2014-11-17T18:09:22-06:00 2013-12-31 861065772 Deloitte Tax LLP 50 South Sixth Street Ste 2800 Minneapolis MN 55402 990 2013-01-01 411200302 Gillette Children's Hospital Foundation GILL 6512912848 200 University Avenue East St Paul MN 55101 James Haddican VP Finance 6512912848 2014-11-14 1 Kristina Rasmussen P00143920 6123974000 2013 2015-11-30 17:44:51Z James Haddican 200 University Avenue East St Paul MN 55101 27799668 0 X www.gillettechildrens.org X 1985 MN The Foundation raises money for and otherwise supports Gillette Children's Specialty Healthcare. 27 23 0 104 0 0 6577377 7214296 0 0 1014302 2293934 -247813 -397813 7343866 9110417 1497294 1639111 0 0 2072455 2140881 335034 343090 2347657 1256847 1014771 5161630 5137853 2182236 3972564 15469199 18648647 696684 725827 14772515 17922820 X The mission of Gillette Children's Hospital Foundation (Foundation) is to raise money, build awareness, and develop relationships so the mission of Gillette Children's Specialty Healthcare (Gillette) can be fulfilled. 0 0 1441648 1441648 Patient Care:The Foundation raises money to support Gillette's patient-care needs. In 2013, the largest amount of money raised for patient care went toward financial assistance and charity care to patients. Gillette offers financial aid to those who need it, whether or not they have health insurance and charity care for patients who are financially unable to pay all or part of their medical bills. See Schedule O.Gillette evaluates each situation based on a patient's income, assets and other resources, and the hospital helps patients set up manageable payment plans (including co-pays and co-insurance). For people who don't have 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 will try to qualify patients for public assistance or Gillette's charity care program. Income eligibility for Gillette's program is based on national poverty guidelines.In addition, this fundraising area provides charitable support to the many areas of Gillette's operations that are unreimbursed or under-reimbursed by third-party payers. For example, Gillette holds Outreach Clinics in 16 communities in greater Minnesota. The Outreach Clinics offer services from doctors, nurse practitioners, seating and adaptive equipment specialists, and rehabilitation engineering technologists, providing patients with more convenient and timely health care appointments. They also enhance the knowledge base of community providers and improve the quality of ongoing care available in greater Minnesota. Gillette increased its number of Outreach Clinics visits by 30% over 2012.Gillette also provides a variety of services to patients through our Child and Family Services area. Child life specialists help children and families prepare for and cope with hospital stays and medical procedures. We offer play therapy, music therapy and positive distractions to help patients understand their health-care experiences and overcome fear and anxiety. 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. Therapeutic recreation specialists help Gillette patients develop healthy lifestyles and Gillette Lifetime Specialty Healthcare offers services for patients 16 and older who have conditions that began during childhood and require lifelong specialty care. We treat the age-related effects of cerebral palsy, epilepsy, spina bifida and neuromuscular conditions. 119455 119455 Capital:The Foundation raises money to support Gillette in providing specialty health care for people who have disabilities. In 2013, the Foundation completed fundraising (through outright gifts and pledges) to help pay off our capital expansion projects, which were finished in 2013. That expansion included a new outpatient services building on our St. Paul campus, expanded space for Rehabilitation Therapies and the James R. Gage Center for Gait and Motion Analysis, expanded surgery suites and a surgery waiting area, a surgery simulation center for training, and renovated inpatient facilities in St. Paul. 78008 78008 Research/Other:The Foundation also raises money to support Gillette's ongoing research projects and education programs.During 2013, Gillette researchers focused on studies related to neurosciences, orthopedics, pain