Form990


Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
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MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
A For the 2021 calendar year, or tax year beginning 01-01-2022 , and ending 12-31-2022
BCheck if applicable:
CName of organization
Gillette Children's Specialty Healthcare
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
200 University Avenue East
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Saint Paul, MN55101
D Employer identification number

36-3379150
E Telephone number

G Gross receipts $ 307,148,908
F Name and address of principal officer:
Barbara Joers
200 University Avenue East
Saint Paul,MN55101
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.gillettechildrens.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. See instructions.
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1897
M State of legal domicile: MN
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: Redefine what is possible for children with brain, bone and movement conditions through clinical leadership, research, and global advocacy.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 14
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 12
5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) ...... 5 1,672
6 Total number of volunteers (estimate if necessary) ............. 6 86
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 25,500
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 16,744,684 13,792,031
9 Program service revenue (Part VIII, line 2g) ......... 264,385,984 277,178,097
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 18,588,833 9,551,806
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 48,429 44,459
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 299,767,930 300,566,393
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 112,700 64,225
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), lines 5–10) 147,651,014 154,872,462
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 117,501,844 124,080,254
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 265,265,558 279,016,941
19 Revenue less expenses. Subtract line 18 from line 12....... 34,502,372 21,549,452
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 456,353,572 466,364,734
21 Total liabilities (Part X, line 26)............. 118,948,638 142,471,917
22 Net assets or fund balances. Subtract line 21 from line 20..... 337,404,934 323,892,817
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
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Type or print name and title
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Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2021)
Form 990 (2021)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: In collaboration with patients, families and partners, Gillette Children's Specialty Healthcare (Gillette) redefines what is possible for children with brain, bone and movement conditions through clinical leadership, research and global advocacy.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. 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 $ 228,493,830 including grants of $ 64,225 ) (Revenue $ 275,027,253 )
Patient services: Founded in 1897, Gillette's vision is a world in which every child is able to create their own story. In collaboration with patients, families and partners, we redefine what is possible for children with brain, bone and movement conditions through clinical leadership, research and global advocacy. Gillette is dedicated to providing high quality subspecialty care to children with complex and/or disabling conditions. During 2022, Gillette served 26,074 patients from all 87 Minnesota counties, 41 U.S. states and territories, and six international countries. Gillette operates a 60 licensed-bed specialty hospital in St. Paul, Minnesota; clinics in Alexandria, Baxter, Bemidji, Burnsville, Duluth, Mankato, Maple Grove, St. Cloud, Willmar, and St. Paul, Minnesota, and outreach and virtual telemedicine collaborations across Minnesota and the Upper Midwest.Gillette cares for patients who have some of the most complex, rare and traumatic conditions in pediatric medicine, including cerebral palsy, epilepsy, spina bifida, hydrocephalus, complex orthopedic conditions, craniofacial anomalies, genetic disorders, neurological conditions and brain and spinal cord injuries. Care at Gillette is clinically integrated, bringing experts together from multiple areas to coordinate and care for patients from initial diagnosis through the lifetime of their condition, with individualized care planning at the center of our work. This integrated care model has differentiated us from traditional health systems. For over 125 years, Gillette has led in the diagnosis and management of complex medical conditions through the development of innovative medical and surgical interventions, proven rehabilitative therapies and the novel application of customized services from compassionate health care professionals, Gillette's care helps ensure every child can create their own story and realize their full potential.Gillette is a regional referral center healthcare destination for people who have complex, rare and traumatic conditions that began in childhood. The diagnosis and management of these conditions requires significant clinical expertise and an integrated and proactive care planning system that support the delivery of a comprehensive treatment plan. The majority of conditions Gillette specializes in treating have courses of care that run for months, years, or an entire lifetime. Although a number of hospitals can and do provide certain pediatric specialty services, Gillette is unique in the region for specializing exclusively in the care and rehabilitation needs of individuals with medical complexity and lifelong conditions that affect the musculoskeletal and neurological systems.Gillette clinics in greater Minnesota improve access to care for families who live outside the Twin Cities metro area, and support local providers by facilitating collaboration with Gillette specialists. Gillette continues to enhance its presence around the state, aiming for a more consistent presence in key communities and providing more consistent