2011-11-14T15:49:02-06:00 2010-12-31 DELOITTE TAX LLP 50 SOUTH SIXTH STREET STE 2800 MINNEAPOLIS MN 55402 990 2010-01-01 411200302 Gillette Children's Hospital Foundation GILL 6512912848 200 University Avenue East St Paul MN 55101 JAMES HADDICAN 6512912848 2011-11-08 1 Kristina Rasmussen 6123974000 2010 2016-02-24 21:20:13Z James Haddican 200 University Avenue East StPaul MN 55101 11746318 0 X WWW.GILLETTECHILDRENS.ORG X 1985 MN The Foundation raises money for and otherwise supports Gillette Children's Specialty Healthcare. 24 18 0 81 0 0 7087719 6758539 0 0 -249671 493383 -13615 -27440 6824433 7224482 1417107 3966306 0 0 1940318 1982285 190055 72136 2775027 1854662 1880527 5402142 7901254 1422291 -676772 14486626 15317321 53173 783419 14433453 14533902 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 3368967 3368967 Capital:The Foundation raises money to support Gillette in providing specialty health care for people who have disabilities. In 2010, the largest capital fundraising expenditures involved renovating and expanding Gillette's hospital facilities in St. Paul. To accomodate significant growth, Gillette embarked on a major expansion in 2010 - including a 10-bed Pediatric Intensive Care Unit (PICU) and a 52,000-square-foot patient care building. Gillette's new and larger PICU serves a growing surgical practice and Regions Hospital's Level I Pediatric Trauma Center, which Gillette supports.See Schedule OThe unit's technology and design enhance patient safety and privacy. The 10 private rooms each have their own nursing stations and space for a parent or caregiver to stay overnight.Gillette's new patient care building houses Rehabilitation Therapies and the James R. Gage Center for Gait and Motion Analysis. Connected to the main hospital by skyway, the new building provides more space for motion analysis research and enhances the rehabilitation experience of patients. 538405 538405 Patient Care:The Foundation raises money to support Gillette's patient-care needs. The second-largest fundraising area in 2010 involved charitable support for Gillette's outpatient clinics. In 2010, Gillette had 125,448 outpatient visits-excluding casting, X-ray, advanced imaging, and neurodiagnostic services-from people with many chronic and acquired conditions, including cerebral palsy, spinal-cord injuries, spina bifida, brain injuries, complex orthopaedic needs, neurological disorders, craniofacial anomalies and juvenile arthritis. Outpatient appointments for all services came to 132,962. 58934 58934 Research & Education:The Foundation also raises money to support Gillette's ongoing research projects and education programs. During 2010, Gillette researchers focused on studies including:-The quality of life for families after sleep intervention -Characteristics of a successful transition to adult independence for young adults who have spina bifida-Whether intrathecal baclofen is associated with changes in the frequency or progression of scoliosis. See Schedule OEach year, Gillette doctors and staff publish research studies in medical journals and speak at medical conferences. Through its priority areas for coordinated research, Gillette is working to increase the amount and quality of clinically relevant research conducted in the organization. 3966306 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 0 0 1 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 1 1 1 0 0 0 X 24 18 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 0 0 1 1 0 MN WI X Scott Ryberg 6512912848 200 University Avenue East St Paul MN 55101 X Deborah Quanbeck MD 1.00 X 0 403082 44087 Carol Clark 1.00 X 0 0 0 John Diehl 1.00 X X 0 0 0 Bonnie Dougherty 1.00 X 0 0 0 Heidi Erspamer 1.00 X 0 0 0 Todd Fisher 1.00 X 0 0 0 David Glaser 1.00 X 0 0 0 James Hynes 1.00 X 0 0 0 Theresa McEnaney 1.00 X 0 0 0 Bruce O'Brien 1.00 X 0 0 0 Margaret Perryman 15.00 X X 0 834194 102570 Jerome Kahnke 1.00 X 0 0 0 Scott Ward 1.00 X X 0 0 0 Cassandra Warner 1.00 X 0 0 0 Beverly Wical MD 1.00 X 0 203941 29326 Braxton Haulcy 1.00 X 0 0 0 Michael Partington MD 1.00 X 0 565360 44993 Chuck Amos 1.00 X 0 0 0 James Bradshaw 1.00 X 0 0 0 Jeff Evanson 1.00 X 0 0 0 John Guider 1.00 X 0 0 0 Robert Folkes 1.00 X X 0 0 0 Robert Long 1.00 X 0 0 0 Dale Schoonover 1.00 X X 0 0 0 James Haddican 5.00 X 0 305714 51633 Jon Galloway 40.00 X 304528 0 31303 Scott Nelson 40.00 X 106194 0 16084 Darlis Clausen 40.00 X 116619 0 12560 Blaine Thrasher 40.00 X 107238 0 17895 634579 2312291 350451 4 