and motion analysis. For example, one study looked at long term follow-up of people who have cerebral palsy and who have undergone selective dorsal rhizotomy surgery. The study compared the differences in outcomes between those patients and patient who had alternative treatments.See Schedule O. One of the primary Foundation grants in the area of education involved funding an academically affiliated spasticity management fellowship. The fellowship helps prepare physicians who are highly qualified in spasticity management to incorporate spasticity management therapies (including, but not limited to, intrathecal baclofen therapy) into their clinical practices. 1639111 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 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 8 8 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 27 23 1 0 0 0 1 1 0 1 1 0 0 0 1 1 1 0 0 1 1 0 MN WI X Scott Ryberg 6512912848 200 University Avenue East St Paul MN 55101 Scott Ward Chairman 1.00 1.00 X X 0 0 0 Brad Keil Vice Chairman 1.00 1.00 X X 0 0 0 Fay DeBellis Secretary 1.00 1.00 X X 0 0 0 Scott Robinson Treasurer 1.00 1.00 X X 0 0 0 Barbara Joers President, CEO (Start 10/13) 15.00 40.00 X X 0 194021 9204 Margaret E Perryman President, CEO (End 10/13) 15.00 40.00 X X 0 847200 143115 Chuck Amos Director 1.00 1.00 X 0 0 0 Nancy Barnes Director (End 12/13) 1.00 1.00 X 0 0 0 Yvonne Cheek Director 1.00 1.00 X 0 0 0 John Ellenberger Director 1.00 1.00 X 0 0 0 Jeff Evanson Director 1.00 1.00 X 0 0 0 David Fettig Director 1.00 1.00 X 0 0 0 Todd Fisher Director 1.00 1.00 X 0 0 0 Robert Folkes Director 1.00 1.00 X 0 0 0 John Foster Director 1.00 1.00 X 0 0 0 John Guider Director 1.00 1.00 X 0 0 0 Diane Harper Director 1.00 1.00 X 0 0 0 Braxton Haulcy Director 1.00 1.00 X 0 0 0 Michael Healy MD Chief of Staff Elect 1.00 40.00 X 0 544992 64964 James Hynes Director 1.00 1.00 X 0 0 0 Mark Kimball Director 1.00 1.00 X 0 0 0 Dan Monson Director 1.00 1.00 X 0 0 0 Deborah S Quanbeck MD Director 1.00 40.00 X 0 513064 61980 Kristin Rassmussen Director 1.00 1.00 X 0 0 0 Debra Rowland Director 1.00 1.00 X 0 0 0 David Saggau Director 1.00 1.00 X 0 0 0 Dale Schoonover Director 1.00 1.00 X 0 0 0 Robert Wagner MD Chief of Staff 1.00 40.00 X 0 238076 46179 Warren Watson Director 1.00 1.00 X 0 0 0 Jon Galloway VP of Development 40.00 0.00 X 291340 0 42979 James Haddican VP of Finance 5.00 40.00 X 0 374112 58302 Darlis Clausen CMN Manager 40.00 0.00 X 130514 0 15698 Blaine Thrasher Supervisor Senior Gifts 40.00 0.00 X 125428 0 32202 547282 2711465 474623 3 0 1 0 NNE Marketing 754 Massachusetts Avenue Arlington MA 02476 Direct Marketing 251256 Bob Lind Group Corporation 5204 Rio Grande Drive Raleigh NC 27616 Consulting 157743 Production Solutions 1953 Gallows Road Suite 600 Vienna VA 22182 Mail Shop 101347 3 799523 6414773 1167472 7214296 188021 188021 20211945 18106032 2105913 2105913 2105913 157238 799523 579315 -422077 -422077 28168 3904 24264 24264 9110417 0 0 1896121 1628216 1628216 10895 10895 334319 334319 1806562 366725 1439837 8144 4478 3666 343090 343090 42774 26520 16254 496286 269833 226453 73819 13928 59891 96637 34359 62278 23710 11985 11725 63578 18563 45015 7849 4866 2983 Dues & Memberships 227731 46602 181129 Meals 20090 8258 11832 Minor Equipment 8980 2560 6420 Bad Debt -70201 -70201 15374 8089 7285 5137853 1639111 1151085 2347657 X 201151 1107061 1467327 8651260 1162570 764771 47364 103347 210331 287332 255132 75466 2540 179666 12042316 7200541 335600 354669 15469199 18648647 29939 14959 666745 710868 696684 725827 X 8613712 10749779 3924688 4934020 2234115 2239021 14772515 17922820 15469199 18648647 3972564 -822259 0 X 0 1 X 1 0 X X X 0 0 0 Gillette Children's Specialty Healthcare 363379150 3 1 1 1 1573251 1 1573251 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3365618 105570 303267 362928 128836 3282691 3365786 79278 480113 446878 112681 3365618 3791838 8432 56433 369299 121618 3365786 3708926 7209 402507 180146 146658 3791838 3346189 67528 445743 48639 101895 3708926 0.68000 0.32000 0 0 255132 75466 179666 179666 Gift Annuity Liability - Wisc 65578 Gift Annuity Liability 63740 Due to Medical Center 581550 710868 X 8876169 -822263 4796 583219 -234248 9110417 0 9110417 5725868 