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Form990 Return of Organization Exempt From Income Tax OMB No 1545-0047

Under section 501 ( c), 527, or 4947( a)(1) of the Internal Revenue Code (except private2O1 3foundations)

Department of the Treasury Do not enter Social Security numbers on this form as it may be made public By law, the IRSOpen

Internal Revenue Service generally cannot redact the information on the formInspection

- Information about Form 990 and its instructions is at www.IRS.gov/form990

For the 2013 calendar year, or tax year beginning 10-01-2013 , 2013, and ending 09-30-2014

B Check if applicableC Name of organization D Employer identification number

'Cook Children s Medical CenterF Address change 75-2051646

Doing Business AsF Name change

1 Initial return Number and street (or P 0 box if mail is not delivered to street address) Room/suite E Telephone number801 Seventh Avenue

F_ TerminatedSuite

(682)885-4000-( Amended return City or town, state or province, country, and ZIP or foreign postal code

Fort Worth, TX 761041 Application pending G Gross receipts $ 858,011,121

F Name and address of principal officer H(a) Is this a group return forNANCY CYCHOL subordinates? (-Yes No801 SEVENTH AVENUEFORT WORTH,TX 76104 H(b) Are all subordinates 1Yes(-No

included?

I Tax-exempt status F 501(c)(3) 1 501(c) ( ) I (insert no (- 4947(a)(1) or F_ 527 If "No," attach a list (see instructions)

J Website :1- WWW COOKCHILDRENS ORG H(c) Group exemption number 0-

K Form of organization F Corporation 1 Trust F_ Association (- Other 0- L Year of formation 1985 M State of legal domicile TX

Summary

1 Briefly describe the organization's mission or most significant activitiesKNOWING THAT EVERY CHILD'S LIFE IS SACRED, IT IS THE PROMISE OF COOK OUR PROMISE IS TO IMPROVE THEHEALTH OF EVERY CHILD IN OUR REGION THROUGH THE PREVENTION AND TREATMENT OF ILLNESS, DISEASE ANDINJURY

2 Check this box Of- if the organization discontinued its operations or disposed of more than 25% of its net assets

r;r 3 Number of voting members of the governing body (Part VI, line 1a) . . . . . . . 3 13

4 N umber of independent voting members of the governing body (Part VI, line 1 b) . 4 13

5 Total number of individuals employed in calendar year 2013 (Part V, line 2a) . 5 4,530

6 Total number of volunteers (estimate if necessary) 6 1,467

7aTotal unrelated business revenue from Part VIII, column (C), line 12 . . . . . . . 7a 138,077

b Net unrelated business taxable income from Form 990-T, line 34 . . . . . . . . 7b 104,304

Prior Year Current Year

8 Contributions and grants (Part VIII, line 1 h) . 11,605,462 11,021,381

9 Program service revenue (Part V I I I , l i n e 2g) . . . . . . . . 812,298,871 842,058,390

N 10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) . . . 542,569 384,343

11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 3,739,334 2,845,462

12 Total revenue-add lines 8 through 11 (must equal Part VIII, column (A), line12) . . . . . . . . . . . . . . . . . . 828,186,236 856,309,576

13 Grants and similar amounts paid (Part IX, column (A), lines 1-3) . 47,236,427 51,133,835

14 Benefits paid to or for members (Part IX, column (A), line 4) . 0 0

15 Salaries, other compensation, employee benefits (Part IX, column (A), lines5-10) 289,635,935 298,199,145

16a Professional fundraising fees (Part IX, column (A), line 11e) 0 0

LLJb Total fundraising expenses (Part IX, column (D), line 25) 0-0

17 Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e) . . . . 330,831,092 326,406,844

18 Total expenses Add lines 13-17 (must equal Part IX, column (A), line 25) 667,703,454 675,739,824

19 Revenue less expenses Subtract line 18 from line 12 . 160,482,782 180,569,752

Beginning of CurrentEnd of Year

Year

M20 Total assets (Part X, line 16) . . . . . . . . . . . . 854,499,605 1,217,738,885

%TS 21 Total liabilities (Part X, line 26) . . . . . . . . . . . . 383,129,428 558,969,359

ZLL 22 Net assets or fund balances Subtract line 21 from line 20 471,370,177 658,769,526

lijaW Signature Block

Under penalties of perjury, I declare that I have examined this return, includinmy knowledge and belief, it is true, correct, and complete Declaration of prepspreparer has any knowledge

SignSignature of officer

Here Cory Rhoades VP & Chief Accounting Officer

Type or print name and title

Print/Type preparer's name Preparers signatureM P Gerich

PaidFirm's name 1- BKD LLP

Pre pare rUse Only Firm's address -2800 Post Oak Blvd Ste 3200

HOUSTON, TX 77056

May the IRS discuss this return with the preparer shown above? (see instructs

For Paperwork Reduction Act Notice, see the separate instructions.

Form 990 ( 2013)

Statement of Program Service AccomplishmentsCheck if Schedule 0 contains a response or note to any line in this Part III .F

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 REGIONTHROUGH 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 onthe prior Form 990 or 990-EZ? . . . . . . . . . . . . . . . . . . . . . . fl Yes F No

If "Yes," describe these new services on Schedule 0

3 Did the organization cease conducting , or make significant changes in how it conducts , any programservices? . . . . . . . . . . . . . . . . . . . . . . . . . . . . F Yes F No

If "Yes," describe these changes on Schedule 0

4 Describe the organization 's program service accomplishments for each of its three largest program services , as measured byexpenses 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 $ 498,454,255 including grants of $ 51,133,835 ) (Revenue $ 843,671,102

COOK CHILDREN'S MEDICAL CENTER HAS NATIONALLY RESPECTED NURSING STAFF WITH MAGNET DESIGNATION BY THE AMERICAN NURSES CREDENTLALINGCENTER SINCE 2006 AND RE-DESIGNATED IN 2011 THIS RECOGNITION OF QUALITY PATIENT CARE AND NURSING EXCELLENCE HAS BEEN ACHIEVED BY 7PERCENT OF ALL HEALTHCARE ORGANIZATIONS NATIONWIDE COOK CHILDREN'S IS KNOWN FOR ITS NURSING EXCELLENCE AND HAS A DISTINGUISHEDINTERNATIONAL REPUTATION FOR PROVIDING EXTRAORDINARY CARE AND ACHIEVING POSITIVE OUTCOMES IN ITS NEUROLOGY, NEUROSURGERY, CARDIOLOGY,CARDIOTHORACIC SURGERY, HEMATOLOGY AND ONCOLOGY, NEONATOLOGY AND PULMONOLOGY PROGRAMS THE MEDICAL CENTER ACCOUNTED FOR 84 PERCENTOF TARRANT COUNTY'S PEDIATRIC ADMISSIONS IN 2014 WITH THE CULMINATION OF A HISTORIC BUILDING INITIATIVE THAT BEGAN IN 2009, THE MEDICALCENTER IS NOW LICENSED FOR 430 BEDS, MAKING IT ONE OF THE LARGEST CHILDREN'S HOSPITALS IN THE COUNTRY THE 530,000 SQUARE FOOT EXPANSIONINCLUDES A LEVEL IV NICU, MORE ROOMS IN THE HEMATOLOGY AND ONCOLOGY UNIT AND THE TRANSITIONAL CARE AND REHABILITATION CARE UNITS, TWO NEWHELIPADS, A FOOD COURT, A PATIENT LIBRARY WITH CLASSROOMS, A PATIENT BUSINESS CENTER, AN INDOOR/OUTDOOR PLAYGROUND AND 1,300 ADDITIONALPARKING SPACES THE DODSON SPECIALTY CLINICS BUILDING HOUSES 18 PEDIATRIC SUBSPECIALTY CLINICS, INCLUDING THE SURGERY CENTER, A CANCERCENTER, HEART CENTER AND NEUROSCIENCES THE DODSON SURGERY CENTER OPENED IN MARCH 2012 AND SERVES PEDIATRIC PATIENTS NEEDINGOUTPATIENT PROCEDURES SUCH AS TREATING ISSUES WITH EYES, EAR/NOSE/THROAT, MINOR ORTHOPEDICS AND GENERAL SURGERY IT INCLUDES - SIXACUTE BEDS AND 22 PREP/RECOVERY BEDS - SIX STATE OF THE ART OPERATING SUITES FOR OUTPATIENT PROCEDURES, INCLUDING TWO EYE SURGERY SUITES- COMPLIMENTARY VALET PARKING ON THE DAY OF SURGERY FOR THE FAMILIES IN ADDITION TO THE DODSON SURGERY CENTER, THE LOWER LEVEL HOUSESRADIOLOGY OUTPATIENT SERVICES AND THE MAGNETOENCEPHALOGRAPHY (MEG), BOTH ARE NONINVASIVE, ADVANCED IMAGING TECHNOLOGIES THE MEG,COUPLED WITH COOK CHILDREN'S MRI AND IMRI TECHNOLOGY, KEEPS THE MEDICAL CENTER AT THE FOREFRONT AMONG THE NATION'S BEST STATE-OF-THE-ART FACILITIES - THE FIRST LEVEL OF THE BUILDING IS THE ENTRY POINT FOR ALL CLINICAL SERVICES IT INCLUDES CENTRALIZED REGISTRATION/CHECK-IN,DIALYSIS, INFECTIOUS DISEASE, NEPHROLOGY, ORTHOPEDICS AND OUTPATIENT LAB SERVICES - THE SECOND LEVEL PROVIDES CLINIC SPACE FOR PATIENTSNEEDING ENDOCRINOLOGY, GASTROENTEROLOGY AND PULMONOLOGY SERVICES - THE THIRD LEVEL IS THE HOME TO COOK CHILDREN'S HEART CENTER WHICHINCLUDES CLINICS, DIAGNOSTICS AND OFFICE SPACE PEDIATRIC SURGERY AND NICU OFFICES ARE ON THE THIRD FLOOR AS WELL TO TAKE ADVANTAGE OF THEDIRECT CONNECTION TO THE NEW NICU SPACE ON LEVEL 3 OF THE NORTH TOWER - THE FOURTH LEVEL IS PART OF THE JANE AND JOHN JUSTINNEUROSCIENCES CENTER AND INCLUDES CLINICS, DIAGNOSTICS AND OFFICE SPACE FOR NEUROLOGY, NEUROSURGERY, PAIN MANAGEMENT, CRANIOFACIAL ANDCLEFT SURGERY, RHEUMATOLOGY, PALLIATIVE CARE AND NEUROPSYCHOLOGY - THE NEURODIAGNOSTICS CENTER HAS A DUAL FUNCTION AS A SLEEP STUDYCENTER AND A DIRECT CONNECTION TO TRANSITIONAL CARE UNIT AND REHABILITATION CARE UNIT BEDS IN THE NORTH TOWER AND NORTH PAVILION - THEFIFTH LEVEL IS THE CANCER CENTER IT INCLUDES - AN EXPANDED INFUSION AREA, DEDICATED LABORATORY AND DEDICATED, FULL-TIME PHARMACY - ACCESSTO HEMATOLOGY AND ONCOLOGY INPATIENT BEDS THROUGH A DIRECT CONNECTION TO THE NORTH TOWER - NEW, PRIVATE FAMILY SPACES FOR NEEDEDBREAKS - NEW MEDITATIVE GARDEN AND FAMILY SUITE FOR PALLIATIVE CARE PATIENTS - DEDICATED OFFICES AND SPACE TO PROMOTE COLLABORATIVE CAREAND COMPREHENSIVE CARE - A TELEMEDICINE ROOM FOR CONSULTATIONS - STATE-OF-THE-ART WIRELESS NETWORKING INFRASTRUCTURE COOKCHILDREN'S IS THE ONLY PEDIATRIC FACILITY IN THE SOUTHWEST TO OFFER 1-131 METAIODOBENZYLGUANIDINE (MIBG) THERAPY THIS EXPANSION HASPOSITIONED COOK CHILDREN'S TO CONTINUE TO PROVIDE THE OUTSTANDING QUALITY THAT IS THE CORNERSTONE OF ITS CARE, IN RESPONSE TO THECHALLENGES OF AN EVERGROWING POPULATION IN ADDITION, COOK CHILDREN'S MEDICAL CENTER WAS SELECTED AS A LEAPFROG TOP CHILDREN'S HOSPITALTHIS DISTINCTION IS ONLY ACHIEVED BY AN ELITE GROUP OF HOSPITALS THAT MEET THE NATION'S TOUGHEST STANDARDS FOR SAFETY AND QUALITY AS PARTOF THIS DISTINCTION, COOK CHILDREN'S WAS RECOGNIZED FOR THE IMPLEMENTATION OF COMPUTERIZED PROVIDER ORDER ENTRY (CPOE) AND BAR CODEDMEDICATION ADMINISTRATION THE MEDICAL CENTER OFFERS ADVANCED TECHNOLOGICAL EQUIPMENT, LEADING SURGICAL TECHNIQUES, REHABILITATIONFACILITIES AND ANCILLARY SERVICES DESIGNED TO MEET THE SPECIAL NEEDS OF CHILDREN ADDITIONALLY, THE CAMPUS BOASTS A PROFESSIONAL AND HIGHLYSKILLED STAFF OF NURSES, TECHNOLOGISTS, THERAPISTS AND OTHER CLINICIANS, AS WELL AS MORE THAN 600 PHYSICIANS AND DENTISTS WHO PROVIDEPRIMARY, SECONDARY, TERTIARY AND QUATERNARY LEVELS OF PEDIATRIC CARE CHILD LIFE SPECIALISTS, CHAPLAINS, TEACHERS, SOCIAL SERVICESCOORDINATORS AND TRANSLATORS HELP PATIENTS AND FAMILIES COPE WITH THE STRESSES THAT ACCOMPANY A CHILD'S HOSPITALIZATION THE MEDICALCENTER IS HOME TO THE ONLY EMS-DESIGNATED, LEVEL II PEDIATRIC TRAUMA CENTER IN TARRANT COUNTY, TEXAS IN 2012, 127,941 PATIENTS WERE TREATEDIN THE EMERGENCY DEPARTMENT AND URGENT CARE CENTER AT COOK CHILDREN'S THE AWARD-WINNING COOK CHILDREN'S MEDICAL CENTER IS SUPPORTEDBY ONE OF THE BUSIEST NEONATAL/ PEDIATRIC TRANSPORT PROGRAMS IN THE NATION, TEDDY BEAR TRANSPORT, WHICH BRINGS MORE THAN 3,000 CHILDRENTO THE MEDICAL CENTER ANNUALLY FOR A HIGHER LEVEL OF CARE SERVICES INCLUDE AMBULANCE, HELICOPTER AND FIXED-WING AIRPLANE TRANSPORTATIONCOOK CHILDREN'S TEDDY BEAR TRANSPORT STAFF OF 52 NEONATAL/ PEDIATRIC NURSES, RESPIRATORY THERAPISTS AND PARAMEDICS IS PROUD TO HAVE MORETHAN 400 COMBINED YEARS OF TRANSPORT EXPERIENCE THIS TEAM IS DEDICATED TO GETTING THE MOST MEDICALLY FRAGILE CHILDREN AND NEONATES TOOUR AWARD-WINNING MEDICAL CENTER QUICKLY AND SAFELY OUR TEAM OF HIGHLY SPECIALIZED NURSES, RESPIRATORY THERAPISTS AND PARAMEDICS BEGINGIVING CARE TO PATIENTS IMMEDIATELY UPON ARRIVAL TO THEIR LOCATION ONCE THEY ARRIVE AT COOK CHILDREN'S MEDICAL CENTER, PATIENTS ARETREATED BY OUR BOARD CERTIFIED PHYSICIANS AND NATIONALLY RECOGNIZED NURSING STAFF COOK CHILDREN'S IS THE ONLY LEVEL IV NICU IN TARRANTCOUNTY, THE HIGHEST QUALIFICATION FOR SUCH PROGRAMS AS ESTABLISHED BY THE AMERICAN ACADEMY OF PEDIATRICS LEVEL IV NICUS MAINTAIN A FULLRANGE OF PEDIATRIC MEDICAL AND SURGICAL SUBSPECIALISTS AND PEDIATRIC ANESTHESIOLOGISTS ON-SITE THE TWO-LEVEL, ALL-SINGLE-ROOM ENVIRONMENTIS STAFFED WITH A TEAM OF NEONATOLOGISTS AND SPECIALISTS WHO COMBINE EXPERTISE WITH THE LATEST TECHNOLOGY TO PROVIDE THE HIGHEST LEVEL OFNEONATAL CARE AVAILABLE STUDIES SHOW THAT PREMATURE AND CRITICALLY ILL INFANTS WHO ARE CARED FOR IN A SINGLE ROOM SETTING HAVE BETTERLONG-TERM OUTCOMES THESE TINY PATIENTS ARE SHOWN TO GROW BETTER, GET MORE OXYGEN, AND GO HOME QUICKER COOK CHILDREN'S ALL-SINGLEROOM NICU WAS THE LARGEST IN THE NATION AT THE TIME OF COMPLETION, AND ONE OF THE FEW THAT CAN ACCOMMODATE TWINS, TRIPLETS AND EVENQUADS IN A SINGLE ROOM COOK CHILDREN'S DESIGNATED LEVEL II TRAUMA CENTER IS STAFFED AND EQUIPPED TO PROVIDE COMPREHENSIVE EMERGENCYMEDICAL SERVICES TO PATIENTS SUFFERING TRAUMATIC INJURIES 24 HOURS A DAY, 7 DAYS A WEEK COOK CHILDREN'S OPENED THE CHILD LIFE ZONE IN THEMEDICAL CENTER ON MAY 15, 2012 COUNTRY MUSIC LEGEND GARTH BROOKS AND FORMER DALLAS COWBOYS QUARTERBACK AND NFL HALL OF FAMER TROYAIKMAN WERE ON HAND TO HELP WITH THE CELEBRATION THEY REPRESENTED THE GARTH BROOKS/TROY AIKMAN TEAMMATES FOR KIDS FOUNDATION THATWAS A DRIVING FORCE BEHIND THE PROJECT THE NEW AREA WITHIN COOK CHILDREN'S MEDICAL CENTER WAS DESIGNED TO BE A PLACE WHERE KIDS CANHAVE FUN, HANG OUT WITH EACH OTHER AND FORGET ABOUT BEING PATIENTS FOR A WHILE TEENS FROM THE YOUTH ADVISORY COUNCIL- PATIENTSADVOCATING FOR CHANGE (YAC-PAC) WERE INSTRUMENTAL IN HELPING TO DESIGN THE SPACE THE 4,000-SQUARE-FOOT ADDITION HOUSES A TEENS-ONLYROOM WITH ARCADE GAMES, POOL AND FOOSBALL TABLES, A JUKE BOX, SEVERAL GAMING SYSTEMS AND MORE IN ADDITION, THE CHILD LIFE ZONE ALSOCONSISTS OF THE MATUSTIK FAMILY RESOURCE CENTER, BOMAR LIBRARY, COMPUTERS FOR PARENTS AND FAMILIES AND RAY'S PLACE SNACK BAR HOWEVER,THE MAIN ATTRACTION IS THE RECORDING AND BROADCAST STUDIO, OFFERING THE MOST CONTEMPORARY TECHNOLOGY, WHERE PATIENTS CAN EXPERIENCEHEALING AND ESCAPE THROUGH MUSIC AND VIDEO CREATION

4b (Code ) (Expenses $ including grants of $ ) (Revenue $

4c (Code ) (Expenses $ including grants of $ ) (Revenue $

4d Other program services (Describe in Schedule 0 )

(Expenses $ including grants of $ ) (Revenue $

4e Total program service expenses 0- 498,454,255

Form 990 (2013)

Form 990 (2013)

Checklist of Required Schedules

Yes No

1 Is the organization described in section 501(c)(3) or4947(a)(1) (other than a private foundation)? If "Yes," Yes

complete Schedule As . . . . . . . . . . . . . . . . . . . . . . . 1

2 Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? 2 Yes

3 Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to Nocandidates for public office? If "Yes,"complete Schedule C, Part I . . . . . . . . . . 3

4 Section 501 ( c)(3) organizations . Did the organization engage in lobbying activities, or have a section 501(h) Noelection in effect during the tax year? If "Yes,"complete Schedule C, Part II . . . . . . . 4

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 Revenue Procedure 98-19? If "Yes," complete Schedule C,Part III . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 N o

6 Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have theright to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes,"complete

Schedule D, Part Is . . . . . . . . . . . . . . . . . . . . . . 6 N o

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 N o

9 Did the organization report an amount in Part X, line 21 for escrow or custodial account liability, serve as acustodian 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, 10 Yespermanent endowments, or quasi-endowments? If "Yes,"complete Schedule D, Part V .

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.19 . . . . . . . . . . . . . . . . . . . lla 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 VIAN . llb 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, PartVIII95 . . . . . . llc 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, PartIX'S . . . . . . . . . . . lid No

e Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part,lle Yes

f Did the organization's separate or consolidated financial statements for the tax year include a footnote thatllf No

addresses the organization's liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete

Schedule D, Part X. . . . . . . . . . . . . . . . . . . . . . . . . .

12a Did the organization obtain separate, independent audited financial statements for the tax year?

If "Yes," complete Schedule D, Parts XI and XII . . . . . . . . . . . . . . . . . 12a N o

b Was the organization included in consolidated, independent audited financial statements for the tax year? If12b Yes

"Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional 95

13 Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," completeScheduleE13 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 investmentsvalued 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 orfor 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 otherassistance 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 17 NoIX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Partl (seeinstructions) . . . .

18 Did the organization report more than $15,000 total of fundraising event gross income and contributions on PartVIII, 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 19 No"Yes," complete Schedule G, Part III . . . . . . . . . . . . . . . . . . .

20a Did the organization operate one or more hospital facilities? If "Yes,"complete Schedule H . . 19 20a Yes

b If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?20b Yes

Form 990 (2013)

Form 990 (2013)

Checklist of Required Schedules (continued)

21 Did the organization report more than $5,000 of grants or other assistance to any domestic organization or 21 Yes

1government on Part IX, column (A), line 1? If "Yes, "complete Schedule I, Parts I and II . . . IN

22 Did the organization report more than $5,000 of grants or other assistance to individuals in the United States on 22Part IX, column (A), line 2? If "Yes," complete Schedule I, Parts I and III . S Yes

23 Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization'scurrent and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," 23 Yes

complete Schedule J . . . . . . . . . . . . . . . . . . . . . . IN

24a Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000as 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 . . . . . . . . . . . . . . . 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 yearto 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) and 501 ( c)(4) organizations . Did the organization engage in an excess benefit transaction witha 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 prioryear, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ? If 25b No

"Yes," complete Schedule L, Part I . . . . . . . . . . . . . . . . . . .

26 Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any currentor former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? 26 NoIf so, complete Schedule L, Part II . . . . . . . . . . . . . . . . . . . .

27 Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantialcontributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family 27 No

member of any of these persons? If "Yes," complete Schedule L, Part III . . . . . . . . .

28 Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IVinstructions for applicable filing thresholds, conditions, and exceptions)

a A current or former officer, director, trustee, or key employee? If "Yes,"complete Schedule L, PartIV . . . . . . . . . . . . . . . . . . . . . . . . . 28a No

b A family member of a current or former officer, director, trustee, or key employee? If "Yes,"complete Schedule L, Part IV . . . . . . . . . . . . . . . . . . . . 28b No

c A n entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) wasan officer, director, trustee, or direct or indirect owner? If "Yes,"complete Schedule L, Part IV . . 28c No

29 Did the organization receive more than $25,000 in non-cash contributions? If "Yes,"completeScheduleM 29 No

30 Did the organization receive contributions of art, historical treasures, or other similar assets, or qualifiedconservation 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 N o

32 Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes, " completeSchedule N, Part II . . . . . . . . . . . . . . . . . . . . . . 32 N o

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, PartI . . . . . . . . 95 1 33 No

34 Was the organization related to any tax-exempt or taxable entity? If "Yes,"complete Schedule R, Part II, III, orIV,

and Part V, line 1 . . . . . . . . . . . . . . . . . . . . . . . t 34 Yes

35a Did the organization have a controlled entity within the meaning of section 512(b)(13)?35a N o

b If'Yes'to line 35a, did the organization receive any payment from or engage in any transaction with a controlled35bentity within the meaning of section 512 (b)(13 )? If "Yes,"complete Schedule R, Part V, line 2 . . .

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, line2 . . . . . . . . . . . . . 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 0 and provide explanations in Schedule 0 for Part VI, lines 1 lb and 19?Note . All Form 990 filers are required to complete Schedule 0 . . . . . . . . . . . . 38 Yes

Form 990 (2013)

Form 990 (2013)

MEW-Statements Regarding Other IRS Filings and Tax Compliance

Check if Schedule 0 contains a response or note to any line in this Part V (-

Yes 1 No

la Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable . la 233

b Enter the number of Forms W-2G included in line la Enter -0- if not applicable lb 0

c Did the organization comply with backup withholding rules for reportable payments to vendors and reportablegaming (gambling) winnings to prize winners? . . . . . . . . . . . . . . . . . 1c Yes

2a Enter the number of employees reported on Form W-3, Transmittal of Wage andTax Statements, filed for the calendar year ending with or within the year coveredby this return . . . . . . . . . . . . . . . . . 2a 4,530

b If at least one is reported on line 2a, did the organization file all required federal employment tax returns?2b Yes

Note . If the sum of lines la and 2a is greater than 250, you may be required to e-file (see instructions)

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 0 . 3b Yes

4a At any time during the calendar year, did the organization have an interest in, or a signature or other authorityover, a financial account in a foreign country (such as a bank account, securities account, or other financialaccount)? . . . . . . . . . . . . . . . . . . . . . . . . . . 4a

b If "Yes," enter the name of the foreign country 0-See instructions for filing requirements for Form TD F 90-22 1, Report of Foreign Bank and Financial Accounts

5a Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? . .

b Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?

c If "Yes," to line 5a or 5b, did the organization file Form 8886-T?

6a Does the organization have annual gross receipts that are normally greater than $100,000, and did theorganization solicit any contributions that were not tax deductible as charitable contributions? . .

b If "Yes," did the organization include with every solicitation an express statement that such contributions or giftswere not tax deductible? .

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 andservices provided to the payor? .

b If "Yes," did the organization notify the donor of the value of the goods or services provided? . .

c Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required tofile Form 82827 .

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 benefitcontract? .

f Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?

g If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 asrequired? .

h If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file aForm 1098-C? .

8 Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Didthe supporting organization, or a donor advised fund maintained by a sponsoring organization, have excessbusiness holdings at any time during the year? .

9 Sponsoring organizations maintaining donor advised funds.

a Did the organization make any taxable distributions under section 4966? . .

b Did the organization make a distribution to a donor, donor advisor, or related person? . .

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 10bfacilities

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 sourcesagainst 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?

b If "Yes," enter the amount of tax-exempt interest received or accrued during theyear . . . . . . . . . . . . . . . . . . . 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 0

b Enter the amount of reserves the organization is required to maintain by the statesin which the organization is licensed to issue qualified health plans 13b

c Enter the amount of reserves on hand 13c

5a

5b

5c

6a

6b

7a

7b

7c

7e

7f

7g

7h

8

9a

9b

12a

13a

No

No

No

No

No

No

No

No

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 0 . 14b

Form 990 (2013)

Form 990 ( 2013)

Lam Governance , Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a"No" response to lines 8a, 8b, or 1Ob below, describe the circumstances, processes, or changes in Schedule 0.See instructions.Check if Schedule 0 contains a response or note to any line in this Part VI .F

Section A. Governing Body and Management

la Enter the number of voting members of the governing body at the end of the taxla 13

year

If there are material differences in voting rights among members of the governingbody, or if the governing body delegated broad authority to an executive committeeor similar committee, explain in Schedule 0

b Enter the number of voting members included in line la, above, who areindependent . . . . . . . . . . . . . . . . . lb 13

2 Did any officer, director, trustee, or key employee have a family relationship or a business relationship with anyother officer, director, trustee, or key employee?

3 Did the organization delegate control over management duties customarily performed by or under the directsupervision of officers, directors or trustees, or key employees to a management company or other person?

4 Did the organization make any significant changes to its governing documents since the prior Form 990 wasfiled?

5 Did the organization become aware during the year of a significant diversion of the organization's assets?

6 Did the organization have members or stockholders?

7a Did the organization have members, stockholders, or other persons who had the power to elect or appoint one ormore members of the governing body? . .

b Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders,or persons other than the governing body?

8 Did the organization contemporaneously document the meetings held or written actions undertaken during theyear by the following

a The governing body?

b Each committee with authority to act on behalf of the governing body?

9 Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at theorganization's mailing address? If "Yes,"provide the names and addresses in Schedule 0 . . . . . . .

