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Cook Children's 2019 Annual Report

with 2018 Summary

Patients from Cook Children's


Our Promise

Knowing that every child's life is sacred, it is the Promise of Cook Children's to improve the health of every child through the prevention and treatment of illness, disease and injury.

We've worked to improve the health of children for more than 100 years, and we're proud that we've been able to serve our community and impact generations of families.

What started as a small hospital in Fort Worth has grown substantially, and we constantly evolve to provide the best care for the families who need us. Our health care system now includes a medical center, two surgery centers, a physician network, home health services and a health plan. It also includes the Child Study Center and Cook Children's Health Foundation.

With more than 60 primary, specialty and urgent care locations throughout Texas, families can access our top-ranked specialty programs and network of services to meet their unique needs. Additionally, patients travel to Cook Children's from around the country and the globe to receive lifesaving pediatric care built on leading technology, extraordinary collaboration and the art of caring.

2019 Awards and accolades

USNEWS

A GREAT honor

Two outstanding nurses from Cook Children's were named as 2019 Dallas-Fort Worth Great 100 Nurses: Director of Nursing Research Mary Cazzell, RN, Ph.D., and TCU Clinical Nurse Leader Kaylan Branson, RN, MSN, CPN.

Heroes among us

Meredith Brooks, M.D., MPH from Cook Children's Pain Management and Yvette R. Johnson, M.D., Medical Director of our Developmental Follow-up Center were named among the Fort Worth Business Press Healthcare Heroes.

Employee of the year

Dallas-Fort Worth Hospital Council selected Cook Children's Security Services Investigator Matthew Hatcher as Employee of the Year for 2019.

Leveling up

Cook Children's Medical Center was verified as a Level II Trauma Center by the American College of Surgeons (ACS) in April 2019.

Organ donation reaches platinum level

Cook Children's earned Platinum Recognition during the National Hospital Organ Donation Campaign, sponsored by the Department of Health and Human Services and the Health Resources and Services Administration. The campaign was designed to encourage hospital staff and community members to register as organ, eye and tissue donors.

Connecting globally

Fort Worth Sister Cities honored Cook Children's with their Global Nexus Award. This award is given to businesses that are connected globally and are good representatives of Fort Worth to the world, creating commerce and a healthier community for all.

Most beautiful hospital

Cook Children's was recognized by Soliant as one of the Top 20 Most Beautiful Hospitals in America in 2019. Such recognition is a credit to the meticulous work and care given to our campus by so many dedicated teams.

Cook Children's Information Services team is wired

The College of Healthcare Information Management Executives (CHIME), named Chief Information Officer (CIO) Theresa Meadows as the winner of the 2019 Federal Public Policy Award for CIO Leadership by CHIME.

A heart of gold

Cook Children's achieved gold recognition by the American Heart Association's 2019 Workplace Health Achievement Index.

Pioneering neurosurgical procedure

Pioneering neurosurgical procedure

When a child with a neurological disorder requires a surgical intervention, the experts at Cook Children's offer comprehensive care and use state-of-the-art technology like intraoperative MRI (iMRI), robotic arm assisted surgery, laser ablation, stereotactic EEG, deep brain stimulation and endoscopic neurosurgery. Our team of neurosurgeons are dedicated to bringing innovation and minimally invasive procedures, to improve overall operating time and recovery time.

In 2019, Cook Children's neurosurgeon, Daniel Hansen, M.D. began using a pioneering approach to epilepsy surgery was introduced at Cook Children's to help reduce and even prevent seizures and dramatically change the lives of young epilepsy patients.

Learn more

Physical Medicine and Rehabilitation

Physical Medicine and Rehabilitation

In August 2019, Cook Children's expanded Neurorehabilitation Services with the addition of Physical Medicine and Rehabilitation (PM&R). The new specialty augments our comprehensive approach to pediatric rehabilitation and helps improve outcomes and physical abilities in children with complex medical needs such as patients with trauma, cancer and spina bifida. PM&R can help reduce lengths-of-stay in the hospital, as well as help with transition home by providing education to parents on the child's diagnosis, consequently reducing readmissions.

