PLAN IS PROCEEDING THROUGH THE COURTS. IN THE MIDST OF UNCERTAINTY, CCHP HAS WORKED TO REASSURE ITS MEMBERS THAT THEIR COVERAGE REMAINS ACTIVE UNTIL A FINAL DECISION IS MADE, THEY MAY CONTINUE SEEING THEIR CURRENT PHYSICIANS AND PROVIDERS, AND THEIR CHILD'S HEALTH IS TOP PRIORITY. THIS ORDER IS CURRENTLY BEING REVIEWED BY THE FIFTEENTH COURT OF APPEALS. RAISING AWARENESS THROUGH LEADERSHIP FROM THE CENTER FOR COMMUNITY HEALTH, COOK CHILDREN'S CONTINUES TO INFORM AND EDUCATE THE PUBLIC ON TIMELY PEDIATRIC HEALTH AND SAFETY ISSUES. INJURY PREVENTION MESSAGES IN FY25 INCLUDED THE IMPORTANCE OF CAR SEATS, REMINDERS OF SUMMER POOL SAFETY, AWARENESS OF BATHTUB SAFETY, ATV SAFETY AND DOG BITE PREVENTION. DURING FOOTBALL SEASON, COOK CHILDREN'S HIGHLIGHTED TIPS ON HOW TO PROTECT ATHLETES AND THE MOST IMPORTANT SAFETY ELEMENTS OF A FOOTBALL PROGRAM. AN ARTICLE DURING POISON PREVENTION WEEK REPORTED THE GROWING NUMBER OF YOUNG CHILDREN TREATED IN THE EMERGENCY DEPARTMENT (ED) FOR ACCIDENTAL OVERDOSES AND PROVIDED TIPS FOR SAFE DOSING, STORAGE AND DISPOSAL. ACCESSING HEALTHY FOODS BECAME EASIER FOR FAMILIES THANKS TO A PARTNERSHIP WITH COOK CHILDREN'S AND TEXAS HEALTH RESOURCES. THE RENOVATED EASTSIDE YMCA OPENED JANUARY 27 WITH NEW AMENITIES INCLUDING A GOOD FOR YOU HEALTHY HUB TO HELP FIGHT FOOD INSECURITY IN THE SURROUNDING NEIGHBORHOOD. THE CENTER FOR COMMUNITY HEALTH, LED BY COOK CHILDREN'S, IS FUNDING THE HUB'S STARTUP COSTS AND THE FIRST TWO YEARS OF OPERATION. THE CENTER OFFERS CLASSES ON NUTRITION, GARDENING AND PREPARING MEALS IN THE YMCA'S DEMONSTRATION KITCHEN AS PART OF THE COLLABORATION. EDUCATION ALSO COVERS HEALTHY LIFESTYLE TOPICS SUCH AS EXERCISE, SLEEP AND LIMITS ON SCREEN TIME. IN THE SUMMER OF 2025, THE AIM FOR SAFETY PROGRAM AT COOK CHILDREN'S CONTINUED TO SPREAD AWARENESS ABOUT PROPER STORAGE OF FIREARMS, FOCUSING ON THE INCREASED RISK OF UNINTENTIONAL GUN INJURIES WHILE SCHOOL IS OUT AND EDUCATION TO PREVENT ACCIDENTAL SHOOTINGS IN THE HOME. SURGING CASES OF FLU AND RESPIRATORY ILLNESSES STRAINED THE ED, PEDIATRIC OFFICES AND URGENT CARE CENTER SEVERAL TIMES IN FY25. COOK CHILDREN'S RESPONDED ON SOCIAL MEDIA AND OTHER OUTLETS BY ASKING FOR THE COMMUNITY'S HELP TO LIMIT THE SPREAD. THROUGH ARTICLES, CHARTS AND VIDEOS, THE COMMUNICATIONS TEAM PROMOTED TIPS TO HELP FAMILIES MANAGE MILD ILLNESS AT HOME - AND TO RECOGNIZE THE MORE SEVERE SYMPTOMS THAT WARRANT A TRIP TO URGENT CARE OR THE ED. TELEHEALTH REMAINS A CRITICAL RESOURCE FOR THE HOSPITAL, ESPECIALLY DURING TIMES OF INTENSE VIRAL SPREAD. FISCAL YEAR 2025 VIRTUAL HEALTH VISITS TOTALED 40,702 ACROSS ALL OF COOK CHILDREN'S HEALTH CARE SYSTEM. MENTAL WELL-BEING THE PODCAST, AN EXTENSION OF COOK CHILDREN'S SUICIDE PREVENTION JOY CAMPAIGN, AIRED ITS 100TH EPISODE IN FEBRUARY 2025. A RANGE OF TOPICS WERE COVERED IN FY25 INCLUDING PARENTING STRATEGIES, THE IMPACT OF ANXIETY AND TRAUMA ON CHILDREN, SOCIAL MEDIA'S INFLUENCE AND FOSTERING RESILIENCE IN YOUNG ATHLETES. DURING NATIONAL SUICIDE PREVENTION MONTH IN SEPTEMBER 2025, COOK CHILDREN'S TOOK A STAND FOR