Yes I No

2 No

3 Yes

4 No

5 No

6 Yes

7a Yes

7b Yes

8a Yes

8b Yes

9 1 1 No

Section B. Policies ( This Section B requests information about p olicies not required b y the Internal Revenue Code.)Yes No

10a Did the organization have local chapters, branches, or affiliates? 10a No

b If "Yes," did the organization have written policies and procedures governing the activities of such chapters,affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? 10b

11a Has the organization provided a complete copy of this Form 990 to all members of its governing body before filingthe form? . . . . . . . . . . . . . . . . . . . . . . . . . . . 11a Yes

b Describe in Schedule 0 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 giverise to conflicts? . . . . . . . . . . . . . . . . . . . . . . . . . 12b Yes

c Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describein Schedule 0 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 byindependent 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 in Schedule 0 (see instructions)

16a Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with ataxable entity during the year? 16a Yes

b If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate itsparticipation in joint venture arrangements under applicable federal tax law, and take steps to safeguard theorganization'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-

18 Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3 )s only) available for public inspection Indicate how you made these available Check all that apply

fl Own website fl Another's website F Upon request fl Other (explain in Schedule O )

19 Describe in Schedule 0 whether (and if so, how) the organization made its governing documents, conflict ofinterest policy, and financial statements available to the public during the tax year

20 State the name, physical address, and telephone number of the person who possesses the books and records of the organization-CORY RHOADES 801 SEVENTH AVENUEFORT WORTH,TX 76104 (682)885-4000

Form 990 (2013)

Form 990 (2013)

Compensation of Officers, Directors,Trustees, Key Employees, Highest CompensatedEmployees, and Independent ContractorsCheck if Schedule 0 contains a response or note to any line in this Part VII .F

Section A. Officers, Directors, Trustees, Kev Employees, and Highest Compensated Employees

la Complete this table for all persons required to be listed Report compensation for the calendar year ending with or within the organization'stax year* 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

* List all of the organization's current key employees, if any See instructions for definition of "key employee "

* 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 and/or Box 7 of Form 1099-MISC) of more than $100,000 from theorganization and any related organizations

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

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

List persons in the following order individual trustees or directors, institutional trustees, officers, key employees, highestcompensated employees, and former such persons

1 Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee

(A) (B) (C) (D) (E) (F)Name and Title Average Position (do not check Reportable Reportable Estimated

hours per more than one box, unless compensation compensation amount ofweek ( list person is both an officer from the from related otherany hours and a director/trustee) organization organizations compensationfor related

25 0 = T (W- 2/1099- (W- 2/1099- from the

organizations CL :1 fD ado a MISC) MISC) organizationbelow 7 m (D art, and related

dotted line) u S_

- - organizations

(1) JAMES F HERD SR MD 1 0X

TRUSTEE 1 0

(2) MARSHA HILCHER 2 0X X

TRUSTEE-CHAIRMAN 1 0

(3) CHRISTOPHER M HUCKABEE 1 0X

TRUSTEE 1 0

(4) WM MACK LAWHON 10X

TRUSTEE 1 0

(5) ROGER NOBER 1 0X

TRUSTEE 0 0

(6) BONNIE PETSCHE 1 0X

TRUSTEE 1 0

(7) PETER L PHILPOTT 1 0X

TRUSTEE 4 0

(8) JERRY R CONATSER 2 0X X

TRUSTEE-SECRETARY/TREASURER 1 0

(9) JOHN P BOSWELL 2 0X X

TRUSTEE/VICE-CHAIRMAN 4 0

(10) SHARON S MAYES 1 0X

TRUSTEE 0 0

(11) DANA C KELLY 1 0X

TRUSTEE 1 0

(12) MICHELLE M MARLOW 10X

TRUSTEE 0 0

(13) JEFF CONNOR 1 0X

TRUSTEE 0 0

(14) GARY G WALSH 10X

TRUSTEE 0 0

(15) NANCY C CYCHOL 40 0X 703,378 28,533

PRESIDENT 0 0

(16) STANLEY E DAVIS 40 0X 251,806 27,676

VP, SUPPORT SERVICES 0 0

(17) RICHARD P GOODE 22 0X 367,824 300,947 29,091

CHIEF FINANCIAL OFFICER 18 0

Form 990 (2013)

Form 990 (2013)

Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)

(A) (B) (C) (D) ( E) (F)Name and Title Average Position (do not check Reportable Reportable Estimated

hours per more than one box, unless compensation compensation amount of otherweek (list person is both an officer from the from related compensationany hours and a director/trustee ) organization organizations from thefor related 0 - 5 0 = T (W- 2/1099- ( W- 2/1099- organizationorganizations - c fD ado a MISC) MISC) and related

below Q- 5m (D U_

ait organizations

dotted line ) u_

Q a,4 rD 0

c

(18) CARA MARTZ 1 0X 111,349 8,771

SECRETARY 39 0

(19) RICK W MERRILL 12 0X 401,414 936,632 190,582

CHIEF EXECUTIVE OFFICER 28 0

(20) GEORGE B MONTAGUE 2 0X 307,293 31,571

VP, REAL ESTATE 38 0

(21) PAULA J WEBB 40 0X 307,027 22,575

VP, NURSING 0 0

(22) TARESA J CLARK 40 0X 248,230 22,917

VP, NURSING/CNO 0 0

(23) JACK SOSEBEE 40 0X 183,124 23, 696

VP, FAMILY SUPPORT SVCS 0 0

(24) STEPHEN W KIMMEL 22 0X

CHIEF FINANCIAL OFFICER 18 0

(25) BRADLEY HORN 40 0X 191,864 22,036

PHARMACIST 0 0

(26) ROSANNE THURMAN 40 0X 178, 448 19, 481

DIRECTOR, PHARMACY 0 0

(27) KEVIN L DAHLE 40 0X 177,278 23,225

PHARMACIST 0 0

(28) KIMBERLY JONES 40 0X 276,125 27, 516

AVP-PERIOPERATIVE SVCS 0 0

(29) SHARON SMITH 40 0X 201,009 9,405

DIRECTOR-AMBULATORY SURG SVCS 0 0

lb Sub-Total . . . . . . . . . . . . . . . . 0-

c Total from continuation sheets to Part VII, Section A . . . . 0-

d Total ( add lines lb and 1c) . . . . . . . . . . . . 0- 3,487,527 1,656,221 487,075

Total number of individuals (including but not limited to those listed above) who received more than$100,000 of reportable compensation from the organization-213

No

Did the organization list any former officer, director or trustee, key employee, or highest compensated employee

on line la? If "Yes," complete Schedule Jfor such individual . . . . . . . . . . . . . 3 No

4 For any individual listed on line la, is the sum of reportable compensation and other compensation from theorganization and related organizations greater than $150,0007 If "Yes," complete Schedule -7 for such

individual . . . . . . . . . . . . . . . . . . . . . . . . . . .

Did any person listed on line la receive or accrue compensation from any unrelated organization or individual for

services rendered to the organization? If "Yes," complete Schedule Jfor 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 ofcompensation 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, 201 MAIN STREET STE 1801 FORT WORTH TX 76102 CONSTR CONTRACTOR 16,819,397

MEDTRONIC, PO BOX 848086 DALLAS TX 752848086 MED SUPPLY SERVICES 3,295,946

PROGRESSIVE PARKING SOLUTIONS, 201 W BROADWAY SUITE G-5 N LITTLE ROCK AR 72114 PARKING SERVICES 781,911

MAQUET CARDIOVASCULAR US SALES, 3615 SOLUTIONS CENTER CHICAGO IL606773006 MED SUPPLY SERVICES 776,343

DUNAWAY ASSOCIATES LP, 550 BAILEY AVE STE 400 FORT WORTH TX 76107 CONSTR CONTRACTOR 704,913

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 0-14

Form 990 (2013)

Form 990 (2013)

Statement of RevenueCheck if Schedule 0 contains a response or note to any line in this Part VIII F

(A) (B) (C) (D)Total revenue Related or Unrelated Revenue

exempt business excluded fromfunction revenue tax underrevenue sections

512-514

la Federated campaigns . laZ

r = b Membership dues . . . . lb6- 0

0 E c Fundraising events . . . . 1c

d Related organizations . ld 9,688,533

tJ'E e Government grants (contributions) le 310,183

V f All other contributions, gifts, grants, and if 1,022,665^ similar amounts not included above

g Noncash contributions included in linesla-If $

h Total . Add lines la-1f 11,021,381

Business Code

2a PATIENT SERVICES 621110 775,709,383 775,709,383

a2 b OTHER OPERATING REVENUE 621110 55,157,489 55,157,489

a' c JOINT VENTURE REVENUE 621110 11,053,441 11,053,441

d LAB REFERRALS 621500 138,077 138,077

e

f All other program service revenue

g Total . Add lines 2a-2f . . . . . . . 0- 842,058,390

3 Investment income (including dividends, interest,10-and other similar amounts)

237,294 237,294

4 Income from investment of tax-exempt bond proceeds • • 0- 0

5 Royalties . . . . . . . . . . . 0- 0

(i) Real (ii) Personal

6a Gross rents 2,884,295

b Less rental 1,651,545expenses

c Rental income 1,232,750 0or (loss)

d Net rental inco me or (loss) . lim- 1,232,750 1,232,750

(i) Securities (ii) Other

7a Gross amountfrom sales of 197,049assets otherthan inventory

b Less cost orother basis and 50,000sales expenses

c Gain or (loss) 147,049

d Net gain or (loss) . lim- 147,049 147,049

8a Gross income from fundraisingW events (not including

$

of contributions reported on line 1c)See Part IV, line 18

a

s b Less direct expenses . b

c Net income or (loss) from fundraising events . . 0- 0

9a Gross income from gaming activitiesSee Part IV, line 19 . .

a

b Less direct expenses . b

c Net income or (loss) from gaming acti vities . . .- 0

10a Gross sales of inventory, lessreturns and allowances .

a

b Less cost of goods sold . b

c Net income or (loss) from sales of inventory . lim- 0

Miscellaneous Revenue Business Code

11a CCIC RETRO PREMIUM 900099 1,612,712 1,612,712

b

C

d All other revenue . .

e Total.Add lines 11a-11d . 0-1,612,712

12 Total revenue . See Instructions 0- 1 856,309,576 843,533,025 138,077 1,617,093

Form 990 (2013)

Form 990 (2013)

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 0 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 andgeneral expenses

(D)Fundraisingexpenses

1 Grants and other assistance to governments and organizations

in the United States See Part IV, line 2150,960,970 50,960,970

2 Grants and other assistance to individuals in the

United States See Part IV, line 22172,865 172,865

3 Grants and other assistance to governments,organizations, and individuals outside the UnitedStates See Part IV, lines 15 and 16 0

4 Benefits paid to or for members 0

5 Compensation of current officers, directors , trustees, and

key employees 2,775,730 2,775,730

6 Compensation not included above, to disqualified persons(as defined under section 4958(f)(1)) and personsdescribed in section 4958 (c)(3)(B) . 0

7 Other salaries and wages 220,648,665 198,549,005 22,099,660

8 Pension plan accruals and contributions ( include section 401(k)and 403(b) employer contributions) 0

9 Other employee benefits 74,774,750 67,259,175 7,515,575

10 Payroll taxes . 0

11 Fees for services (non-employees)

a Management 118,804,857 4,622,772 114,182,085

b Legal 111,157 111,157

c Accounting . 0

d Lobbying . 0

e Professional fundraising services See Part IV, line 17 0

f Investment management fees . 0

g Other ( If line 11g amount exceeds 10 % of line 25,column ( A) amount, list line 11g expenses onSchedule 0 ) . 20,763,577 15,380,468 5,383,109

12 Advertising and promotion 97,674 71,724 25,950

13 Office expenses 75,494,210 73,183,100 2,311,110

14 Information technology 0

15 Royalties . 0

16 Occupancy 5,795,085 4,425,297 1,369,788

17 Travel 1,239,950 1,087,394 152,556

18 Payments of travel or entertainment expenses for any federal,state, or local public officials 0

19 Conferences , conventions , and meetings 528,483 394,261 134,222

20 Interest 13,194,972 13,114,235 80,737

21 Payments to affiliates 0

22 Depreciation , depletion, and amortization 34,934,423 25,432,026 9,502,397

23 Insurance 1,869,250 1,869,250

24 Other expenses Itemize expenses not covered above (Listmiscellaneous expenses in line 24e If line 24e amount exceeds 10%of line 25, column ( A) amount, list line 24e expenses on Schedule 0

a PHYSICIAN REMUNERATION 8,196,792 6,681,316 1,515,476

b BAD DEBT EXPENSE 22,469,045 22,469,045

c MINOR EQUIPMENT 4,933,893 1,563,191 3,370,702

d REPAIRS & MAINTENANCE 5,803,726 2,144,855 3,658,871

e All other expenses 12,169,750 9,073,306 3,096,444

25 Total functional expenses. Add lines 1 through 24e 675,739,824 498,454,255 177,285,569 0

26 Joint costs. Complete this line only if the organizationreported in column ( B) joint costs from a combinededucational campaign and fundraising solicitation Checkhere - fl if following SOP 98-2 (ASC 958-720)

Form 990 (2013)

Form 990 (2013)

Balance SheetCheck if Schedule 0 contains a response or note to any line in this Part X F

(A) (B)Beginning of year End of year

1 Cash-non-interest-bearing 12,260 1 12,995

2 Savings and temporary cash investments . . . . . . . . 269,263,512 2 373,121,277

3 Pledges and grants receivable, net 0 3 0

4 Accounts receivable, net . . . . . . . . . . . . 74,744,066 4 80,026,528

5 Loans and other receivables from current and former officers, directors, trustees,key employees, and highest compensated employees Complete Part II ofSchedule L . .

0 5 0

6 Loans and other receivables from other disqualified persons (as defined undersection 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributingemployers and sponsoring organizations of section 501(c)(9) voluntary employees'beneficiary organizations (see instructions) Complete Part II of Schedule L

0 6 0

7 Notes and loans receivable, net . . . . . . . . . . . . 18,870,960 7 24,219,660

8 Inventories for sale or use 6,927,758 8 7,588,405

9 Prepaid expenses and deferred charges . 838,931 9 272,583

10a Land, buildings, and equipment cost or other basisComplete Part VI of Schedule D 10a 788,518,922

b Less accumulated depreciation . 10b 289,577,801 436,783,028 10c 498,941,121

11 Investments-publicly traded securities . 8,009,418 11 182,340,486

12 Investments-other securities See Part IV, line 11 0 12 0

13 Investments-program-related See Part IV, line 11 0 13 0

14 Intangible assets . . . . . . . . . . . . . . 7,424,990 14 7,424,990

15 Other assets See Part IV, line 11 31,624,682 15 43,790,840

16 Total assets . Add lines 1 through 15 (must equal line 34) . 854,499,605 16 1,217,738,885

17 Accounts payable and accrued expenses . . . . . . . . 63,700,555 17 86,961,995

18 Grants payable . . . . . . . . . . . . . . . . 0 18 0

19 Deferred revenue . . . . . . . . . . . . . . . 6,832 19 15,982

20 Tax-exempt bond liabilities . . . . . . . . . . . . 295,407,851 20 467,295,766

21 Escrow or custodial account liability Complete Part IV of Schedule D . 0 21 0

22 Loans and other payables to current and former officers, directors, trustees,key employees, highest compensated employees, and disqualified

persons Complete Part II of Schedule L . . . . . . . . . 0 22 0

23 Secured mortgages and notes payable to unrelated third parties 0 23 0

24 Unsecured notes and loans payable to unrelated third parties 0 24 0

25 Other liabilities (including federal income tax, payables to related third parties,and other liabilities not included on lines 17-24) Complete Part X of ScheduleD . 24,014,190 25 4,695,616

26 Total liabilities . Add lines 17 through 25 . 383,129,428 26 558,969,359

Organizations that follow SFAS 117 (ASC 958), check here 1- F and complete

lines 27 through 29, and lines 33 and 34.

C5 27 Unrestricted net assets 471,370,177 27 658,769,526

Mca 28 Temporarily restricted net assets 0 28 0

r29 Permanently restricted net assets 0 29 0

Organizations that do not follow SFAS 117 (ASC 958), check here 1 andFW_complete lines 30 through 34.

30 Capital stock or trust principal, or current funds 30

31 Paid-in or capital surplus, or land, building or equipment fund 31

4T 32 Retained earnings, endowment, accumulated income, or other funds 32

33 Total net assets or fund balances 471,370,177 33 658,769,526z

34 Total liabilities and net assets/fund balances . . . . . . . 854,499,605 34 1,217,738,885

Form 990 (2013)

Form 990 (2013)

« Reconcilliation of Net AssetsCheck if Schedule 0 contains a response or note to any line in this Part XI . F

1 Total revenue (must equal Part VIII, column (A), line 12) . .

2 Total expenses (must equal Part IX, column (A), line 25) . .

3 Revenue less expenses Subtract line 2 from line 1

4 Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A))

5 Net unrealized gains (losses) on investments

6 Donated services and use of facilities

7 Investment expenses . .

8 Prior period adjustments . .

9 Other changes in net assets or fund balances (explain in Schedule 0)

10 Net assets or fund balances at end of year Combine lines 3 through 9 (must equal Part X, line 33,column (B))

1 856,309,576

2 675,739,824

3 180,569,752

4 471,370,177

5

6

7

8

9 6,829,597

10 658,769,526

Financial Statements and Reporting

Check if Schedule 0 contains a response or note to any line in this Part XII (-

Yes No

1 Accounting method used to prepare the Form 990 fl Cash 17 Accrual (OtherIf the organization changed its method of accounting from a prior year or checked " Other," explain inSchedule 0

2a Were the organization 's financial statements compiled or reviewed by an independent accountant? 2a

If'Yes,'check a box below to indicate whether the financial statements for the year were compiled or reviewed ona separate basis, consolidated basis, or both

fl Separate basis fl Consolidated basis fl Both consolidated and separate basis

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 separatebasis, consolidated basis, or both

fl Separate basis F Consolidated basis fl Both consolidated and separate basis

c If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of theaudit, 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 inSchedule 0

3a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in theSingle Audit Act and 0 MB Circular A-1 33? 3a

b If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the 3brequired audit or audits, explain why in Schedule 0 and describe any steps taken to undergo such audits

No

No

Form 990 (2013)


SCHEDULE A Public Charity Status and Public SupportOMB No 1545-0047

(Form 990 or 990EZ) Complete if the organization is a section 501(c)( 3) organization or a section 4947(a)(1)2013nonexempt charitable trust.

Department of the I Oil Attach to Form 990 or Form 990-EZ . Oil See separate instructions. Ope nTreasury Oil Information about Schedule A (Form 990 or 990-EZ) and its instructions is at Inspe ctInternal Revenue Service

www.irs.gov form 990.

Name of the organization Employer identification numberCook Children's Medical Center

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 11, check only one box )

1 1 A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

2 fl A school described in section 170(b)(1)(A)(ii). (Attach Schedule E )

3 F A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

4 1 A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the

hospital's name, city, and state5 1 An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170 ( b)(1)(A)(iv ). (Complete Part II )

6 1 A federal, state, or local government or governmental unit described in section 170 ( b)(1)(A)(v).

7 1 An organization that normally receives a substantial part of its support from a governmental unit or from the general publicdescribed in section 170 ( b)(1)(A)(vi ). (Complete Part II )

8 fl A community trust described in section 170 ( b)(1)(A)(vi ) (Complete Part II )

9 1 An organization that normally receives (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions-subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975 See section 509( a)(2). (Complete Part III )

10 1 An organization organized and operated exclusively to test for public safety See section 509(a)(4).

11 1 An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes ofone or more publicly supported organizations described in section 509 ( a)(1) or section 509(a )( 2) See section 509( a)(3). Checkthe box that describes the type of supporting organization and complete lines Ile through 11 h

a fl Type I b fl Type II c fl Type III - Functionally integrated d fl Type III - Non -functionally integrated

e (- By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified personsother than foundation managers and other than one or more publicly supported organizations described in section 509 ( a)(1 ) orsection 509(a)(2)

f If the organization received a written determination from the IRS that it is a Type I, Type II, orType III supporting organization,check this box F

g Since August 17, 2006, has the organization accepted any gift or contribution from any of thefollowing persons?(i) A person who directly or indirectly controls , either alone or together with persons described in (ii) Yes No

and (iii) below, the governing body of the supported organization? 11g(i)

(ii) A family member of a person described in (i) above? 11g(ii)

(iii) A 35% controlled entity of a person described in (i) or (ii) above? 11g(iii)

h Provide the following information about the supported organization(s)

(i) Name of (ii) EIN (iii) Type of (iv) Is the (v) Did you notify (vi) Is the (vii) Amount ofsupported organization organization in the organization organization in monetary

organization (described on col (i) listed in in col (i) of your col (i) organized supportlines 1- 9 above your governing support? in the U S ?or IRC section document?

(seeinstructions))

Yes No Yes No Yes No

Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ . Cat No 11285F ScheduleA(Form 990 or 990-EZ)2013

Schedule A (Form 990 or 990-EZ) 2013 Page 2

MU^ 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 underPart III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A . Public SupportCalendar year ( or fiscal year beginning (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total

in) 111111 Gifts, grants, contributions, and

membership fees received (Do notinclude any "unusualgrants ")

2 Tax revenues levied for theorganization's benefit and eitherpaid to or expended on itsbehalf

3 The value of services or facilitiesfurnished by a governmental unit tothe organization without charge

4 Total .Add lines 1 through 3

5 The portion of total contributionsby each person (other than agovernmental unit or publiclysupported organization) included online 1 that exceeds 2% of theamount shown on line 11, column(f)

6 Public support . Subtract line 5 fromline 4

Section B. Total SupportCalendar year ( or fiscal year beginning (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total

in) ►7 Amounts from line 4

8 Gross income from interest,dividends, payments received onsecurities loans, rents, royaltiesand income from similarsources

9 Net income from unrelatedbusiness activities, whether or notthe business is regularly carriedon

10 Other income Do not include gainor loss from the sale of capitalassets (Explain in Part IV )

11 Total support (Add lines 7 through10)

12 Gross receipts from related activities, etc (see instructions) 12

13 First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, checkthis box and stop here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ^.

Section C. Com p utation of Public Support Percenta g e14 Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f)) 14

15 Public support percentage for 2012 Schedule A, Part II, line 14 15

16a 331 / 3%support test-2013. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this boxand stop here . The organization qualifies as a publicly supported organization

b 331 / 3%support test-2012 . If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check thisbox and stop here . The organization qualifies as a publicly supported organization

17a 10%-facts-and -circumstances test - 2013. If the organization did not check a box on line 13, 16a, or 16b, and line 14is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here . Explainin Part IV how the organization meets the "facts-and-circumstances" test The organization qualifies as a publicly supportedorganization

b 10%-facts-and-circumstances test-2012 . If the organization did not check a box on line 13, 16a, 16b, or 17a, and line15 is 10% or more, and if the organization meets the "facts- and-circumstances" test, check this box and stop here.Explain in Part IV how the organization meets the "facts-and-circumstances" test The organization qualifies as a publiclysupported organization

18 Private foundation . If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and seeinstructions

Schedule A (Form 990 or 990-EZ) 2013


IMMITM Support Schedule for Organizations Described in Section 509(a)(2)(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify underPart II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A . Public SupportCalendar year ( or fiscal year beginning (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total

in) 111111 Gifts, grants, contributions, and

membership fees received (Do notinclude any "unusual grants ")

2 Gross receipts from admissions,merchandise sold or servicesperformed, or facilities furnished inany activity that is related to theorganization's tax-exemptpurpose

3 Gross receipts from activities thatare not an unrelated trade orbusiness under section 513

4 Tax revenues levied for theorganization's benefit and eitherpaid to or expended on itsbehalf

5 The value of services or facilitiesfurnished by a governmental unit tothe organization without charge

6 Total . Add lines 1 through 5

7a Amounts included on lines 1, 2,and 3 received from disqualifiedpersons

b Amounts included on lines 2 and 3received from other thandisqualified persons that exceedthe greater of$5,000 or 1% of theamount on line 13 for the year

c Add lines 7a and 7b

8 Public support (Subtract line 7cfrom line 6 )

Section B. Total SuuuortCalendar year ( or fiscal year beginning (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total

in) ►9 Amounts from line 6

10a Gross income from interest,dividends, payments received onsecurities loans, rents, royaltiesand income from similarsources

b Unrelated business taxableincome (less section 511 taxes)from businesses acquired afterJune 30, 1975

c Add lines 10a and 10b

11 Net income from unrelatedbusiness activities not includedin line 10b, whether or not thebusiness is regularly carried on

12 Other income Do not includegain or loss from the sale ofcapital assets (Explain in PartIV )

13 Total support . (Add lines 9, 1Oc,11, and 12 )

14 First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,check this box and stop here

Section C. Computation of Public Support Percentage

15 Public support percentage for 2013 ( line 8, column (f) divided by line 13, column (f)) 15

16 Public support percentage from 2012 Schedule A , Part III, line 15 16

Section D . Com p utation of Investment Income Percenta g e

17 Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f)) 17

18 Investment income percentage from 2012 Schedule A, Part III, line 17 18

19a 331 / 3% support tests-2013. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is notmore than 33 1/3%, check this box and stop here . The organization qualifies as a publicly supported organization lk'F-

b 331 / 3% support tests-2012 . 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 18is not more than 33 1/3%, check this box and stop here . The organization qualifies as a publicly supported organization lk'F-

20 Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions



Supplemental Information . Provide the explanations required by Part II, line 10; Part II, line 17a or17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

I Return Reference I Explanation I


lefile GRAPHIC print - DO NOT PROCESS As Filed Data - DLN: 93493225039185

SCHEDULE D Supplemental Financial StatementsOMB No 1545-0047

(Form 990)Complete if the organization answered "Yes," to Form 990,0- 2013

Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b

Department of the Treasury 0- Attach to Form 990. 0- See separate instructions . 1- Information about Schedule D (Form 990) •II. -

Internal Revenue Service and its instructions is at www.irs.gov /form990. . -


75-2051646Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts . Complete if theorg anization answered "Yes" to Form 990 , Part IV , line 6.

(a) Donor advised funds (b) Funds and other accounts

1 Total number at end of year

2 Aggregate contributions to (during year)

3 Aggregate grants from (during year)

4 Aggregate value at end of year

5 Did the organization inform all donors and donor advisors in writing that the assets held in donor advisedfunds are the organization's property, subject to the organization's exclusive legal control? F Yes I No

6 Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can beused only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purposeconferring impermissible private benefit? fl Yes fl No

MRSTI-Conservation Easements . Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

1 Purpose(s) of conservation easements held by the organization (check all that apply)

1 Preservation of land for public use (e g , recreation or education) 1 Preservation of an historically important land area

1 Protection of natural habitat 1 Preservation of a certified historic structure

fl Preservation of open space

2 Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservationeasement on the last day of the tax year

a Total number of conservation easements

b Total acreage restricted by conservation easements

c Number of conservation easements on a certified historic structure included in (a)

d Number of conservation easements included in (c) acquired after 8/17/06, and not on ahistoric structure listed in the National Register

Held at the End of the Year

2a

2b

2c

2d

3 N umber of conservation easements modified, transferred , released, extinguished, or terminated by the organization during

the tax year 0-

4 N umber of states where property subject to conservation easement is located 0-

5 Does the organization have a written policy regarding the periodic monitoring , inspection , handling of violations, andenforcement of the conservation easements it holds? fl Yes fl No

6 Staff and volunteer hours devoted to monitoring , inspecting , and enforcing conservation easements during the year

0-

7 Amount of expenses incurred in monitoring , inspecting , and enforcing conservation easements during the year

0- $

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)? F Yes 1 No

9 In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, andbalance sheet, and include, if applicable, the text of the footnote to the organization's financial statements that describesthe organization's accounting for conservation easements

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.Complete if the oraanization answered "Yes" to Form 990. Part IV. line 8.

la If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheetworks of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of publicservice, 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 SFAS 116 (ASC 958), to report in its revenue statement and balance sheetworks of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of publicservice, provide the following amounts relating to these items

(i) Revenues included in Form 990, Part VIII, line 1 $

(ii)Assets included in Form 990, Part X $

2 If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide thefollowing amounts required to be reported under SFAS 116 (ASC 958) relating to these items

a Revenues included in Form 990, Part VIII, line 1 $

b Assets included in Form 990, Part X $

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat No 52283D Schedule D ( Form 990) 2013

Schedule D (Form 990) 2013 Page 2

r:FTnFW 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 itscollection items (check all that apply)

a F_ Public exhibition d fl Loan or exchange programs

b 1 Scholarly research e (- Other

c F Preservation for future generations

4 Provide a description of the organization's collections and explain how they further the organization's exempt purpose inPart XIII

5 During the year, did the organization solicit or receive donations of art, historical treasures or other similarassets to be sold to raise funds rather than to be maintained as part of the organization's collection? 1 Yes 1 No

Escrow and Custodial Arrangements . Complete if the organization answered "Yes" to Form 990,Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

la Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets notincluded on Form 990, Part X7 1 Yes F No

b If "Yes," explain the arrangement in Part XIII and complete the following table

c Beginning balance 1c

d Additions during the year ld

e Distributions during the year le

f Ending balance if

A mount

2a Did the organization include an amount on Form 990, Part X, line 21? fl Yes fl No

b If "Yes," explain the arrangement in Part XIII Check here if the explanation has been provided in Part XIII . . . . . . . . F

MWAF-Endowment Funds . Com p lete if the org anization answered "Yes" to Form 990 , Part IV, line 10.

la Beginning of year balance .

b Contributions

c Net investment earnings, gains, and losses

d Grants or scholarships

e Other expenditures for facilitiesand programs

f Administrative expenses .

g End of year balance

(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back

56,839,390 90,534,565 82,538,362 80,357,260 70,947,601

336,613 29,553 -256,157 18,935 3,803,664

5,450,280 9,201,059 8,800,000 2,595,270 5,976,642

603,585 42,925,787 547,640 433,103 370,647

62,022,698 56,839,390 90,534,565 82,538,362 80,357,260

2 Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as

a Board designated or quasi-endowment 0- 23 000 %

b Permanent endowment 0- 74 000 %

c Temporarily restricted endowment 0- 3 000 %

The percentages in 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 theorganization by Yes No

(i) unrelated organizations . . . . . . . . . . . . . . . . . . . . . . . . 3a(i) No

(ii) related organizations . . . . . . . . . . . . . . . . . . . . . . 3a(ii) Yes

b If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? . . I 3b I Yes

4 Describe in Part XIII the intended uses of the organization's endowment funds

Land , Buildings, and Equipment . Complete if the organization answered 'Yes' to Form 990, Part IV, line1 1 a See Form 990 Part X line 1(l

Description of property (a) Cost or otherbasis ( investment)

(b)Cost or otherbasis (other )

(c) Accumulateddepreciation

(d) Book value

la Land 13,464,223 13,464,223

b Buildings 513,395,879 164,015,909 349,379,970

c Leasehold improvements 3,923,080 3,075,868 847,212

d Equipment 171,159,511 117,886,857 53,272,654

e Other 86,576,230 4,599,167 81,977,063

Total . Add lines la through 1 e (Column (d) must equal Form 990, Part X, column (B), line 10 (c).) . . 0- 498,941,122

Schedule D (Form 990) 2013


Investments-Other Securities . Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b.See Form 990 , Part X line 12.

(a) Description of security or category (b)Book value (c) Method of valuation(including name of security) Cost or end-of-year market value

(1 )Financial derivatives

(2)Closely-held equity interests

Other

Total . (Column (b) must equa l Form 990, Part X, col (B) line 12 ) 11.

Fnrm QQn Part Y lino 7S


Investments-Program Related . Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c.Caa Form QQ(1 Dart X lino 1 -^

2. Liability for uncertain tax positions In Part XIII, provide the text of the footnote to the organization's financial statements thatreports the organization ' s liability for uncertain tax positions under FIN 48 (A SC 740) C heck here if the text of the footnote has beenprovided in Part XIII F


Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete ifthe org anization answered 'Yes' to Form 990 , Part IV line 12a.