4796 583219 588015 5137853 0 5137853 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 the 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, 2013 and 2012. Part XI, Line 2d - Other Adjustments: Special events expense 583,219. Part XII, Line 2d - Other Adjustments: Special events expense 583,219. X X X X X X 1 NNE Marketing 754 Massachusetts Avenue Arlington MA 02476 Direct Mail 0 215270 251255 -35985 Strategic Fundraising 7591 Ninth Street N Oakdale MN 55128 Telefundraising 0 123331 91833 31498 338601 343088 -4487 MN WI Friends of Gillette Event 291618 244418 47200 85086 Laugh Out Loud 259535 213891 45644 242294 6 405608 341214 64394 251935 956761 799523 157238 579315 579315 -422077 28168 3904 0 28168 3904 3904 24264 MN 1 A license is not required in the State of Minnesota for 5 or fewer raffles. The Foundation held 5 raffles this year. A State exempt permit was obtained on each of them. 0 1 0 0.00000 1.00000 Scott Ryberg 200 University Avenue East St Paul MN 55101 0 Jon Galloway 0 Mr. Galloway oversees gaming activities conducted during the year. X 0 Schedule G, Part I, Line 2b, Column (v) Gillette retains NNE Marketing, a direct response agency, to help with fundraising efforts. The amount paid to NNE in 2013 was $251,255, which includes payment for printing and production costs that NNE in turn paid out to printers and database contractors. Gillette's direct response program strategy is twofold: 1) to acquire new donors at an acceptable new donor investment level and 2) to increase the number of donors who support the Foundation year over year and create positive giving relationships with those donors. Gillette is measuring and seeing improvement in both of these strategic initiatives. SFI Nonprofit is a telefundraising firm that Gillette retains to execute a telefundraising program. We use telefundraising to gain additional gifts from current donors at a net profit. We also use telefundraising to acquire new donors, an investment we intentionally make in order to increase the number of people donating to Gillette. This is a necessary investment to raise even more money in future years. 1 Handi Medical 2505 University Avenue West St Paul MN 55114 411668164 5246 FMV Adaptive Equipment Technology for Education 4131 Old Sibley Mem Hwy Ste 200 Eagan MN 55122 411814073 8620 FMV Adaptive Equipment Gillette Children's Specialty Healthcare 200 University Avenue East St Paul MN 55101 363379150 501(c)(3) 1573251 FMV General Support 1 2 Patient Care Grants 17 10895 FMV Part I, Line 2: Members of Gillette's hospital 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 Type II support organization pursuant to IRC section 509(a)(3), Reg. 1.509(a)-4(f)(2)(ii), 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 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. X X X X X 0 1 0 0 0 0 0 1 0 Barbara Joers President, CEO (Start 10/13) 0 86490 0 90000 0 17531 0 0 0 9204 0 203225 0 0 Margaret E Perryman President, CEO (End 10/13) 0 514010 0 191386 0 141804 0 117658 0 25457 0 990315 0 52288 Michael Healy MD Chief of Staff Elect 0 496948 0 10643 0 37401 0 27064 0 37900 0 609956 0 0 Deborah S Quanbeck MD Director 0 461105 0 625 0 51334 0 13490 0 48490 0 575044 0 0 Robert Wagner MD Chief of Staff 0 215585 0 625 0 21866 0 11910 0 34269 0 284255 0 0 Jon Galloway VP of Development 218553 0 54662 0 18125 0 37115 0 5864 0 334319 0 0 0 James Haddican VP of Finance 0 253047 0 79491 0 41574 0 26975 0 31327 0 432414 0 0 Blaine Thrasher Supervisor Senior Gifts 124702 0 625 0 101 0 7016 0 25186 0 157630 0 0 0 Part I, Line 3 The chair of Gillette's personnel committee requests information from the external consultant. The personnel committee is empowered to evaluate the reasonableness of compensation and other financial transactions in which the Foundation is engaged. 