Learn more

Expanding to meet the needs

Expanding to meet the needs

In keeping with our Promise to improve the health of every child, Cook Children's continues to expand our services to meet the needs of the growing communities around us. In 2019, we added facilities near Walsh in Fort Worth, in Prosper and in Carrollton with primary care, urgent care and orthopedics services.

Bringing pediatric cardiac surgery closer to home

Bringing pediatric cardiac surgery closer to home

Through a new partnership, Cook Children's and Covenant Children's are now providing expert care for the children of West Texas and New Mexico with congenital heart defects. From the simple to the rarest and most complex condition, Cook Children's and Covenant Children's are working together to diagnose and treat patients, keeping them as close to home as possible. Cook Children's Heart Center's team features more than 30 cardiologists, cardiothoracic surgeons, cardiac intensivists and cardiac anesthesiologists, and provides patient families with more than 400 years of total experience.

Cook Children's surgeons take an individualized approach to treating complex conditions. Whenever possible, the team works to partner with leading regional hospitals like Covenant Children's allowing for more complex surgical procedures to be performed closer to home. The team also takes on cases that other hospitals may shy away from treating altogether.

Covenant Children's is the largest free-standing children's hospital in West Texas and Eastern New Mexico, offering a wide range of pediatric specialty and sub-specialty care to the region.

New targeted therapy

New targeted therapy

Beginning in 2019, Cook Children's became one of only a few hospitals in the U.S. to offer targeted therapy for acute lymphoblastic leukemia (ALL) and acute lymphoblastic lymphoma (LLy). Total Therapy XVII clinical research trial is currently the best available targeted therapy for children with ALL and LLy, and is being done in partnership with St. Jude Children's Research Hospital. The primary objective of the study is to attempt to cure as many children as possible, while minimalizing side effects during therapy and long-term side effects after therapy has completed. The overall goal of this precision medicine for ALL patients is to provide them with exact doses needed and nothing more.

Listen to Kenneth Heym, M.D., talk about this revolutionary study now available at Cook Children's.

Listen now

A breakthrough for hemophilia patients

A breakthrough for hemophilia patients

While there are daily advancements being made within in the medical industry, Cook Children's is proud to be at the forefront of innovative technologies and serve as an industry leader in clinical research trials that are provided to our patients. Through the clinical research study of Total Therapy XVII and implementation of Hemlibra®, a new drug to control bleeding in hemophilia patients, and gene therapy, our Hematology and Oncology Center strives to provide our patients with treatment that is unparalled with anything else.

In 2019, Cook Children's Bleeding Disorder Program and Hemophilia Treatment Center cared for 100 hemophilia patients and 200 with variety of other bleeding disorders. Two notable clinical research programs initiated within this department were:

  • Hemlibra – treats patients with severe hemophilia A through a revolutionary practice that provides a monoclonal antibody that functions in place of a natural blood-clotting factor that is missing in people with hemophilia A. Hemlibra is used to help prevent bleeding episodes or make them occur less often.
  • Gene therapy – treats patients with both hemophilia A and B. The goal for gene therapy is to get the body to produce the missing clotting factor on its own. This would reduce or eliminate the need for injections with clotting factor, as well as reduce the number of bleeds. This is done by injecting a genetically engineered virus into the liver or a muscle, where it “infects” the body and starts expressing the protein.

Listen to Timothy McCavit, M.D., discuss how these two studies are changing lives.

Listen now

Paw-sitively excited!

Paw-sitively excited!

Welcome home to Steve and Brienne, our two new facility dogs who joined our Sit…Stay…PLAY program in September of 2019. Joining Chanel, Journey, Neely and Kitty, the trained service dogs help patients lower their stress and anxiety and encourage them to complete their health care goals. Steve (pictured right) will be working in the Child Life Zone and throughout the rest of the medical center. At just over 1 year old, Steve was the first in his litter to graduate from service animal training. He also thinks he's a 61-pound lapdog. Brienne (pictured left) will work on the fourth floor of the north tower (Rehabilitation and Transitional Care Units) and in the Special Procedures Area at the medical center. Brienne is 3 years old and loves to cuddle! Her favorite thing to do is to find the largest stick in the yard to carry around and show to her mom.