1 Total revenue, gains, and other support per audited financial statements . 1 869,416,361

2 Amounts included on line 1 but not on Form 990, Part VIII, line 12

a Net unrealized gains on investments . 2a

b Donated services and use of facilities . 2b

c Recoveries of prior year grants 2c

d Other (Describe in Part XIII ) . . . . . . . . . . . 2d 15,728,498

e Add lines 2a through 2d . . . . . . . . . . . . . . . . . . . . 2e 15,728,498

3 Subtract line 2e from line 1 . . . . . . . . . . . . . . . . . . . . 3 853,687,863

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 2,621,713

c Add lines 4a and 4b . . . . . . . . . . . . . . . . . . . . . 4c 2,621,713

5 Total revenue Add lines 3 and 4c. (This must equal Form 990, Part I, line 12 ) . . . . 5 856,309,576

« Reconciliation of Expenses per Audited Financial Statements With Expenses per Return . Completeif the org anization answered 'Yes' to Form 990 , Part IV line 12a.

1 Total expenses and losses per audited financial statements 1 684,437,219

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 31,166,441

e Add lines 2a through 2d . . . . . . . . . . . . . . . . . . . . . 2e 31,166,441

3 Subtract line 2e from line 1 . . . . . . . . . . . . . . . . . . . 3 653,270,778

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 22,469,046

c Add lines 4a and 4b . . . . . . . . . . . . . . . . . . . . . . 4c 22,469,046

5 Total expenses Add lines 3 and 4c. (This must equal Form 990, Part I, line 18 ) . . . . . 5 675,739,824

OT1174M Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9, Part III, lines la and 4, Part IV, lines lb 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 additionalinformation

Return Reference Explanation

SCHEDULE D, PART XI, LINE 2D RECONCILATION OF AUDITED REVENUE TO FORM 990 REVENUE JOINT VENTURE REVENUENOT INCLUDED ON 990 $39,062,288 INTEREST RATE SWAP ADJUSTMENT ($ 715,896) BADDEBT DEDUCTION FROM REVENUE ($22,469,045) PLANO GAIN ON SALE OF ASSET (IN AUDITEXP) ($ 1,800) GAIN ON SALE/DISPOSAL OF ASSET (IN AUDIT EXP) ($ 147,049) ---------------TOTAL $15,728,498

SCHEDULE D, PART XI, LINE 4B RECONCILATION OF AUDITED REVENUE TO FORM 990 REVENUE CONTRIBUTION FROM HSRECORDED TO NET ASSETS $ 7,973 CONTRIBUTION FROM HF RECORDED TO NET ASSETS $4,265,285 RENT EXPENSE ($ 1,651,545) ---------------- TOTAL $ 2,621,713

SCHEDULE D, PART XII, LINE 2D RECONCILATION OF AUDITED EXPENSE TO FORM 990 EXPENSE JOINT VENTUREACCOUNTS NOT INCLUDED ON 990 $39,062,288 MINORITY INTEREST ($ 9,398,543) RENTEXPENSE $ 1,651,545 GAIN ON SALE/DISPOSAL OF ASSET (IN AUDIT EXP)($ 147,049)PLANO GAIN ON SALE OF ASSET (IN AUDIT EXP) ($ 1,800) -------------- TOTAL $31,166,441

SCHEDULE D, PART V, QUESTION INTENDED USE OF ENDOWMENT FUNDS COOK CHILDREN'S HAS ADOPTED INVESTMENT4 AND SPENDING POLICIES FOR ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A

PREDICTABLE STREAM OF FUNDING TO PROGRAMS AND OTHER ITEMS SUPPORTED BY ITSENDOWMENT WHILE SEEKING TO MAINTAIN THE PURCHASING POWER OFTHE ENDOWMENTUNDER COOK CHILDREN'S POLICIES, ENDOWMENT ASSETS ARE INVESTED IN A MANNERTHAT IS INTENDED TO PRODUCE AN AMOUNT THAT IS EQUAL TO A RETURN HURDLEDEFINED AS THE SPENDING RATE, INFLATION RATE AND THE MANAGEMENT COST OF THEENDOWMENT ON AN ANNUAL BASIS WHILE ASSUMING A PRUDENT LEVEL OF INVESTMENTRISK ACTUAL RETURNS IN ANY GIVEN YEAR MAY VARY FROM THIS AMOUNT TO SATISFYITS LONG-TERM RATE OF RETURN OBJECTIVES, COOK CHILDREN'S RELIES ON A TOTALRETURN STRATEGY IN WHICH INVESTMENT RETURNS ARE ACHIEVED THROUGH BOTHCURRENT YIELD (INVESTMENT INCOME SUCH AS DIVIDENDS AND INTEREST) AND CAPITALAPPRECIATION (BOTH REALIZED AND UNREALIZED) COOK CHILDREN'S TARGETS ADIVERSIFIED ASSET ALLOCATION THAT PLACED A GREATER EMPHASIS ON EQUITY-BASEDINVESTMENTS TO ACHIEVE ITS LONG-TERM RETURN OBJECTIVES WITHIN PRUDENT RISKCONSTRAINTS COOK CHILDREN'S HAS A POLICY (THE SPENDING POLICY) OFAPPROPRIATING FOR EXPENDITURE EACH YEAR 5% OFTHE FOUNDATION'S INVESTMENTSAVERAGE FAIR VALUE OVER THE PRIOR 5 YEARS ENDED JUNE 30 PRECEDING THE YEAR INWHICH EXPENDITURE IS PLANNED IN ESTABLISHING THIS POLICY, COOK CHILDREN'SCONSIDERED THE LONG-TERM EXPECTED RETURN ON ITS ENDOWMENT ACCORDINGLY,OVER THE LONG TERM, COOK CHILDREN'S EXPECTS THE CURRENT SPENDING POLICY TOALLOW ITS ENDOWMENT TO GROW AT THE RETURN HURDLE THIS IS CONSISTENT WITHCOOK CHILDREN'S OBJECTIVE TO MAINTAIN THE PURCHASING POWER OF ENDOWMENTASSETS HELD IN PERPETUITY OR FOR A SPECIFIED TERM, AS WELL AS TO PROVIDEADDITIONAL REAL GROWTH THROUGH NEW GIFTS AND INVESTMENT RETURN

SCHEDULE D, PART XII, LINE 4B RECONCILATION OF AUDITED EXPENSE TO FORM 990 EXPENSE BAD DEBT DEDUCTIONFROM REVENUE $22,469,046


l efile GRAPHIC print - DO NOT PROCESS As Filed Data - DLN: 93493225039185

SCHEDULE H HospitalsOMB No 1545-0047

(Form 990)

20131- Complete if the organization answered "Yes" to Form 990, Part IV , question 20.1- Attach to Form 990. 1- See separate instructions.

Department of the Treasury 0- Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990. OpenInternal Revenue Service

I Inspection

Name of the organizationCook Children's Medical Center

Employer identification number

75-2051646

Financial Assistance and Certain Other Community Benefits at CostYes I No

la Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a la Yes

b If "Yes," was it a written policy? . . . . . . . . . . . . . . . . . . . . . lb Yes

2 If the organization had multiple hospital facilities , indicate which of the following best describes application of thefinancial assistance policy to its various hospital facilities during the tax year

F Applied uniformly to all hospital facilities F Applied uniformly to most hospital facilities

r Generally tailored to individual hospital facilities

3 Answer the following based on the financial assistance eligibility criteria that applied to the largest number of theorganization ' 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

F 100% F 150% F 200% F Other 400 %

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

F 200% F 250% F 300% F 350% F 400% F Other 500 %

c If the organization used factors other than FPG in determining eligibility, describe in Part VI the income basedcriteria for determining eligibility for free or discounted care Include in the description whether the organizationused an asset test or other threshold , regardless of income, as a factor in determining eligibility for free ordiscounted care

4 Did the organization ' s financial assistance policy that applied to the largest number of its patients during the tax yea rprovide 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 duringthe 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 theseworksheets with the Schedule H

7 Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and (a) Number of b Persons( )

c Total community( )

d Direct offsetting( ) g

a Net community benefit()

f Percent of( )

Means-Testedactivities or served benefit expense revenue expense total expense

Government Programsprograms(optional)

(optional)

a Financial Assistance at cost(from Worksheet 1) . 4,194,038 4,194,038 0 640 %

b Medicaid (from Worksheet 3,column a) . . . 348,588,956 301,034,894 47,554,062 7 280 %

c Costs of other means-testedgovernment programs (fromWorksheet 3, column b)

d Total Financial Assistanceand Means-TestedGovernment Programs 352,782,994 301,034,894 51,748,100 7 920 %

Other Benefitse Community health

improvement services andcommunity benefit operations(from Worksheet 4) . 5,072,772 17,164 5,055,608 0 770 %

f Health professions education(from Worksheet 5) . 575,552 188,134 387,418 0 060 %

g Subsidized health services(from Worksheet 6) .

h Research (from Worksheet 7) 642,325 710,762 -68,437 0 010 %

i Cash and in-kindcontributions for communitybenefit (from Worksheet 8) 51,195,795 51,195,795 7 840 %

j Total . Other Benefits . 57,486,444 916,060 56,570,384 8 660 %

k Total . Add lines 7d and 7j 410,269,438 301,950,954 108,318,484 16 580

For Paperwork Reduction Act Noticee see the Instructions for Form 990 . Cat N o 5019 2T Schedule H (Form 990) 2013

Schedule H (Form 990) 2013 Page 2 2

Community Building Activities Complete this table if the organization conducted any community buildingactivities during the tax year, and describe in Part VI how its community building activities promoted the healthof the communities it serves-

(a) Number ofactivities orprograms(optional)

(b) Personsserved (optional)

(c) Total communitybuilding expense

(d) Direct offsettingrevenue

(e) Net communitybuilding expense

(f) Percent oftotal expense

1 Ph y sical im p rovements and housin g 26,757 26,757

2 Economic development

3 Community su pp ort 1,935 1,935

4 Environmental improvements

5 Leadership development and trainingfor community members

6 Coalition building 14,306 14,306

7 Community health improvementadvocacy 136,985 136,985 0 020 %

8 Workforce development 46,798 46,798 0 010 %

9 Other

10 Total 226,781 226,781 0 030 %

Ill: Bad Debt , Medicare , & Collection PracticesSection A. Bad Debt Expense Yes No

1 Did the organization report bad debt expense in accordance with Heathcare Financial Management AssociationStatement No 15? . . . . . . . . . . . . . . . . . . . . 1 Yes

2 Enter the amount of the organization's bad debt expense Explain in Part VI themethodology used by the organization to estimate this amount 2 25,588,453

3 Enter the estimated amount of the organization's bad debt expense attributable topatients eligible under the organization's financial assistance policy Explain in Part VIthe methodology used by the organization to estimate this amount and the rationale, ifany, 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 expenseor the page number on which this footnote is contained in the attached financial statements

Section B. Medicare

5 Entertotal revenue received from Medicare (including DSH and IME) . 5 2,649,945

6 Enter Medicare allowable costs of care relating to payments on line 5 . 6 4,929,513

7 Subtract line 6 from line 5 This is the surplus (or shortfall) . 7 -2,279,568

8 Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefitAlso describe in Part VI the costing methodology or source used to determine the amount reported on line 6Check the box that describes the method used

r- Cost accounting system F Cost to charge ratio F Other

Section C. Collection Practices

9a Did the organization have a written debt collection policy during the tax year? .

b If "Yes," did the organization 's collection policy that applied to the largest number of its patients during the tax yearcontain provisions on the collection practices to be followed for patients who are known to qualify for financialassistance? Describe in Part VI 9b Yes. . . . . . . . . . . . . . . . . . . . . . .

MITUT Mananernent Comnanies and Joint VenturesrnvunPri ,n° nr mnra hvnfrarc rLrartnrc triictaac kavamnlnvaac and nhvananc-s inctrnrtinncl

(a) Name of entity (b) Description of primaryactivity of entity

(c) Organization'sprofit % or stockownership %

(d) Officers, directors,trustees, or key

employees' profit %or stock ownership

(e) Physicians'profit % or stockownership

1 CC NORTHEAST HOSP FREESTANDING SURGICAL HOSP 46 000 % 36 720 %

2

3

4

5

6

7

8

9

10

11

12

13

Schedule H (Form 990) 2013


Facility Information

Section A . Hospital Facilities -^ s CD -m

0

(list in order of size from largest tosmallest-see instructions) o CL 0 aHow many hospital facilities did the 5 -0 (organization operate during the tax year? a

2 U

Name, address, primary website address,and state license number a Other (Describe) Facility reporting group

See Additional Data Table



Facility 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 facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number ofhospital facility (from Schedule H, Part V, Section A)

1

1

a

b

c

d

e

f

9

h

2

3

4

5

a

b

c

d

6

a

b

c

d

e

f

9

h

7

8a

b

c

munity Health Needs Assessment ( Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years , did the hospital facility conduct a communityhealth needs assessment (CHNA )? If "No," skip to line 9 . . . . . . . . . . . . . . . . . . .

If "Yes," indicate what the CHNA report describes ( check all that apply)

F A definition of the community served by the hospital facility

F Demographics of the community

7 Existing health care facilities and resources within the community that are available to respond to the health needs ofthe community

F' How data was obtained

F' The health needs of the community

7 Primary and chronic disease needs and other health issues of uninsured persons, low- income persons, and minoritygroups

I The process for identifying and prioritizing community health needs and services to meet the community health needs

I The process for consulting with persons representing the community 's interests

I Information gaps that limit the hospital facility's ability to assess the community 's health needs

I Other ( describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA 20 12

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broadinterests of the community served by the hospital facility, including those with special knowledge of or expertise in publichealth? If "Yes," describe in Part VI how the hospital facility took into account input from persons who represent thecommunity , and identify the persons the hospital facilityconsulted . . . . . . . . . . . . . . . . . . . .

Was the hospital facility's CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospitalfacilities in Part VI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Did the hospital facility make its CHNA report widely available to the public? . . . . . . . . . . . . .

If "Yes," indicate how the CHNA report was made widely available ( check all that apply)

F' Hospital facility's website (list url ) WWW COOKCHILDRENS ORG

F Otherwebsite ( list url ) WWW CENTERFORCHILDRENSHEALTH ORG

F Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that applyas of the end of the tax year)7' Adoption of an implementation strategy that addresses each of the community health needs identified through the

CHNA

F Execution of the implementation strategy

F Participation in the development of a community - wide plan

I Participation in the execution of a community-wide plan

I Inclusion of a community benefit section in operational plans

F Adoption of a budget for provision of services that address the needs identified in the CHNA

F Prioritization of health needs in its community

F Prioritization of services that the hospital facility will undertake to meet health needs in its community

1' Other ( describe in Part VI)

Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VIwhich needs it has not addressed and the reasons why it has not addressed such needs . . . . . . . .

Did the organization incur an excise tax under section 4959 for the hospital facility ' s failure to conduct a CHNA asrequired by section 501 (r)(3)? . . . . . . . . . . . . . . . . . . . . . . . . . . .

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? . . . . . .

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its

hospital facilities? $

No

1 Yes

3 Yes

4 Yes

7 Yes

8a N o



Facility Information (continued)

Financial Assistance Policy Yes No

9 Did the hospital facility have in place during the tax year a written financial assistance policy that

Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes

10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care? . . . . . . . . . . . 10 Yes

If "Yes," indicate the FPG family income limit for eligibility for free care 400 %

If "No," explain in Part VI the criteria the hospital facility used

11 Used FPG to determine eligibility for providing discounted care? . . . . . . . . . . . . . . . . . 11 Yes

If "Yes," indicate the FPG family income limit for eligibility for discounted care 500 %


12 Explained the basis for calculating amounts charged to patients? . . . . . . . . . . . . . . . . . 12 Yes

If "Yes," indicate the factors used in determining such amounts (check all that apply)

a F Income level

b F Asset level

c F Medical indigency

d F Insurance status

e F Uninsured discount

f F Medicaid/Medicare

g F State regulation

h F Residency

i 7 Other (describe in Part VI)

13 Explained the method for applying for financial assistance? . . . . . . . . . . . . . . . . . . . 13 Yes

14 Included measures to publicize the policy within the community served by the hospital facility? . . . . . . . 14 No

If "Yes," indicate how the hospital facility publicized the policy (check all that apply)

a 1 The policy was posted on the hospital facility's website

b 1 The policy was attached to billing invoices

c 1 The policy was posted in the hospital facility's emergency rooms or waiting rooms

d 1 The policy was posted in the hospital facility's admissions offices

e 1 The policy was provided, in writing, to patients on admission to the hospital facility

f F The policy was available upon request

g I Other (describe in Part VI)

Billing and Collections

15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financialassistance policy (FAP) that explained actions the hospital facility may take upon non-payment? . . . . . . . 15 Yes

16 Check all of the following actions against an individual that were permitted under the hospital facility's policies duringthe tax year before making reasonable efforts to determine the individual's eligibility under the facility's FAP

a F Reporting to credit agency

b F Lawsuits

c F Liens on residences

d F Body attachments

e F Other similar actions (describe in Section C)

17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year beforemaking reasonable efforts to determine the individual's eligibility under the facility's FAP? . . . . . . . 17 No

If "Yes," check all actions in which the hospital facility or a third party engaged


b F Lawsuits



e F-Other similar actions (describe in Section C)




18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply)

a F Notified individuals of the financial assistance policy on admission

b F Notified individuals of the financial assistance policy prior to discharge

c F Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals' bills

d F- Documented its determination of whether individuals were eligible for financial assistance under the hospital facility'sfinancial assistance policy

e I Other (describe in Section C)

Policy Relating to Emergency Medical Care

19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requiresthe hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless oftheir eligibility under the hospital facility's financial assistance policy? . . . . . . . . . .

If "No," indicate why

1 The hospital facility did not provide care for any emergency medical conditions

1 The hospital facility's policy was not in writing

1 The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

1 Other ( describe in Part VI)

No

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FA P-eligible individuals for emergency or other medically necessary care

a F- The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts thatcan be charged

b F- The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating themaximum amounts that can be charged

c 1 The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

d I Other (describe in Part VI)

21 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility providedemergency or other medically necessary services more than the amounts generally billed to individuals who had insurancecovering such care? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 No

If "Yes," explain in Part VI

22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for anyservice provided to that individual? . . . . . . . . . . . . . . . . . . . . . . . . . 22 No




Facility 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 NORTHEAST HOSPITAL

Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number ofhospital facility (from Schedule H, Part V, Section A)

2

1

a

b

c

d

e

f

9

h

2

3

4

5

a

b

c

d

6

a

b

c

d

e

f

9

h

7

8a

b

c

munity Health Needs Assessment ( Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years , did the hospital facility conduct a communityhealth needs assessment (CHNA )? If "No," skip to line 9 . . . . . . . . . . . . . . . . . . .

If "Yes," indicate what the CHNA report describes ( check all that apply)

F A definition of the community served by the hospital facility

F Demographics of the community

7 Existing health care facilities and resources within the community that are available to respond to the health needs ofthe community

F' How data was obtained

F' The health needs of the community

7 Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minoritygroups

I The process for identifying and prioritizing community health needs and services to meet the community health needs

I The process for consulting with persons representing the community 's interests

I Information gaps that limit the hospital facility's ability to assess the community's health needs

I Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA 20 12

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broadinterests of the community served by the hospital facility, including those with special knowledge of or expertise in publichealth? If "Yes ," describe in Part VI how the hospital facility took into account input from persons who represent thecommunity , and identify the persons the hospital facilityconsulted . . . . . . . . . . . . . . . . . . . .

Was the hospital facility's CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospitalfacilities in Part VI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Did the hospital facility make its CHNA report widely available to the public? . . . . . . . . . . . . .

If "Yes," indicate how the CHNA report was made widely available ( check all that apply)

F Hospital facility 's website ( list url ) WWW COOKCHILDRENS ORG

F Otherwebsite ( list url ) WWW CENTERFORCHILDRENSHEALTH ORG

F' Available upon request from the hospital facility

Other ( describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that applyas of the end of the tax year)7' Adoption of an implementation strategy that addresses each of the community health needs identified through the

CHNA

F Execution of the implementation strategy

F Participation in the development of a community - wide plan

I Participation in the execution of a community - wide plan

I Inclusion of a community benefit section in operational plans

F Adoption of a budget for provision of services that address the needs identified in the CHNA

F Prioritization of health needs in its community

F Prioritization of services that the hospital facility will undertake to meet health needs in its community

1' Other ( describe in Part VI)

Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VIwhich needs it has not addressed and the reasons why it has not addressed such needs . . . . . . . .

Did the organization incur an excise tax under section 4959 for the hospital facility ' s failure to conduct a CHNA asrequired by section 501 (r)(3)? . . . . . . . . . . . . . . . . . . . . . . . . . . .

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? . . . . . .

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its

hospital facilities? $

No

1 Yes

3 Yes

4 Yes

7 Yes

8a N o




Financial Assistance Policy Yes No

9 Did the hospital facility have in place during the tax year a written financial assistance policy that

Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes

10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care? . . . . . . . . . . . 10 Yes

If "Yes," indicate the FPG family income limit for eligibility for free care 400 %


11 Used FPG to determine eligibility for providing discounted care? . . . . . . . . . . . . . . . . . 11 Yes

If "Yes," indicate the FPG family income limit for eligibility for discounted care 500 %


12 Explained the basis for calculating amounts charged to patients? . . . . . . . . . . . . . . . . . 12 Yes

If "Yes," indicate the factors used in determining such amounts (check all that apply)

a F Income level

b F Asset level

c F Medical indigency

d F Insurance status

e F Uninsured discount

f F Medicaid/Medicare

g F State regulation

h F Residency

i 7 Other (describe in Part VI)

13 Explained the method for applying for financial assistance? . . . . . . . . . . . . . . . . . . . 13 Yes

14 Included measures to publicize the policy within the community served by the hospital facility? . . . . . . . 14 No

If "Yes," indicate how the hospital facility publicized the policy (check all that apply)

a 1 The policy was posted on the hospital facility's website

b 1 The policy was attached to billing invoices

c 1 The policy was posted in the hospital facility's emergency rooms or waiting rooms

d 1 The policy was posted in the hospital facility's admissions offices

e 1 The policy was provided, in writing, to patients on admission to the hospital facility

f F The policy was available upon request

g I Other (describe in Part VI)

Billing and Collections

15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financialassistance policy (FAP) that explained actions the hospital facility may take upon non-payment? . . . . . . . 15 Yes

16 Check all of the following actions against an individual that were permitted under the hospital facility's policies duringthe tax year before making reasonable efforts to determine the individual's eligibility under the facility's FAP


b F Lawsuits



e F Other similar actions (describe in Section C)

17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year beforemaking reasonable efforts to determine the individual's eligibility under the facility's FAP? . . . . . . . 17 No

If "Yes," check all actions in which the hospital facility or a third party engaged


b F Lawsuits



e F-Other similar actions (describe in Section C)




18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply)

a F Notified individuals of the financial assistance policy on admission

b F Notified individuals of the financial assistance policy prior to discharge

c F Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals' bills

d F- Documented its determination of whether individuals were eligible for financial assistance under the hospital facility'sfinancial assistance policy

e I Other (describe in Section C)

Policy Relating to Emergency Medical Care

19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requiresthe hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless oftheir eligibility under the hospital facility's financial assistance policy? . . . . . . . . . .

If "No," indicate why

1 The hospital facility did not provide care for any emergency medical conditions

1 The hospital facility's policy was not in writing

1 The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

1 Other ( describe in Part VI)

No

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FA P-eligible individuals for emergency or other medically necessary care

a F- The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts thatcan be charged

b F- The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating themaximum amounts that can be charged

c 1 The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

d I Other (describe in Part VI)

21 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility providedemergency or other medically necessary services more than the amounts generally billed to individuals who had insurancecovering such care? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 No


22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for anyservice provided to that individual? . . . . . . . . . . . . . . . . . . . . . . . . . 22 No





Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines1], 3, 4, 5d, 61, 7, 10, 11, 121, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptionsfor each facility in a facility reporting g rou p, desig nated by "Facility A , " "Facility B , " etc.

Form and Line Reference Explanation




MVIVI-Facility Information (continued)

Section D . Other Health Care Facilities That Are Not Licensed , Registered, or Similarly Recognized as aHospital 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? 1

Name and address Typ e of Facility ( describe )1 CENTER FOR PEDIATRIC SURGERY

7000 W PLANO PARKWAY STE 100PLANO,TX 75093

AMBULATORY SURGERY CENTER

2

3

4

5

6

7

8

9

10



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 anyCHNAs reported in Part V, Section B

3 Patient education of eligibility for assistance . Describe how the organization informs and educates patients and persons who maybe billed for patient care about their eligibility for assistance under federal, state, or local government programs or under theorganization's financial assistance policy

4 Community information . Describe the community the organization serves, taking into account the geographic area and demographicconstituents it serves

5 Promotion of community health . Provide any other information important to describing how the organization's hospital facilities orother health care facilities further its exempt purpose by promoting the health of the community (e g , open medical staff, communityboard, 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 theorganization 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, filesa community benefit report


PART I, LINE 3C COOK FREE AND DISCOUNTED CARE PART I, LINE 6A NOT APPLICABLE PART I, LINE 7G NOTCHILDREN'S USES FPG TO APPLICABLE PART I, LINE 7, COLUMN (F) BAD DEBT EXPENSE OF $22,469,045 WASDETERMINE ELIGIBILITY FOR INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT WAS SUBTRACTED FROM

TOTAL EXPENSE FOR THE CALCULATION OF "PE RCENT OF TOTAL EXPENSE" IN THISCOLUMN PART I, LINE 7 COSTS FOR LINE 7 WERE CALCULATED U SING AN OVERALLCOST TO CHARGE RATIO CALCULATED BY THE HOSPITAL'S COST ACCOUNTING SYSTEMPART II - COMMUNITY BUILDING ACTIVITIES PHYSICAL IMPROVEMENTS AND HOUSINGCOOK CHILDREN'S IS LOCATED IN THE NEAR SOUTH SIDE OF FORT WORTH WHICHINCLUDES THE MEDICAL DISTRICT AS WE LL AS A DIVERSE MIX OF RESIDENTIALNEIGHBORHOODS TO ADDRESS NEIGHBORHOOD IMPROVEMENT NEED S, COOKCHILDREN'S IS A MEMBER OF FORT WORTH SOUTH, INC , A NONPROFIT ORGANIZATIONTHAT PA RTNERS WITH THE CITY OF FORT WORTH AND OTHER COMMUNITYORGANIZATIONS TO ADVANCE EDUCATIONA LINITIATIVES, PUBLIC POLICIES, ANDCOMMUNITY PROGRAMS THAT FOSTER A REVITALIZED AND SAFE CENTRAL CITYSTRATEGIC PLANNING HAS RESULTED IN IMPROVED SECURITY, CODE ENFORCEMENT,AND TRANSPORTATION FOR RESIDENTS AND EMPLOYEES WHO WORK IN THE AREADURING FY 2014 COOK CHILD REN'S BECAME A PARTNER IN THE RENAISSANCEDEVELOPMENT GROUP, A PURPOSE-BUILT COMMUNITY PRO JECT AROUND THE COOKCHILDREN'S RENAISSANCE NEIGHBORHOOD CLINIC THE ORGANIZATIONS IN THEPARTNERSHIP ARE COMMITTED TO IMPROVE THE QUALITY OF LIFE ANDOPPORTUNITIES FOR FUTURE AFFO RDABLE HOUSING RESIDENTS AND ARE WILLING TOCOMMIT SPECIFIC SERVICES AND RESOURCES TO THE FUTURE RESIDENTS COMMUNITYSUPPORT COOK CHILDREN'S LEADERSHIP HAD THE OPPORTUNITY TO SERVE ON AFACILITIES STEERING COMMITTEE TASKED WITH THE SELECTION OFA GENERALCONTRACTOR TO BUILD A COMMUNITY CENTER COALITION BUILDING COOKCHILDREN'S IS A CO-FOUNDING MEMBER OFTHE INFANT MORTALITY NETWORKORGANIZED TO ADDRESS THE HIGH RATES OF INFANT MORTALITY IN TH E COUNTY THENETWORK HAS RAISED COMMUNITY AWARENESS OFTHE PROBLEM AND WORKED WITHLEGISLATORS TO CREATE PUBLIC POLICY TO HELP ADDRESS THE PROBLEM COOKCHILDREN'S IS ALSO AN ACTI VE MEMBER OF THE HEALTHY TARRANT COUNTYCOLLABORATION,A HEALTH PROMOTION NETWORK OF NONPR OFIT HOSPITALS, PUBLICHEALTH ENTITIES, AND LOCAL UNIVERSITIES THE COLLABORATION EFFORTSINCLUDED HEALTH EDUCATION AT A SUMMER CAMP FOR UNDERSERVED CHILDRENCOMMUNITY HEALTH IMPROVEMENT ADVOCACY ADVOCACY EFFORTS BY COOKCHILDREN'S ARE ENHANCED THROUGH MEMBERSHIP IN V ARIOUS LOCAL, STATE, ANDNATIONAL ORGANIZATIONS ASSESSMENT OF COMMUNITY NEEDS, ACCESS TO HEALTHCARE AND INSURANCE FOR UNDERSERVED POPULATIONS, AND ADVOCACY ON SPECIFICHEALTH ISS UES SUCH AS CHILD ABUSE AND NEGLECT AND PREVENTABLE INJURIES AREAMONG THE ISSUES ADDRESSE D WORKFORCE DEVELOPMENT COOK CHILDREN'S HASREPRESENTATION ON THE TEXAS NURSES' ASSOCIAT ION BOARD OF DIRECTORS COOKCHILDREN'S STAFF ALSO PARTICIPATED IN A COLLEGE CAREER EXPO REPRESENTINGCAREERS IN NURSING PART III, LINE 2 WE RECORD SELF-PAY ACCOUNTS AT THE FULLEXPECTED AMOUNT EACH ACCOUNT GOES THROUGH THE COLLECTION PROCESS ASNECESSARY AN ALLOWAN CE IS ESTABLISHED BASED ON HISTORICAL EXPERIENCEPART III, LINE 3 BAD DEBT, IN WHOLE OR IN PART, SHOULD BE INCLUDED INCOMMUNITY BENEFIT GIVEN THE TANGIBLE AND MEASURABLE BENEFIT OFTHEUNDERLYING SERVICES PROVIDED TO, PRIMARILY, UNDERSERVED MEMBERS OF OURCOMMUNITY FOR INSTANCE, WE HAVE A SIGNIFICANT NON-INSURED, UNDOCUMENTEDWORKER POPULATION THAT MAY N OT PARTICIPATE IN THE CHARITY OR MEDICALLYINDIGENT DISCOUNT QUALIFICATION PROCESS DUE TO CONCERNS ABOUT THEIRIMMIGRATION STATUS WE PROVIDE CRITICAL INPATIENT, EMERGENCY ROOM, AN DOUTPATIENT SERVICES TO THIS DEMOGRAPHIC FOR LITTLE OR NO REIMBURSEMENTAND WITHOUT REGARD FOR THEIR ABILITY TO PAY, BUT RECEIVE NO COMMUNITYBENEFIT CONSIDERATION AT A MINIMUM, HOSPITALS SHOULD HAVE THEOPPORTUNITY TO DELINEATE HOW MUCH BAD DEBT STEMS FROM NON-INSURE DPATIENTS AND THEN BE GIVEN COMMUNITY BENEFIT CONSIDERATION FOR THE COSTBURDEN ASSOCIATE D WITH PROVIDING THESE NEEDED SERVICES KNOWING THAT WEHAVE ALREADY DONE ALL WE CAN WITH REGARD TO SCREENING PATIENTS FORCHARITY AND MEDICALLY INDIGENT DISCOUNTS AND WRITTEN THE P ATIENTS'BALANCES OFF AS SUCH PART III, LINE 4 FOOTNOTE DISCLOSURE REGARDING THETREATME NT OF BAD DEBTS IS LOCATED ON PAGES 15 AND 16 OFTHE MOST RECENTAUDITED FINANCIAL STATEME NTS ATTACHED TO THIS FORM PART III, LINE 8 THEMEDICARE SHORTFALL SHOULD BE CONSIDERED C OMMUNITY BENEFIT SINCE IT ISREPRESENTATIVE OFTHE NON-COVERED COST OF PATIENT CARE THAT H OSPITALSARE USING TO JUSTIFY THE NEED FOR THEIR TAX EXEMPT STATUS PRESENTING THEMEDICARE SHORTFALL IN THE COMMUNITY BENEFIT SECTION ALLOWS REGULATORSAND THE PUBLIC TO SEE THE U NFUNDED COSTS OF SERVICES THAT HOSPITALSPROVIDE TO COMMUNITY MEMBERS THIS PRESENTATION WOULD HELP THECOMMUNITY BETTER UNDERSTAND THAT IN THE ABSENCE OF A TAX EXEMPT STATUS(WHIC H IN EFFECT IS GRANTED TO THEM BY THE PUBLIC), THE HOSPITALS WOULD HAVETO LOOK TO THE COM MUNITY TO FUND THE SHORTFALL OR RISK LOSING VALUED