SUICIDE PREVENTION WITH A PROACTIVE APPROACH. THE PSYCHIATRY AND EMERGENCY DEPARTMENTS COLLABORATED TO IMPLEMENT THE ASK SUICIDE-SCREENING QUESTIONS (ASQ) TOOL, A SCREENING FOR ALL PATIENTS AGES EIGHT TO 18, REGARDLESS OF THE REASON THEY WERE PRESENTING TO THE EMERGENCY DEPARTMENT. IN 2025, COOK CHILDREN'S SCREENED MORE THAN 37,000 PATIENTS WHO PRESENTED TO THE ED FOR NON-BEHAVIORAL HEALTH CONCERNS WITH THE ASQ TOOL. OF THOSE, 834 SCREENED POSITIVE FOR SUICIDE RISK. ANOTHER 2,306 KIDS STRUGGLING WITH SADNESS AND WORRYING WERE PROVIDED WITH A CRISIS CONTACT INFORMATION SHEET. BREAKING BARRIERS WITH CUTTING-EDGE RESEARCH STUDIES THANKS TO A GENEROUS GIFT TO THE COOK CHILDREN'S FOUNDATION, CHILDREN DIAGNOSED WITH AN AGGRESSIVE AND INOPERABLE BRAIN TUMOR HAVE NEW HOPE. THE GIFT ALLOWED THE PURCHASE OF CAPITAL EQUIPMENT FOR NEURO-ONCOLOGY ENDOWED CHAIR FOCUSED ULTRASOUND RESEARCH, AND IN FY25 THE FOCUSED ULTRASOUND CLINICAL TRIAL BEGAN.
FORM 990, PART III, LINE 4A PROGRAM SERVICE DESCRIPTION (CONTINUED) COOK CHILDREN'S IS THE FIRST PEDIATRIC HOSPITAL IN TEXAS - AND ONE OF ONLY THREE IN THE UNITED STATES - TO PARTICIPATE IN AN INTERVENTIONAL STUDY USING LOW-INTENSITY FOCUSED ULTRASOUND TO TREAT DIFFUSE INTRINSIC PONTINE GLIOMA (DIPG) AND POTENTIALLY IMPROVE BOTH SURVIVAL AND QUALITY OF LIFE. THE MEDIAN SURVIVAL FOR DIPG BRAIN TUMORS IS ONE YEAR. DR. SIBO ZHAO, MEDICAL DIRECTOR OF NEURO-ONCOLOGY AND RECIPIENT OF THE ENDOWED CHAIR, DEVELOPED THE FOCUSED ULTRASOUND PROGRAM AND IS GRATEFUL FOR THE CHANCE TO CHANGE LIVES FOR CHILDREN WITH DIPG AND THE POTENTIAL TO TREAT OTHER CONDITIONS SUCH AS EPILEPSY, CEREBRAL PALSY AND MOVEMENT DISORDERS. "BY MAKING THE DECISION TO GO AFTER THE MOST DEVASTATING DISEASE IN PEDIATRICS, WE ARE TELLING THE WORLD THAT WE WANT TO BE THE CHANGEMAKERS," SAID DR. WILLIAM STIGALL, CHIEF RESEARCH OFFICER AT COOK CHILDREN'S. LIFE-CHANGING PROGRAMS IN NOVEMBER 2024, LEANNYVETTE HERNANDEZ MADE COOK CHILDREN'S HISTORY BY BECOMING THE FIRST PATIENT TO UNDERGO WEIGHT LOSS SURGERY AS PART OF THE HOSPITAL'S ADOLESCENT BARIATRIC SURGERY PROGRAM, WHICH REMOVED ABOUT 70 PERCENT OF HER STOMACH. THREE MONTHS AFTER THAT LANDMARK SURGERY, SHE HAD DROPPED MORE THAN 50 POUNDS AND IMPROVED HER OVERALL HEALTH. THE PROGRAM OFFERS CUSTOMIZED SUPPORT AND RESOURCES FOR PATIENTS AGES 13-18. EACH MONTHLY APPOINTMENT PROVIDES ONE HOUR OF INTENSIVE HEALTH BEHAVIOR AND LIFESTYLE THERAPY DESIGNED TO SUPPORT LONG-TERM SUCCESS. IN JUNE 2025, COOK CHILDREN'S OFFICIALLY LAUNCHED A NEW PROGRAM TO HELP CHILDREN AND FAMILIES BETTER MANAGE ASTHMA AND ITS HIDDEN THREATS. IT'S KNOWN AS THE NELSON KU HIGH-RISK ASTHMA PROGRAM IN HONOR OF NELSON, AN 11-YEAR-OLD BOY WHO PASSED AWAY FROM AN ASTHMA ATTACK DURING LACROSSE PRACTICE. THE GOAL OF THE PROGRAM IS TO IDENTIFY AND ADDRESS THE BARRIERS TO ASTHMA CARE AND SYMPTOM CONTROL OF CHILDREN WHO OFTEN SEEK CARE FOR THE CONDITION IN THE EMERGENCY DEPARTMENT. THE PROGRAM AIMS TO GIVE PATIENTS AND FAMILIES THE EDUCATION AND TOOLS THEY NEED TO REDUCE THE SEVERITY OF THEIR ATTACKS AND THE NEED FOR