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Maternal Fetal Medicine Center

Maternal Fetal Medicine Center

High-quality care for at-risk pregnant women in West Texas is now available at Cook Children's Maternal Fetal Medicine (MFM) center in Abilene. The team, led by Holly Dunn, M.D., embraces years of experience specializing in the care and treatment of women whose pregnancies are considered high-risk. The MFM program allows Cook Children's to assess and treat moms with high-risk pregnancies and continue to care for their baby after they are born.

Learn more

Choosing comfort

Choosing comfort

Doctors' visits aren't all lollipops and superhero stickers. Sometimes, a visit to the pediatrician or hospital can include vaccinations, a blood draw or even a special procedure. To many children, these all mean one thing: pain.

In 2019, Cook Children's, staff are starting to use a visual tool to address pain management for every child, every time. The comfort menu helps clinicians engage parents in conversations about their child's pain management, and empowers patients and families to recommend pain management techniques that may work best for them.

Coping tools are not new to the staff or patients at Cook Children's, but the comfort menu is becoming standard protocol. Whether a patient is treated at the medical center, a pediatrician's office or at one of our regional clinics, the comfort menu will always be available. Techniques listed on the comfort menu include comfort positioning, breastfeeding, sugar water, distraction, “Buzzy” (a cold vibration tool) and numbing spray.

Stop the bleed, save a life

Stop the bleed, save a life

Today, we live in a world where life-threatening events are becoming increasingly more frequent. A delayed response to massive bleeding from any cause, such as a shooting, building collapse or car crash, can result in death. Through the Stop the Bleed program, Cook Children's, Fort Worth Fire Fighter Charities and the Fort Worth Fire Department are instructing teachers, churchgoers and community members how to respond and help in these situations. The team teaches proper bleeding control techniques, including dressings, tourniquets and using hands to apply pressure.

As of 2019, 88 Cook Children's employees have become instructors and now help lead community classes along with members of our Trauma Services team. With the number of school-related incidents on the rise, training school staff at our local school districts is a huge priority. Since the Stop the Bleed classes began in March 2018, approximately 4,500 school staff members have been trained through more than 110 classes.

Cook Children's Stop the Bleed team members have trained staff at the following school districts and private schools:

  • Crowley Independent School District
  • Fort Worth Christian
  • Fort Worth Independent School District
  • Godley Independent School District
  • Granbury Independent School District
  • Grapevine/Colleyville Independent School District
  • Haltom Christian School
  • Keene Independent School District
  • Pantego Christian Academy
  • Terrell Independent School District
  • Texas School of the Arts
  • Weatherford Victory Baptist Academy
  • White Settlement Independent School District

After attending the class, the individuals trained are able to act as immediate responders and can often save lives.

Generosity report

Generosity report

Cook Children's was founded on philanthropy, and the promise to care for every child in need. For more than 100 years, this community has come together to support our patients and that Promise made long ago. Each and every gift is hard at work at Cook Children's; administering innovative treatments and therapies, fueling valuable research, fighting to cure childhood diseases and, most importantly, providing hope to our patients and families.

More than 100 areas within Cook Children's Health Care System were supported by philanthropic funds, including:

Cardiology

Cook Children's Heart Center receives a number of gifts from grateful patient families whose children have spent time in our Cardiac Intensive Care Unit. Thanks to their generosity, other families are able to receive sophisticated testing and diagnostic tools, such as Holter monitors. These help us improve outcomes for patients because medical staff can diagnose any issues sooner and treatments can start without delay.

NICU/NEST

The NEST Developmental Follow-up Center team provides support for babies as they are being discharged from the Neonatal Intensive Care Unit (NICU), helping with the transition home. NEST is currently implementing a program for early detection of cerebral palsy that will include psychosocial support, mental health counseling, community referrals and regular evaluation by a NEST dietitian. Donor funding will provide “The Cerebral Palsy Tool Kit” to families with a newly diagnosed infant to help them better understand cerebral palsy and the resources and support available to them.