PART I, LINE 3C COOK HOSPITAL SERVICES THE RATIO OF COST TO CHARGES USED IN THE CALCULATION OFCHILDREN'S USES FPG TO COSTS FOR MEDI CARE WAS TAKEN FROM THE MEDICARE COST REPORT PART III, LINEDETERMINE ELIGIBILITY FOR 9B THE HOSPITAL DOES NOT PUR SUE COLLECTION OF AMOUNTS DETERMINED TO

QUALIFY AS CHARITY CARE


PART VI, ITEM 2 NEEDS ASSESSMENT THERE ARE NO NEEDS ASSESSMENTS RELEVANT TO THE CHILDPOPULATION IN OUR COMMUNITY THAT WOULD BE IN ADDITION TO THE ONE ALREADYREPORTED IN PART V, SECTION B


PART VI, ITEM 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE ENGLISH AND SPANISH VERSIONSOFA ONE-PAGE DOCUMENT EXPLAINING THE CHARITY CARE OFFERED AT COOKCHILDREN'S ARE POSTED IN EACH OF THE PATIENT REGISTRATION AREAS, THEEMERGENCY ROOM, URGENT CARE, AND MEDICAL OFFICE BUILDING THIS DOCUMENTINCLUDES INFORMATION ON THE FOLLOWING 1 HOW ONE MIGHT QUALIFY FORFINANCIAL ASSISTANCE, 2 EXPLAINS QUALIFICATION IS DETERMINED BY FAMILY SIZEND INCOME, AND, 3 GUIDES FAMILIES TO CONTACT THE PATIENT ACCOUNTING

DEPARTMENT TO APPLY FOR FINANCIAL ASSISTANCE A FINANCIAL COUNSELOR WILLSSIST ALL SELF-PAY INPATIENTS, OBSERVATION STAYS AND SCHEDULED PROCEDURES,

SCREENING THEM FOR VARIOUS GOVERNMENT PROGRAMS, SUCH AS MEDICAID AND CHIPIN ADDITION, A FINANCIAL COUNSELOR WILL ASSIST ANY PATIENT THAT PRESENTS TOREGISTRATION FOR FINANCIAL ASSISTANCE, PROVIDING THEM WITH A MEDICAIDPPLICATION AND REVIEWING THE CHARITY POLICY PATIENT REPRESENTATIVES AND

CASE MANAGEMENT PERSONNEL ALSO DIRECT FAMILIES TO THE PATIENT REGISTRATIONSTAFF WHEN THEY NEED FINANCIAL ASSISTANCE IN ADDITION,THE FINANCIALSSISTANCE POLICY, EXPLANATION OF AMOUNTS GENERALLY BILLED AND THE CHARITYPPLICATION ARE POSTED ON THE COOK CHILDREN'S WEBSITE AT

WWWCOOKCHILDRENS ORG THE CHARITY APPLICATION IS POSTED IN BOTH ENGLISH ANDSPANISH VERSIONS


PART VI, ITEM 4 COMMUNITY INFORMATION COOK CHILDREN'S HEALTH CARE SYSTEM (COOK CHILDREN'S)IS ONE OFTHE COUNTRY'S LEADING VERTICALLY INTEGRATED PEDIATRIC HEALTHCAREORGANIZATIONS BASED IN FORT WORTH,TEXAS, COOK CHILDREN'S IS A NOT-FOR-PROFITORGANIZATION WHICH INCLUDES THE MEDICAL CENTER (430 BEDS), PHYSICIAN NETWORK(343 PEDIATRIC SPECIALISTS), NORTHEAST HOSPITAL, PEDIATRIC SURGERY CENTER,HOME HEALTH, HEALTH PLAN (113,091 MEDICAID AND CHIP COVERED LIVES) AND THEHEALTH FOUNDATION THE SYSTEM HAS A SIX-COUNTY PRIMARY SERVICE AREA THATREPRESENTS 86% OF ITS TOTAL VOLUME COVERING 4,711 MILES IT ALSO PROVIDESERTIARY AND QUATERNARY PEDIATRIC MEDICAL CARE TO 122 COUNTIES IN WEST ANDNORTH CENTRAL TEXAS, COVERING 257,086 MILES AND TO OUT-OF-STATE PATIENTS THESYSTEM HAS MORE THAN 1 3 MILLION PATIENT ENCOUNTERS PER YEAR ACROSS THECONTINUUM OF PEDIATRIC CARE 57 4% OFTHE SYSTEM'S PATIENT CARE IS PROVIDEDO MEDICAID MANAGED CARE AND CHIP BENEFICIARIES THE SIX-COUNTY PRIMARY

SERVICE AREA CONSISTS OF DENTON, HOOD, JOHNSON, PARKER,TARRANT AND WISECOUNTIES IN TEXAS THIS AREA IS HOME TO 682,528 CHILDREN AGES BIRTH TO 14 YEARSWHO REPRESENT 22 4% OFTHE TOTAL POPULATION AND WHOSE NUMBERS ARE EXPECTEDO GROWTO 705,268 BY 2019 OR A 5-YEAR GROWTH RATE OF 3 3% THERE ARE 1,109,453HOUSEHOLDS WITHIN THAT GEOGRAPHY WITH 19 6% HAVING INCOME AT OR BELOWTHEFEDERAL POVERTY LEVEL, HOWEVER, THERE IS WIDE VARIATION AMONG COMMUNITIESWITHIN THESE GEOGRAPHIC BOUNDS SIMILARLY, WIDE VARIATION ALSO EXISTS IN RACEND ETHNICITY AMONG THE DIFFERENT COMMUNITIES THE ENTIRE AREA'S POPULATION

OF 2,847,650 PEOPLE CONSISTS OF 56 7% WHITE NON-HISPANIC, 24 9% HISPANIC, 11 3%BLACK NON-HISPANIC AND 4 7% ASIAN AND PACIFIC ISLANDERS


PART VI, ITEM 5 PROMOTION OF COMMUNITY HEALTH COOK CHILDREN'S MAINTAINS AN OPEN MEDICALSTAFF, AND THE GOVERNING BODIES OF THE VARIOUS COMPANIES ARE MADE UP (UNLESSCONSTRAINED BY THE TEXAS MEDICAL PRACTICE ACT) OF VOLUNTARY COMMUNITYMEMBERS ALONG WITH PHYSICIANS THE ORGANIZATION CARES FOR ALL CHILDRENREGARDLESS OF THEIR ABILITY TO PAY, AND PROACTIVELY SEEKS TO ENROLL ALLELIGIBLE CHILDREN INTO APPROPRIATE PROGRAMS TO IMPROVE THEIR ACCESS TO CARE


PART VI, ITEM 6 AFFILIATED HEALTH CARE SYSTEM COOK CHILDREN'S ALSO OPERATES SIXNEIGHBORHOOD CLINICS PROVIDING PRIMARY CARE TO UNDERSERVED POPULATIONSROUND THE CITY'S PERIMETER AND INNER CITY TO HELP ASSURE CARE IS PROVIDED INHE MOST APPROPRIATE SETTING BOTH PREVENTIVE AND THERAPEUTIC DENTAL HEALTH

CARE ARE PROVIDED TO UNDERSERVED POPULATIONS MENTAL AND BEHAVIORAL HEALTHIS PROVIDED IN BOTH INPATIENT AND OUTPATIENT SETTINGS SUBSIDIZED BY COOKCHILDREN'S COOK CHILDREN'S HEALTH PLAN IS A CONTRACTED INTERMEDIARY FORMEDICAID MANAGED CARE AND SCHIP, PROVIDING AN OPEN PROVIDER PANEL FOR ALLELIGIBLE CHILDREN IN THE SIX-COUNTY PRIMARY SERVICE AREA COOK CHILDREN'SHOME HEALTH OFFERS PEDIATRIC-SPECIFIC HOME CARE TO ASSURE CARE IS PROVIDEDIN THE MOST APPROPRIATE AND LOWEST COST SETTING


PART VI, ITEM 7 STATE FILING OF COMMUNITY BENEFIT REPORT TEXAS

Additional Data

Software ID:

Software Version:

EIN: 75 -2051646

Name : Cook Children's Medical Center

Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines1], 3, 4, 5d, 6i, 7, 10, 11, 121, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptionsfor each facilit in a facility re p ortin g g rou p, desig nated by "Facility A , " "Facility 13 , " etc.

Form and Line ExplanationReference

PART V, INPUT FROM THE COMMUNITY THE COOK CHILDREN'S COMMUNITY-WIDE CHILDREN'S HEALTH ASSESSMENTSECTION B, AND PLANNING SURVEY (CCHAPS)CONDUCTED IN 2008-2009 INCLUDED A HOUSEHOLD SURVEY OFTHELINE 3, STATUS OF CHILDREN'S HEALTH AGES 0-14 (7,439 COMPLETED SURVEYS), A COMMUNITY LEADER SURVEY,COOK SECONDARY DATA REVIEW, AND MULTIPLE FOCUS GROUPS WITH COMMUNITY LEADERS, 20 COMMUNITYCHILDREN'S GROUP/COALITION MEETINGS, 12 LISTENING SESSIONS AND 7 INTERNAL MEETINGS ALL OF THIS WAS DONEMEDICAL TO OBTAIN FEEDBACK FROM APPROXIMATELY 486 EXTERNAL AND 59 INTERNAL COMMUNITY MEMBERSCENTER FEEDBACK FROM GROUP MEETINGS WAS OBTAINED THROUGH DISCUSSION AND A WRITTEN SURVEY A

SECOND CCHAPS WAS CONDUCTED IN 2011-2012 TO UPDATE THE ORIGINAL DATA AND INCLUDED A PARENTSURVEY (8,394 COMPLETED SURVEYS)AND ONE-ON-ONE SURVEY INTERVIEWS WITH PARENTS WHO AREHOMELESS OR WHO HAVE AT LEAST ONE UNDOCUMENTED FAMILY MEMBER THE RESULTS OF THE SURVEYWERE COMPARED TO THE 2008 DATA TO SEE HOW CHILDREN'S HEALTH IN THE REGION CHANGEDDISCUSSION GROUPS WERE CONDUCTED WITH THE CHILDREN OF PARENTS WHO PARTICIPATED IN THESURVEY TO PROVIDE FURTHER INFORMATION ABOUT SURVEY FINDINGS IN PARTNERSHIP WITH COOKCHILDREN'S CHILD LIFE SPECIALISTS A COMMUNITY LEADER SURVEY AND SPECIAL REPORTS ON PARENTINGPRACTICES IN HOOD AND WISE COUNTIES BASED ON ADDITIONAL CCHAPS SURVEYS WERE CONDUCTED IN2012 AND 2013 PART V, SECTION B, LINE 4 COOK CHILDREN'S MEDICAL CENTER OTHER HOSPITALFACILITIES COOK CHILDREN'S MEDICAL CENTER AND COOK CHILDREN'S NORTHEAST HOSPITAL PART V,SECTION B, LINE 121, COOK CHILDREN'S MEDICAL CENTER CALCULATING AMOUNTS CHARGED TO PATIENTSTHE HOSPITAL FACILITY USED FEDERAL POVERTY GUIDELINES AND A SLIDING SCALE DISCOUNT TODETERMINE AMOUNTS DUE DURING THE TAX YEAR HOUSEHOLD GROSS INCOME AND FAMILY SIZE ARECONSIDERED IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE THE FINANCIAL ASSISTANCEPOLICY STATES AND USES THE FOLLOWING DEFINITION TO DETERMINE AMOUNTS THAT CAN BE CHARGED TOFAP-ELIGIBLE INDIVIDUALS FOLLOWING A DETERMINATION OF FINANCIAL ASSISTANCE ELIGIBILITY, ANINDIVIDUAL WILL NOT BE CHARGED MORE THAN THE AMOUNTS GENERALLY BILLED (AGB) FOR EMERGENCY OROTHER MEDICAL CARE PROVIDED TO INDIVIDUALS WITH INSURANCE COVERING THAT CARE AT COOKCHILDREN'S THE AGB IS DETERMINED THROUGH THE "LOOK-BACK METHOD" WHICH IS CALCULATED ASFOLLOWS 1 THE AGB IS CALCULATED BY REVIEWING ALL PAST CLAIMS THAT HAVE BEEN PAID IN FULL TO THEHOSPITAL FACILITY FOR MEDICALLY NECESSARY CARE BY MEDICARE FEE-FOR-SERVICE TOGETHER WITH ALLPRIVATE HEALTH INSURERS PAYING CLAIMS TO THE HOSPITAL IN A PRIOR 12-MONTH PERIOD THIS AMOUNTCAN INCLUDE COINSURANCE, COPAYMENTS AND DEDUCTIBLES 2 THE AGB FOR EMERGENCY OR MEDICALLYNECESSARY CARE PROVIDED TO A FINANCIAL ASSISTANCE-ELIGIBLE INDIVIDUAL IS DETERMINED BYMULTIPLYING GROSS CHARGES FOR THAT CARE BY ONE OR MORE PERCENTAGES OF GROSS CHARGES (CALLED"AGB PERCENTAGES") a THE PERCENTAGES ARE CALCULATED AT LEAST ANNUALLY BY DIVIDING THE SUM OFCERTAIN CLAIMS PAID TO THE HOSPITAL FACILITY BY THE SUM OFTHE ASSOCIATED GROSS CHARGES FORTHOSE CLAIMS b MULTIPLE AGB PERCENTAGES MAY BE CALCULATED FOR SEPARATE CATEGORIES OF CARE(FOR EXAMPLE, INPATIENT VERSUS OUTPATIENT CARE, OR CARE PROVIDED BY DIFFERENT DEPARTMENTS) ORFOR SEPARATE ITEMS OR SERVICES 3 THE PERCENTAGES ARE APPLIED BY THE 45TH DAY AFTER THE END OFTHE 12-MONTH PERIOD THE HOSPITAL FACILITY USED IN CALCULATING THE AGB PERCENTAGE(S)

Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V , Section B, lines1], 3, 4, 5d, 6i, 7, 10, 11, 121, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22 . If applicable , provide separate descriptionsfor each facility in a facility re p ortin g g rou p, desig nated by "Facility A , " "Facility 13 , " etc.


PART V, MEASURES TO PUBLICIZE THE POLICY ALTHOUGH THE POLICY DID NOT SPECIFICALLY STATE HOWTHESECTION B, POLICY WOULD BE PUBLICIZED WITHIN THE COMMUNITY DURING THE TAX YEAR,THE FOLLOWING PROCESSLINE 14G, HAS BEEN FOLLOWED ENGLISH AND SPANISH VERSIONS OF A ONE-PAGE DOCUMENT EXPLAINING THECOOK CHARITY CARE OFFERED AT COOK CHILDREN'S ARE POSTED IN EACH OFTHE PATIENT REGISTRATIONCHILDREN'S AREAS, THE EMERGENCY ROOM, NIGHT CLINIC,AND MEDICAL OFFICE BUILDING THIS DOCUMENT INCLUDESMEDICAL INFORMATION ON THE FOLLOWING 1 HOW ONE MIGHT QUALIFY FOR FINANCIAL ASSISTANCE, 2 EXPLAINSCENTER 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 COUNSELORWILL ASSIST ALL SELF-PAY INPATIENTS, OBSERVATION STAYS AND SCHEDULED PROCEDURES, SCREENINGTHEM FOR VARIOUS GOVERNMENT PROGRAMS, SUCH AS MEDICAID AND CHIP IN ADDITION, A FINANCIALCOUNSELOR WILL ASSIST ANY PATIENT THAT PRESENTS TO REGISTRATION FOR FINANCIAL ASSISTANCE,PROVIDING THEM WITH A MEDICAID APPLICATION AND REVIEWING THE CHARITY POLICY PATIENTREPRESENTATIVES AND CASE MANAGEMENT PERSONNEL ALSO DIRECT FAMILIES TO THE PATIENTREGISTRATION STAFF WHEN THEY NEED FINANCIAL ASSISTANCE IN ADDITION,THE FINANCIALASSISTANCE POLICY, EXPLANATION OFAMOUNTS GENERALLY BILLED AND THE CHARITY APPLICATION AREPOSTED ON THE COOK CHILDREN'S WEBSITE AT WWWCOOKCHILDRENS ORG THE CHARITY APPLICATION ISPOSTED IN BOTH ENGLISH AND SPANISH VERSIONS

Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V , Section B, lines1], 3, 4, 5d, 6i, 7, 10, 11, 121, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable , provide separate descriptionsfor each facility in a facility re p ortin g g rou p, desig nated by "Facility A , " " Facility 13 , " etc.


PART V, SECTION B, LINE COLLECTION ACTIONS TAKEN THE HOSPITAL FACILITY DID NOT TAKE ANY OF THE ACTIONS18E, COOK CHILDREN'S LISTED ON LINE 17 PART V, SECTION B, LINE 20D, COOK CHILDREN'S MEDICAL CENTERMEDICAL CENTER AMOUNTS CHARGED SEE RESPONSE TO SCHEDULE H, PART V, SECTION B, LINE 121 LISTED

ABOVE

Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines1], 3, 4, 5d, 6i, 7, 10, 11, 121, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptionsfor each facility in a facility re p ortin g g rou p, desig nated by "Facility A , " "Facility 13 , " etc.


PART V, INPUT FROM THE COMMUNITY THE COOK CHILDREN'S COMMUNITY-WIDE CHILDREN'S HEALTH ASSESSMENTSECTION B, AND PLANNING SURVEY (CCHAPS)CONDUCTED IN 2008-2009 INCLUDED A HOUSEHOLD SURVEY OFTHELINE 3, COOK STATUS OF CHILDREN'S HEALTH AGES 0-14 (7,439 COMPLETED SURVEYS), A COMMUNITY LEADER SURVEY,CHILDREN'S SECONDARY DATA REVIEW, AND MULTIPLE FOCUS GROUPS WITH COMMUNITY LEADERS, 20 COMMUNITYNORTHEAST GROUP/COALITION MEETINGS, 12 LISTENING SESSIONS AND 7 INTERNAL MEETINGS ALL OF THIS WAS DONEHOSPITAL TO OBTAIN FEEDBACK FROM APPROXIMATELY 486 EXTERNAL AND 59 INTERNAL COMMUNITY MEMBERS

FEEDBACK FROM GROUP MEETINGS WAS OBTAINED THROUGH DISCUSSION AND A WRITTEN SURVEY ASECOND CCHAPS WAS CONDUCTED IN 2011-2012 TO UPDATE THE ORIGINAL DATA AND INCLUDED A PARENTSURVEY (8,394 COMPLETED SURVEYS)AND ONE-ON-ONE SURVEY INTERVIEWS WITH PARENTS WHO AREHOMELESS OR WHO HAVE AT LEAST ONE UNDOCUMENTED FAMILY MEMBER THE RESULTS OF THE SURVEYWERE COMPARED TO THE 2008 DATA TO SEE HOW CHILDREN'S HEALTH IN THE REGION CHANGEDDISCUSSION GROUPS WERE CONDUCTED WITH THE CHILDREN OF PARENTS WHO PARTICIPATED IN THESURVEY TO PROVIDE FURTHER INFORMATION ABOUT SURVEY FINDINGS IN PARTNERSHIP WITH COOKCHILDREN'S CHILD LIFE SPECIALISTS A COMMUNITY LEADER SURVEY AND SPECIAL REPORTS ON PARENTINGPRACTICES IN HOOD AND WISE COUNTIES BASED ON ADDITIONAL CCHAPS SURVEYS WERE CONDUCTED IN2012 AND 2013 PART V, SECTION B, LINE 4 COOK CHILDREN'S NORTHEAST HOSPITAL OTHER HOSPITALFACILITIES COOK CHILDREN'S MEDICAL CENTER AND COOK CHILDREN'S NORTHEAST HOSPITAL PART V,SECTION B, LINE 121, COOK CHILDREN'S NORTHEAST HOSPITAL CALCULATING AMOUNTS CHARGED TOPATIENTS THE HOSPITAL FACILITY USED FEDERAL POVERTY GUIDELINES AND A SLIDING SCALE DISCOUNTTO DETERMINE AMOUNTS DUE DURING THE TAX YEAR HOUSEHOLD GROSS INCOME AND FAMILY SIZE ARECONSIDERED IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE THE FINANCIAL ASSISTANCEPOLICY STATES AND USES THE FOLLOWING DEFINITION TO DETERMINE AMOUNTS THAT CAN BE CHARGED TOFAP-ELIGIBLE INDIVIDUALS FOLLOWING A DETERMINATION OF FINANCIAL ASSISTANCE ELIGIBILITY, ANINDIVIDUAL WILL NOT BE CHARGED MORE THAN THE AMOUNTS GENERALLY BILLED (AGB) FOR EMERGENCY OROTHER MEDICAL CARE PROVIDED TO INDIVIDUALS WITH INSURANCE COVERING THAT CARE AT COOKCHILDREN'S THE AGB IS DETERMINED THROUGH THE "LOOK-BACK METHOD" WHICH IS CALCULATED ASFOLLOWS 1 THE AGB IS CALCULATED BY REVIEWING ALL PAST CLAIMS THAT HAVE BEEN PAID IN FULL TOTHE HOSPITAL FACILITY FOR MEDICALLY NECESSARY CARE BY MEDICARE FEE-FOR-SERVICE TOGETHER WITHALL PRIVATE HEALTH INSURERS PAYING CLAIMS TO THE HOSPITAL IN A PRIOR 12-MONTH PERIOD THISAMOUNT CAN INCLUDE COINSURANCE, COPAYMENTS AND DEDUCTIBLES 2 THE AGB FOR EMERGENCY ORMEDICALLY NECESSARY CARE PROVIDED TO A FINANCIAL ASSISTANCE-ELIGIBLE INDIVIDUAL ISDETERMINED BY MULTIPLYING GROSS CHARGES FOR THAT CARE BY ONE OR MORE PERCENTAGES OF GROSSCHARGES (CALLED "AGB PERCENTAGES") a THE PERCENTAGES ARE CALCULATED AT LEAST ANNUALLY BYDIVIDING THE SUM OF CERTAIN CLAIMS PAID TO THE HOSPITAL FACILITY BY THE SUM OFTHE ASSOCIATEDGROSS CHARGES FOR THOSE CLAIMS b MULTIPLE AGB PERCENTAGES MAY BE CALCULATED FOR SEPARATECATEGORIES OF CARE (FOR EXAMPLE, INPATIENT VERSUS OUTPATIENT CARE, OR CARE PROVIDED BYDIFFERENT DEPARTMENTS) OR FOR SEPARATE ITEMS OR SERVICES 3 THE PERCENTAGES ARE APPLIED BY THE45TH DAY AFTER THE END OF THE 12-MONTH PERIOD THE HOSPITAL FACILITY USED IN CALCULATING THEAGB PERCENTAGE(S)

Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V , Section B, lines1], 3, 4, 5d, 6i, 7, 10, 11, 121, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22 . If applicable , provide separate descriptionsfor each facility in a facility re p ortin g g rou p, desig nated by "Facility A , " "Facility 13 , " etc.


PART V, MEASURES TO PUBLICIZE THE POLICY ALTHOUGH THE POLICY DID NOT SPECIFICALLY STATE HOWTHESECTION B, POLICY WOULD BE PUBLICIZED WITHIN THE COMMUNITY DURING THE TAX YEAR,THE FOLLOWING PROCESSLINE 14G, HAS BEEN FOLLOWED ENGLISH AND SPANISH VERSIONS OF A ONE-PAGE DOCUMENT EXPLAINING THECOOK CHARITY CARE OFFERED AT COOK CHILDREN'S ARE POSTED IN EACH OFTHE PATIENT REGISTRATIONCHILDREN'S AREAS, THE EMERGENCY ROOM, NIGHT CLINIC,AND MEDICAL OFFICE BUILDING THIS DOCUMENT INCLUDESNORTHEAST INFORMATION ON THE FOLLOWING 1 HOW ONE MIGHT QUALIFY FOR FINANCIAL ASSISTANCE, 2 EXPLAINSHOSPITAL 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 COUNSELORWILL ASSIST ALL SELF-PAY INPATIENTS, OBSERVATION STAYS AND SCHEDULED PROCEDURES, SCREENINGTHEM FOR VARIOUS GOVERNMENT PROGRAMS, SUCH AS MEDICAID AND CHIP IN ADDITION, A FINANCIALCOUNSELOR WILL ASSIST ANY PATIENT THAT PRESENTS TO REGISTRATION FOR FINANCIAL ASSISTANCE,PROVIDING THEM WITH A MEDICAID APPLICATION AND REVIEWING THE CHARITY POLICY PATIENTREPRESENTATIVES AND CASE MANAGEMENT PERSONNEL ALSO DIRECT FAMILIES TO THE PATIENTREGISTRATION STAFF WHEN THEY NEED FINANCIAL ASSISTANCE IN ADDITION,THE FINANCIALASSISTANCE POLICY, EXPLANATION OFAMOUNTS GENERALLY BILLED AND THE CHARITY APPLICATION AREPOSTED ON THE COOK CHILDREN'S WEBSITE AT WWWCOOKCHILDRENS ORG THE CHARITY APPLICATION ISPOSTED IN BOTH ENGLISH AND SPANISH VERSIONS

Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines1], 3, 4, 5d, 6i, 7, 10, 11, 121, 14g, 16e , 17e, 18e , 19c, 19d, 20d, 21 , and 22. If applicable, provide separate descriptionsfor each facility in a facility re ortin g rou p, desig nated by " Facility A , " "Facility 13 , " etc.


PART V, SECTION B, LINE 18E, COLLECTION ACTIONS TAKEN THE HOSPITAL FACILITY DID NOT TAKE ANY OF THE ACTIONSCOOK CHILDREN'S LISTED ON LINE 17 PART V, SECTION B, LINE 20D, COOK CHILDREN'S NORTHEAST HOSPITALNORTHEAST HOSPITAL AMOUNTS CHARGED SEE RESPONSE TO SCHEDULE H, PART V, SECTION B, LINE 121 LISTED

ABOVE

Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V , Section B, lines1], 3, 4, 5d, 6i, 7, 10, 11, 121, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22 . If applicable , provide separate descriptionsfor each facilit in a facility re p ortin g g rou p, desig nated by "Facility A , " " Facility B , " etc.


PART V, IMPLEMENTATION STRATEGY THE ORGANIZATION'S IMPLEMENTATION STRATEGY IS LOCATED AT THESECTION B, FOLLOWING WEBSITE HTTP //WWWCOOKCHILDRENS ORG/SITECOLLECTIONDOCUMENTS/ABOUTUS/CHNA-LINE 6A IMPLEMEN TATION-STRATEGIES PDF

l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93493225039185

Schedule I OMB No 1545-0047

(Form 990 ) Grants and Other Assistance to Organizations,Governments and Individuals in the United States 2013

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.

Department of the Treasury ► Attach to Form 990 •

Internal Revenue Service ► Information about Schedule I (Form 990) and its instructions is at www.irs.gov /form990 .

Name of the organization Employer identification number

Cook Children's Medical Center75-2051646

jlj^l 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, andthe selection criteria used to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F Yes 1 No

2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States

Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" toForm 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 oforganization

or government

( b) EIN (c ) IRC Codesection

if applicable

(d) Amount of cashgrant

( e) Amount of non-cash

assistance

(f) Method ofvaluation

(book, FMV,appraisal,other )

( g) Description ofnon-cash assistance

(h) Purpose of grantor assistance

2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table lik. 7

3 Enter total number of other organizations listed in the line 1 table . llk^

For Paperwork Reduction Act Noticee see the Instructions for Form 990 . Cat No 50055P Schedule I (Form 990) 2013

Schedule I (Form 990) 2013 Pa g e 2Grants and Other Assistance to Individuals in the United States . Complete if the organization answered "Yes" to Form 990, Part IV, line 22.Part III can be duplicated if additional space is needed.