0 1 0 Russ Reid 14384 Collection Center Drive Chicago IL 60693 Direct Mail 573642 Gabriel Degrood Bendt LLC 608 2nd Avenue S Suite 129 Minneapolis MN 55402 Advertising 294467 2 302521 6456018 38618 6758539 198361 198361 4693751 4398729 295022 295022 295022 95667 302521 123107 -27440 -27440 7224482 0 0 465943 3960398 3960398 5908 5908 335830 335830 1646455 209251 1437204 67130 14584 52546 72136 72136 57658 57658 957243 267801 689442 294687 138060 156627 65929 24757 41172 38963 16733 22230 27024 11858 15166 55440 12326 43114 2300 1078 1222 Dues & Memberships 209427 0 34754 174673 Bad Debt 42350 0 0 42350 Food for Meetings 25203 0 14910 10293 Misc. Expense 17919 0 13844 4075 Minor Equipment 17556 0 6206 11350 1698 271 1427 7901254 3966306 1159921 2775027 X 532773 173240 2662403 2630994 878265 897375 71911 121237 189595 189595 98501 91361 9440 7140 9596583 10998034 545656 299706 14486626 15317321 16004 53173 767415 53173 783419 X 6562222 8705336 5637866 3594951 2233365 2233615 14433453 14533902 14486626 15317321 X -676772 777221 X X 0 1 1 X 0 X X X 0 0 0 Gillette Children's Specialty Healthcare 363379150 3 1 1 1 3906935 1 3906935 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3708926 7209 402507 180146 146658 3791838 3346189 67528 445743 48639 101895 3708929 3913887 265401 -667021 63695 102383 3346189 0.59000 0.41000 0 0 98501 91361 7140 7140 Gift Annuity Liability - Wisc 96788 Gift Annuity Liability 70772 Due to Medical Center 599855 767415 7224482 7901254 -676772 777221 777221 100449 8126810 777221 2000 123107 902328 7224482 0 7224482 8026361 2000 123107 125107 7901254 0 7901254 Description of Intended Use of Endowment Funds: 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. Description of Uncertain Tax Positions Under FIN 48: Part X: 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, 2010 and 2009. Part XII, Line 2d - Other Adjustments: Special Events Expense 123,107. Part XIII, Line 2d - Other Adjustments: Special Events Expense 123,107. X X X X X X 1 Strategic Fundraising 7591 Ninth St No Oakdale MN 55128 Telefundraising 0 99325 72136 27189 99325 72136 27189 MN WI Golf Event 77425 55669 21756 32017 Friends of Gillette Event 258361 203161 55200 66628 1 62402 43691 18711 24462 398188 302521 95667 123107 123107 -27440 1 GILLETTE CHILDREN'S SPECIALTY HEALTHCARE 200 UNIVERSITY AVENUE EAST ST PAUL MN 55101 363379150 501(C)(3) 3906935 FMV General Support REGION'S HOSPITAL 640 JACKSON ST ST PAUL MN 55101 410956618 501(C)(3) 9223 FMV Meal Passes BIKES FOR EVERYBODY 1070 PUTMANE AVANUE REDWING MN 55066 271958997 10171 FMV Adaptive Sports Grant 2 1 Adaptive Equipment Grants 11 5908 0 FMV N/A Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: In 2010, Gillette revised its governance structure to one in which the members of the hospital board are also members of the Foundation board, resulting in common control of both entities. Thus the Foundation has changed classification from a Type I to a Type II support organization. The goal of this redefinition is for the single board to share community oversight, strategic planning, financial oversight, and fundraising responsibilities equally among all board members. As a type II supporting 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 0 1 0 0 0 0 0 0 0 Deborah Quanbeck MD 0 400792 0 1010 0 1280 0 28590 0 15497 0 447169 0 0 Margaret Perryman 0 451442 0 152627 0 230125 0 88646 0 13924 0 936764 0 227970 Beverly Wical MD 0 203281 0 660 0 0 0 12752 0 16574 0 233267 0 0 Michael Partington MD 0 503583 0 61777 0 0 0 23388 0 21605 0 610353 0 0 James Haddican 0 240736 0 64438 0 540 0 33824 0 17809 0 357347 0 0 Jon Galloway 216019 0 33694 0 54815 0 30226 0 1077 0 335831 0 54189 0 Part I, Line 1a Part I, Line 4b Certain employees of Gillette are provided the opportunity to participate in the pension restoration plan (The Plan). The Plan requires that the employee be an executive of Gillette in order to be eligible to participate in The Plan. Payments from The Plan occur annually by July 1 of the year following the end of The Plan year. This 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. Margaret Perryman $29,132 James Haddican $1,175 Supplemental Information Part III 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. Fredrickson & Bryon David Glaser, Director 62699 Legal Services 0 Fredrickson & Bryon Dale Schoonover, Director 62699 Legal Services 0 X 7 38618 Cost or selling price 0 1 1 Third Party Use: Part I, Line 32b: In 2010, the Foundation hired a realtor to sell real estate property which the Foundation had previously received as a noncash contribution in 2007. Form 990, Part VI, Section A, line 4 In 2010, Gillette revised its governance structure to one in which the members of the hospital board are also members of the Foundation board, resulting in common control of both entities. Thus the Foundation has changed classification from a Type I to a Type II support organization. The goal of this redefinition is for the single board to share community oversight, strategic planning, financial oversight, and fundraising responsibilities equally among all board members. 