scheduling and give families greater access to care. Gillette continues work to implement virtual care (telemedicine) services into its clinics and other care settings. Virtual care enables providers to hold consultations with patients via video conference, with 10,268 virtual visits performed during 2022.During 2022, Gillette treated 26,074 patients from all 87 Minnesota counties, 41 U.S. states and territories, and six countries. A large and geographically diverse network of referring physicians has driven growth, with over 2,500 physicians referring patients to Gillette. There were 2,158 inpatient admissions, with an average length of stay of 4.3 days, and 136,825 outpatient visits during 2022. Gillette physicians performed 3,657 inpatient and outpatient surgeries in 2022. The top conditions seen at Gillette include cerebral palsy, limb-length discrepancy, developmental dysplasia of the hip, epilepsy, and idiopathic scoliosis. Over 70% of Gillette patients see providers in more than one specialty. Gillette's areas of expertise, key conditions and services include the following:Cerebral Palsy: Gillette is an internationally recognized leader in the diagnosis and management of spasticity resulting from cerebral palsy and other causes. Gillette offers comprehensive, coordinated care designed to manage the symptoms of cerebral palsy. Services range from infant evaluations to diagnose the condition, to medical and surgical interventions to manage spasticity and related comorbidities as children grow into adulthood. Individualized treatment plans might include developmental assessments, rehabilitation therapies, orthoses, specialized seating, mobility and communicative supports, spasticity management techniques (including surgery), gait and motion analysis, and orthopedic care. Individuals with cerebral palsy often have complex and wide-ranging health care needs. Gillette's unique expertise in the field provides families with healthcare professionals who are aware of the variety of comorbidities commonly associated with cerebral palsy and who are able to identify them early and employ appropriately coordinated management of these conditions. Gillette treats more than 4,000 cerebral palsy patients every year. Gillette is an innovative clinical leader in treating cerebral palsy - from developing new devices to assist in patient care, to the assessments done at the at the James R Gage Center for Gait and Motion Analysis, Gillette is sought out for its care around the world.
4b (Code:   ) (Expenses $ 6,426,545 including grants of $ 0 ) (Revenue $ 1,901,011 )
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 seven major emphasis areas (gait and motion analysis, health services, neurosciences, orthopedics, pain and comfort, rehabilitation, and spine), all of which seek to improve the lives of children who have disabilities and complex conditions. During 2022, Gillette researchers were engaged in 120 active studies, and 91 studies were published in peer-reviewed journals. Additionally, 35 active research projects were supported by extramural funding. In collaboration with clinical patient care, Gillette's research activities advance our mission to help children create their own stories.
4c (Code:   ) (Expenses $ 1,662,758 including grants of $ 0 ) (Revenue $ 249,833 )
Education: Gillette provides graduate medical education in collaboration with the University of Minnesota and provides seminars and other educational programs with the goal to share expertise that benefits all children who have complex conditions. Gillette offers residencies and fellowships in orthopedics, and pediatric rehabilitation medicine. Through fellowships, seminars and other educational programs, Gillette strives to share expertise that benefits all children who have complex conditions.Gillette facilities are made available for training of health care students through arrangements with area educational institutions. Gillette offers residencies and fellowships in such specialties as pediatrics, orthopedics, and pediatric rehabilitation medicine. A teaching hospital, Gillette trains residents from the University of Minnesota and Henry Ford Health in Detroit, who spend one to three months under the mentorship of Gillette's medical staff. In many cases, Gillette offers physicians their only exposure during residency to patients with certain disabilities. Gillette also offers shadowing and mentorship programs for students, along with professional education opportunities in such areas as physical therapy, radiology, nursing, respiratory care and assistive technology. Some of the students who make use of these training programs ultimately join the staff of Gillette.Gillette also provides extensive Continuing Medical Education services to physicians and other health care providers in our area of expertise. Participants travel from around the region and globe to learn from Gillette experts each year. These programs also support the ongoing development of referral and partnership arrangements and relationships that direct patients to Gillette for their care. Gillette covers the unreimbursed costs of medical education and is fully accredited by the Minnesota Medical Association to provide continuing medical education (CME). Gillette sponsors conferences on topics such as cerebral palsy, orthopedics, Duchenne muscular dystrophy, Rett syndrome, and motion analysis. During 2022, Gillette provided over 100 hours of clinical medical education to more than 400 physicians and 1,500 other health care providers. Typical audiences include pediatricians, family practitioners, nurse practitioners, physician assistants, nurses, physical therapists, occupational therapists, and orthotists.
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet236,583,133
Form 990 (2021)
Form 990 (2021)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment
List of Attached Documents:
// Content
.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. Click to see attachment
List of Attached Documents:
// Content
...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment
List of Attached Documents:
// Content
.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment
List of Attached Documents:
// Content
.........
4
Yes
 