(a)Type of grant or assistance (b)N umber ofrecipients

(c)Amount ofcash grant

(d)Amount ofnon-cash assistance

(e)Method of valuation(book,

FMV, appraisal, other)

(f)Description of non-cash assistance


Supplemental Information . Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference I Explanation

SCHEDULE I PART I QUESTION (PROCEDURES FOR MONITORING THE USE OFTHE GRANT FUNDS IN THE US THE ORGANIZATION USES PUBLIC AND PRIVATE DATA TO2 MONITORTHE USE OF FUNDS,AS NEEDED

Schedule I (Form 990) 2013

Additional Data

Software ID:

Software Version:

EIN: 75 -2051646


Form 990, Schedule I, Part III, Grants and Other Assistance to Individuals in the United States

(a)Type of grant or assistance (b)N umber ofrecipients

( c)Amount ofcash grant

(d)Amount ofnon-cash assistance

(e)Method of valuation (book,FMV, appraisal, other)

(f)Description of non-cash assistance

TRANSPORTATION 657 30,510

LODGING 66 16,522

MEDICAL EQUIPMENT 14 12,075

BABY SUPPLIES 84 5,851

GIFT CARDS 108 4,720

MEALS 220 4,490

UTILITIES 12 3,666

MEDICATIONS 4 438

FUNERAL 4 1,950

OTHER 4 19

CITIZENSHIP 1 1,170

l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93493225039185

Schedule J Compensation Information OMB No 1545-0047

(Form 990)For certain Officers, Directors, Trustees, Key Employees, and Highest

2013Compensated Employees1- Complete if the organization answered "Yes" to Form 990, Part IV, line 23.

Department of the Treasury 1- Attach to Form 990. 1- See separate instructions. 'Internal Revenue Service 1- Information about Schedule J (Form 990) and its instructions is at www.irs.gov /form990.


75-2051646

MYRTE Questions Re g arding Com pensation

Yes No

la Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form990, Part VII , Section A, line la Complete Part III to provide any relevant information regarding these items

1 First-class or charter travel 1 Housing allowance or residence for personal use

1 Travel for companions 1 Payments for business use of personal residence

F Tax idemnification and gross - up payments 1 Health or social club dues or initiation fees

1 Discretionary spending account 1 Personal services ( e g , maid, chauffeur, chef)

b If any of the boxes in line la are checked , did the organization follow a written policy regarding payment orreimbursement or provision of all of the expenses described above? If "No ," complete Part III to explain lb No

2 Did the organization require substantiation prior to reimbursing or allowing expenses incurred by alldirectors , trustees , officers, including the CEO/Executive Director, regarding the items checked in line la? 2 Yes

3 Indicate which , if any, of the following the filing organization used to establish the compensation of theorganization 's CEO/Executive Director Check all that apply Do not check any boxes for methodsused by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III

1 Compensation committee 1 Written employment contract

1 Independent compensation consultant 1 Compensation survey or study

1 Form 990 of other organizations 1 Approval by the board or compensation committee

4 During the year, did any person listed in Form 990, Part VII, Section A, line la with respect to the filing organizationor a related organization

a Receive a severance payment or change-of-control payment? 4a Yes

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) and 501 ( c)(4) organizations only must complete lines 5-9.

5 For persons listed in Form 990, Part VII, Section A, line la, did the organization pay or accrue anycompensation contingent on the revenues of

a The organization? 5a No

b Any related organization? 5b No

If "Yes," to line 5a or 5b, describe in Part III

6 For persons listed in Form 990, Part VII, Section A, line la, did the organization pay or accrue anycompensation contingent on the net earnings of

a The organization? 6a No

b Any related organization? 6b No

If "Yes," to line 6a or 6b, describe in Part III

7 For persons listed in Form 990, Part VII, Section A, line la, did the organization provide any non-fixedpayments not described in lines 5 and 6? If "Yes," describe in Part III 7 No

8 Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that wassubject to the initial contract exception described in Regulations section 53 4958-4(a)(3)? If "Yes," describein Part III 8 No

9 If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulationssection 53 4958-6(c)? 9

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat No 50053T Schedule 3 ( Form 990) 2013

Schedule J (Form 990) 2013 Page 2

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 in Schedule J, report compensation from the organization on row (i) and from related organizations, described in theinstructions, on row (ii) Do not list any individuals that are not listed on Form 990, Part VIINote . The sum of columns (B)(1)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line la, applicable column (D) and (E) amounts for that individual

(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and (D) Nontaxable (E) Total of (F) Compensation

(i) Base (ii) Bonus & (iii) Other other deferred benefits columns reported as deferred

compensationincentive reportable compensation (B)(i)-(D) in prior Form 990

compensation compensation


Schedule 3 (Form 990) 2013

Schedule J (Form 990) 2013 Page 3

Supplemental InformationProvide the information, explanation, or descriptions required for Part I, lines la, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part IIAlso complete this part for any additional information


PART I, QUESTION 4B PARTICIPATION IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PARTICIPANTS IN SERP REPORTED IN W-2 DEFERREDCOMPENSATION -------------------- --------------- --------------------- RICK W MERRILL $ 136,311 $ 162,000 NANCY C CYCHOL $ 81,745NONE RICHARD P GOODE $ 71,371 NONE

PART II ALLOCATION OF CEO AND CFO SALARIES SALARIES FOR THE CEO AND CFO ARE ALLOCATED PRO-RATA BASED ON THE AMOUNT OF TIMETHEY SPEND WITH EACH OF THE FOLLOWING COMPANIES COOK CHILDREN'S MEDICAL CENTER COOK CHILDREN'S HEALTH FOUNDATIONCOOK CHILDREN'S HOME HEALTH COOK CHILDREN'S HEALTH CARE SYSTEM COOK CHILDREN'S HEALTH PLAN

PART I, QUESTION 4A RECEIVED SEVERANCE PAYMENTS NAME AMOUNT ------------ --------- SHARON SMITH $ 106,111

PART I, QUESTIONS 1A & 1B TAX INDEMNIFICATION AND GROSS-UP PAYMENTS THERE IS NO WRITTEN POLICY REGARDING PAYMENT OR REIMBURSEMENT OFTAXINDEMNIFICATION AND GROSS-UP PAYMENTS BECAUSE THE COMPANY DOES NOT GENERALLY ALLOW FOR GROSS-UPS IN TAX PAYMENTSEXCEPT IN UNUSUAL CIRCUMSTANCES AND ONLY THEN IF APPROVED BY SENIOR MANAGEMENT IN THIS CASE, $500 00 GIFT CARDS WEREDISTRIBUTED AT CHRISTMAS TO NON-EXECUTIVE EMPLOYEES THE SENIOR VICE PRESIDENT OF HUMAN RESOURCES APPROVED THEGROSS-UP OF $125 00 PER CARD SO THAT EMPLOYEES WOULD RECEIVE THE FULL STATED BENEFIT OF THE GIFT CARD

PART I, QUESTION 3 METHODS USED BY CCHCSTO ESTABLISH COMPENSATION OFTHE CEO/EXEC DIRECTOR COMPENSATION COMMITTEE INDEPENDENTCOMPENSATION CONSULTANT WRITTEN EMPLOYMENT CONTRACT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD ORCOMPENSATION COMMITTEE

Schedule 3 (Form 990) 2013

Additional Data

Software ID:

Software Version:

EIN: 75 -2051646


Form 990, Schedule J , Part II - Officers , Directors , Trustees , Ke y Em p lo y ees . and Hi g hest Com pensated Em p lo y ees

(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Deferred (D) Nontaxable (E) Total of columns (F) Compensation

(ii) Bonus & compensation benefits (B)(i)-(D) reported in prior Form

(i) Base (iii) Other 990 or Form 990-EZ

Compensationincentive

compensationcompensation

NANCY C CYCHOL (1) 396,807 186,002 120,569 19,125 9,408 731,911PRESIDENT (ii)

STANLEY E DAVIS (i) 184,302 65,487 2,017 11,869 15,807 279,482VP, SUPPORT (u)SERVICES

RICHARD P GOODE (i) 171,338 98,001 98,485 8,766 7,234 383,824CHIEF FINANCIAL (ii) 140,186 80,183 80,578 7,172 5,919 314,038OFFICER

RICK W MERRILL (i) 218,943 128,746 53,725 52,425 4,750 458,589 48,600CHIEF EXECUTIVE (ii) 510,869 300,406 125,357 122,325 11,082 1,070,039 113,400OFFICER

GEORGE B (i)MONTAGUE VP, REAL (ii) 216,368 69,281 21,644 19,125 12,446 338,864ESTATE

PAULA J WEBB VP, (i) 223,553 77,922 5,552 13,131 9,444 329,602NURSING (ii)

TARESA J CLARK VP, (i) 170,818 60,521 16,891 11,198 11,719 271,147NURSING/CNO (ii)

JACK SOSEBEE VP, (i) 143,138 32,480 7,506 14,106 9,590 206,820FAMILY SUPPORT (ii)SVGS

BRADLEY HORN (i) 181,743 10,121 12,052 9,984 213,900PHARMACIST (ii)

ROSANNE THURMAN (i) 150,592 20,571 7,285 7,290 12,191 197,929DIRECTOR, (ii)PHARMACY

KEVIN L DAHLE (i) 164,136 13,142 11,061 12,164 200,503PHARMACIST (ii)

KIMBERLY JONES (1) 220,913 54,052 1,160 10,200 17,316 303,641AVP-PERIOPERATIVE (ii)SVGS

SHARON SMITH (1) 41,629 159,380 7,131 2,274 210,414DIRECTOR- (ii)AMBULATORY SURGSVGS


Schedule K OMB No 1545-0047

(Form 990) Supplemental Information on Tax Exempt Bonds1- Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,

2013explanations, and any additional information in Part VI.1- Attach to Form 990. 1- See separate instructions.

Department of the Treasury 1-Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990 .Internal Revenue Service



Bond Issues

(h) On(i) Pool

(g) Defeased behalf of(a) Issuer name ( b) Issuer EIN (c) CUSIP # ( d) Date issued ( e) Issue price (f) Description of purpose financing

issuer


TARRANT COUNTY HEALTHREFUNDING BONDS 2000 &

A FACILITIES DEVELOPMENT 75-1881060 875906MV8 06-27-2007 52,156,976 X X X2005

BELL COUNTY HEALTHFACILITIES DEVELOPMENT REFUNDING BONDS ISSUEDBCO RP

74-2218760 078027HW2 06-27-2007 17,523,5947/19/2000

X X X

TARRANT COUNTY HEALTHDEVELOPMENT, CONSTR,

C FACILITIES DEVELOPMENT 75-1881060 875906NY1 02-04-2010 231,948,097 X X XEQUIPMENT COS

TARRANT COUNTYCULTURAL EDUCATION REFUNDING PORTION OFD

04-3833551 87638Q3C4 08-01-2013 71,222,592 X X XFACILITIES FINAN 2010 BOND SER

n n.ii Proceeds

A B C D

1 Amount of bonds retired 0 0 70,110,000 0

2 Amount of bonds legally defeased 0 0 0 0

3 Total proceeds of issue 52 ,156,976 17,523,594 232,805,916 71,222,592

4 Gross proceeds in reserve funds 0 0 0 0

5 Capitalized interest from proceeds 0 0 0 0

6 Proceeds in refunding escrows 50 ,833,752 17,116,642 0 70,145,033

7 Issuance costs from proceeds 672,932 229,475 2,686,446 1,077,553

8 Credit enhancement from proceeds 650,292 177,477 0 0

9 Working capital expenditures from proceeds 0 0 0 0

10 Capital expenditures from proceeds 0 0 230,119,470 0

11 Other spent proceeds 0 0 0 0

12 Other unspent proceeds 0 0 0 0

13 Year of substantial completion 2007 2007 2011 2013

Yes No Yes No Yes No Yes No

14 Were the bonds issued as part of a current refunding issue? X X X X

15 Were the bonds issued as part of 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 finalallocation of proceeds?

X X X X

I T I I I Private Business Use

A B C D


1 Was the organization a partner in a partnership, or a member of an LLC, which ownedproperty financed by tax-exempt bonds?

X X X X

2 Are there any lease arrangements that may result in private business use of bond-X X X X

financed property?

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat No 50193E Schedule K ( Form 990) 2013

Schedule K (Form 990) 2013 Pa g e 2

Private Business Use (Continued)

A B C D


3a Are there any management or service contracts that may result in private business useof bond-financed property?

X X X X

b If "Yes" to line 3a, does the organization routinely engage bond counsel or otheroutside counsel to review any management or service contracts relating to the financedproperty?

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 otheroutside counsel to review any research agreements relating to the financed property?

4 Enter the percentage of financed property used in a private business use by entitiesother than a section 501(c)(3) organization or a state or local government 0- 0 % 0 % 0 260 % 0 080 %

5 Enter the percentage of financed property used in a private business use as a result ofunrelated trade or business activity carried on by your organization, another section 0 %501(c)(3) organization, or a state or local government 0-

6 Total of lines 4 and 5 0 260 % 0 080 %

7 Does the bond issue meet the private security or payment test? X X

ga Has there been a sale or disposition of any of the bond financed property to anongovernmental person other than a 501(c)(3) organization since the bonds were X X X Xissued?

b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of

c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections1 141-12 and 1 145-27

X X X X

g Has the organization established written procedures to ensure that all nonqualifiedbonds of the issue are remediated in accordance with the requirements under X X X XRegulations sections 1 141-12 and 1 145-2?

ArbitrageA B C D


1 Has the issuerfiled Form 8038-T? X X X X

2 If "No" to line 1, did the following apply?

a Rebate not due yet?

b Exception to rebate?

c No rebate due? X X X X

If you checked No rebate due" in line 2c, provide inPart VI the date the rebate computation was performed

3 Is the bond issue a variable rate issue? X X X X

4a Has the organization or the governmental issuer enteredinto a qualified hedge with respect to the bond issue?

X X X X

b Name of provider 0 0 0

c Term of hedge

d Was the hedge superintegrated?

e Was the hedge terminated?

Schedule K (Form 990) 2013

Schedule K (Form 990) 2013 Page 3

Arbitrage (Continued )

A B C D


5a Were gross proceeds invested in a guaranteed investmentX X X X

contract (GIC)7

b Name of provider 0 0 0 0

c Term of GIC

d Was the regulatory safe harbor for establishing the fair marketvalue of the GIC satisfied?

6 Were any gross proceeds invested beyond an available temporaryperiod?

X X X X

7 Has the organization established written procedures to monitorthe requirements of section 148?

X X X X

ff^illl Procedures To Undertake Corrective ActionA I B I C I D

I Yes I No I Yes I No I Yes I No I Yes I No

Has the organization established written procedures to ensurethat violations of federal tax requirements are timely identified

X X X Xand corrected through the voluntary closing agreement program ifself-remediation is not available under aoolicable regulations?

Supp lemental Information . Provide additional information for res ponses to q uestions on Schedule K ( see instructions ) .

IReturn Reference Explanation

PART II, COLUMN C, LINE 3 TOTAL PROCEEDS OF ISSUE TOTAL PROCEEDS INCLUDE INVESTMENT EARNINGS


PART IV, COLUMN A & B, LINEINO REBATE DUE THE FINAL REBATE COMPUTATION WAS PERFORMED AS OF 6/27/20122C


PART IV, COLUMN C, LINE 2C INO REBATE DUE THE FINAL REBATE COMPUTATION WAS PERFORMED AS OF 2/4/2014


PART IV, COLUMN D, LINE 2C INO REBATE DUE THE FINAL REBATE COMPUTATION WAS PERFORMED AS OF 2/4/2014


FOR THE PURPOSES OF CALCULATING THE PRIVATE SECURITY OR PAYMENT TEST, COOK CHILDREN'S MEDICALCENTER (CCMC) HAS INCLUDED GROSS RECEIPTS FROM CERTAIN ACTIVITIES THAT CCMC HAS CONCLUDED

PART III, LINE 7, COLUMNS CGENERATE PRIVATE PAYMENTS CALCULATED IN THAT MANNER, CC MC HAS CONCLUDED THAT THE PRIVATE

& DPAYMENT TEST HAS BEEN MET WITH RESPECT TO THE BOND ISSUES DESCRIBED IN COLUMNS C &D HOWEVER,THE AMOUNT OF PRIVATE BUSINESS USE WITH RESPECT TO THE BOND ISSUES DESCRIBED IN COLUMNS C & D ISLESS THAN 5%, IN EACH CASE, SO THAT EACH OF THOSE BOND ISSUES FAILS THE PRIVATE BUSINESS USE TESTAND CONTINUES TO MEET THE REQUIREMENTS IMPOSED ON "QUALIFIED 501(C)(3) BONDS "


Schedule K OMB No 1545-0047

(Form 990) Supplemental Information on Tax Exempt Bonds1- Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,

2013explanations, and any additional information in Part VI.1- Attach to Form 990. 1- See separate instructions.

Department of the Treasury 1-Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990 .Internal Revenue Service



Bond Issues

(h) On(i) Pool

(a) Issuer name ( b) Issuer EIN (c) CUSIP # (d) Date issued ( e) Issue price (f) Description of purpose(g) Defeased behalf of

financingissuer


TARRANT COUNTYA CULTURAL EDUCATION

04-3833551 87638QKX6 02-28-2014 176,767,688CONSTRUCTION AND

X X XFACILITIES FINAN EQUIPMENT COSTS

n OOG Proceeds

A B C D

1 A mount of bonds retired 0

2 Amount of bonds legally defeased 0

3 Total proceeds of issue 177,057,170

4 Gross proceeds in reserve funds 0

5 Capitalized interest from proceeds 0

6 Proceeds in refunding escrows 0

7 Issuance costs from proceeds 1,755,350

8 Credit enhancement from proceeds 0

9 Working capital expenditures from proceeds 0

10 Capital expenditures from proceeds 0

11 Other spent proceeds 0

12 Other unspent proceeds 0

13 Year of substantial completion


14 Were the bonds issued as part of a current refunding issue? X

15 Were the bonds issued as part of an advance refunding issue? X

16 Has the final allocation of proceeds been made? X

17 Does the organization maintain adequate books and records to support the finalallocation of proceeds?

X

I T I I I Private Business Use

A B C D


1 Was the organization a partner in a partnership, or a member of an LLC, which ownedproperty financed by tax-exempt bonds?

X

2 Are there any lease arrangements that may result in private business use of bond- Xfinanced property?

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat No 50193E Schedule K (Form 990) 2013

Schedule K (Form 990) 2013 Pa g e 2

Private Business Use (Continued)

A B C D


3a Are there any management or service contracts that may result in private business useof bond-financed property?

X

b If "Yes" to line 3a, does the organization routinely engage bond counsel or otheroutside counsel to review any management or service contracts relating to the financedproperty?

c Are there any research agreements that may result in private business use of bond-financed property? X

d If "Yes" to line 3c, does the organization routinely engage bond counsel or otheroutside counsel to review any research agreements relating to the financed property?

4 Enter the percentage of financed property used in a private business use by entitiesother than a section 501(c)(3) organization or a state or local government 0- 0 %

5 Enter the percentage of financed property used in a private business use as a result ofunrelated trade or business activity carried on by your organization, another section501(c)(3) organization, or a state or local government 0-

6 Total of lines 4 and 5

7 Does the bond issue meet the private security or payment test?

ga Has there been a sale or disposition of any of the bond financed property to anongovernmental person other than a 501(c)(3) organization since the bonds were Xissued?

b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of

c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections1 141-12 and 1 145-27

X

g Has the organization established written procedures to ensure that all nonqualifiedbonds of the issue are remediated in accordance with the requirements under XRegulations sections 1 141-12 and 1 145-2?

ArbitrageA B C D


1 Has the issuerfiled Form 8038-T?

2 If "No" to line 1, did the following apply?

a Rebate not due yet?

b Exception to rebate?

c No rebate due? X

If you checked No rebate due" in line 2c, provide inPart VI the date the rebate computation was performed

3 Is the bond issue a variable rate issue? X

4a Has the organization or the governmental issuer enteredinto a qualified hedge with respect to the bond issue?

X

b Name of provider 0

c Term of hedge

d Was the hedge superintegrated?

e Was the hedge terminated?

Schedule K (Form 990) 2013

Schedule K (Form 990) 2013 Page 3

Arbitrage (Continued )

A B C D


5a Were gross proceeds invested in a guaranteed investment Xcontract (GIC)7

b Name of provider 0

c Term of GIC

d Was the regulatory safe harbor for establishing the fair marketvalue of the GIC satisfied?

6 Were any gross proceeds invested beyond an available temporaryperiod?

X

7 Has the organization established written procedures to monitorthe requirements of section 148?

X

ff^illl Procedures To Undertake Corrective ActionA B C D

Yes No Yes No Yes No Yes NoT F-

Has the organization established written procedures to ensurethat violations of federal tax requirements are timely identified Xand corrected through the voluntary closing agreement program ifself-remediation is not available under arDlicable regulations?

Supp lemental Information . Provide additional information for res ponses to q uestions on Schedule K ( see instructions ) .

IReturn Reference Explanation

PART II, COLUMN A, LINE 3 (2014(TOTAL PROCEEDS INCLUDE INVESTMENT EARNINGS

ISSUE)


PART IV, COLUMN A, LINE 2C INO REBATE DUE THE REBATE COMPUTATION WAS PERFORMED AS OF 2/28/2015(2014 ISSUE)


SCHEDULE 0OMB No 1545 0047

(Form 990 or 990-EZ) Supplemental Information to Form 990 or 990-EZ2013

Department of the Treasury Complete to provide information for responses to specific questions onForm 990 or to provide any additional information . Open

Internal Revenue Service1- Attach to Form 990 or 990-EZ. Inspection

1- Information about Schedule 0 (Form 990 or 990-EZ) and its instructions is atwww.irs.gov/form990.


75-2051646


FORM 990 PART VI, SECTION A,QUESTION 6

SOLE MEMBER COOK CHILDREN'S HEALTH CARE SYSTEM, A TEXAS NON-PROFIT CORPORATION, ISTHE SOLE MEMBER OF THE ORGANIZATION


FORM 990 PART VI, MEMBER ELECTION ABILITIES AS THE SOLE MEMBER OF THE ORGANIZATION COOK CHILDREN'S HEALTH CARESECTION A, QUESTION SYSTEM HAS THE POWER TO DETERMINE THE NUMBER OF MEMBERS OF THE BOARD OF TRUSTEES AND TO7A ELECT THE MEMBERS OF THE BOARD OF TRUSTEES

ReturnReference

Explanation

FORM 990 PART MEMBER DECISION ABILITIES AS THE SOLE MEMBER OF THE ORGANIZATION, COOK CHILDREN'S HEALTH CARE SYSTEMVI, SECTION A, HAS THE EXCLUSIVE POWER AND RESERVED POWER TO DO ANY OF THE FOLLOWING A AMEND, ALTER OR REPEALQUESTION 7B THE BY LAWS, 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 ANYMERGER, 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 THEORGANIZATION, AND, F APPROVE THE CREATION OF, OR INVESTMENT IN, ANY SUBSIDIARY ENTITY

ReturnReference

Explanation

FORM 990 PART REVIEW PROCESS FOR FORM 990 THE ORGANIZATION ENGAGES AN OUTSIDE INDEPENDENT ACCOUNTING FIRM TOVI, SECTION B, ASSIST IN THE PREPARATION OF THE FORM 990 AND RELATED FILINGS ALL INFORMATION PROVIDED TO THE OUTSIDEQUESTION 11 B 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 OFTRUSTEES FOR REVIEW AND COMMENT IN ADDITION, IT IS PRESENTED TO THE COOK CHILDREN'S HEALTH CARE SYSTEMAUDIT COMMITTEE FOR REVIEW AND COMMENT SUBSEQUENT TO AUDIT COMMITTEE REVIEW, THE FORM 990 IS FILEDWITH THE INTERNAL REVENUE SERVICE AND MADE AVAILABLE TO THE PUBLIC FOR REVIEW

ReturnReference

Explanation

FORM 990 REVIEW AND APPROVAL OF COMPENSATION COOK CHILDREN'S HEALTH CARE SYSTEM HAS ESTABLISHED APART VI, COMPENSATION COMMITTEE WITH OVERSIGHT OF EXECUTIVE AND PHYSICIAN COMPENSATION, WHICH INCLUDES THESECTION B, ORGANIZATION'S CEO AND OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION THE COMPENSATIONQUESTION COMMITTEE APPROVES COMPENSATION ARRANGEMENTS IN ADVANCE, WHICH INCLUDES A REVIEW AND APPROVAL BY15A & 15B INDEPENDENT COMMITTEE MEMBERS, USING COMPARABLE MARKET DATA RELATING TO COMPENSATION, WHICH IS

PROVIDED BY SULLIVAN COTTER AND ASSOCIATES, INC, AN INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATIONCONSULTANT THE COMPENSATION COMMITTEE DOCUMENTS THE BASIS FOR ITS DETERMINATIONS FOLLOWINGCONTEMPORANEOUS SUBSTANTIATION OF THE COMPENSATION COMMITTEES DELIBERATIONS AND DECISIONS THECOMPENSATION COMMITTEE REQUIRES THE COMPENSATION CONSULTANT TO UPDATE MARKET DATA PERIODICALLY,USUALLY EVERY TWO YEARS, WITH INTERIM REVIEWS BEING CONDUCTED AS NEEDED WITH REGARD TO PHYSICIANCOMPENSATION, THE COMPENSATION COMMITTEE ALSO RETAINS THE LAW FIRM OF MCDERMOTT, WILL & EMERY OFCHICAGO, ILLINOIS, TO ISSUE A REASONABLENESS OPINION COVERING THE PHYSICIAN COMPENSATION PLAN FOR COOKCHILDREN'S PHYSICIAN NETWORK

ReturnReference

Explanation

FORM 990 PART PROCESS OF MAKING GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION DOES NOT MAKE ITSVI, SECTION C, GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC, EXCEPT TO THE EXTENT THEYQUESTION 19 ARE ON FILE WITH THE SECRETARY OF STATE OF TEXAS THE CONFLICT OF INTEREST POLICY IS POSTED ON THE

ORGANIZATION'S INTERNAL WEBSITE AND AVAILABLE TO ALL EMPLOYEES AND BOARD MEMBERS OF COOKCHILDREN'S HEALTH CARE SYSTEM ENTITIES CONSOLIDATED FINANCIAL STATEMENTS ARE REPORTEDELECTRONICALLY FOR ALL COOK CHILDREN'S HEALTH CARE SYSTEM ENTITIES VIA THE ELECTRONIC MUNICIPALMARKET ACCESS ("EMMA") WEB SITE

ReturnReference

Explanation

FORM 990 WRITTEN CONFLICT OF INTEREST POLICY EVERY YEAR THE LEGAL DEPARTMENT OF THE COOK CHILDREN'S HEALTH CAREPART VI, SYSTEM ("SYSTEM') SENDS OUT A FORM 990 QUESTIONNAIRE/CONFLICT OF INTEREST DISCLOSURE STATEMENT TOSECTION B, OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES OF ALL SYSTEM COMPANIES, AS WELL AS CERTAIN OTHERQUESTION EMPLOYEES, INCLUDING PHYSICIANS, WHO ARE DETERMINED TO BE EMPLOYED IN POSITIONS THAT MIGHT BE SUBJECT TO12C 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 TORESPONSES THAT INDICATE THE EXISTENCE OF ACTUAL OR POTENTIAL CONFLICTS OF INTEREST THE RESPONSES TO THEQUESTIONNAIRES AND FOLLOW-UP INFORMATION ARE PROVIDED TO THE SYSTEM AUDIT COMMITTEE FOR REVIEW ANDFOLLOW-UP FURTHER, THE AUDIT COMMITTEE OF COOK CHILDREN'S HEALTH CARE SYSTEM IS RESPONSIBLE FORMONITORING THE IMPLEMENTATION AND ENFORCEMENT OF THE CONFLICT OF INTEREST POLICY THAT IS APPLICABLE TOALL AFFILIATED COMPANIES OF THE COOK CHILDREN'S HEALTH CARE SYSTEM THE AUDIT COMMITTEE IS ALSORESPONSIBLE FOR OVERSIGHT OF THE COMPLIANCE DEPARTMENT OF COOK CHILDREN'S HEALTH CARE SYSTEM THECOMPLIANCE DEPARTMENT MAINTAINS A HOT-LINE TO RECEIVE REPORTS OF INAPPROPRIATE ACTIVITIES INCLUDINGACTIVITIES THAT MIGHT CONSTITUTE A CONFLICT OF INTEREST INTERNAL AUDIT AND COMPLIANCE ALSO CONDUCTRANDOM AUDITS OF CORPORATE ACTIVITIES SUCH AS EXPENSE REIMBURSEMENTS AND ACCOUNTS PAYABLE TODETERMINE IF ANY INAPPROPRIATE PAYMENTS ARE BEING MADE TO INDIVIDUALS, SOME OF WHICH COULD BE EVIDENCE OFA CONFLICT OF INTEREST ANY CORRECTIVE ACTION RELATED TO CONFLICTS OF INTEREST WOULD BE REPORTED TO THEAUDIT COMMITTEE FOR REVIEW, APPROVAL, AND MODIFICATION, AS NECESSARY, WITH FURTHER REPORTING TO THESYSTEM BOARD OF TRUSTEES AS APPROPRIATE


FORM 990 PART VI, SECTION A,QUESTION 3

A MANAGEMENT COMPANY MANAGES THE DAY TO DAY OPERATIONS OF BOTH OF OUR JOINTVENTURES


FORM 990 PART XI,

LINE 9

OTHER CHANGES IN NET ASSETS OR FUND BALANCES TRANSFERS BETWEEN AFFILIATES ($ 7,545,493) INTERESTRATE SWAP ADJUSTMENT 715,896 --------------- TOTAL ($ 6,829,597)

l efile GRAPHIC p rint - DO NOT PROCESS

SCHEDULE R(Form 990)

Department of the Treasury

Internal Revenue Service

As Filed Data -

Related Organizations and Unrelated Partnerships

1- Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.1- Attach to Form 990. 1- See separate instructions.

1- Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990 .

DLN:93493225039185

OMB No 1545-0047

2013


75-2051646

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 (stateor foreign country)

(d)Total income

(e)End-of-year assets

(f)Direct controlling

entity

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had oneor more related tax-exempt organizations during the tax year.

(a) ( b) (c) (d) (e) (f) (g)Name, address, and EIN of related organization Primary activity Legal domicile (state Exempt Code section Public charity status Direct controlling Section 512(b)

or foreign country) (if section 501(c)(3)) entity (13) controlledentity?