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 A, line 7b The decisions of the governing body are subject to the approval of the Foundation's sole member, Gillette Children's Specialty Healthcare. The hospital board reserved powers are the election of board members and the Foundation board; as long as it follows its bylaws, the board has autonomy in other decisions. Form 990, Part VI, Section B, line 11 A copy of the form 990 was provided to every member of the governing body before it was filed. The form was completed by a committee that included representatives from finance, human resources, development and communications. This committee prepared all the documentation necessary; the forms were compiled by Gillette's accounting firm and reviewed by our legal counsel. The draft documents were then reviewed by the vice president of finance, the vice president of strategic planning, and the vice president of development. 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 manager of quality improvement resources. 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 Board of Directors, 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 adopted by the Board of Directors. The compensation philosophy 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 mails its annual report (which includes the audited financial statements) to Gillette employees, medical staff and board members; Gillette donors; state and city legislators; Minnesota pediatricians; media representatives; the Minnesota Hospital Association (MHA); and presidents and chief executive officers of members of the National Association of Children's Hospitals and related institutions. 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: According to new accounting guidelines, Gillette is obligated to answer "no" to this question because the Gillette board of directors or a subcommittee of the board of directors does not review Gillette's document retention and destruction policy. In fact, Gillette has written record retention policies for both patient medical records and for other records, including those of legal, historical, fiscal/tax and operational value. Gillette's chief executive officer, Margaret Perryman, has reviewed and approved the policies. Form 990, Part VII: The following individuals held positions at both Gillette Children's Hospital Foundation and Gillette Childrens Specialty Healthcare, the parent of Gillette Children's Hospital Foundation. The hours listed on Part VII are the average hours per week these individuals devoted to Gillette Children's Hospital Foundation during the year. In addition, these individuals also devoted the following average hours per week to Gillette Children's Specialty Healthcare. Margaret E. Perryman 40.0 hours James L. Haddican 40.0 hours Deborah Quanbeck 40.0 hours Michael Partington 40.0 hours Beverly Wical 40.0 hours Carol Clark 1.0 hours John Diehl 1.0 hours Bonnie Dougherty 1.0 hours Heidi Erspamer 1.0 hours Todd Fisher 1.0 hours David Glaser 1.0 hours James Hynes 1.0 hours Theresa McEnaney 1.0 hours Bruce O'Brien 1.0 hours Jerome Kahnke 1.0 hours Scott Ward 1.0 hours Cassandra Warner 1.0 hours Braxton Haulcy 1.0 hours Chuck Amos 1.0 hours James Bradshaw 1.0 hours Jeff Evanson 1.0 hours John Guider 1.0 hours Robert Folkes 1.0 hours Robert Long 1.0 hours Dale Schoonover 1.0 hours Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 777,221. GILLETTE CHILDREN'S SPECIALTY HEALTHCARE 200 UNIVERSITY AVENUE EAST ST PAUL MN 55101 363379150 HEALTHCARE MN 501(C)(3) 3 N/A 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 1 GILLETTE CHILDREN'S SPECIALITY HEALTHCARE O 3368866 FMV GILLETTE CHILDREN'S SPECIALITY HEALTHCARE B 3906935 FMV GILLETTE CHILDREN'S SPECIALITY HEALTHCARE R 97551 FMV GILLETTE CHILDREN'S SPECIALITY HEALTHCARE Q 6258 FMV GILLETTE CHILDREN'S SPECIALITY HEALTHCARE J 27024 FMV