HOSPITALIZATION. HIGH EXPECTATIONS IN OCTOBER 2025, U.S. NEWS & WORLD REPORT RANKED SIX COOK CHILDREN'S SPECIALTY PROGRAMS AMONG THE TOP 50 IN THE NATION FOR PEDIATRICS. RANKED SPECIALTIES INCLUDED PEDIATRIC BEHAVIORAL HEALTH, CANCER, DIABETES & ENDOCRINOLOGY, NEUROLOGY & NEUROSURGERY, ORTHOPEDICS AND PULMONOLOGY & LUNG SURGERY. COOK CHILDREN'S CONTINUALLY PURSUES QUALITY AND SAFETY. THAT COMMITMENT TO EXCELLENCE WAS REFLECTED IN THE 87% LIHOOD TO RECOMMEND" SCORE FOR PATIENT EXPERIENCE IN FY25. NURSES HONORED AS PART OF THE 2025 DALLAS/FORT WORTH GREAT 100 NURSES LIST INCLUDE REBECCA BROVINA, RESEARCH NURSE COORDINATOR, CAMMIE LARSON, CLINICAL NURSE LEADER, AND NATALIE PALAU, CLINICAL NURSE LEADER. HONOREES ARE NOMINATED BY THEIR NURSING PEERS FOR THEIR EXAMPLE AS LEADERS, ROLE MODELS AND COMPASSIONATE CAREGIVERS. BUILDING TRUST IN FY25, THE PATIENT AND FAMILY EXPERIENCE TEAM STRIVED TO CREATE A SEAMLESS EXPERIENCE SO THAT WHEREVER FAMILIES RECEIVE CARE, IT ALWAYS FEELS LIKE ONE HOSPITAL, ONE TEAM AND ONE PROMISE. FROM THEIR FIRST INTERACTION AT THE FRONT DESK TO THE MOMENT THEY WALK OUT THE HOSPITAL'S DOORS, THE GOAL IS FOR PATIENT FAMILIES TO FEEL LIKE THEY WERE TREATED AS PART OF THE COOK CHILDREN'S FAMILY. THE TEAM ALSO OVERSEES 16 FAMILY ADVISORY COUNCIL GROUPS. THE GROUPS PARTNER WITH THE TEAM AND SHARE THEIR PERSPECTIVES WITH STAFF IN MULTIPLE WAYS TO HELP MAKE PATIENTS FAMILIES' EXPERIENCES BETTER. THE TEAM PROVIDES MENTORSHIP OPPORTUNITIES FOR FAMILIES WHO ARE NEWLY ADMITTED, FEELING OVERWHELMED OR WITH A NEW DIAGNOSIS THROUGH THE PARENTS AS PARTNERS PROGRAM WHICH MATCHES THEM WITH THOSE WHO HAVE WALKED IN THEIR SHOES. WHEN EVERYONE IS CONNECTED AS ONE WITH A FOCUS ON EMPATHY AND BUILDING TRUST, THE FAMILIES AND CHILDREN FEEL THAT AND ARE CONFIDENT IN THEIR CARE.
FORM 990, PART VI, LINE 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS VARIOUS TRUSTEES & OFFICERS EMPLOYED OR SERVING BOARDS WITHIN THE SYSTEM - BUSINESS RELATIONSHIP
FORM 990, PART VI, LINE 3 DELEGATION OF MANAGEMENT DUTIES A MANAGEMENT COMPANY MANAGES THE DAY TO DAY OPERATIONS OF THE JOINT VENTURES.
FORM 990, PART VI, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS COOK CHILDREN'S HEALTH CARE SYSTEM, A TEXAS NON-PROFIT CORPORATION, IS THE SOLE MEMBER OF THE ORGANIZATION.
FORM 990, PART VI, LINE 7A MEMBERS OR STOCKHOLDERS ELECTING MEMBERS OF GOVERNING BODY 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, LINE 7B DECISIONS REQUIRING APPROVAL BY MEMBERS OR STOCKHOLDERS 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, LINE 11B REVIEW OF FORM 990 BY GOVERNING BODY 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, LINE 12C CONFLICT OF INTEREST POLICY EVERY YEAR THE LEGAL DEPARTMENT OF THE COOK CHILDREN'S HEALTH CARE SYSTEM (SYSTEM) SENDS OUT A CONFLICT OF INTEREST DISCLOSURE STATEMENT TO OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES OF ALL SYSTEM COMPANIES, AS WELL AS CERTAIN OTHER EMPLOYEES, INCLUDING PHYSICIANS, WHO ARE DETERMINED TO BE EMPLOYED IN POSITIONS THAT MIGHT BE SUBJECT TO THE SYSTEM'S CONFLICT OF