Yes No

(1) COOK CHILDREN'S PHYSICIAN NETWORK PHYSICIAN SVC TX 501(C)(3) 3 CCHCS No

801 SEVENTH AVE

FORT WORTH, TX 7610475-2485366

(2) WI COOK FOUNDATION FUNDRAISING TX 501(C)(3) 11 NA No

801 SEVENTH AVE

FORT WORTH, TX 7610475-2056149

(3) COOK CHILDREN'S HOME HEALTH HEALTHCARE TX 501(C)(3) 9 CCHCS No

801 SEVENTH AVE

FT WORTH, TX 7610475-2896983

(4) COOK CHILDREN'S HEALTH CARE SYSTEM HLTH CARE SUP TX 501(C)(3) 11C CCHF No

801 SEVENTH AVE

FORT WORTH, TX 7610475-2705881

(5) COOK CHILDREN'S HEALTH PLAN INSURANCE TX 501(C)(3) 9 CCHCS No

801 SEVENTH AVE

FORT WORTH, TX 7610476-0585240

(6) ROSEDALE OFFICE BUILDING INC TITLE HOLDING TX 501(C)(2) N/A CCHF No

1500 W ROSEDALE

FORT WORTH, TX 7610446-0866421

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat No 50135Y Schedule R (Form 990) 2013

Schedule R (Form 990) 2013 Page 2

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34because It naa one or more relatea organizations treatea as a partnersnlp auring the tax year.

(a) (b) (c) (d) (e) (f) (g) (h) (i) 0) (k)Name, address, and EIN of Primary activity Legal Direct Predominant Share of total Share of end- Disproprtionate Code V-UBI General or Percentage

related organization domicile controlling income(related, income of-year allocations? amount in managing ownership(state or entity unrelated, assets box 20 of part ner?foreign excluded from Schedule K-1country) tax under (Form 1065)

sections 512-514)

Yes No Yes No

(1) COOK CHILDREN'S NORTHEAST HOSPITAL TX NA RELATED 3,836,523 5,722,948 No 0 Yes 56 354 %HOSPITAL

801 SEVENTH AVEFORT WORTH, TX 7610420-5227064

(2) CENTER FOR PEDIATRIC SURGERY ASC TX NA RELATED 6,759,016 12,627,089 No 0 No 52 319 %


(3) CPS PEDIATRICS LLC ASC TX NA RELATED 34,512 103,336 No 0 Yes 52 646 %

11221 ROE AVE SUITE 320LEAWOOD, KS 6621147-0871718

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-yearassets

(h)Percentageownership

(i)Section 512

(b)(13)controlledentity?

Yes No

(1) COOK CHILDREN'SHEALTH SERVICES INC

801 7TH AVENUEFORT WORTH, TX 7610445-4024843

HEALTHCARE TX CCHCS C CORPORATION No

Schedule R (Form 990) 2013


ff^ 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

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

b Gift, grant, or capital contribution to related organization(s)

c Gift, grant, or capital contribution from related organization(s)

d Loans or loan guarantees to or for related organization(s)

e Loans or loan guarantees by related organization(s)

f Dividends from related organization(s)

g Sale of assets to related organization(s)

h Purchase of assets from related organization(s)

i Exchange of assets with related organization(s)

j Lease of facilities, equipment, or other assets to related organization(s)

k Lease of facilities, equipment, or other assets from related organization(s)

I Performance of services or membership or fundraising solicitations for related organization(s)

m Performance of services or membership or fundraising solicitations by related organization(s)

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)

o Sharing of paid employees with related organization(s)

p Reimbursement paid to related organization(s) for expenses

q Reimbursement paid by related organization(s) for expenses

r Other transfer of cash or property to related organization(s)

s Other transfer of cash or property from related organization(s)

Page 3

YesFNo

la Yes

lb No

1c Yes

ld No

le Yes

if Yes

1g No

1h No

1i Yes

1j Yes

1k Yes

11 No

1m Yes

in No

to Yes

1p Yes

1q Yes

lr Yes

is 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)Transactiontype (a-s)

(c)Amount involved

(d)Method of determining amount involved

(1) COOK CHILDREN'S NORTHEAST HOSPITAL LLC S 4,295,004 FMV

(2) CENTER FOR PEDIATRIC SURGERY LTD S 7,528,728 FMV



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 grossrevenue) 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 orforeigncountry)

(d)Predominant

income(related,unrelated,

excluded fromtax under

sections 512-

(e)Are all partners

section501(c)(3)

organizations?

(f)Share of

totalincome

(g)Share of

end-of-yearassets

(h)Disproprtionateallocations?

(i)Code V7UBIamount inbox 20

of ScheduleK-1

(Form 1065)

U)General ormanagingpart ner?

(k)Percentageownership

514)Yes No Yes No Yes No



Supplemental Information

Provide additional information for responses to auestions on Schedule R (see instructions



Additional Data

Software ID:

Software Version:

EIN: 75 -2051646


Form 990, Schedule R, Part II - Identification of Related Tax-Exempt Organizations(a) (b) (c) (d) (e) (f) (g)

Name, address, and EIN of related organization Primary activity Legal domicile Exempt Code Public charity Direct controlling Section 512(state section status entity (b)(13)

or foreign country) (if section 501(c) controlled(3)) entity?

Yes No

(1)000K CHILDREN'S PHYSICIAN NETWORK PHYSICIAN SVC TX 501(C)(3) 3 CCHCS No


(1) WI COOK FOUNDATION FUNDRAISING TX 501(C)(3) 11 NA No


(2)COOK CHILDREN'S HOME HEALTH HEALTHCARE TX 501(C)(3) 9 CCHCS No

801 SEVENTH AVEFT WORTH, TX 7610475-2896983

(3) COOK CHILDREN'S HEALTH CARE SYSTEM HLTH CARE SUP TX 501(C)(3) 11C CCHF No


(4) COOK CHILDREN'S HEALTH PLAN INSURANCE TX 501(C)(3) 9 CCHCS No


(5) ROSEDALE OFFICE BUILDING INC TITLE HOLDING TX 501(C)(2) N/A CCHF No

1500 WROSEDALEFORT WORTH, TX 7610446-0866421

W.I. Cook Foundation , Inc. and Subsidiaries d/b/aCook Children's Health Foundation and Subsidiaries

Auditor's Report and Consolidated Financial Statements

September 30, 2014 and 2013

BKD LLP

CPAs & Advisors

W.I. Cook Foundation, Inc. and Subsidiaries d/b/aCook Children's Health Foundation and Subsidiaries


Contents

Independent Auditor's Report ...............................................................................................1

Consolidated Financial Statements

Balance Sheets 3

Statements of Operations and Changes in Net Assets 4

Statements of Cash Flo« s 6

Notes to Financial Statements 7

Supplementary Information

Balance Sheet Information - Consolidating Schedule 42

Statement of Operations Information - Consolidating Schedule 43

Statement of Changes in Net Assets Information - Consolidating Schedule 44

BKD LLP

CPAs & Advisors

I I

Independent Auditor's Report

Board of TrusteesW I Cook Foundation . Inc and Subsidiaries d/b/aCook Children 's Health Foundation and Subsidiaries

Fort Worth. Texas

i1Q 11 it bkd com

We have audited the accompany ing consolidated financial statements ofW I Cook Foundation. Inc andSubsidiaries d/b/a Cook Children's Health Foundation and Subsidiaries (Cook Children's). «hichcomprise the consolidated balance sheets as of September 30. 2014 and 2013. and the related consolidatedstatements of operations and changes in net assets and cash flo« s for the N ears then ended. and the relatednotes to the consolidated financial statements

Management 's Responsibility for the Financial Statements

Management is responsible for the preparation and fair presentation of these consolidated financialstatements in accordance «ith accounting principles generallN accepted in the United States of America.this includes the design. implementation and maintenance of internal control relevant to the preparationand fair presentation of consolidated financial statements that are free from material misstatement.«hether due to fraud or error

Auditor's Responsibility

Our responsibilitN is to express an opinion on these consolidated financial statements based on our auditsWe conducted our audits in accordance «ith auditing standards generall-N accepted in the United States ofAmerica Those standards require that «e plan and perform the audit to obtain reasonable assuranceabout «hether the consolidated financial statements are free from material misstatement

An audit involves performing procedures to obtain audit evidence about the amounts and disclosures inthe consolidated financial statements The procedures selected depend on the auditor's judgment.including the assessment of the risks of material misstatement of the consolidated financial statements.«hether due to fraud or error In making those risk assessments. the auditor considers internal controlrelevant to the entit\ 's preparation and fair presentation of the consolidated financial statements in orderto design audit procedures that are appropriate in the circumstances. but not for the purpose of expressingan opinion on the effectiveness of the entit 's internal control Accordingl-N. «e express no such opinionAn audit also includes evaluating the appropriateness of accounting policies used and the reasonablenessof significant accounting estimates made b-N management. as NN ell as evaluating the overall presentation ofthe consolidated financial statements

We believe that the audit evidence «e have obtained is sufficient and appropriate to provide a basis forour audit opinion

Board of TrusteesW I Cook Foundation. Inc and Subsidiaries d/b/aCook Children's Health Foundation and Subsidiaries

Page 2

Opinion

In our opinion. the consolidated financial statements referred to above present fairlN. in all materialrespects. the financial position ofW I Cook Foundation. Inc and Subsidiaries d/b/a Cook Children'sHealth Foundation and Subsidiaries as of September 30. 2014 and 2013. and the results of its operations.the changes in its net assets and its cash flo« s for the N ears then ended in accordance «ith accountingprinciples generallN accepted in the United States of America

Other Matter

Our audit NN as conducted for the purpose of forming an opinion on the basic consolidated financialstatements as a NN hole The consolidating information listed in the table of contents is presented forpurposes of additional analN sis and is not a required part of the basic consolidated financial statementsSuch information has not been subjected to the auditing procedures applied in the audit of the basicconsolidated financial statements. and accordinglN. «e do not express an opinion or provide anNassurance on it

Dallas. TexasJanuary 28. 2015


Consolidated Balance Sheets


(rn thouson 1s)

Assets

Current Assets

Cash and cash eciui alents

Shot-term m%.estments

Patient accounts receivable, net of alloxxance.

2014 - $88,425, 2013 - S67.930

Other current assets

Total current assets

Assets Whose Use is Linuted or Restricted

Long-term Investments

Propert and Equipment, Net

Other Assets

Total assets

Liabilities and Net Assets

Current Liabilities

-\ccounts paN able

Medical claims acaued and paNable

Estimated paN able for professional liabilit

self-msmance claims. current portion

Current portion of long-term debt outstanding

-\ccrued liabilities and other

Estimated paN able to third-party paN ors

Total current liabilities

Estimated PaNable for Professional Liabilit_N

Self-insurance Claints

Long-terns Debt Outstanding

Total liabilities

Net Assets

Um esu icted

Cool. Children's

Nonconttollmg mtetests

Total umesuicted net assets

Tempotatil tesnicted

Permanenth tesnicted

Total net assets

Total liabilities and net assets

2014 2013

$ 627.554 $ 490.441

2.901 28.203

97.643 94.994

64.411 48.645

792.509 662.283

183.465 6.666

1.1; 2.79_ 1.0 05.8. 1

602.518 533.235

50.391 46.175

$ 2.761.676 $ 2.254.190

S 77.832 $ 46.388

0.505 35.009

943 1.270

8,186 35.627

104.409 89.279

4.822 24.123

256.697 2. 1.696

9.851 9.256

462.520 286.667

729.068 527.619

1.954.052 1.651.065

6.072 6.058

1.960.124 1.657.123

20.465 20.872

52.019 48.576

2.032.608 1.726.571

$ 2.761.676 $ 2.254.190

See Notes to Consolidated Financial Statements 3

W.I. Cook Foundation, Inc. and Subsidiaries d/b/aCook Children's Health Foundation and SubsidiariesConsolidated Statements of Operations and Changes in Net Assets

Years Ended September 30, 2014 and 2013

On thousands)

2014 2013

Unrestricted Rei enues , Gains and Other Support

Net patient service revenue $ 943.8()8 $ 915.297

Less provision for uncollectible accounts 36.724 34.-422

Net patient service revenue less provision for

uncollectible accounts 9()7.()84 88().875

Premium and capitation revenue 286.227 259.139

Other revenue 81.546 58.1 1()

Net assets released from restrictions used for operations 7.212 6.988

Total unrestricted revenues, gains and other support 1.282.()69 1,205,112

Expenses and Losses

Salaries and \\ages 463_()88 440,961

EmploNee benefits 114.680 105.468

Medical claims e\pense 167.()19 145.()97

Operating supplies and e\penses 253_()28 256.214

Depreciation and amortization 47.2()7 48.526

Interest e\pense and fees 22.271 17.()()4

Gain on disposition of propertN and equipment (182) ( 357)

Total e\penses and losses 1,067,111 1.()12.913

Operating Income 214 .958 192.199

Other Income ( Expense)

Loss on extinguishment of debt - (573)

Investment return 34.()11 50,062

Change in net unrealized gains and losses on investments 59.513 36.84()

Change lll fair value of interest rate s\ ap ( 716) 3.8()8

Total other income (e\pennse) 92.8 () 8 9 0, 137

Excess of Rei enues 01 er Expenses 307.766 282.336



Consolidated Statements of Operations and Changes in Net Assets (Continued)


On thousands)

2014 2013

Unrestricted Net Assets

Excess of revenues over expenses $ 3()7.766 $ 282.336

Net assets released from restriction used for purchase of

propertN and equipment 4.612 4.508

Contributions for purchase of propertN and equipment 8 -

Purchase of units from noncontrolling interest (813) (939)

Sale of units to nolncontrolling interest 1.463 -

Distributions to noncontrolling interests ( 10).0)35) ( 1().11())

Increase in unrestricte d net assets 303,00 1 275.795

Temporarily Restricted Net Assets

Change in beneficial interest in lead trust 4 13

Contributions and investment return 11 .471 17.024

Net assets released from restrictions (1 1.824) (1 1.-496 )

Net assets transferred to pennanenth restricted (58) (4)

Increase (decrease ) in temporarllN restricted net assets (407) 5J37

Permanently Restricted Net Assets

Change in beneficial interest in perpetual trusts 140) 521

Contributions and investment return 3 .245 2.662

Net assets transferred from temporarllN restricted 58 4

Increase in permanentIN restricted net assets 3.443 3.187

Change in Net Assets 31)6.1)37 284.519

Net Assets , Beginning of Year 1.726.571 1.442.052

Net Assets , End of Year $ 2.032.608 $ 1.726.571



Consolidated Statements of Cash Flows


(117 (17071 fcIflcIs

2014 2013

Operating Activities

Change in net assets $ 306.037 $ 284.519

Change i n net assets atiubutable to noncont(olling mteiests (14) 292

Change in net assets atiubutable to Cook Chil d(en 's 306.023 284.811

Items not (equumg (piox (ding ) ope(atmg cash floxx

Rest( i cted cont( (but(ons and in est(nent i ncome, Ions-tern (13.157) (13.480)

Deptec ( at(on and amort ization 47.207 48.526

Amortization of bond issuance costs and pi em(um discount (124) 16

Loss on e'-tmsu ( shment of debt - 573

Pi ox (s(on foi had debts 36.724 34.422

Change i n benefic i al iiiteiest in t i usts (144) (534)

Gain on d isposition of fixed assets (182) (357)

Net (eal( zed ga i ns and net change i n umeal(zed

gains on in estments (87.949) (76.965)

Change i n fau xalue of mte( est (ate sxxap 716 (3.808)

Noncont( olling mte(est 9.399 10.757

Changes in

Patient accounts (ecenable. net (39.373) (25.297)

Oche ( assets (12.883 ) (21.273)

Accounts pa,, able 18.400 8.637Acc(ued li abilities and othe ( 10.629 10.684

Estunatedpa,, able to thud-pa(t-, pa\o(s (19.301) (1.206)

Estimated self-mswance I(ab(I(t-, 269 (1.998)

Net cash p(ox (ded b,, ope(atmg acts rt es 256.254 253.508

In-. esting Activities

Put chase of i n estments (828.463) (627.712)

Sales of mx est(nents 637.953 501,697

Put chase of piope(t-% and ecqu ( pment (103.326) (73.049)

Pioceeds fiom sale of p i ope(tN and ecqu(pment 59 23

Adx vices on notes ( ecenable (5.349) (18.871)

Net cash used i n mxestms actnrt(es (299.126) (217.912)

Financing A ctivities

Pioceeds fiom hot towing 183.768 97.552

Debt p( mc(pal and cap i tal lease pa\ments (5.787) (75.400)

Payment of debt issuance costs (1.768) (1.113)

Rest((cted cunt(( but(ons and (mestment income, Ions-tern 13 .157 13.480

Put chase of un i ts fiom noncont ( olling iiite iest (813) (939)

Sale of un its to noncont ( olling iiiteiest 1.463 -

D(sth (but(ons to noncont ( ollins iiiteiest (10,035) (10.110)

Net cash p(ox (ded b,, financing acts rt es 179.985 23.470

Increase in Cash and Cash Equivalents 137.113 59.066

Cash and Cash Equivalents , Beginning of 1 ear 490, 441 431.375

Cash and Cash Equivalents, End of 1 ear $ 627.554 $ 490.441

Supplemental Cash Flows Information

Inte(est pa id $ 15.741 $ 10.514

Capital acclu ( srt(ons in accounts pa,, able $ 2 5 .215 $ 12.171



Notes to Consolidated Financial Statements


Note 1: Nature of Operations and Summary of Significant Accounting Policies

Nature of Operations and Principles of Consolidation

W I Cook Foundation. Inc (Foundation) is a not-for-profit corporation located in Fort Worth.Texas. established to solicit. receive and manage contributions for the benefit of Cook Children'sMedical Center

The accompany mg consolidated financial statements include the accounts of the Foundation and allcompanies ov ned and controlled bN the Foundation including the follo« ing subsidiaries

• Cook Children ' s Health Care System ( System ) - a not-for-profit corporation organized toprovide administrative and management functions to subsidiaries The Foundation is the solemember of the SN stem

• Cook Children ' s Medical Center ( Medical Center) - a not-for-profit corporation. «hichoperates a' 63-bed (430-bed license) children's hospital in Fort Worth. Texas The SN stem isthe sole member of the Medical Center The Medical Center provides inpatient and outpatientsurgery services. emergenc\ care. full service neonatal intensive care and pediatric intensivecare services Additionally. the Medical Center participates in t«o joint ventures «tth localphy sicians a freestanding surgical hospital (Northeast Hospital) in Tarrant Counts. Texas.and a surgical center (Pediatric Surgical Center) in Denton Count. Texas

• Cook Children ' s Physician Network ( Physician Network) - a not-for-profit corporationorganized as a multi-specialty phi sician net« ork providing services to Fort Worth andsurrounding communities The Sv stem is the sole member of the Phi sician Net« ork

• Cook Children's Health Plan (Health Plan ) - a not-for-profit corporation organized toparticipate in state-fimded insurance programs and provide insurance coverage to eligiblechildren in the North Texas area The Sv stem is the sole member of the Health Plan

• Cook Children ' s Home Health (Home Health ) - a not-for-profit corporation organized toprovide pediatric medical care in the patient's home The S\ stem is the sole member of HomeHealth

• Cook Children's Indemnity Company ( Indemnity Company ) - a corporation organizedunder the la« s of the CaN man Islands that holds an Unrestricted Class "B" Insurer's licenseunder the provisions of the CaN man Islands insurance la« The principal activit-\ of theIndemnrth Compan-\ is the insurance of the Medical Center and Phv sician Net« ork formedical malpractice insurance risks The Indemnit-\ Compan-\ is «hollv o« ned b-\ theS-\ stem

• Rosedale Office Building ( ROB) - a not-for-profit corporation organized to hold title to realand personal property that is used in association «ith the mission of the Foundation There isno member The ROB Board is nominated b-\ the Trusteeship Committee of the FoundationAt all times. a majorit\ of the ROB Board must also be members of the Board of Trustees ofthe Foundation




• Cook Children ' s Health Services, Inc. (Health Services) - a corporation organized to holdCook Children' s businesses that are registered as for-profit corporations under the TexasBusiness Organization Code Health Services is a «hollv o« ned substdtarv of the S-\ stem

These companies are collecttvek referred to as "Cook Children's" in the consolidated financialstatements unless spectficalk identified All significant intercompan\ accounts and transactionshave been eliminated in consolidation

Noncontrolling Interests

Noncontrolling interests represent the 45% and 44% interest in Northeast Hospital that CookChildren's did not on at September 30. 2014 and 2013. respecttvek. and the 47% interest inPediatric Surgical Center that Cook Children's did not o«n at both September 30. 2014 and 2013

Changes in consolidated unrestricted net assets attributable to the controlling financial interest ofCook Children's and the noncontrolling interests are

On thousands)

Controlling Noncontrolling

Total Interest Interests

Balance, October 1, 2012

Excess of revenues over expenses

Net assets released from restriction used for purchase

of properth and equipment

Purchase of shares from noncontrolling interests

Distributions to noncontrollmg interests

Increase (decrease) in unrestricted net assets

Balance, September 30, 2013

Excess of revenues over expenses

Net assets released from restriction used for purchase

of properth and equipment

Contributions for purchase of propert\ and equipment

Purchase of shares from noncontrolling interests

Sale of units to noncontrolling interests

Distributions to noncontrolling interests

Increase in unrestricted net assets

Balance, September 30, 2014

$ 1.381.328 $ 1.374.978 $ 6.35()

282.336 271.579 M757

4,508 4.5O8 -

(939) - (939)

(1().11()) - (1().11())

275.795 276.O87 (292)

1.657.123 1.651.O65 6.O58

3O7.766 298.367 9.399

4.612 4.612 -

8 8 -

(813) - (813)

1.-463 - 1.-463(1n II ZS\ _ (1n( \

303.001 302.987 14

$ 1.96O.124 $ 1.954.O52 $ 6.O72

The change in temporanl\ and permanentl\ restricted net assets is attributable solel\ to thecontrolling interest

8




Use of Estimates

The preparation of financial statements in conform «ith accounting principles generallNaccepted in the United States of America requires management to make estimates and assumptionsthat affect the reported amounts of assets and liabilities and disclosure of contingent assets andliabilities at the date of the financial statements and the reported amounts of revenues and expensesduring the reporting period Actual results could differ from those estimates

Cash and Cash Equivalents

Cook Children's considers all liquid investments. other than those limited as to use. «ith originalmaturities of three months or less to be cash equivalents At September 30. 2014 and 2013. theseconsisted pnmanlN of moneN market accounts «ith brokers

At September 30. 2014. Cook Children's cash accounts exceeded federallN insured limits bNapproximatelN $196.115.000

Investments and Investment Return

Investments in equit\ and debt securities are carved at fair value Other investments are valued atthe lo« er of cost (or fair value at time of donation. if acquired bN contribution) or fair value

Investments also include investments in alternative assets. such as hedge finds structured aslimited liabilitN corporations or partnerships These fiends are earned at net asset value Theestimated fair value of these alternative investments is based on the most recent valuationsprovided bN external investment managers

Management has revie«ed and evaluated the values provided bN the managers and agrees «ith thevaluation methods and assumptions used to determine those fair values. and believes the carr\ ingamount of these investments is a reasonable estimate of fair value The amount at «hich CookChildren's mav be able to sell the investments mav be different than the estimated cans mg value

Investment return includes dividend. interest and other investment income. realized and unrealizedgains and losses on investments carried at fair value. and realized gains and losses on otherinvestments Investment return that is initially restricted bv donor stipulation and for «bich therestriction NN ill be satisfied in the same ear is included in unrestricted net assets Investment returnrelated to endo«ments is included in temporanh restricted net assets until appropriated forexpenditure Other investment return is reflected in the accompan\ ing consolidated statements ofoperations and changes in net assets as unrestricted. temporanh restricted or permanently restrictedbased upon the existence and nature of anv donor or legally imposed restrictions

Assets Whose Use is Limited or Restricted

Assets hose use is limited or restricted include (1) assets held b\ trustees deferred forcompensation agreements or held under bond indenture agreements and (2) assets set aside b\ theBoard of Trustees (Board). «hich include the Woman's Board finds. over «hich the Board retainscontrol and max. at its discretion. subsequently use for other purposes




Patient Accounts Receivable

Accounts receivable are reduced bN an allo«ance for doubtftil accounts In evaluating thecollectibilitN of accounts receivable. Cook Children's analNzes its past historv and identifies trendsfor each of its mayor pa\ or sources of revenue to estimate the appropriate allo« ance for doubtftilaccounts and provision for uncollectible accounts Management regularl\ revie« s data about thesemayor pay or sources of revenue in evaluating the sufficiencv of the allo« ance for doubtftilaccounts

For receivables associated «ith services provided to patients NN ho have third-parts coverage. CookChildren's anal-\ zes contractuall-\ due amounts and provides an allo«ance for doubtftil accountsand a provision for uncollectible accounts. if necessar\ (for example. for expected uncollectibledeductibles and copalments on accounts for «bich the third-part\ pad or has not -\ et paid)

For receivables associated «ith self-pad patients («hich includes both patients «rthout insuranceand patients «ith deductible and copal ment balances due for «bich third-part\ coverage exists forpart of the bill). Cook Children's records a significant provision for uncollectible accounts in theperiod of service on the basis of its past experience. «bich indicates that mans patients are unableor Lm« illing to pad the portion of their bill for «bich thev are financiallv responsible Thedifference bet« een the standard rates (or the discounted rates if negotiated or provided b\ polic\ )and the amounts actuall\ collected after all reasonable collection efforts have been exhausted ischarged off against the allo« ance for doubtftil accounts

Cook Children's allo« ance for doubtful accounts for self-pad patients NN as approximatel-\ 88% and84% at September 30. 2014 and 2013 In addition. patient account «nte-offs NN ere consistentbet« een 2014 and 2013

Inventories

Inventories are comprised of medical. surgical and pharmaceutical supplies. and are valued at thelo« er of cost or market on a first-in. first-out basis Inventories are included in other current assetsin the accompany ing consolidated balance sheets

Property and Equipment

Propert\ and equipment are stated at cost Routine maintenance and repairs are charged to expenseas incurred Expenditures that increase capacities or extend useftil life are capitalized

Propert\ and equipment are depreciated on a straight-line basis over the estimated useftil life ofeach asset Assets under capital lease obligations and leasehold improvements are depreciated overthe shorter of the lease term or their respective estimated useful lives Average useftil lives rangefrom 10 - 40 \ ears for buildings and improvements and 3 - 20 \ ears for equipment

10




Donations of propert\ and equipment are reported at fair value as an increase in unrestricted netassets unless use of the assets is restricted bN the donor Monetar\ gifts that must be used toacquire propert\ and equipment are reported as restricted support The expiration of suchrestrictions is reported as an increase in unrestricted net assets NN hen the donated asset is placed inservice

Cook Children's capitalizes interest costs as a component of construction-in-progress based oninterest costs of borro« ings for the projects. net of interest earned on investments acquired v ith theproceeds of the borro« ing Total interest capitalized and incurred during the sears endedSeptember 30. 2014 and 2013. is summarized belo«

on thousands)

2014 2013

Interest e\pen,e capitalized $ 5.246 $ 224

Le,,,, interest income from in e,,tment of

proceed, of borro\\mg, for project 301 -

Net interest cost capitalized $ 4.945 $ 224

Intere st e\pen,e capitalized $ 5 .246 $ 224

Intere st and fee, charged to e\pen,e 22.271 17.004

Total interest and tee,, incurred $ 27.517 $ 17.228

Long-lived Asset Impairment

Cook Children's evaluates the recoverabilit\ of the cam mg value of long-lived assets «heneverevents or circumstances indicate the cam mg amount may not be recoverable If a long-lived assetis tested for recoverabilit\ and the undiscounted estimated ftiture cash flo« s expected to resultfrom the use and eventual disposition of the asset is less than the cans ing amount of the asset. theasset cost is adjusted to fair value and an impairment loss is recognized as the amount b< «hich thecarry mg amount of a long-lived asset exceeds its fair value

No asset impairment NN as recognized during the s ears ended September 30. 2014 and 2013

11




Goodwill

During 2008. Cook Children's purchased a nlajoritN o« nership in the Pediatric Surgical CenterThe transaction resulted in good« ill of $9.479.000 Good« ill is evaluated annuallN for impairmentor more frequentlN if impairment indicators are present If the implied fair value of good« ill islo« er than its cans ing amount. a good« ill impairment is indicated and good« ill is «ritten do« n toits implied fair value Subsequent increases in good« ill value are not recognized in theconsolidated financial statements No impairment as recognized for the \ ears ended September30. 2014 and 2013

Deferred Financing Costs

Deferred financing costs represent costs incurred in connection «ith the issuance of long-term debtSuch costs are being amortized over the term of the respective debt using the interest methodUnamortized cost at September 30. 2014 and 2013. «as approximatel\ $7.322.000 and $5.587.000respectivel\. and is a component of other assets on the accompan\ ing consolidated balance sheets

Interest Rate Swap Agreement

Cook Children's has entered into an interest rate sap agreement (S«ap) to reduce the effect ofchanges in cash flo« s pnmanl\ related to interest rate fluctuations on a portion of its variableinterest rate debt

The S« ap is recognized on the accompan\ ing consolidated balance sheets at its fair value The netcash pad ments or receipts under the S« ap are recorded as an increase or decrease to interestexpense

Temporarily and Permanently Restricted Net Assets

Temporanly restricted net assets are those NN hose use bv Cook Children's has been limited bvdonors or pa\ors to a specific time period or purpose Permanentl\ restricted net assets have beenrestricted bv donors to be maintained bv Cook Children's in perpethuth

Net Patient Service Revenue

Cook Children's has agreements «ith third-part\ pad ors. including government programs andmanaged care plans that provide for pad ments at amounts different from its established rates Netpatient service revenue is reported at the estimated net realizable amounts from patients. third-partspa^ors and others for services rendered and include estimated retroactive revenue adjustmentsRetroactive adjustments are considered in the recognition of revenue on an estimated basis in theperiod the related services are rendered and such estimated amounts are revised in future periods asadjustments become kno«n

12




Premium/Capitation Revenue

The Health Plan provides health insurance coverage to enrollees through the Child HealthInsurance Program (CHIP) and the State of Texas Access Reform (STAR) STAR is the managedcare program for Medicaid in selected Texas counties Both of these programs are designed for thelo«-income population and are financed bN the State of Texas and the federal government Underthese agreements. the Health Plan receives monthlN capitation paNments based on the number ofenrollees and capitation revenue is recognized in the month in «hich the enrollees are entitled tohealth care services and anN adjustments are recorded as theN become kno«n The Health Planalso receives delivers supplemental paN meats «hich are accrued as deliveries occur The HealthPlan makes fee-for-service pa\ ments to Cook Children's and other service providers fornoncapitated services based on discounted fee schedules

