2020-11-10T08:13:37-06:00 2019-12-31 861065772 Deloitte Tax LLP 50 South Sixth Street Ste 2800 Minneapolis MN 55402 990 2019-01-01 411200302 Gillette Children's Hospital Foundation GILL 6512912848 200 University Avenue East St Paul MN 55101 Patrick Nolan Vice President, Finance 6512912848 2020-11-04 1 Kristina Rasmussen P00143920 6123974000 27.62.191.125 2020-11-10 01:15:24 US P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 F8AE3CF70B6D5343795F499A8FB4AE99E74455CD 2019 2021-01-29 14:40:06Z Dennis Jolley 200 University Avenue East St Paul MN 55101 20441341 0 X www.gillettechildrens.org X 1985 MN The mission of Gillette Children's Hospital Foundation is to support the mission and vision of Gillette Children's Specialty Healthcare. 17 15 0 220 0 0 11989114 5731642 0 0 795336 936398 -85491 -82680 12698959 6585360 1467978 5004537 0 0 1314372 1374262 0 36010 1848158 1374060 1262509 4156410 7677318 8542549 -1091958 29471447 30727868 671791 1237105 28799656 29490763 X The mission of Gillette Children's Hospital Foundation (Foundation) is to raise money, build awareness, and develop relationships in support of the patient care, education and research activities of Gillette Children's Specialty Healthcare. 0 0 2211761 2211761 Research: Gillette research activities concentrate on clinical applications devoted to finding effective medical interventions for disabling conditions and their related effects. Research at Gillette consists of fourteen emphasis areas, all of which seek to improve the lives of children who have disabilities and complex conditions. These areas include bone health, cerebral palsy, craniofacial, epilepsy, gait and motion analysis, Legg-Calve-Perthes Disease, musculoskeletal, neuromuscular disease, pain and comfort, Rett syndrome, spina bifida, spine, upper extremities and nursing research.During 2019, over 228 active studies were underway and 58 studies were published in peer-reviewed journals and manuscripts. Following are several examples of research studies and advancements:Gillette is working to understand how the social determinants of health impact the health of medically complex children. Research is underway to evaluate the prevalence of the social determinants of health in our patient population, to identify potential relationships between the social determinants of health and health outcomes, and to improve comprehensive care management to address disparities created by the social determinates of health. Gillette is a leader in pediatric rehab medicine. Work is underway to better measure motor control following a pediatric traumatic brain injury (TBI), as current outcome measures of recovery of walking ability after a TBI are indirect and subjective. The goal of this study is to test the usefulness of an objective measure of dynamic motor control to assess recovery from a TBI. Gillette is a leader in the research and treatment a rare orthopedic condition called Legg-Calve-Perthes (LCP) disease. Investigators are currently working to develop a minimally invasive animal model of LCP to better understand the etiology of this disease which will lead to work on prevention of the sequelae and impact on individuals who present with LCP. Ongoing clinical and pre-clinical studies have prognostic, diagnostic, and therapeutic implications for treatment of LCP. Gillette research teams are working to understand the impact of virtual reality as an adjunct to pediatric cast removal. Virtual reality has the potential to distract children during cast removal through suppression of both auditory and visual aspects of the procedure. The primary objective of this work is to decrease the pain experience during what can feel like an invasive procedure for children. 1706000 1706000 Patient Care: The Foundation raises money to support activities related to the Gillette mission. This includes offering financial aid to patients based on need, whether or not they have health insurance, and offering charity care to patients who are financially unable to pay all or part of their medical bills. Gillette evaluates each situation based on a patient's income, assets and other resources, and the hospital assists with establishing manageable payment plans (including co-pays and co-insurance). For people without insurance, Gillette charges for care in accordance with the 501(r) guidelines.If patients inform Gillette that they will have a difficult time meeting their financial obligations, Gillette helps patients in their efforts to qualify for public assistance or the Gillette charity care program. Income eligibility for the program is based on national poverty guidelines. Gillette will never turn away a family due to an inability to pay for treatment. The Foundation also provides grants to support startup and expansion for new and/or strategic patient care initiatives. This includes areas such as the Gillette Pediatric Spine Institute, which advances the care of children with spine conditions, including scoliosis. This initiative centers around three pillars: (1) excellence in clinical care and outcomes, (2) research