Child Study Center

The Child Study Center at Cook Children's began expanding the upper school, a program where students are diagnosed with developmental and learning disabilities in 2019. Renovations included the addition of an on-site mock apartment and vocational training spaces. Thanks to the generosity of donors, the mock apartment was fully furnished and equipped to allow staff to work with students on daily living skills including cooking, cleaning, budgeting and other components to manage a household.

Uncompensated care

The Children's Fund at Cook Children's has allowed patients to undergo lifesaving treatments, participate in clinical trials, and receive the quality care they deserve. By filling in the gaps left by insurance shortfalls or the inability to pay, families can focus on what's most important: their child.

Our role in the community

Our role in the community

The Center for Children's Health, led by Cook Children's, is home to the community health needs assessment and community health outreach programs focusing specifically on the prevention of injury and illness in the service area. The center's goal is to create aligned collaborations that work to make our North Texas region one of the healthiest places to raise a child.

Key community initiatives

  • Nutrition and physical activity education
  • Child passenger safety training and certification, parent education and car seat distribution events
  • Lifeguard Your Child™ drowning prevention campaign
  • Aim for Safety® initiative to protect children through safe gun storage
  • Early detection of child abuse and neglect training
  • In-home asthma education and trigger remediation program
  • Mental health educational workshops and youth art contest
  • Oral health education, treatment and kit assembly and distribution
  • Parent education and support
  • Train the Trainer programs for poison prevention and oral health
  • Community-wide education for safe baby sleep practices

Community collaborations

  • Adverse childhood experiences taskforce
  • Children's Oral Health Coalition
  • Healthy Homes Asthma program
  • Hood County for Healthy Children
  • Johnson County Alliance for Healthy Kids
  • Healthy Children Coalition of Parker County
  • Safe Baby Sleep Council
  • Safe Kids North Texas
  • Save a Smile
  • Wellness Alliance for Total Children's Health of Denton County
  • Wise Coalition for Healthy Children

How we helped

Outreach numbers

Financial statement

Net revenue: 2018 2019
Medical Center $926,927 $999,944
Physician Network $183,165 $195,651
Home Health $28,752 $30,608
Child Study Center $2,744 $3,694
Health Plan $546,073 $564,884
Investment Income $98,264 $64,252
Other Revenue $129,005 $163,992
Total sources of revenue $1,914,930 $2,023,025
 
Operating Expense $1,427,044 $1,413,832
Community Benefit $220,396 $214,166
Interest Expense and Fees $30,308 $28,049
Capital Expenditures $134,613 $82,636
Funds Available to Reinvest in Children's Health $102,569 $284,342
Total uses of revenue $1,914,930 $2,023,025
 
(dollar amounts above are in thousands)
 
Charity care at cost: 2018 2019
Cook Children's Medical Center $7,414,290 $12,060,809
Cook Children's Physician Network $1,386,815 $3,262,771
Cook Children's Home Health $107,086 $128,055
Total charity care $8,908,191 $15,451,635
 
Total uncompensated care at cost:
(charity + Medicare shortfall + Medicaid shortfall + bad debt)
2018 2019
Cook Children's Medical Center $130,933,042 $117,720,609
Cook Children's Physician Network $7,344,518 $11,680,047
Cook Children's Home Health $13,517,309 $14,602,223
Total uncompensated care $151,794,869 $144,002,879

System leadership

We offer our heartfelt thanks to the members of our leadership team who served tirelessly and helped guide Cook Children's from July 2018 through June 2019.