Medical Claims Expense

Medical claims expense for services rendered to members of capitated programs is recognized asservices are provided. including estimated amounts for claims incurred but not Net reported Theexpenses are reported net of subscriber copaN and deductible amounts and net of reimbursementfrom coordination of benefits arrangements Reinsurance premims. net of recoveries. are includedin medical claims expense in the accompany ing consolidated statements of operations and changesin net assets

Charity Care

The Medical Center. PhN sician Net« ork and Home Health provide care «ithout charge or atamounts less than its established rates to patients meeting certain cntena under its financialassistance polic-\ Because these providers do not pursue collection of amounts determined toqualif as chants care. these amounts are not reported as net patient service revenue

Contributions and Pledges Receivable

Unconditional promises to give cash and other assets are accrued at estimated fair value at the dateeach promise is received Gifts received «ith donor stipulations are reported as either temporarilyor pennanenth restricted support When a donor restriction expires (i e . NN hen a time restrictionends or purpose restriction is accomplished). temporarily restricted net assets are reclassified andreported as an increase in unrestricted net assets Donor-restricted contributions «hose restrictionsare met «tthin the same -\ear as received are reported as unrestricted contributions Conditionalcontributions are reported as liabilities until the condition is eliminated or the contributed assets arereturned to the donor

Split-interest Agreements

Cook Children's holds irrevocable interests in various trusts established b-\ donors These interestsare initially recorded in temporanh or penlianenth restricted net assets based on the nature of thedonor's restriction and Cook Children's share of the fair value of the trust at the date CookChildren's NN as notified of the trust's existence

13




For perpetual trust agreements. Cook Children's share of the fair value of underl,, ing trust assets\ as approximatelh $7.036.000 and $6.892.000 at September 30. 2014 and 2013. respectivelN Thebeneficial interests in trusts are included in other assets in the accompany ing consolidated balancesheets Increases or decreases in the net fair value of the trust are recorded as changes intemporanlN or permanentl,, restricted net assets in the accompan\ ing consolidated statements ofoperations and changes in net assets Distributions received from the earnings of the beneficialtrust agreements are recorded as unrestricted or temporaril,, restricted net assets. as specified bN thedonor. in the period received

Self-funded Insurance

Cook Children's maintains self-funded health insurance and «orkers' compensation insuranceplans covering substantiallN all emploN ees Contributions are made to the administrators of theplans as claims are paid «hile expenses are accrued as incurred

Estimated Professional Liability Costs

An annual estimated provision is accrued for the self-insured portion of medical malpractice claimsand includes an estimate of the ultimate costs for both reported claims and claims incurred but notreported

Income Taxes

The Foundation. SN stem. Medical Center. PhN sician Net« ork. Health Plan. Home Health and ROBhave been recognized as exempt from income taxes under Section 501 of the Internal RevenueCode (IRC) and a similar provision of state la« Ho«ever. these entities are subject to federalincome tax on anN unrelated business taxable income

The Pediatric Surgical Center is organized as a limited partnership (LP) The Northeast Hospital isorganized as a limited liability compan\ (LLC) Under provisions of the IRC. LLCs are taxed aspartnerships Taxable income or losses of partnerships is generall-N reported to the individualpartner for inclusion in their respective tax returns As such. no provision for federal income taxesis included in these consolidated financial statements for these entities

Health Services is organized as a for-profit corporation and is subject to taxation through federaland state i unsdictions

The IndemnitN Compan-N is incorporated under the la« s of the CaN man Islands and no taxes arelevied in the Ca-N man Islands

Cook Children's files an IRS Form 990 for all its nonprofit entities in the U S Federal jurisdictionAn IRS Form 1120 is filed for Health Services along «ith requisite state tax forms With fe«exceptions. Cook Children's entities are no longer subject to examination b-N tax authorities for thes ears before 2011

14




Operating Income

Cook Children's uses operating income as an intermediate reporting measure on the accompan\ mgconsolidated statements of operations and changes in net assets Amounts excluded from operatingincome include investment return. changes in unrealized gains and losses on trading securities.change in fair value of interest rate s«ap and other nonoperating activities

Excess of Revenues Over Expenses

The consolidated statements of operations and changes in net assets include excess of revenuesover expenses Changes in unrestricted net assets «hich are excluded from excess of revenues overexpenses. consistent «tth industr\ practice. include transactions «tth noncontrolling interesto«ners and contributions of long-lived assets (including assets acquired using contributions «hichb\ donor restrictions NN ere to be used for the purpose of acquiring such assets)

Transfers Between Fair Value Hierarchy Levels

Transfers in and out of Level 1 (quoted market prices). Level 2 (other significant observableinputs) and Level 3 (significant unobservable inputs) are recognized on the actual transfer date

Note 2: Net Patient Service Revenue

Cook Children's recognizes patient service revenue associated «ith services provided to patientsNN ho have third-part\ pad or coverage on the basis of contractual rates for the services rendered Foruninsured patients that do not qualifi for chant\ care. Cook Children's recognizes revenue on thebasis of its standard rates (or the discounted rates if negotiated or provided b-\ polic-\ ) for servicesprovided On the basis of historical experience. a significant portion of Cook Children's uninsuredpatients NN ill be unable or Lm« illmg to pa-\ for the services provided Thus. Cook Children'srecords a significant provision for uncollectible accounts related to uninsured patients in the periodthe services are provided This provision for uncollectible accounts is presented on theconsolidated statement of operations as a component of net patient service revenue

The Medical Center. Ph\ sician Net« ork and Home Health have agreements «ith third-parts pa\ orsthat provide for paN meats to the companies at amounts different from their established rates

The majority of Medicaid beneficiaries in a six-counts region around the Medical Center's servicearea are required to enroll in a Medicaid managed care plan «tth various health maintenanceorganizations (HMO) These HMOs (including the Health Plan) contract «tth the Medicaidprogram to provide pnmar\ . acute care and ps\ chiatric services to Medicaid beneficianes TheMedical Center has contracted «ith certain of these HMOs to provide services to pediatricMedicaid recipients through the Medical Center and Ph\ sician Net« ork for a fee for service rate

15




Medical Center inpatient services and some outpatient services rendered to Medicaid programbeneficiaries not enrolled in the Medicaid managed care plan are reimbursed at prospectivelNdetermined rates The Medical Center outpatient services that are not reimbursed based on theprospective rate structure are reimbursed based on a cost reimbursement methodology at tentativerates «ith final settlement determined after submission of annual cost reports b,, the MedicalCenter and audits thereof bN the Medicaid fiscal mtermediar\ Retroactive adjustments are accruedon an estimated basis in the period the related services are rendered and adjusted in future periodsas final settlements have been determined

La« s and regulations governing Medicaid and other federal health care programs are complex andsubject to interpretation and change As a result. it is reasonabl-\ possible that recorded estimatesNN ill change matenall-\ in the near term Compliance «ith such la« s and regulations can be subjectto future government revie« and interpretation. as NN ell as significant regulator\ action includingfines. penalties and exclusion from the Medicaid program

Cook Children's has also entered into pad ment agreements «ith certain commercial insurancecarvers and preferred provider organizations The basis for pa\ ments to Cook Children's underthese agreements includes prospectivel-\ determined rates per discharge. discounts from establishedcharges and prospectivel-\ determined dail-\ rates

Patient service revenue. net of contractual allo« ances and discounts (but before the provision foruncollectible accounts). recognized in the -\ ears ended September 30. 2014 and 2013. respectivel-\.NN as approximatel-\

2014 2013

Medicaid/other gov ennllent paN or,

Medicaid managed care/CHIP

Other third-partv paN or,

Self-pay

14% 14%

22% 22%

62% 60%

2% 4%

100% 100%

16




Note 3: Supplemental Medicaid Funding Programs

The Medical Center receives fiords under the Medicaid Disproportionate Share (DSH) programThe DSH program provides supplemental pad ments to qualifi ing hospitals that provide adisproportionate level of care to patients NN ho are either uninsured or qualifi for the Medicaidprogram DSH proceeds recognized as a component of other operating revenue NN as approximate 1\$17.698.000 and $11.327.000 DSH pa\ ments of $12.730.000 and $0 NN ere received in the \ earsended September 30. 2014 and 2013. respectivel\ DSH recorded as a receivable in other currentassets at September 30. 2014 and 2013. as $16.925.000 and $11.327.000. respectivel\ In 2008.the Centers for Medicare and Medicaid Services (CMS) adopted a rule «bich limits the t\ pes ofcost a hospital may claim to receive DSH padments As a result. DSH paNments made during orafter 2011 are subject to recoupment based on the results of audits to be conducted beginning in2014 A reserve has been established for estimated future recoupments It is reasonabl\ possiblethat actual recoupments could be matenall\ different than the estimated recoupments

During 2013. the Medical Center began receiving pay ments for its participation in the TexasMedicaid 1115 Healthcare Transformation Waiver (1115 Waiver) for both Uncompensated Care(UC) and the Delivers Sv stem Reform Incentive PaNment (DSRIP) Total 1115 Waiver revenuerecognized as a component of other operating revenue in 2014 and 2013 as approximatel\$9.985.000 and $4.213.000. respectivel\ Approvmatel\ $6.609.000 and $2.278.000 NN as recordedas a receivable in other current assets at September 30. 2014 and 2013

The funding is subject to recoupment based on future audits and is not necessanl\ representative offunding the Medical Center NN ill receive in future v ears

Note 4: Concentration of Credit Risk

Accounts Receivable

Cook Children's grants credit «tthout collateral to its patients. most of «hom are area residents andare insured under third-parts pa\ or agreements The mix of gross receivables from patients andthird-parts pa\ ors at September 30. 2014 and 2013. is summarized as follo« s

2014 2013

Medicaid /other gov ernment paN or, 18% 19%

Medicaid managed care/CHIP 26% 25%

Other third-partv paN or, 44% 43%

Self-pav 12% 13%

100% 100%

17




Note 5 : Investments and Investment Return

Assets Whose Use is Limited or Restricted

Assets limited as to use are summarized belo«

On thousands)

Internallv designated. Woman's Board

Cash and cash equi alents

Held bN trustee under deferred compensation agreement

Mutual funds

Held bN trustee under indenture agreement

Mone\ market mutual funds

Corr nercial paper

U S agencv obligations

U S TreasurN obligations

Total assets hose use is limited or restricted

2014 2013

$ 405 $ 351

8.012 6.315

43.169 -

46.188 -

18.868 -

$ 183.465 $ 6.666

Investments

Investments at September 30. 2014 and 2013. ere as sho« n belo«

(in thousands)

Debt ,ecuritie,,

U S Trea,ur obligation, $

Global debt mutual fund,

In e,,tment grade corporate bond,,

Prl\ ate placement "eculltle"

Other

Equltl ,ecuritie,,

G1 11 1 1 d

1.197 $ 838

- 26.639

20.756 84.086

16.724 14.234

1.788 -

o a equIL' IIIUL lcc Il n -

Consumer di cretionar\ and ,taple,, 74.330

Energ\ and utilities 34.741

Financial, 35.794

Health care 12.041

Indu,,tr1a1,, and materials 45.337

Information technolog\ 36.144

Telecommunication ,er\ ices 7.2 12

Altematl\ e 111\ e,,tment^ 849.630

$ L135.694

2014 2013

;9514

68.146

52.457

40.404

10.221

34.476

25.055

10.887

627.077

$ 1.0,4.0,4

18




Alternative Investments

Alternative investments include investments in hedge fiords. limited partnerships and offshoreinvestment fiends These fiends maN invest in certain tv pes of financial instruments. includingfutures and fonN and contracts. options and securities sold but not Net purchased. intended to hedgeagainst changes in the market value of investments These financial instrments. «hich involvevan ing degrees of risk. ma-\ result in loss due to changes in market risk Cook Children's isinvested in 63 different alternative investments at September 30. 2014

Cook Children's has elected to account for its investments in alternative investments using the fairvalue option Total alternative investments at September 30. 2014 and 2013. are $849.630.000 and$627.077.000. respectivel\ Changes in fair value of items for «hich the fair value option has beenelected are reported as unrealized gains and losses in the accompan\ mg consolidated statements ofoperations and changes in net assets The fair value change in 2014 and 2013 as an increase of$66.096.000 and $23.399.000. respectivel\

Alternative investments held at September 30. 2014 and 2013. and unfunded commitments as ofSeptember 30. 2014. are as follo« s

Unfunded(in thynn mdO 2014 2013 Commitments

Equitri long ,Iioit hedge funds (A) $ 135.513 $ 96.016 $ -

Multi-stiategN hedge funds (B) 97.322 83.242 -

Real estate funds (C) 51.673 49.639 36.201

Ptnate anestment funds (D) 162.488 97.436 158.615

Single-,,Ii atep credit hedge fiords (E) 160.640 110.056 -

Global macro funds (F) - 12.617 -

Global equit\ funds (G) 116.410 130.255 4.210

Global fixed income funds (H) 29.152 41.149 -

Cunenc\ hedge funds (I) 8.038 6.667 -

Long emelgmg market funds (J) 88.394 - -

$ 849.630 $ 627.077 $ 199.026

(A) This category includes investments in hedge funds that take both long and short positions.primarily in U S common stocks Management of the fiends has the abilitv to shiftinvestments among differing investment strategies These fiends maN use derivatives.leverage and short positions in an attempt to maximize total returns. regardless of marketconditions

(B) This category includes investments in hedge fiords that pursue multiple strategies todiversif risks and reduce volatilrth The fiends' composite portfolio maN includeinvestments in U S common stocks. debt instruments. global real estate projects andarbitraged investments

19




(C) This categor\ includes several real estate/land funds that invest pnmarily in U Scommercial real estate These investments can never be redeemed «tth the findsDistributions from each Rind NN ill be made as the underlv ing investments of the Rinds areliquidated It is estimated the underlv ing assets of the Rinds NN ill be liquidated over thenext seven to ten \ ears

(D) This categor\ includes several private equity and debt funds that invest pnmanl innonlisted companies These investments cannot be redeemed until 5 - 12 \ ears after theclosing date of the find The nature of the investments in this categor\ is that distributionsare received through the liquidation of underlv ing assets of the find. «hich is expected tooccur over the course of the next 5 - 12 s ears

(E) This categor\ includes several finds that invest in limited t\ pes of debt instruments.including mortgage-related securities These Rinds' objective is to seek current income asNN ell as capital appreciation These Rinds mav engage in hedging and other investmentstrategies to pursue their investment objectives Funds mav be redeemed «ithm 1 - i

ears «ith notices ranging from 45 - 60 daN s after the respective lockup period forredemption

(F) This categor\ includes Rinds that can take long and short positions in multiple t\ pes ofinvestment instruments on a global basis. including but not limited to equities. debt.currencies and derivatives The pnmarn objective is to express an overall economic vie«on one or more countries These investments t-\ picall-\ have initial lockups up to 1 - 2s ears «ith notice periods of 30 - 60 daN s for redemption

(G) This categor\ includes finds that take long positions in equity of corporations in the UnitedStates and/or outside the United States T-\ picall-\ these t-\ pes of investments do not havelockup periods

(H) This categor\ includes finds «hich pursue fixed income securities in a «ide range ofsegments including investment grade corporates. non-U S corporates. sovereigns.treasuries/agencies. U S high -\ field. bank loans and structured securities T-\ picall-\ thesetvpes of investments are verv liquid and have limited lockup periods

(I) This categor\ includes finds «hich trade liquid foreign exchange market instrumentsgloball-\ on a long- and short-basis Instruments are concentrated on bighl-\ liquid G10markets and consist primanl-\ of large developed market currencies (USD. EUR JPY.GBP. CHF. CAD) along «tth other smaller developed countries (AUD. NZD. NOK. SEK)

(J) This categor\ includes finds that take long equity positions in corporations that are basedin countries designated as Emerging. «hich is contingent on factors such as gross domesticproduct per capita. local government regulations. perceived investment risk. foreigno«nership limits and capital controls These investments can have slightl-\ lo«er liquidit-\and higher volatilit-\ than other general global equith investments given the size andgeopolitical and economic standing of the markets in «bich the-\ are located

20




Investments at September 30. 2014 and 2013. are reflected in the accompan\ mg consolidatedbalance sheets as follo« s

on thousands) 2014 2013

Short-term in\ e,,tment,,

Long-term in\ e'tment'

$ 1901 $ 28.20;

$ L135.694 $ 1.034.034

Total investment return for the N ears ended September 30. 2014 and 2013. is summarized asfollo« s


Interest and di idend income $ 9.246

Net unrealized g ains on in e,,tment^ 62.304

Realized gains on in e,,tment^ 25.645

Mineral income and other 698

$ 97.893 $

13.285

; 8566

;8.;99

740

90.990

Total investment return for the s ears ended September 30. 2014 and 2013. is reflected in theaccompan\ ing consolidated statements of operations and changes in net assets as follo« s

on thousands)

2014 2013

Unrestricted net a ,,,, et,,In\ e,,tment return $ 34.01 1 $ 50.062

Current Near change in net unrealized gain'

on in\ e,,tment,, 59J13 36.840

Other 103 125

Temporarilv restricted net a„et, 1300 1.327

Pernlanentlv re,tricted net a„et, 2.966 2.636

$ 97.893 $ 90.990

21




Note 6 : Pledges Receivable

Pledges receivable NN ere $6.825.000 and $9.169.000 at September 30 . 2014 and 2013. respectively.and are sho« n belo« All of the pledges receivable NN ere temporanlN restricted at September 30.2014 and 2013

(iri thousands) 2014 2013

Due R ithin one-\ ear $ 3.010 $ 2.343

Due in fi e N ear, 4.179 7.481

7.189 9.824

Le,,,, allo\\ ance for uncollectible pledge,, 97 198

Le,,,, unamortized discount 267 457

$ 6.825 $ 9.169

Pledges receivable NN ere discounted at a rate of 4 6% and 3 6% at September 30. 2014 and 2013.respectivelN The receivables due «ithin one-sear are included «tth other current assets v hale theremaining receivables are included «ith other assets on the accompany mg consolidated balancesheets

Note 7 : Property and Equipment

Propert\ and equipment at September 30. 2014 and 2013. is summarized as follo« s


Land and impro\emenh $ 42.816 $ 37.271

Building,, and impro\ emenh 581.109 553.023

Equipment 235.781 214.71 1

859.706 805.005

Le,,,, accumulated depreciation and amortization 341.023 298.358

518.683 506.647

Con, tructlon-in-progre,,,, 83.835 26.588

602.518 $ 533.235

22




During 2013. Cook Children's initiated a ne« project that includes the construction of a ne«building on the south side of the Medical Center campus. renovations in the existing MedicalCenter and a ne« facilities plant The project includes the expansion of surgical services. labservices. emergenc\ room services. a ne« heart center and t« o ne« floors shelled for futuremedical/surgical bed growth The project is expected to span 4 '/2 N ears and is anticipated to costapproximateIN $349.000.000 The Medical Center plans to use proceeds from bond financing andexisting cash reserves to fiend the project

Note 8: Medical Claims and Self-funded Insurance

Cook Children's retains professional actuaries to assist in determining the required reserves for itsincurred but not reported liabilitN for the medical claims covered bN the Health Plan and the self-fimded emploNee health insurance and «orkers' compensation insurance programs It isreasonablN possible that Cook Children's estimate NN ill change bN a material amount in the near

term

Medical claims accrued and pad able at September 30. 201 4 and 2013. are summarized as follo« s

on thousands)

2014 2013

Medical claim, $ 21.653 $ 24.381

Emplovee health insurance 6.127 7,432

workers compensation insurance 2.725 3.196

$ 30.505 $ 5.009

Note 9 : Professional Liability Self-insurance

Cook Children's provides malpractice coverage for the Medical Center and PhN sician Net« orkthrough its «bollv o« ned captive insurance provider. the IndemnitN CompanN Losses fromasserted and unasserted claims are based on estimates that incorporate the entities' past experience.as NN ell as other considerations. including the nature of each claim or incident and relevant trendfactors

Cook Children's has retained professional actuarial insurance consultants to assist «tth determiningthe amounts to be deposited «ith the IndemnitN CompanN as reserves and the estimated IndemnitNCompanN liabilitN It is reasonablN possible that the estimate of these losses NN ill change bN amaterial amount in the near tern

Amounts accrued and pad able on an undiscounted basis at September 30. 2014 and 2013. NN ere$10.794.000 and $10.526.000. respectiveIN

23




Note 10: Long-term Debt


Series 2014 Re\ enue Bond, (A) $ 164.640 $ -

Series 2013A Re\enue Bond, (B) 68.950 68.950

Series 2010A Re\enue Bond, (C) 113.730 1 17.925

Series 2010B Re\ enue Bond, (D) 29.840 29.840

Series 2007A Re\ enue Bond, (E) 14595 15.710

Series 2007B Re\ enue Bond, (F) 51.045 51.045

Note, paN able (G) 32390 25390

Other obligation, 1.020 1.497

476.2 10 310357

Net bond premium 17.372 5329

493.582 315.886

Fair \ Glue of mtere,,t rate ,\\ all agreement 7.124 6.408

Current maturities (38.186) (35.627)

$ 462.520 $ 286.667

(A) $164.640.000 original issue Series 2014 Tarrant Count\ Cultural Education FacilitiesFinance Corporation (Cook Children's Medical Center) Hospital Revenue Bonds (2014Bonds). interest at rates ranging from 3%- 5%. serial bonds paid annuallv beginning in2014 through 2034. term bonds paid annuall\ in 2039 and 2044. secured b\ a promissor\note from the Obligated Group The 2014 Bonds maN be called at Cook Children'selection at 100% of the par on or after December 1. 2023 The Medical Center used theproceeds from the sale of the 2014 Bonds to pad for the (i) costs of constructing andequipping certain health facilities and (ii) cost of issuance of the 2014 Bonds

(B) $68.950.000 original issue Series 2013A Tarrant Counts Cultural Education FacilitiesFinance Corporation (Cook Children's Medical Center) Hospital Revenue Bonds (2013ABonds). interest at 5 25%. principal payable annuallv beginning in 2035 through 2039.secured b\ a promissory note from the Obligated Group The 2013A Bonds maN be calledat Cook Children's election at 100% of par on an\ date on or after December 1. 2023 TheMedical Center used the proceeds from the sale of the 2013A Bonds to redeem a portion ofthe 2010B Bonds. all of the 2010C Bonds and pad the costs of issuance of the 2013ABonds

24




(C) $129.660.000 original issue Serves 2010A Tarrant Counts Health Facilities DevelopmentCorporation (Cook Children's Medical Center Project) Hospital Revenue Bonds(2010A Bonds). interest at rates ranging from 3%- 5%. serial bonds paid annuallNbet«een 2010 and 2025. term bonds paid annuallN in 2030. 2033 and 2036. secured bN apromissor\ note from the Obligated Group The 2010A Bonds maN be called at CookChildren's election at 100% of par on an\ date on or after December 1. 2019 The MedicalCenter used the proceeds from the sale of the 2010A Bonds to pad (i) costs of thedevelopment. construction and equipping of certain health facilities and (ii) costs ofissuance of the 2010A Bonds

(D) $64.615.000 original issue Serves 2010B Tarrant Count\ Health Facilities DevelopmentCorporation (Cook Children's Medical Center Project) Hospital Revenue Bonds(201 OB Bonds). variable interest determined «eekl\ b-\ a remarketing agent (0 03% atSeptember 30. 2014). annual mandatorv principal payments beginning in 2024 through2030. secured b-\ a promissor\ note from the Obligated Group The 201 OB Bonds ma-\ becalled at Cook Children's election at 100% of par prior to their stated matunt-\ TheMedical Center used the proceeds from the sale of the 2010B Bonds to pad (i) costs of thedevelopment. construction and equipping of certain health facilities and (ii) costs ofissuance of the 2010B Bonds These bonds include a put option that allo« s a bond holderto tender the bonds for pad ment each «eek If tendered bonds are not remarketed. CookChildren's must repay the bond holder During 2013. a portion of the 2010B Bonds «ithoriginal matunt-\ dates in 2035 through 2039 NN ere redeemed «ith proceeds of the 2013ABonds

(E) $17.250.000 original issue Serves 2007A Bell Counts Health Facilities DevelopmentCorporation (Cook Children's Medical Center Project) Hospital Revenue Refunding Bonds(2007A Bonds). interest at rates ranging from 4 00% - 5 50%. principal pad able annuall\bet«een 2007 and 2023. secured b\ a promissory note from the Obligated Group The2007A Bonds maN be called at Cook Children's election at 100% of par on an\ date on orafter December 1. 2017 Proceeds of the 2007A Bonds NN ere placed in an escro« accountand are pledged to make pa\ ment of the principal. interest and redemption premium on aportion of the 2000A Tarrant Counts Health Facilities Development Corporation (CookChildren's Medical Center Project)

(F) $51.045.000 original issue Serves 2007B Tarrant Count\ Health Facilities DevelopmentCorporation (Cook Children's Medical Center Project) Hospital Revenue Refunding Bonds(2007B Bonds). interest at 5%. principal payable annuallv beginning in 2018 through2030. secured b\ a promissor\ note from the Obligated Group The 2007B Bonds ma\ becalled at Cook Children's election at 100% of par on an\ date on or after December 1.2017 Proceeds of the 2007B Bonds NN ere used to redeem a portion of the 2000B and all ofthe 2005 Tarrant Count\ Health Facilities Development Corporation (Cook Children'sMedical Center Project)

25




(G) Notes pad able to various lenders (Notes). interest at rates ranging from 1 12% - 1 25%.principal pay able quarterIN beginning in 2021 through 2042 The Notes maN be prepaid atthe option of Cook Children's after the seventh anniversar\ of the date of the Notes Theproceeds from the Notes NN ere used to acquire land and construct a ne« administrativebuilding The Notes NN ere issued as part of an integrated financing structure developedunder the Ne« Markets Tax Credit (NMTC) program pursuant to Section 45D of the IRCand the regulations. compliance and reporting requirements thereunder

The Obligated Group is comprised of the Sv stem. Medical Center. Foundation and Phv sicianNet«ork The Indenture and Loan Agreements place limitations on the Obligated Group's abilityto incur additional debt and requires that the Obligated Group meet certain measures of financialperformance (including a debt service coverage ratio of 110%) as long as the bonds areoutstanding

At the date of issuance of the 201 OB Bonds. Cook Children's covenanted to maintain sufficient

liquidit\ to repay the bonds in the event of a remarketing failure Cook Children's is responsible to

provide sufficient liquidit\ to cover a failed remarketing event. and as a result. the principal

balance of the 2010E bonds remaining at September 30. 2014 and 2013. have been classified as a

current liabilitv in the consolidated balance sheets Should Cook Children's be required to Rind

non-remarketed 201 OB Bonds. the potential maturities «ould be different than scheduled

maturities

The follo« ing table compares the potentiall-\ accelerated maturities and scheduled maturities ofCook Children' s debt at September 30. 2014

Accelerated Scheduledon thousands) Maturities Maturities

2015 $ 38.186 $ 8.346

2016 8.51 8.51

2017 &863 &863

2018 9.294 9.294

2019 9545 9545

Thereafter 401.871 43L711

$ 476.210 $ 476.210

26




Note 11: Derivative Financial Instrument

Cook Children's has entered an interest rate s« ap agreement. the purpose of «hich is to reduce thevariability of interest pad ments on a portion of its variable rate demand bonds The sv ap providesfor Cook Children's to receive interest from the counterpart\ at 75% of LIBOR and to pad interestto the counterpart\ at a fixed rate of 4 075% on a notional amount of $29.816.000 at bothSeptember 30. 2014 and 2013 Under the agreement. Cook Children's pads or receives the netinterest amount monthl-N. «tth monthl-N settlements included in interest expense The agreementexpires on December 1. 2030

All changes in the fair value of the s« ap are recorded as a component of other income (expense)

The table belo« presents certain information regarding Cook Children' s interest rate sapagreement

/In thousands)

Fair \ aloe of ,\\ ap agreement

Balance ,fleet location of fair \ Glue amount

Gain (lo„) recognized in consolidated ,tatement, of

operation, and change, in net a„et,

Location of gain (lo„) recognized in consolidated

,tatement, of operation, and change,

in net a ,,,,et,,

2014 2013

$ (7.124) $ (6.408)

Long-term debt Long-term debt

$ (716) $ 3.808

Other income Other income

(e\pen,e) (e\pen,e)

Note 12: Temporarily and Permanently Restricted Net Assets

Temporanl\ restricted net assets are available for the follo« mg purpose or periods

on thousands)

2014 2013

Health care ,er\ ice,

Indigent care $ 209 $ 172

Propert\ . equipment and other 19.874 20.322

Beneficial interest in tru,,t' to be recel\ ed in

future \ ear, 382 378

$ 20.465 $ 20.872

During 2014 and 2013. net assets NN ere released from donor restrictions bN incurring expensessatisfi ing the restricted purposes of indigent care or purchasing qualifi ing property and equipmentin the amount of $11.824.000 and $11.496.000. respectivelN

27




Permanentl,, restricted net assets are restricted to

on thousands)

2014 2013

In\e,,tment,, to be held in pe11 etult-, . the income

i, unrestricted $ 36.548 $ 34.207

Endo\\ment requiring income to be Used

for indigent care 15.471 14.369

52.019 $ 48576

Note 13: Endowment

Cook Children's endo«ment consists ofapproximateIN 32 individual Rinds established for avarietN of purposes The endo«ment includes both donor-restncted endo«ment Rinds and Rindsdesignated bN the governing both to ftinction as endo«ments (Board-designated endo«mentftmds) As required b,, accounting principles general1N accepted in the United States of America(GAAP). net assets associated «ith endo« ment Rinds. including Board-designated endo« mentRinds. are classified and reported based on the existence or absence of donor-imposed restrictions

Cook Children's governing both has interpreted the state of Texas' Uniform Prudent Managementof Investment Funds Act (UPMIFA) as requiring preservation of the fair value of the original giftas of the gift date of the donor-restncted endo« meet Rinds absent explicit donor stipulations to thecontrar\ As a result of this interpretation. Cook Children's classifies as permanentl\ restricted netassets (a) the original value of gifts donated to the permanent endo« meet. (b) the original value ofsubsequent gifts to the permanent endo« ment and (c) accumulations to the permanent endo« mentmade in accordance «ith the direction of the applicable donor gift instrument at the time theaccumulation is added to the Rind