that investigates long-term outcomes, care innovation, and knowledge translation, and (3) education of future experts in spine care.Additionally, funds raised by the Foundation support areas of Gillette operations that are unreimbursed or under-reimbursed. For example, Gillette operates outreach clinics in communities in greater (largely rural) Minnesota. However, in providing these services, Gillette incurs losses. Gillette outreach clinics offer appointments with doctors, nurse practitioners, and seating and adaptive equipment specialists. Outreach clinics also help with care coordination and education for community providers in the specialized needs of Gillette patients living in their communities. Similarly, Gillette provides a variety of services to patients through our Child and Family Services area that are unreimbursed or under-reimbursed. Child life specialists, for example, help children and families prepare for and cope with hospital stays and medical procedures. Social workers provide emotional support and help with practical concerns for families of children who have disabilities, such as ordering medical equipment and finding transportation or other resources. 1086776 1086776 Capital: The Foundation raises funds to support Gillette Children's Specialty Healthcare's mission of providing specialized health care for children and adults who have complex and rare medical conditions. The Foundation's support allows Gillette to further its vision of helping patients realize their full potential. This includes raising contributions for improvements to capital assets of Gillette Children's Specialty Healthcare, which ensures modern, efficient and effective technology and resources are available to serve our patients.During 2019, Gillette transferred funds for capital projects related to various projects such as Mobile CT imaging and support for Gillette's Pediatric Spine Institute, including capital investments in technology such as EOS and LessRay imaging systems, and a 3-D robot carver. 5004537 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 1 0 1 1 1 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 17 15 1 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 1 0 MN WI X Kyle Eidem 6512912848 200 University Avenue East St Paul MN 55101 John Foster Chair 1.00 1.00 X X 0 0 0 John Ellenberger Vice Chair 1.00 1.00 X X 0 0 0 Dan Monson Secretary 1.00 1.00 X X 0 0 0 David Bestler Treasurer 1.00 1.00 X X 0 0 0 Barbara Joers President & CEO 5.00 50.00 X X 0 835753 75127 Phil Becker Director 1.00 1.00 X 0 0 0 David Fettig Director 1.00 1.00 X 0 0 0 Jeffrey Freyer Director 1.00 1.00 X 0 0 0 Tenner Guillaume MD Chief of Staff (Start 1/19) 1.00 49.00 X 0 812568 46591 Diane Harper Director 1.00 1.00 X 0 0 0 Linda Ireland Director 1.00 1.00 X 0 0 0 Mark Kimball Director 1.00 1.00 X 0 0 0 Kevin Klemz Director (End 1/19) 1.00 1.00 X 0 0 0 Julie Neville Director (Start 1/19) 1.00 1.00 X 0 0 0 Thomas Novacheck MD Chief of Staff (End 1/19) 0.50 49.50 X 0 716083 77824 Scott Robinson Director 1.00 1.00 X 0 0 0 Rulon Stacey Director 1.00 1.00 X 0 0 0 Marshall Stanton MD Director (End 4/19) 1.00 1.00 X 0 0 0 Phillip Trier Director 1.00 1.00 X 0 0 0 Kathy Tune Director (Start 4/19) 1.00 1.00 X 0 0 0 Martin Brad Winges Director (End 4/19) 1.00 1.00 X 0 0 0 Dennis Jolley Foundation President 5.00 45.00 X 35010 315094 33495 Kate Abbott Executive Director 50.00 0.00 X 181530 0 10661 Rachel Wobschall Senior Major Gifts Officer 50.00 0.00 X 126792 0 20013 343332 2679498 263711 2 0 1 0 0 765218 4966424 80351 5731642 909046 909046 13703790 13676438 27352 27352 27352 80800 765218 171945 -91145 -91145 16063 7598 8465 8465 6585360 0 0 853718 4942711 4942711 28655 28655 33171 33171 230549 230549 926370 110297 816073 41653 3051 38602 96196 20133 76063 79494 21790 57704 36010 36010 50696 50696 12234 6439 5795 180364 47399 132965 12023 5190 6833 69803 31411 38392 23977 6122 17855 16258 5477 10781 Intercompany Expenses 526391 236389 290002 Dues & Memberships 419197 49646 369551 Other Expenses 290 34 256 Bad Debt -48724 -48724 7677318 5004537 824623 1848158 12031584 10707191 6460437 0 327431 79366 16744 46247 288323 307739 184975 184975 0 0 10346928 19587325 29471447 30727868 84011 21320 50257 32000 537523 1183785 671791 1237105 X 14981365 17491937 13818291 11998826 28799656 29490763 29471447 30727868 -1091958 1817525 -34460 0 X 0 1 X 1 0 X 6406365 7244908 6895732 11989114 5731642 38267761 6406365 7244908 6895732 11989114 5731642 38267761 16647057 21620704 276382 243654 515537 789970 909046 2734589 227310 157898 209689 171797 96863 863557 41865907 0.51640 X Schedule A, Part II, Line 10, Explanation of Other Income: Gross fundraising events - 2015 Amount: $ 191,663. 2016 Amount: $ 130,248. 2017 Amount: $ 151,360. 2018 Amount: $ 130,266. 2019 Amount: $ 80,800. Gross gaming activities - 2015 Amount: $ 35,647. 2016 Amount: $ 27,650. 2017 Amount: $ 58,329. 2018 Amount: $ 41,531. 2019 Amount: $ 16,063. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3521471 100992 242032 383447 0 3481048 3379948 305455 -44439 22083 97420 3521461 3508732 225153 63058 328980 88015 3379948 3799706 183272 27865 406953 95158 3508732 3880733 145615 -15453 99923 111266 3799706 0.00000 0.68000 0.32000 0 0 184975 184975 0 0 Gift Annuity Liability 76830 Due to Gillette Children's Specialty Healthcare 1106955 1183785 X Part V, Line 4: The Foundation has endowment funds for capital, charity care, patient care, research and education, and unrestricted needs. These funds are used to improve and provide health care and related services to patients of Gillette. Part X, Line 2: As a result of the implementation of authoritative guidance on the accounting for uncertainty in income taxes, the organization was not required to recognize a liability. There were no unrecognized tax liabilities for the years ended December 31, 2019 and 2018. 1 0 0 0 0 0 0 0 0 0 North America Adaptive Equipment 33171 Electronic fund/wire transfer 0 1 0 0 0 0 0 0 Part I, Line 2: Funds held by the Foundation may be granted to various organizations pursuant to the restrictions of the particular fund. Gillette leaders are responsible for reviewing and authorizing all grants to outside parties, in accordance with fund restrictions. Financial reports and records are maintained by Gillette and Foundation staff for all grants and assistance award by the Foundation. Part III Accounting Method: X 1 Allegiant Direct 278 Franklin Rd Ste 290 Brentwood TN 37027 Mail Solicitations 0 35608 36010 -402 35608 36010 -402 MN WI Mauer & Friends 439998 427398 12600 48703 Friends of Gillette 203575 174775 28800 61539 3 202445 163045 39400 61703 846018 765218 80800 171945 171945 -91145 16063 7598 1 1.00000 16063 7598 7598 8465 MN 1 A license is not required in the State of Minnesota for five or fewer raffles. The Foundation held three raffles this year. A State exempt permit was obtained on each of them. 0 1 0 0.00000 1.00000 Kyle Eidem 200 University Avenue East St Paul MN 55101 0 Dennis Jolley Oversight of all gaming activities X 1 8465 1 Gillette Children's Specialty Healthcare 200 University Avenue E St Paul MN 55101 363379150 501(c)(3) 4821288 General Support Northern Engineering & Manufacturing Inc 11841 243rd Ave NW Zimmerman MN 55338 411817420 10990 Adaptive Equipment Mobility and Access Inc 1003 International Drive Oakdale PA 15071 208037554 9257 Adaptive Equipment Handi Medical 2505 University Ave W St Paul MN 55114 411668164 8517 Adaptive Equipment Nustep LLC 5111 Venture Drive Suite 1 Ann Arbor MI 48108 383347347 11040 Adaptive Equipment Reliable Medical Supply 9401 Winnetka Ave N Brooklyn Park MN 55445 411631370 10305 Adaptive Equipment Strauss Skates & Bicycles 1751 Cope Ave E Maplewood MN 55109 411446679 35072 Adaptive Equipment 1 6 Adaptive Equipment 15 28655 FMV Part I, Line 2: Members of Gillette Children's Specialty Healthcare board are also members of the Foundation board, resulting in common control of both entities and the sharing of community oversight, strategic planning, financial oversight, and fundraising responsibilities equally among all board members. As a public charity as described in IRC section 509(a)(1) and 170(b)(1)(A)(vi) , the Foundation grants monies to Gillette and maintains endowment funds, restricted and unrestricted assets, and contributions received to benefit Gillette. These funds held by the Foundation are granted to Gillette and other organizations pursuant to the restrictions of the particular fund. Periodically, the Foundation receives financial reports from Gillette documenting the use of monies, including endowment funds, restricted funds, and unrestricted funds, received by Gillette. 1 X X X X 0 1 0 0 0 0 0 1 0 Barbara Joers President & CEO 0 595740 0 147513 0 92500 0 39502 0 35625 0 910880 0 0 Tenner Guillaume MD Chief of Staff (Start 1/19) 0 748968 0 700 0 62900 0 14840 0 31751 0 859159 0 0 Thomas Novacheck MD Chief of Staff (End 1/19) 0 629610 0 17500 0 68973 0 14840 0 62984 0 793907 0 0 Dennis Jolley Foundation President 26306 236751 4300 38705 4404 39638 1607 14467 1741 15680 38358 345241 0 0 Kate Abbott Executive Director 180866 0 250 0 414 0 9646 0 1015 0 192191 0 0 0 Part I, Line 3: The chair of Gillette's Executive Committee requests information from the external consultant. The Executive Committee is empowered to evaluate the reasonableness of compensation. It does so in all cases by referencing recognized, objective resources on the reasonableness of and market value for the types of personnel and services being considered. That data is prepared for and distributed to the Executive Committee members. Compensation policy is approved by the board of directors. Actions related to CEO/president and other executive compensation are discussed and voted upon at Executive Committee meetings. Meeting minutes are recorded. Part I, Line 4b: Certain Gillette employees (executives and physicians) are eligible to participate in non-qualified deferred compensation plans. These plans comply with Section 457(f) of the Internal Revenue Code. These plans require employees to be executives or physicians to participate. Payments from the Plan occur