Jerry R. Conatser, Chairman
G. Thomas Boswell, Vice Chairman
Brian C. Crumley, Secretary/Treasurer
Larry G. Autrey
Brian D. Barnard
Ashli R. Blumenfeld
Lezlie P. Davis
Michael R. Dike
Clarabele “Pit” Dodson, Trustee Emeritus
James R. Dunaway Jr.
Richard W. Dyess
Rosalind Y. Evans
Kathryn M. Farmer
Jay L. Fierke, M.D.
Kent A. Horst
James Matthew Johnson
R. Kyle Kight
Andrew P. Lombardi
G. Malcolm Louden
Roger P. Marcincuk Jr.
Ryan T. Matthews
R. Russell Morton
Brian C. Newby
Bonnie K. Petsche
Peter L. Philpott
Cynthia R. Prince
John M. Richardson, M.D., Trustee Emeritus
Todd N. Ritterbusch
Andrew J. Rosell
Rick G. Sorenson
Rebecca M. Stupfel
James E. Webb

Jerry R. Conatser, Chairman
Matthew V. Dzurik, M.D., Vice Chairman
Jeffrey H. Conner, Secretary/Treasurer
Brian D. Barnard
G. Thomas Boswell
John P. Boswell
Samson Cantu, M.D.
Matthew B. Carroll, M.D.
Brian C. Crumley
James R. Dunaway Jr.
Jose Iglesias, M.D.
G. Malcolm Louden
Saleem I. Malik, M.D.
Jonathan H. Nedrelow, M.D.
Brian C. Newby
Lindsay D. Newton, M.D.
Bonnie K. Petsche
Alice W. Phillips, M.D.
Peter L. Philpott
Billie R. Pugh Jr., M.D.
Andrew J. Rosell
Jason V. Terk, M.D.

Brian D. Barnard, Chairman
Julee S. Morrow, M.D., Vice Chairman
Jerry R. Conatser
Jay L. Fierke, M.D.
Saideepa Murali, M.D.
Catherine Nicholas, M.D.
Peter L. Philpott
Todd N. Ritterbusch
Andrew J. Rosell
Rick G. Sorenson
Paul S. Thornton, M.D.
Kevin D. Wylie, D.O.

Bonnie K. Petsche, Chairman
M. Scott Perry, M.D., Vice Chairman
John P. Boswell
Anne M. Carvalho
Richard W. Dyess
Rosalind Y. Evans
Jason M. Kennedy, M.D.
Danny S. Rafati, M.D.

Matthew V. Dzurik, M.D., Chairman
Alice W. Phillips, M.D., Vice Chair, Primary Care
Samson Cantu, M.D., Vice Chair, Specialty Care
Jose Iglesias, M.D., Secretary
Lindsay D. Newton, M.D., Treasurer
Vida Amin, M.D.
Sara Garza, M.D.
Michelle Marcincuk, M.D.
Bradley Mercer, M.D.
Julee S. Morrow, M.D.
Maria Perez, M.D.
M. Scott Perry, M.D.
Justin Smith, M.D.

John P. Boswell, Chairman
Andrew S. Wayne, Vice Chairman
Jeffrey H. Conner, Secretary/Treasurer
Frank A. Anderson
Robert J. Batton
Anne M. Carvalho
Dana C. Kelly
Leah M. King
Joseph LaMarca Jr.
Billie R. Pugh Jr., M.D.
John M. Richardson, M.D., Trustee Emeritus
Ryan T. Senter
James E. Webb

Natalie Roberge, M.D., Chairman
Stanley E. Davis, Vice Chairman
Andrea Gonzales, Secretary/Treasurer
Nancy C. Cychol
Stephen W. Kimmel
John K. Uffman, M.D.
Andrew S. Wayne

Paul Bauer, M.D., Chairman
Stanley E. Davis, Vice Chairman
Andrea Gonzales, Secretary/Treasurer
Nancy C. Cychol
Stephen W. Kimmel
William Strand, M.D.
Andrew S. Wayne

Peter L. Philpott, Chairman
Andy J. Broadus
J. Heath Coffman
Jerry R. Conatser
Paul Coulter
Judge Jeff Cureton
Richard W. Dyess
Steve Phillips

Jonathan H. Nedrelow, M.D., President
John K. Uffman, M.D., Vice President - Quality
Donald Beam, M.D., Vice President - Credentialing
Steve Phillips
Billie R. Pugh Jr., M.D.

Pamela Pigman, President–Jewel Charity Inc.
Angela Donahue, President–Woman's Board

Cook Children's 2019 by the numbers

By the numbers

By the numbers