INTEREST POLICY. THE RESPONSES ARE REVIEWED BY THE LEGAL, FINANCE, AND COMPLIANCE DEPARTMENTS. FOLLOW UP AND/OR CORRECTIVE ACTION IS TAKEN AS NEEDED WITH RESPECT TO RESPONSES THAT INDICATE THE EXISTENCE OF ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. A SUMMARY OF THE RESPONSES TO THE QUESTIONNAIRES AND FOLLOW-UP INFORMATION 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, LINE 15A PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL COOK CHILDREN'S HEALTH CARE SYSTEM HAS ESTABLISHED A COMPENSATION COMMITTEE WITH OVERSIGHT OF THE CEO. THE COMPENSATION COMMITTEE APPROVES COMPENSATION ARRANGEMENT IN ADVANCE, WHICH INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT COMMITTEE MEMBERS, USING COMPARABLE MARKET DATA RELATING TO COMPENSATION, WHICH IS PROVIDED BY SULLIVAN COTTER AND ASSOCIATES, INC. , WHICH IS AN INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE DOCUMENTS THE BASIS FOR ITS DETERMINATIONS FOLLOWING CONTEMPORANEOUS SUBSTANTIATION OF THE COMPENSATION COMMITTEE'S DELIBERATIONS AND DECISIONS. THE COMPENSATION COMMITTEE REQUIRES THE COMPENSATION CONSULTANT TO UPDATE MARKET DATA PERIODICALLY, USUALLY EVERY TWO YEARS, WITH INTERIM REVIEWS BEING CONDUCTED AS NEEDED.
FORM 990, PART VI, LINE 15B PROCESS TO ESTABLISH COMPENSATION OF OTHER EMPLOYEES COOK CHILDREN'S HEALTH CARE SYSTEM HAS ESTABLISHED A COMPENSATION COMMITTEE WITH OVERSIGHT OF THE COMPENSATION OF THE OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. THE COMPENSATION COMMITTEE APPROVES COMPENSATION ARRANGEMENTS IN ADVANCE, WHICH INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT COMMITTEE MEMBERS, USING COMPARABLE MARKET DATA RELATING TO COMPENSATION, WHICH IS PROVIDED BY SULLIVAN COTTER AND ASSOCIATES, INC. FOR EXECUTIVE COMPENSATION AND PHYSICIAN COMPENSATION, WHICH IS AN INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE DOCUMENTS THE BASIS FOR ITS DETERMINATIONS FOLLOWING CONTEMPORANEOUS SUBSTANTIATION OF THE COMPENSATION COMMITTEE'S DELIBERATIONS AND DECISIONS. THE COMPENSATION COMMITTEE REQUIRES THE COMPENSATION CONSULTANT TO UPDATE MARKET DATA PERIODICALLY, USUALLY EVERY TWO YEARS, WITH INTERIM REVIEWS BEING CONDUCTED AS NEEDED. WITH REGARD TO PHYSICIAN COMPENSATION, THE COMPENSATION COMMITTEE ALSO RETAINS THE LAW FIRM OF JONES DAY OF CHICAGO, ILLINOIS, TO ISSUE A REASONABLENESS OPINION COVERING THE PHYSICIAN COMPENSATION PLAN FOR COOK CHILDREN'S PHYSICIAN NETWORK.
FORM 990, PART VI, LINE 19 REQUIRED 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 TEXAS SECRETARY OF STATE. THE CONFLICT-OF-INTEREST POLICY IS POSTED ON THE ORGANIZATION'S INTERNAL WEBSITE AND AVAILABLE TO ALL EMPLOYEES AND BOARD MEMBERS OF COOK CHILDREN'S HEALTH CARE SYSTEM ENTITIES. CONSOLIDATED FINANCIAL STATEMENTS ARE REPORTED ELECTRONICALLY FOR ALL COOK CHILDREN'S HEALTH CARE SYSTEM ENTITIES VIA THE ELECTRONIC MUNICIPAL MARKET ACCESS ("EMMA") WEB SITE.
FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES CHANGE IN FAIR VALUE OF SWAP - 447114; TOTAL - 447114;
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) (Rev. 1-2025)