annually by July 1 of the year following the end of the Plan year. The Plan is a "gap" plan, which provides participants with a deposit that closes the gap between the limits of IRC 403(b) and the actual cash compensation of the participant. None of the individuals received payments from the plans. Part I, Line 7: Certain employees are eligible for an annual one-time award to recognize employees. The amount and payment of the award is made at the discretion of the Board of Directors. X 9 80351 Cost or Selling Price 0 0 1 0 Part I, Column (b): The organization used the number of contributions received. Form 990, Part VI, Section A, line 2 Members of the Gillette Children's Specialty Healthcare (Hospital) board are also members of the Gillette Children's Hospital Foundation (Foundation) board, resulting in common control of both entities and the sharing of community oversight, strategic planning, financial oversight, and fundraising responsibilities equally among all board members. The following individuals have a business relationship: Barbara Joers, Dan Monson, David Bestler, David Fettig, Dennis Jolley, Diane Harper, Jeffrey Freyer, John Ellenberger, John Foster, Julie Neville, Kathy Tune, Kevin Klemz, Linda Ireland, Mark Kimball, Marshall Stanton, Martin (Brad) Winges, Phil Becker, Philip Trier, Rulon Stacey, Scott Robinson, Tenner Guillaume, Thomas Novacheck, MD Form 990, Part VI, Section A, line 6 The Foundation has a sole member, Gillette Children's Specialty Healthcare, a Minnesota nonprofit corporation. Form 990, Part VI, Section A, line 7a The Foundation has a sole member, Gillette Children's Specialty Healthcare, a Minnesota nonprofit corporation, which elects all members of the Foundation board. Form 990, Part VI, Section B, line 11b A copy of Form 990, including all supplemental schedules except Schedule B, was provided to every member of the governing body before filing the form. Schedule B was redacted in order to protect donor confidentiality. A committee including representatives of executive leadership and subject matter experts completed the form. This committee prepared all the documents necessary; Gillette's accounting firm compiled the forms. Draft documents were reviewed by executive leadership representatives. After all internal reviews were complete, the final version was presented to the finance committee and the board of directors for approval. Form 990, Part VI, Section B, line 12c Gillette enforces policies on external professional activities. Gillette employees, officers, volunteers, board members, and medical staff members are expected to disclose outside activities that involve potential conflicts of interests. Directors must sign a conflict of interest statement acknowledging any potential conflicts related to Gillette. Gillette requires staff members to discuss potential conflicts with their immediate manager and with the compliance officer. The disclosure includes a written description of the activity, the extent of the staff member's participation, and the possible duration of the relationship. If a conflict exists, the employee must not engage in the activity. Form 990, Part VI, Section B, line 15 Foundation staff members are employed by Gillette. Gillette is the organization that actually pays the compensation and has the process for determining compensation as stated below. As directed by the Executive Committee of the Gillette Board of Directors, an independent consultant provides the committee with survey data containing recommendations for the CEO and other executive salary ranges. The ranges are developed by the external consultant based on Gillette's compensation philosophy, which was developed by the Committee and adopted by the Board of Directors. The compensation philosophy is reviewed regularly. The members of the Committee determine the CEO salary and the salary ranges for other executives. The committee oversees the executive incentive plan, approves incentive plan payouts, and regularly evaluates the benefits provided to executives. The external consultant has provided total compensation data for all executives, and the committee has diligently followed the process for establishing a presumption of reasonableness. In addition to the oversight function of executive total compensation, the committee oversees payments under any incentive compensation plans, and evaluates all transactions with "disqualified persons." Form 990, Part VI, Section C, line 19 Audited financial statements are available upon request and via www.gillettechildrens.org. Gillette's 990 form is available from the states of Minnesota and Wisconsin and at Guidestar.org. Gillette discloses consolidated financial statements to bondholders, the Minnesota Hospital Association, and the Minnesota Attorney General office. The governing documents and conflict of interest policy are made available to the public upon request. Gillette Children's Specialty Healthcare 200 University Avenue East St Paul MN 55101 363379150 Hospital MN 501(c)(3) 3 N/A 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0