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 Rev. Proc. 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment
List of Attached Documents:
// Content
..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment
List of Attached Documents:
// Content
.........................
6
 
No
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 IIClick to see attachment
List of Attached Documents:
// Content
....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part IIIClick to see attachment
List of Attached Documents:
// Content
..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian 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 IVClick to see attachment
List of Attached Documents:
// Content
..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
Yes
 
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. Click to see attachment
List of Attached Documents:
// Content
...................
11a
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 VIIClick to see attachment
List of Attached Documents:
// Content
.......
11b
 
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, Part VIIIClick to see attachment
List of Attached Documents:
// Content
.......
11c
 
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, Part IXClick to see attachment
List of Attached Documents:
// Content
............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
List of Attached Documents:
// Content
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
List of Attached Documents:
// Content
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
Click to see attachment
List of Attached Documents:
// Content
......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
List of Attached Documents:
// Content
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
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 investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........Click to see attachment
List of Attached Documents:
// Content
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....Click to see attachment
List of Attached Documents:
// Content
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...Click to see attachment
List of Attached Documents:
// Content
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I. See instructions. ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, 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 "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
List of Attached Documents:
// Content
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
List of Attached Documents:
// Content
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
List of Attached Documents:
// Content
21
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
List of Attached Documents:
// Content
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
List of Attached Documents:
// Content
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as 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...............Click to see attachment
List of Attached Documents:
// Content
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 year
to 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), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a 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 prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation 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
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
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, Part I............Click to see attachment
List of Attached Documents:
// Content
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
List of Attached Documents:
// Content
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
List of Attached Documents:
// Content
35b
Yes
 
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, line 2............. Click to see attachment
List of Attached Documents:
// Content
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 VIClick to see attachment
List of Attached Documents:
// Content
37
 
No
38
Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in box 3 of Form 1096. Enter -0- if not applicable ..
1a
168
b
Enter the number of Forms W-2G included on line 1a. Enter -0- if not applicable .
1b
1
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
1,672
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. See instructions.
2b
Yes
 
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 O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
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 and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
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 benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
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 facilities
10b
 
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 sources against 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?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
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 O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
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 O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see the instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
17
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2021)
Form 990 (2021)
Page 6
Part VI
Governance, Management, and Disclosure. For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
14
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
12
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by 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 filing the form? ............................
11a
Yes
 
b
Describe on Schedule O 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 give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe on Schedule O 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 by independent 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 on Schedule O. See instructions.
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
MN , WI
18
Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletKyle Eidem200 University Avenue East   Saint Paul,MN55101 (651) 291-2848
Form 990 (2021)
Form 990 (2021)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet 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.

RoundBullet List all of the organization’s current key employees, if any. See the instructions for definition of "key employee."
RoundBullet 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, Form 1099-MISC, and/or box 1 of Form 1099-NEC) of more than $100,000 from the
organization and any related organizations.