Additional Data


Software ID: 24020961
Software Version: 2024v5.1
SCHEDULE R
(Form 990)
(Rev. January 2025)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
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 HEALTH CARE SYSTEM
801 SEVENTH AVE

FORT WORTH,TX76104
75-2705881 		HEALTH CARE SUPPORT TX 501(C)(3) TYPE III-FI CCHF
 
Yes
 
(2)COOK CHILDREN'S PHYSICIAN NETWORK
801 SEVENTH AVE

FORT WORTH,TX76104
75-2485366 		PHYSICIAN SERVICES TX 501(C)(3) 3 CCHCS
 
Yes
 
(3)WI COOK FOUNDATION DBA COOK CHILDREN'S HEALTH FOUNDATION
801 SEVENTH AVE

FORT WORTH,TX76104
75-2051649 		FUNDRAISING TX 501(C)(3) 7 NA
 
 
No
(4)ROSEDALE OFFICE BUILDING
1500 W ROSEDALE

FORT WORTH,TX76104
46-0866421 		TITLE HOLDING TX 501(C)(2)   CCHF
 
Yes
 
(5)COOK CHILDREN'S HOME HEALTH
801 SEVENTH AVE

FORT WORTH,TX76104
75-2896983 		HEALTHCARE TX 501(C)(3) 10 CCHCS
 
Yes
 
(6)COOK CHILDREN'S HEALTH PLAN
801 SEVENTH AVE

FORT WORTH,TX76104
76-0585240 		INSURANCE TX 501(C)(3) 10 CCHCS
 
Yes
 
(7)CHILD STUDY CENTER
1300 WEST LANCASTER

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

FORT WORTH,TX76104
84-2625990 		HEALTHCARE SERVICES TX 501(C)(3) TYPE II CCHCS
 
Yes
 
(9)COOK CHILDREN'S 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) (Rev. 1-2025)
Schedule R (Form 990) (Rev. 1-2025)
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) CPS PEDIATRICS LLC