28




The remaining portion of donor-restricted endo« ment funds is classified as temporanlN restrictednet assets until those amounts are appropriated for expenditure bN Cook Children's in a mannerconsistent «ith the standard of prudence prescribed bN UPMIFA In accordance «ith UPMIFA.Cook Children's considers the follo« ing factors in making a determination to appropriate oraccumulate donor-restncted endo« ment funds

1 Duration and preservation of the fund

2 Purposes of Cook Children's and the fund

3 General economic conditions

4 Possible effect of inflation and deflation

5 Expected total return from investment income and appreciation or depreciation of

investments

6 Other resources of Cook Children's

7 Investment policies of Cook Children's

The composition of net assets b,, t\ pe of endo« meat fund at September 30. 201 4 and 2013. NN as

(,n thou and) Temporarily PermanentlyUnrestricted Restricted Restricted Total

2014

Donor-lestiicted endoNNment funds

Board-designated endoNNment funds

Total endowment funds

2013

Donor-lestiicted endoNNment funds

Board-designated endoNNment funds

Total endowment funds

S - S 2.627 S 45.365 S 47.992

S 14.031 S 2.627 S 45.365 S 62.02;

S - S 1.93() S 42.()62 S 43.992

S 11847 S 1.930 S 42.062 S 56.839

29




Changes in endo« meat net assets for the Nears ended September 30. 2014 and 2013. NN ere

(in thousands) Temporarily Permanently

Unrestricted Restricted Restricted Total

2014

Endowment net assets, beginning of Near $ 12 .847 $ 1.930 $ 42.062 $ 56.839

Investment return

Investment Income 388 625 886 1.899

Net appreciation 796 675 2 .()8() 3J51

Total investment retuni 1 .18 4 1.3()() 2.966 5.45()

Contributions - - 337 337

Appropriation of endoxxment assets

for expenditure - (6()3) - (603)

Endoxxment net assets, end of Near

On thousands)

2013

Endoxxment net assets, begnuung of Near

Investment retuni

Investment income

Net appreciation (depreciation)

Total investment retuni

Contributions

Appropriation of endoxxment assets

for expenditure

Endoxxment net assets, end of Near

$ 14.()31 $ 2.627 $ 45.365 $ 62.()23

Temporarily Permanently

Unrestricted Restricted Restricted Total

$ 49.521 $ 1.616 $ 39.397 $ 9().534

1().883 9()3 1.354 13.14()

(5.644) 424 1.281 (3.939)

5.239 1.327 2.635 9.201

- - 3() 3()

(41.913) (1.013) - (42.926)

(36.674) 314 2.665 (33.695)

$ 12.847 $ 1.93() $ 42.()62 $ 56.839

30




Amounts of donor-restncted endow meet fiends classified as permanentlN and temporarilN restrictednet assets at September 30. 2014 and 2013. consisted of

on thousands)

2014 2013

Permanentlv restricted net a„et, - portion of

peiiletua1 endo \\ment fund' required to be

retained peimanent1N bN e\plicit donor

,tipulation or UPMIFA $ 45365 $ 42.062

Temporarilv restricted net a„et, - portion of

peiiletua1 endo \\ment fund' subjeet to a time

restriction under UPMIFA vvith puipo,ere,trietion, $ 2 .627 $ 1.9 30

From time to time. the fair value of assets associated «ith individual donor-restncted endo« meetfiends maN fall belo« the level Cook Children's is required to retain as a fiend of perpetual durationpursuant to donor stipulation or UPMIFA In accordance «tth GAAP. deficiencies of this natureare reported in unrestricted net assets and totaled $0 at both September 30. 2014 and 2013

Cook Children's has adopted investment and spending policies for endo«ment assets that attemptto provide a predictable stream of funding to programs and other items supported bN its endo« ment«bile seeking to maintain the purchasing po« er of the endo« meet Endo« meet assets includethose assets of donor-restricted endo«ment funds that Cook Children's must hold in perpetuit\ orfor donor-specified periods. as NN ell as those of Board-designated endo« ment fiends

Under Cook Children's policies. endo«ment assets are invested in a manner that is intended toproduce results that is equal to a return hurdle defined as the spending rate. inflation rate and themanagement cost of the endo«ment on an annual basis «hile assuming a prudent level ofinvestment risk

To satisf its long-ten i rate of return objectives. Cook Children's relies on a total return strateg\ in«hich investment returns are achieved through both current v field (investment income such asdividends and interest) and capital appreciation (both realized and unrealized) Cook Children'stargets a diversified asset allocation that places a greater emphasis on equit\ -based investments toachieve its long-ten i return objectives «ithin prudent nsk constraints

31




Cook Children's has a policN (spending policN) of appropriating for expenditure each N ear 5% of

the Foundation's investments (« Bich excludes Board-designated endo« meat Rinds and other

donor-restricted endo«ment Rinds. NN hose income is directlN allocated to the Medical Center)

average fair value over the prior five N ears ending June 30. preceding the N ear in «hich expenditure

is planned In establishing this policN. Cook Children's considered the long-term expected return

on its endo«ment AccordinglN. over the long-term. Cook Children's expects the current spending

policN to allo« its endoyvment to gro« at the return hurdle This is consistent «ith Cook

Children's objective to maintain the purchasing po« er of endo« meat assets held in perpetuity or

for a specified term. as NN ell as to provide additional real growth through ne« gifts and investment

return

Note 14: Notes Receivable

In conjunction «ith its participation in the NMTC program. Cook Children's made leveraged loansto a NMTC investment Rind The notes bear interest at an annual rate of I% and paN able inquarterlN installments from 2021 through 2042 The notes receivable balances as of September 30.2014 and 2013. NN ere $24.220.000 and $18.871.000. respectivelN The notes maN be paid in Rillprior to the scheduled matuntN after seven N ears from the effective date Through participation inthe NMTC structure. Cook Children's projects a net benefit of approximatelN $5. 100.000 over theexpected life of the program

Note 15 : Charity Care

The Medical Center. PhN sician Net« ork and Home Health maintain records «bich identif andmonitor the level of chant\ care the\ provide These records include charges and costs for servicesand supplies furnished under the financial assistance policies The cost of chants care providedduring the s ears ended September 30. 2014 and 2013. totaled $5,255.000 and $5.918.000.respectivel\ The cost of chants care is estimated b\ appl\ ing the ratio of cost to gross charges tothe gross uncompensated charges

32




Note 16: Functional Expenses

Cook Children's provides health care services pnmanlN to residents «ithin its geographic areaExpenses related to providing these services are as sho«n belo«


Health care ,er\ ice , $ 752.557 $ 721.259

General and adll im tratl\ e 133.387 132.287

Health in,urance acti\ itie , 177.631 155.667

Fundrai ing 3.536 3.700

$ 1.067.111 $ 1.012.913

Note 17: Retirement Plan

Cook Children's has a defined contribution pension plan covering substantiallN all emploNees TheBoard determines the amount that Cook Children's contributes to the plan Cook Children'scontributes a maximum of 7 50% of the participating emplo,, ees' salaries. «bich is fulls vestedafter three s ears Retirement expense «as $19.977.000 and $17.208.000 for 2014 and 2013.respectively

Cook Children's has also established a defined contribution tax-deferred annuitN plan for thepurpose of purchasing annuit,, contracts for its emploN ees pursuant to Section 403(b) of the IRC. asamended The program is available to all emploN ees Cook Children's does not contribute to thisplan

Cook Children's also has a nonqualified deferred compensation plan organized under Section457(b) of the IRC for certain emploN ees Benefits generallN vest immediatelN The assets of theplan are recorded in assets NN hose use is limited in the accompany ing consolidated balance sheetsand are approximatelN $8.012.000 and $6.315.000 at September 30. 2014 and 2013. respectivelNThere is an offsetting liabilitN recorded in accrued liabilities in the accompany mg consolidatedbalance sheets

33




Note 18: Related Party Transactions

The Je« el Chant\ Ball NN as organized to raise funds to aid the charity fiend of the Medical CenterContributions from the Je« el Chants Ball recognized in operating income for chants care NN ere$2.451.000 and $2.676.000 in 2014 and 2013. respectivel-N

From time to time. Cook Children's conducts business transactions «ith companies that membersof the Board have a direct or indirect relationship These relationships and transactions aredisclosed bN the Board members in annual conflict of interest statements and are approved annuallNbN the Board Certain of these transactions are also disclosed in Cook Children's annual IRS Form990. in accordance «tth applicable disclosure requirements

Note 19: Disclosures About Fair Value of Assets and Liabilities

Fair value is the pace that «ould be received to sell an asset or paid to transfer a liabilitN in anorderlN transaction bet« een market participants at the measurement date Fair value measurementsmust maximize the use of observable inputs and minimize the use of unobservable inputs There isa hierarchN of three levels of inputs that maN be used to measure fair value

Level 1 Quoted paces in active markets for identical assets or liabilities

Level 2 Observable inputs other than Level 1 paces. such as quoted paces for similar assets orliabilities. quoted prices in markets that are not active. or other inputs that areobservable or can be corroborated bN observable market data for substantiallN the fullteam of the assets or liabilities

Level 3 Unobservable inputs that are supported bN little or no market activitN and that aresignificant to the fair value of the assets or liabilities

Recurring Measurements

The table on the follo« ing page presents the fair value measurements of assets and liabilitiesrecognized in the accompan\ ing consolidated balance sheets measured at fair value on a recurringbasis and the level «ithin the fair value hierarchN in «bich the fair value measurements fall atSeptember 30. 2014 and 2013

34




(In thomando

September 30, 2014

Financial assets

Morse,, market mutual funds

Commercial paper

Mutual funds

Debt secwrties

U S agenc,, obligations

U S Tteasw\ obligations

Im estment glade cot pot ate bonds

Ptnate placement secutrties

Other

Equm securities

Consumer discietionar\ and staples

Enetg and utilities

Financials

Health cafe

Industrials and materials

Information technolog

Telecommunication set ices

Altetnatne investments

Equm shot long hedge funds

Multi-sttateg hedge funds

Real estate fiends

Pi n ate in estment funds

Single-sttateg\ ciedit hedge fiends

Global equm fiends

Global fixed income funds

Cuttenc,, hedge fiends

Long emerging market funds

Beneficial interests in trust

Financial liabilities

Interest Late s\4ap agreement

Fair Value Measurement Using

Quoted Prices

in Active Significant

Markets for Other Significant

Identical Observable Unobservable

Fair Assets Inputs Inputs

Value (Level 1) (Level 2) (Level 3)

S 467.206 S 467.206 S - S -46.188 - 46.188 -

8.012 8.012 - -

18.868 - 18.868 -

68.020 - 68.020 -

20.756 - 20.756 -16.724 - 16.724 -

1.788 - 1.788 -

74.330 74.330 - -

34.741 34.741 - -35.794 35.794 - -

12.041 12.041 - -45.337 45.337 - -

36.144 36.144 - -

7.212 7.212 - -

135.513 - 135.513 -97.322 - 97.322 -

51.673 - - 51.673162.488 - 2.421 160.067

160.640 - 160.640 -116.410 - 116.410 -

29.152 - 29.152 -

8.038 - 8.038 -88.394 - 88.394 -

7.036 - 7.036 -

7.124 - 7.124 -

35




(in thousanrds)

September 30, 2013

Financial assets

More,, market mutual funds

Mutual funds

Debt secwities

U S Tteasur\ obligations

Global debt mutual funds

Im estment grade cotpotate bonds

Pt i\ ate placement secut sties

Ecluit securities

Global ecluit\ mutual funds

Consumer disc!etionar\ and staples

EneTg\ and utilities

Financials

Health cage

IndustT ials and mater ials

Into oration technolog

Telecommunication sen ices

Alte! natn e investments

Ecludt short long hedge funds

Multi-sttateg\ hedge funds

Real estate funds

Pt i\ ate in estment funds

Single-stTateg\ credit hedge funds

Global macro funds

Global ecluit\ funds

Global fixed income funds

Cuttenc\ hedge funds

Beneficial mtetests in trust


Interest Late s\xap agreement

Fair Value Measurement UsingQuoted P rices




Fair Assets Inputs Inputs

Value (Level 1) (Level 2) (Level 3)

S 380.022 S 380.022 S - S -

6.315 6.315 - -

838 - 838 -

26.639 - 26.639 -

84.086 - 84.086 -

14.234 - 14.234 -

39.514 39.514 - -

68.146 68.146 - -

52.457 52.457 - -

40.404 40.404 - -

10.221 10.221 - -

34.476 34.476 - -

25.055 25.055 - -

10.887 10.887 - -

96.016 - 96.016 -

83.242 - 83.242 -

49.639 - - 49.639

97.436 - 1.317 96.119

110.056 - 110.056 -

12.617 - 12.617 -

130.255 - 130.255 -

41.149 - 41.149 -

6.580 - 6.580 -

6.892 - 6.892 -

6.408 - 6.408 -

Follo« ing is a description of the valuation methodologies and inputs used for assets and liabilitiesmeasured at fair value on a recurring basis and recognized in the accompany ing consolidatedbalance sheets. as NN ell as the general classification of such assets and liabilities pursuant to thevaluation hierarchN There have been no significant changes in the valuation techniques during theear ended September' 0. 2014 For assets classified «ithin Level 3 of the fair value hierarchN. the

process used to develop the reported fair value is described belo«

36




Investments

Where quoted market paces are available in an active market. securities are classified «tthinLevel 1 of the valuation hierarchN If quoted market prices are not available. then fair values areestimated bN using quoted paces of securities «ith similar characteristics or independent assetpacing services and pricing models. the inputs of «bich are market-based or independentlN sourcedmarket parameters. including. but not limited to. N field curves. interest rates. volatilities.prepay meats. defaults. cumulative loss projections and cash flo« s Such securities are classified inLevel 2 of the valuation hierarchN In certain cases NN here Level 1 or Level 2 inputs are notavailable. securities are classified «ithin Level 3 of the hierarchN

The value of certain investments. classified as alternative investments. is determined using net assetvalue (or its equivalent) as a practical expedient Investments for «bich Cook Children's expectsto have the abilitN to redeem its investments «ith the investee «ithin 12 months after the reportingdate are categorized as Level 2 Investments for «bich Cook Children's does not expect to be ableto redeem its investments «tth the investee «ithin 12 months after the reporting date arecategorized as Level 3

Fair value determinations for Level 3 measurements of securities are the responsibilitN of the ChiefInvestment Officer (CIO) The CIO's office challenges the reasonableness of the assumptions usedand revie« s the methodology to ensure the estimated fair value complies «ith accounting standardsgenerallN accepted in the United States

Beneficial Interest in Trusts

Fair value is estimated at the present value of the ftiture distributions expected to be received overthe team of the agreement Due to the nature of the valuation inputs. the interest is classified «tthmLevel 2 of the hierarchN

Interest Rate Swap Agreement

The fair value is estimated using fonNard-looking interest rate curves and discounted cash flo«sthat are observable or can be corroborated bN observable market data and. therefore. are classified«ithm Level 2 of the valuation hierarch

37




Level 3 Reconciliation

The follo« ing is a reconciliation of the beginning and ending balances of recurring fair valuemeasurements recognized in the accompany mg consolidated balance sheets using significantunobservable (Level 3) inputs

on thousands)

Real Private

Estate Investment

Funds Funds

Balance, October 1, 2012

Unrealized appreciation (depreciation)

during period

In\ e,,tment return during period

Purcha e' during period

Redemption during period

Balance , September 30, 2013

Unrealized appreciation

during period

In\ e,,tment return during period

Purcha e' during period

Redemption during period

Balance , September 30, 2014

$ 46.083 $ 61.727

;.;88

253

10.7»

(10.840)

4.939

190;

44.;;2

(16.782)

49.639

3.215

2.780

4.»1

(8.512)

96.119

7.289

4.;;9

74.416

(22 .096)

$ 51.67 ; $ 160.067

The unrealized appreciation (depreciation) and investment return during the period is recognized asa component of unrestricted net assets' investment return in the consolidated statements ofoperations and changes in net assets

Real estate funds are classified as Level 3 fair value investments because of the unobservableinputs involved in the investment valuation including comparable properties and adjustments formarket conditions since the most recent appraisals Private investment finds classified as Level 3fair value investments are categorized as Level 3 due to the lack of redeemabilitN/liquiditN in thefollo« ing 12 months

38




Fair Value of Financial Instruments

The following table presents estimated fair values of Cook Children's financial

instruments and the level within the fair value hierarchy at September 30, 2014 and 2013

(In thou oauid0

2014

Financial assets

Cash and cash equixalents

Assets hose use is limited

and inxestments

Beneficial interests in trusts

Pledges ieceix able

Note ieceixable


Long-ter m debt

Interest late s,%Nap

2013

Financial assets

Cash and cash equixalents

Assets hose use is limited

and inxestments

Beneficial interests in trusts

Pledges ieceix able

Note ieceixable


Long-ter m debt

Interest late s,%Nap

Fair Value Measurement Using

Quoted Prices




Assets Inputs Inputs

Carrying Value (Level 1) (Level 2) (Level 3)

$ 627.»4 $ 627.»4 $ - $ -

1.319.159 297.185 81 0,234 211.740

7.036 - 7.036 -

6.825 - 6.825 -

24220 - 17.731 -

493J82

7.124

512.914

7.124

490,441 490,441 - -

1,040,700 287.913 607.029 145.758

6.892 - 6.892 -

9.169 - 9.169 -

18.871 - 12.739 -

315.886 - 317.097 -

6.408 - 6.408 -

39




The follo« ing methods NN ere used to estimate the fair value of all other financial instrumentsrecognized in the accompan\ ing consolidated balance sheets at amounts other than fair value

Cash and Cash Equivalents

The carr\ ing amount approximates fair value

Notes Receivable

Fair value is estimated at the present value of the future pad ments expected to be received

Pledges Receivable

Fair value is estimated at the present value of the future distributions expected to be received overthe tern of the pledge Due to the nature of the valuation inputs. these assets are classified «tthmLevel 2 of the hierarch-\

Long-term Debt

Fair value is estimated based on the borro« ing rates currently available to the Cook Children's fordebt «ith similar terms and maturities and determined through the use of a discounted cash flo«model

Note 20: Significant Estimates and Concentrations

Accounting principles generally accepted in the United States of America require disclosure ofcertain significant estimates and current vulnerabilities due to certain concentrations Thosematters include the follo« ing

Allowance for Net Patient Service Revenue Adjustments

Estimates of allo« ances for adjustments included in net patient service revenue are described inNotes 1. 2 and 3

Medical Claims and Self-funded Insurance

Estimates related to the accrual of the Health Plan's medical claims and self-funded insuranceprograms are described in Notes 1 and 8

Professional Liability Claims

Estimates related to the accrual for medical malpractice claims are described in Notes 1 and 9

40




Litigation

In the normal course of business. Cook Children's is. from time to time. subject to allegations thatmaN or do result in litigation Some of these allegations are in areas not covered bN CookChildren's self-insurance program (discussed else«bere in these notes) or bN commercialinsurance. for example. allegations regarding emploN meet practices or performance of contractsCook Children's evaluates such allegations bN conducting investigations to determine the validrthof each potential claim Based upon the advice of counsel. management records an estimate of theamount of ultimate expected loss. if an. for each of these matters Events could occur that «ouldcause the estimate of ultimate loss to differ matenall-N in the near term

Investments

Cook Children's invests in various investment securities Investment securities are exposed tovarious risks. such as interest rate. market and credit risks Due to the level of risk associated «tthcertain investment securities. it is at least reasonablN possible that changes in the values ofinvestment securities NN ill occur in the near term and that such change could matenallN affect theamounts reported in the accompan\ ing consolidated balance sheets

Note 21: Subsequent Events

Subsequent events have been evaluated through the date of the Independent Auditor's Report.«hich is the date the consolidated financial statements NN ere issued

41

Supplementary Information


Balance Sheet Information - Consolidating Schedule

September 30, 2014

(In Ihoumndu

Assets

Current AssetsCa.h and ca,h equn alenh

Shot t-tel in 1m e,tinenh

Patient account , Iecenable net of allow ante

Inteicompam Iecenable,

Idxi c u1 ent a-et,

Total c u1ent a-et,

Assets NAbose Use is Limited or Restricted

Long-term Im estments

Property and Equipment, Net

Other Assets

Total a-et,

Liabilities and Net Assets

C urrent Liabilities

account, payable

Medical clam), accrued and pa) able

EStunated pa)able tot p1ote,,ional habdth

,elt-ul uance clam), c u1ent portion

Current portion of long-term debt out,tandmo

Accrued habditie, and other

Intei compam payable,

E,tunated pad able to tlmd-part) pad ol,

Total c ulent habilitie,

Estimated Payable for Professional

Liabihh Self- insurance C lama

Long-term Debt Outstanding

Total habditie,

Net assets

i T1u e,ti leted

Cool. Child en

Noncontiollmo mtele,t,

Total wue,tocted net a-et,

Tempolaol\ Ie,tocted

Pemianentl\ Ie,tticted

Total net a-et,

Total habditie, and net a-et,

Medical Physician Home Health Indemnity Rosedale Combined Eliminating Consolidated

Foundation System Center Network Health Plan Company Office Bldg Total Entries Total

$ 65 5I X $ 41 -4 $ 3X() fi-_ $ 1 1 5 5 $ 1 _ 24 $ -X _-9 $ 1- _-S $ _o 2X3 $ fi_- ;,4 $ - $ fi_- ^,4

- - - - - - -9nl - _9nl - _9nl

- - ^t4 -'oo 9 (151 4 392 - - - 9 643 9 64359 - 3 - 8 - 43- l _ 43-

3 8 ln 122n5 42-8_ 11x63 2o4 12^n6 1^^ 6( 8116 64411

693_8 ^6 112 5 ()-654 31 54- 19156 go -^t^ 2 o 331 8 1 5 -()3 (_3194 -92 5(19

_ il12 1-541 3 - - - - - 183465 - 183465

1 1 1 - 36 - - - - - 15 425 - 1 13_ -93 - 1 13_ -93

1 1 _ 543-3 5()33," 918 1 1 1 _ 6 1 - - 34521 6 l _ 5 1 8 - 6 2518

1o928 425 41310 392 1'_31 542 6 (389 x(1391

$ 1 19- -36 $ f l $ 1 - $ 4 $ $ 9o $ 36 1 4 $ 56642 $ -65 $ l _ - x89) $ _ -61 6-6

$ -45 $ 665 $ 3X 41 $ 9 194 $ 1 -o6 $_1 941 $ 1 l26 $

- 8 X>_ - - - _1 6>3 -

- - - - - - 943

- - 3X 186 - - - -2 1(14 9-5 ^l 183 18 325 1469 13 3 862

- - --a - - 2)134 1-9

_849 4649_ 13_832 2-519 31-5 4698 1

3_ $ 9- -_6 $

- 3o ini

943

- 3X 1 X6

ln>'-1

_43-

48 _2

3_ _-9X9o

19 X94) $ --X3_

- 3o ini

943

- 3X 1 X6

lXfi_i 1()44()9

43Th -

1 8'

(23193( 25669-

- - - - - -

69-

13 62- - 13 62- (3--fi) 9X^1

43)1(3)) 3239)) 4625-'o 4625-'o

4649_ X62962 2 519 31-5 469X 1 3363- 32-122 - 5 6 3- (26969( o6182

11__4 3 331 6ef--1 l3nl9 I-lo- 43X_1 _^l1 24 19541-_ (1 -, o) 19•4 n._- - 6 n--1 - - - - - fi n- ' - fi n-'

11__4 3 331 664X43 13(1(19 1-log 43X_1 2511 2-1__(1 196(1244 (12W 196(11_4

_o 465 - - - - - - - _o 465 - _o 465

52(1(9 ,_nl9 ,_nl9

1194 ^f^f- 330 664X43 l3ol9 1-lo 43X_1 _^l1 24__ii _o3_-_I (12W _(13_6l18

1 19- -36 1 lit X 1 - 1 __- - $ 4 l ,2 8 2 l _ "_ 9 i i X ii_ 36141-18 Sfi 642 $ -65 l_- ii 8 9 ) $ _ -fil fi-fi

42


Statement of Operations Information - Consolidating Schedule

Year Ended September 30, 2014

(III (/,OI,t O,H,V

Medical Physician Home Health Indemnity Rosedale Combined Eliminating Consolidated

Foundation System Center Network Health Plan Company Office Bldg Total Entries Total

IInrestncted Re%enues , Gains and

Other Support

Net patient ei%icele\enue $ - $ - $ 833384 $ 153 92 $ 383-() $ - $ - $ - $ l (C5 $ (XI 538 $ 9438()8

Lei, pio% mon tot ulcollectlble account, 5 -181 5 499 5 444 36 -24 36 -24

Net patient -en ice Ie\ enue lei, 1)1o\ i,ion tot

ulcollectlble account. - - 8n- 6o3 148 n93 32 926 - - - 988 fi_ _ (81 538) 9n- ()84

Plenuwn and capitation le\enue - - - - - 286 2,16 _ _- - _8fi __-

Ethel le\enue 4 251 141 484 ^I ll ^ 144 - 3 -()l 3 X91 _88 9 1 (,()-3-9)3-9( 81 546

Net a-eh ielea,ed horn le,tiictiom

u ed tot opelatiom 168 632 x423 989

Total wue,tileted le\enue, Haul

and other .upport 4 419 142 116 868 _-n 224 ^92 38 n-n 286 3-()l 3X91 1 -o 986 (_88 91- i 1 282 o69

Expenses and Losses

Salai ie, and wi age, 1 9-8 x(1985233 6-4 161 (l ^ 9 1 99 6o-- 463 (188 - 463 (188

Emplo\ ee benetIt, 6(13 12 15- 8 513 45526-4 1 8-1 - - 119_-3 (4 593) 114 68) )

Medical clauli, e\peme - - - - - _46 ^8n 3 1>n (83 131 1 16- oI9

) elating upplie, and e\peme. 1 498 -65 3 ,na 39 --_ _5 393 13 1 n> 231 1 nab 456 1116 988) 253 n'8

Depreciation and amort¢atlon - - -_n 36 fir- 693 32n 16 - 1 894 4- _n- - 4-

Intele't e\pen,e and tee, 19 _115 13 459 "I - 41 -649 - 611

(Gam( to,, on di,po.ition

of pi opelt^ and equipment (_8l ( 3O 31 38 (l 8_ i (l 8_

Total e pen e and lo-e, 4 ln> 123 »l 684 43- 2 2^ 313 3- -6, _98 3 8n1 3 ^^3 1 3^- 8_3 (29n -12) 1 o6- I I I

Operating Income (Loss) 314 18565 183 833 (-21 3()5 1()929 (1ooo1 ) 38 _13163 1-95 _14958

Other Income (Expense)

Ime'tmentIetun 33-13 U 341) 16- 1 214 8 34()ll - 34()ll

Change m net wuealized gam, on ime.tmenh ^8 13n ' nn' - - - - (619) - 59 513 - ?9 513

Change m tau % aloe of Intel e,t iate map - - (-16( - - - - - (-16( - (-16(

Retio,pectne piemmm ciedit l 1 613 1 -9? (1 -95

Total other uicome (e\pen.e( 91 843 843 1 14- 16- X95 8 946o3 (1 -95 9_ 8()8

Excess ( Deficiency ) ofRe%enuesO%erExpenses $ 9215- $ 194()8 $ 18498() $ (-_II $ 3()5 $ 11 (196 $ 495 $ 46 $ 3()- -66 $ 3o -66

43


Statement of Changes in Net Assets Information - Consolidating Schedule

Year Ended September 30, 2014

(In !.l0I,t0,l[,t,

Medical Physician Home Health Indemnity Rosedale Combined Eliminating ConsolidatedFoundation System Center Network Health Plan Company Office Bldg Total Entries Total

Unrestricted Net Assets

E\ce.. (detlclenc\ ) of le\ enue, o% el e^pen.e. $ 9_ 1 ?- $ 19 4() $ 1 X4 9X() $ (-'1 $ 3n> $ 11 n96 $ 49? $ 46 $ 3n- -66 $ - $ 3n- -66

Net a-et, ielea,ed horn le'tiletion aed tol

pill cha.e of pi opell and equipment - - 4 265 34 - - - - 4 61 4 61 _

Conti ibution. tot ptucha.e of pi open)

and equipment - - S - - - - - S - S

Ptucha,e of unit, to noncontiollmo mtele't - - (513) - - - - - (513) - (513)

Sale of unit, hone noncontiolling mtele,t - - 1 463 - - - - - 1 463 - 1 463

Di.tubutiom tononcontiollmo mtele.t - - (lnn3a - - - - - (l) n3.i - (l) n3a

Tiamtei, betweenattiliate. (546) (1? 3n5) -546 (-nnni (5912) 24

Inciea,e (declea,e( in tuue,ti feted net a-et, 91 611 41()() 15-414 (-3-4 3()? 11((96 (541 _4266 3()3((()1 3()3((()1

Temporarily Restricted Net Assets

Change in beneficial mtele,t in lead tiv,t 4 - - - - - - - 4 - 4

Conti ibutionm and un e,tntent iet un 11 4-1 - - - - - - - 11 4-1 - 11 4-1

Net a-et, I elea,ed h oni i e,ti ictionm (11 X'4) - - - - - - - (11 X'4) - (11 5_4

Net a-et, ti amten ed to pet manentl\ i e,tutted (55) - - - - - - - (55) - (55 )

Dec ea,e m tempos ai il\ i e,ti icted net a-et, (4()-) (4()-) (4()-

Permanently Restricted Net Assets

Change m beneficial mtele,t in peipettail tint, 14() - - - - - - - 14() - 14()

Conti ibutionm and u i% e,tment set un 3 _-15 - - - - - - - 3 2-15 - 3 2 45

Net a-et, tiamtened horn tempoiaiil\ ie,tiicted 55 55 55

Inei ea,e m pemianentl\ ie,tiicted net a-et, 3 443 3 443 3 443

Change in Net Assets 9464 41()() 15-414 1-3-4 3()5 11(196 (541-1 _-1_66 3()6()3- - 3()6(13-

Net Assets. Beginning of ]ear 1 1()(1 24() 65 23o 4-- 429 _n 353 16 5n' 32 -_5 In 9218 (46) 1 -26 691 (12()) 1 -26 -1

Net Assets, End of ]ear 119-1"- 33() ((-15-13 13()()9 1-1()- -135_1 $ _511 $ _-1o $ _()3_-_5 $ (1_()) $ _()3_6(15

44

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