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

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

See the instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Joers Barbara......................................................................
President & CEO
50.00
.................
5.00
X   X       1,039,894 0 50,357
(2) Sinner Angela......................................................................
Chief of Staff
49.00
.................
1.00
X           233,842 0 26,954
(3) Ellenberger John......................................................................
Chair
1.00
.................
1.00
X   X       0 0 0
(4) Neville Julie......................................................................
Treasurer
1.00
.................
1.00
X   X       0 0 0
(5) Trier Phllip......................................................................
Secretary
1.00
.................
1.00
X   X       0 0 0
(6) Tune Kathy......................................................................
Vice Chair
1.00
.................
1.00
X   X       0 0 0
(7) Bestler David......................................................................
Director
1.00
.................
1.00
X           0 0 0
(8) Cush Marlon......................................................................
Director
1.00
.................
1.00
X           0 0 0
(9) Fettig David......................................................................
Director
1.00
.................
1.00
X           0 0 0
(10) Freyer Jeffrey......................................................................
Director
1.00
.................
1.00
X           0 0 0
(11) Garcia Sharifa......................................................................
Director (Start 01/22)
1.00
.................
1.00
X           0 0 0
(12) Ireland Linda......................................................................
Director
1.00
.................
1.00
X           0 0 0
(13) Liddicoat John......................................................................
Director (Start 01/22)
1.00
.................
1.00
X           0 0 0
(14) McDonald William......................................................................
Director
1.00
.................
1.00
X           0 0 0
(15) Rhodes Pete......................................................................
Director (End 01/22)
1.00
.................
1.00
X           0 0 0
(16) Stacey Rulon......................................................................
Director (End 01/22)
1.00
.................
1.00
X           0 0 0
(17) Niermann Micah......................................................................
EVP Medical Affairs
50.00
.................
0.00
      X     608,165 0 48,947
Form 990 (2021)
Form 990 (2021)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Nolan Patrick........................................................................
EVP Finance
50.00
.......................0.00
      X     561,749 0 51,081
(19) Montgomery Paula........................................................................
EVP Administrative Affairs
50.00
.......................0.00
      X     489,155 0 55,761
(20) Getsay Tim........................................................................
EVP Performance
50.00
.......................0.00
      X     466,939 0 51,406
(21) Harris Thomas........................................................................
EVP Operations
50.00
.......................0.00
      X     457,563 0 49,872
(22) Bariteau Stephen........................................................................
EVP Philanthropy
1.00
.......................49.00
      X     0 282,002 44,266
(23) Kim Peter........................................................................
Neurosurgeon
50.00
.......................0.00
        X   1,292,010 0 54,219
(24) Graupman Patrick........................................................................
Neurosurgeon
50.00
.......................0.00
        X   1,264,669 0 56,700
(25) Song Debbie........................................................................
Neurosurgeon
50.00
.......................0.00
        X   1,261,861 0 55,840
(26) Guillaume Tenner........................................................................
Orthopedic Surgeon
50.00
.......................0.00
        X   1,098,378 0 51,260
(27) Truong Walter........................................................................
Orthopedic Surgeon
50.00
.......................0.00
        X   823,790 0 54,385
(28) Brady Karen........................................................................
VP People
50.00
.......................0.00
          X 379,556 0 45,821
(29) Brill Karen........................................................................
VP Quality
50.00
.......................0.00
          X 327,745 0 38,695
(30) Jolley Dennis........................................................................
VP Development (End 04/22)
0.00
.......................0.00
          X 165,109 0 12,964
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 10,470,425 282,002 748,528
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet290
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for 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 of compensation 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
McGough Construction

NW5970 PO Box 1450
Minneapolis,MN55485
Construction Services 17,013,768
Regions Hospital