340 SEVEN SPRINGS WAY
STE 600
BRENTWOOD,TN37027
47-0871718 		ASC TX NA
  		RELATED 114,804 112,121   No     No 52.55 %
(2) COOK CHILDREN'S SURGERY CENTER

340 SEVEN SPRINGS WAY
STE 600
BRENTWOOD,TN37027
20-5227064 		ASC TX NA
  		RELATED 12,695,488 3,915,557   No   Yes   51 %
(3) CENTER FOR PEDIATRIC SURGERY

340 SEVEN SPRINGS WAY
STE 600
BRENTWOOD,TN37027
47-0871715 		ASC TX NA
  		RELATED 11,362,282 13,405,583   No     No 52.03 %
(4) CAFFEINATED CAPITAL PLAYGROUND SPV LLC

520 E COOPER AVE 2ND FL
STE C-7
ASPEN,CO81611
99-2725317 		INVESTMENTS CO NA
  		N/A                
(5) CC TRUEACCORD SPV II LLC

520 E COOPER AVE 2ND FL
STE C-7
ASPEN,CO81611
82-2997101 		INVESTMENTS CO NA
  		N/A                
(6) CAZ PARTNERS FUND LP- LIQUID INCOME PORTFOLIO

ONE RIVERWAY
STE 2000
HOUSTON,TX77056
80-0969684 		INVESTMENTS TX NA
  		N/A                
(7) GOFF FOCUSED ENERGY STRATEGIES LP

3230 CAMP BOWIE BLVD
STE 800
FORT WORTH,TX76107
82-2764240 		INVESTMENTS TX NA
  		N/A                
(8) HT STORK LP

120 STATE ROUTE 28
UNIT 9
CRYSTAL BAY,NV89402
88-1770748 		INVESTMENTS NV NA
  		N/A                
(9) OBERWEIS INTERNATIONAL SELECT FUND LLC

3333 WARRENVILLE ROAD
STE 500
LISLE,IL60532
84-2094004 		INVESTMENTS IL NA
  		N/A                
(10) STEPSTONE VC HEALTHCARE I LP

100 PAINTERS MILL ROAD
SUITE 700
OWINGS MILLS,MD21117
26-2423493 		INVESTMENTS MD NA
  		N/A                
(11) SAGAMORE HEALTHCARE I LP

100 PAINTERS MILL ROAD
SUITE 700
OWINGS MILLS,MD21117
26-2821679 		INVESTMENTS MD NA
  		N/A                
(12) SCP OPPORTUNITY FUND LLC

190 ELGIN AVENUE
GEORGE TOWN   KY19008
CJ
98-1647424 		INVESTMENTS CJ NA
  		N/A                
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

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

878 WEST BAY ROAD
PO BOX 1159
GRAND CAYMAN,GRAND CAYMANKY1110
CJ
98-0424041 		SELF INSURANCE CJ CCHCS
  		C CORPORATION       Yes  
(3) SPLIT INTEREST TRUSTS (2)

 
 
SPLIT INTEREST TRUST TX NA
  		TRUST       Yes  
(4) LIVE LEARN URBAN FUND FEEDER LLC

801 7TH AVENUE
FORT WORTH,TX76104
35-2597171 		REAL ESTATE TX CCHF
  		C CORPORATION       Yes  






Schedule R (Form 990) (Rev. 1-2025)
Schedule R (Form 990) (Rev. 1-2025)
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 1,856,744 FMV
(2) COOK CHILDREN'S PHYSICIAN NETWORK