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 personnel 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 personnel committee meetings. Meeting minutes are recorded. Part I, Line 4b Certain employees of Gillette are provided the opportunity to participate in various non-qualifed compensation plans organized under code section 457(f). The exact purpose of each plan varies but they include: compensation limitation make-up plans, supplemental retirement benefits and capital accumulation. All plans are administered by Gillette. The following employees received payments from the non-qualified deferred compensation plans in 2013, which have been previously reported as amounts deferred on a prior Form 990: Margaret Perryman - $52,288 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 Personnel Committee of the Board of Directors. X 20 1162676 Cost or selling price X In-Kind Donat 2 4796 Cost or selling pric 0 0 1 1 Part I, Column (b): This is the number of contributions. Part I, Line 32b: The Foundation used Wells Fargo to manage stock donations until June 2013. The Foundation used Charles Schwab and Twele Capital Management, Inc. to manage stock donations June through December. Form 990, Part VI, Section A, line 2 Members of Gillette's hospital 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. The following individuals have a business relationship: Chuck Amos Nancy Barnes Yvonne Cheek Fay DeBellis John Ellenberger Jeff Evanson David Fettig Todd Fisher Robert Folkes John Foster John Guider Diane Harper Braxton Haulcy Michael Healy, MD James Hynes Barbara Joers Brad Keil Mark Kimball Dan Monson Margaret E. Perryman Deborah S. Quanbeck, MD Kristin Rassmussen Scott Robinson Debra Rowland David Saggau Dale Schoonover Robert Wagner, MD Scott Ward Warren Watson James Haddican Form 990, Part VI, Section A, line 6 The Foundation has a sole member, Gillette Children's Speciality 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 11 A copy of the form 990, including all supplemental schedules except schedule B, was provided to every member of the governing body before it was filed. Schedule B was redacted in order protect donor confidentiality. The form was completed by a committee that included representatives from finance, human resources and communications. This committee prepared all the documentation necessary; the forms were compiled by Gillette's accounting firm. The draft documents were then reviewed by representatives from our Administrative Council. 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. In fact, 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. At the request of the personnel committee of the Gillette board, an independent consultant provides the committee with survey data along with its needs and expenses for patient care, under- and uncompensated care, and recommendations for chief executive officer (CEO)/president and other executive salary ranges. The ranges are developed by the external consultant based on Gillette's compensation philosophy, which was developed by the personnel committee and is reviewed regularly. The members of this committee determine the CEO/president's salary and the salary ranges for other executives. The committee oversees the executive incentive plan, approves any incentive plan payouts, and regularly evaluates the benefits provided to executives. The external consultant has provided an opinion that the CEO/president's total compensation is well within the standards of reasonableness and fair market value. In addition to the oversight function of executive total compensation, the personnel committee oversees any payments under any incentive compensation plans and evaluates all transactions with "disqualified persons." Form 990, Part VI, Section C, line 19 Gillette posts an abbreviated audited financial statement to its website, www.gillettechildrens.org. Gillette's 990 form is available from the states of Minnesota and Wisconsin and at Guidestar.org. Gillette discloses financial statements to bondholders, the MHA and the Minnesota attorney general's office. The governing documents and conflict of interest policy are made available to the public upon request. Form 990, Part VI, Section B, Line 14: Foundation employees are expected to follow all hospital policies. The code-of-conduct, document-retention, and document-destruction policies authorized by the hospital hence are followed by the Foundation staff. Gillette Children's Specialty Healthcare 200 University Avenue East St Paul MN 55101 363379150 Healthcare MN 501(c)(3) Line 3: 170(b)(1)(a) N/A 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1