640 Jackson St
St Paul,MN55101
Direct Patient Services 8,628,720
Quality Nurse Anesthesia

5600 Edgewood Blvd
Minneapolis,MN55147
Anesthesia Services 3,739,173
Childrens Resp & Critical Care

2530 Chicago Ave Ste 400
Minneapolis,MN55404
Physician Services 3,723,953
Allina Health

2925 Chicago Ave S
Minneapolis,MN55407
Physician Services 2,683,415
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet69
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 11,582,371
e Government grants (contributions)1e 2,209,660
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 13,792,031
 Program Service RevenueAmt Business Code
2a Patient Services 621400 202,088,541 202,088,541    
b Medicare/Medicaid 621400 73,870,448 73,870,448    
c Intercompany Services 621400 628,378 628,378    
d Parking Revenue 812930 582,521     582,521
e Book Sales 621400 8,209 8,209    
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 277,178,097
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 8,208,980     8,208,980
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   48,959 6a
b Less: rental expenses   4,500 6b
c Rental income or (loss)   44,459 6c
d Net rental income or (loss).......MediumBullet 44,459   25,500 18,959
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory   7,920,841 7a
b Less: cost or other basis and sales expenses   6,578,015 7b
c Gain or (loss)   1,342,826 7c
d Net gain or (loss).........MediumBullet 1,342,826     1,342,826
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet  
12 Total revenue. See instructions.....MediumBullet 300,566,393 276,595,576 25,500 10,153,286
Form 990 (2021)
Form 990 (2021)
Page 10
Part IX
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 O 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 and general expenses
(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 64,225 64,225
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ...........    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 5,161,575 182,557 4,979,018  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........        
7 Other salaries and wages........ 122,555,697 105,292,571 17,263,126  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 3,472,664 2,630,485 842,179  
9 Other employee benefits ....... 15,802,043 14,119,322 1,682,721  
10 Payroll taxes ........... 7,880,483 6,639,410 1,241,073  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 365,478   365,478  
c Accounting ........... 270,382   270,382  
d Lobbying ........... 163,173   163,173  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 410,609   410,609  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 34,239,101 29,593,684 4,645,417  
12 Advertising and promotion .... 1,554,237 54,869 1,499,368  
13 Office expenses ....... 2,306,428 1,412,466 893,962  
14 Information technology ...... 9,380,736 6,584,978 2,795,758  
15 Royalties ..        
16 Occupancy ........... 9,181,600 7,186,114 1,995,486  
17 Travel ............ 582,314 430,320 151,994  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 443,396 271,380 172,016  
20 Interest ........... 1,470,540 1,399,179 71,361  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 12,600,360 10,632,764 1,967,596  
23 Insurance ... 853,424 240,975 612,449  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a Medical Supplies 40,049,112 40,035,328 13,784 0
b MNCare Taxes 4,058,526 4,058,526 0 0
c MA Surcharge 2,986,743 2,986,743 0 0
d Repairs & Maintenance 2,560,851 2,259,017 301,834 0
e All other expenses 603,244 508,220 95,024  
25 Total functional expenses. Add lines 1 through 24e 279,016,941 236,583,133 42,433,808 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2021)
Form 990 (2021)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 4,016,256 1 29,852,626
2 Savings and temporary cash investments ......... 115,297,437 2 81,337,793
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 51,567,429 4 52,599,555
5 Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
  6  
7 Notes and loans receivable, net ........... 0 7 0
8 Inventories for sale or use ............ 4,296,115 8 4,894,325
9 Prepaid expenses and deferred charges ...... 7,617,354 9 5,508,597
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 254,842,343
b Less: accumulated depreciation 10b 152,951,087 90,343,573 10c 101,891,256
11 Investments—publicly traded securities . 142,504,044 11 123,786,724
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 40,711,364 15 66,493,858
16 Total assets. Add lines 1 through 15 (must equal line 33)... 456,353,572 16 466,364,734
Liabilities 17 Accounts payable and accrued expenses ..... 56,407,999 17 51,036,635
18 Grants payable ...   18  
19 Deferred revenue .........   19  
20 Tax-exempt bond liabilities ......... 29,697,967 20 29,036,888
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
  22  
23 Secured mortgages and notes payable to unrelated third parties .. 32,842,672 23 29,410,606
24 Unsecured notes and loans payable to unrelated third parties ..   24  
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 Schedule D 0 25 32,987,788
26 Total liabilities. Add lines 17 through 25.. 118,948,638 26 142,471,917
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 324,298,860 27 312,655,552
28 Net assets with donor restrictions ........... 13,106,074 28 11,237,265
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 337,404,934 32 323,892,817
33 Total liabilities and net assets/fund balances ........ 456,353,572 33 466,364,734
Form 990 (2021)
Form 990 (2021)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
300,566,393
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
279,016,941
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
21,549,452
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
337,404,934
5
Net unrealized gains (losses) on investments ...............
5
-27,960,324
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-7,101,245
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
323,892,817
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain on
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
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 separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, 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 in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2021)
Form 990 (2021)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public
Inspection
Name of the organization
Gillette Children's Specialty Healthcare
 