 O 67,021,584 FMV
(3) COOK CHILDREN'S PHYSICIAN NETWORK

 Q 502,914 FMV
(4) COOK CHILDREN'S PHYSICIAN NETWORK

 R 830,596 FMV
(5) COOK CHILDREN'S PHYSICIAN NETWORK

 B 110,042,991 FMV
(6) COOK CHILDREN'S HOME HEALTH

 P 362,963 FMV
(7) COOK CHILDREN'S HOME HEALTH

 R 1,956,235 FMV
(8) COOK CHILDREN'S HEALTH PLAN

 Q 318,623 FMV
(9) COOK CHILDREN'S HEALTH PLAN

 Q 63,624 FMV
(10) COOK CHILDREN'S HEALTH PLAN

 S 280,424,612 FMV
(11) COOK CHILDREN'S SURGERY CENTER (NE)

 A 1,653,336 FMV
(12) COOK CHILDREN'S HEALTH ENTERPRISES

 N 7,378,783 FMV
(13) COOK CHILDREN'S MC PROSPER

 O 2,290,304 FMV
(14) COOK CHILDREN'S HEALTH CARE SYSTEM

 K 810,646 FMV
(15) COOK CHILDREN'S HEALTH CARE SYSTEM

 S 2,264,599 FMV
(16) COOK CHILDREN'S HEALTH CARE SYSTEM

 C 202,959 FMV
(17) COOK CHILDREN'S HEALTH CARE SYSTEM

 O 1,411,768 FMV
(18) COOK CHILDREN'S HEALTH CARE SYSTEM

 P 447,979,652 FMV
(19) COOK CHILDREN'S HEALTH CARE SYSTEM

 R 120,000,000 FMV
(20) COOK CHILDREN'S SURGERY CENTER

 S 11,962,990 FMV
(21) CENTER FOR PEDIATRIC SURGERY LTD

 S 11,436,286 FMV
(22) CPS PEDIATRICS LLC

 S 115,518 FMV
(23) ROSEDALE OFFICE BUILDING

 R 87,761 FMV
Schedule R (Form 990) (Rev. 1-2025)
Schedule R (Form 990) (Rev. 1-2025)
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) (Rev. 1-2025)
Schedule R (Form 990) (Rev. 1-2025)
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) (Rev. 1-2025)

Additional Data


Software ID: 24020961
Software Version: 2024v5.1






TY 2024 AffiliatedGroupSchedule
Name:
COOK CHILDREN'S MEDICAL CENTER
EIN:
75-2051646
Software ID:
24020961
Software Version:
2024v5.1
Affiliated Group Business Name:
COOK CHILDREN'S MEDICAL CENTER
Address. Either US or Foreign Type:
801 SEVENTH AVENUE
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:
1,746,134,010
Total Exempt Purpose Expenditures:
1,746,134,010
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:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
904,439,779
Total Exempt Purpose Expenditures:
904,439,779
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 SYSTEM
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:
427,090
Total Lobbying Expenditures:
427,090
Other Exempt Purpose Expenditures:
405,682,508
Total Exempt Purpose Expenditures:
406,109,598
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 NETWORK
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:
578,304,246
Total Exempt Purpose Expenditures:
578,304,246
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:
64,584,867
Total Exempt Purpose Expenditures:
64,584,867
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:
801 SEVENTH AVE
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:
2,471,731
Total Exempt Purpose Expenditures:
2,471,731
Lobbying Nontaxable Amount:
273,587
Grassroots Nontaxable Amount:
68,397
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:
9,802,134
Total Exempt Purpose Expenditures:
9,802,134
Lobbying Nontaxable Amount:
640,107
Grassroots Nontaxable Amount:
160,027
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 ENTERPRISES
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:
9,318,792
Total Exempt Purpose Expenditures:
9,318,792
Lobbying Nontaxable Amount:
615,940
Grassroots Nontaxable Amount:
153,985
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 CENTER - PROSPER
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:
165,878,477
Total Exempt Purpose Expenditures:
165,878,477
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:
81,354,819
Total Exempt Purpose Expenditures:
81,354,819
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 MEDICAL CENTER
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:
1,746,134,010
Total Exempt Purpose Expenditures:
1,746,134,010
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