Employer identification number

36-3379150
Part I
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 12, check only one box.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 2
Part II
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 under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
33 1/3% support test—2022. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization .......................right arrow
b
33 1/3% support test—2021. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow
17a
10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow
b
10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose            
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge            
6 Total. Add lines 1 through 5            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
33 1/3% support tests-2022. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow
b
33 1/3% support tests—2021. 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 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow
20
Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    
Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by 0.035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes 1  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
2  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations 3  
4 Amounts paid to acquire exempt-use assets 4  
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) 5  
6 Other distributions (describe in Part VI). See instructions 6  
7Total annual distributions. Add lines 1 through 6. 7  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI
). See instructions
8  
9 Distributable amount for 2022 from Section C, line 6 9  
10 Line 8 amount divided by Line 9 amount 10  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2022
(iii)
Distributable
Amount for 2022
1 Distributable amount for 2022 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2022:
a From 2017.......  
b From 2018.......  
c From 2019.......  
d From 2020.......  
e From 2021.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2022 distributable amount  
i Carryover from 2017 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2022 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2022 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2022, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions.
 
6 Remaining underdistributions for 2022. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions.
 
7 Excess distributions carryover to 2023. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2018.....  
b Excess from 2019.....  
c Excess from 2020.....  
d Excess from 2021.....  
e Excess from 2022.....  
Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990) 2022


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2022
Name of the organization
Gillette Children's Specialty Healthcare
 
Employer identification number

36-3379150
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990) (2022)
Schedule B (Form 990) (2022) Page 2
Name of organization
Gillette Children's Specialty Healthcare
 
Employer identification number
36-3379150
Part I
Contributors
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990) (2022)
Schedule B (Form 990) (2022)
Page 3
Name of organization
Gillette Children's Specialty Healthcare
 
Employer identification number

36-3379150
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
Schedule B (Form 990) (2022)
Schedule B (Form 990) (2022)
Page 4
Name of organization
Gillette Children's Specialty Healthcare
 
Employer identification number

36-3379150
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990) (2022)
Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet Complete if the organization is described below. SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
Gillette Children's Specialty Healthcare
 
Employer identification number

36-3379150
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

2
Political campaign activity expenditures. See instructions ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities. See instructions ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990) 2021

Schedule C (Form 990) 2021
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ........................    
c Total lobbying expenditures (add lines 1a and 1b) ............................................................    
d Other exempt purpose expenditures ...............................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ..................................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e))
 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))
 
f Grassroots lobbying expenditures          
Schedule C (Form 990) 2021


Schedule C (Form 990) 2021
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes|No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
Yes
 
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
Yes
 
50
e
Publications, or published or broadcast statements? ...........................................................
Yes
 
500
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
Yes
 
120,694
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
267,219
j
Total. Add lines 1c through 1i ....................................................................................................
388,463
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures. See Instructions .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Part II-B, Line 1: Gillette employs a director of public policy and a director of external affairs who devote time to federal and state policy initiatives. Gillette also contracted with McDermott + Consulting as lobbyists to act as advocates on its behalf at the federal level. Gillette contracted with Fredrikson & Byron PA to assist with state level lobbying. Gillette is a member of the Children's Hospital Association; Minnesota Hospital Association; Minnesota Consortium for Citizens With Disabilities; Minnesota Business Partnership; St Paul Area Chamber of Commerce; and the Minneapolis Chamber of Commerce. A portion of membership dues for these organizations relate to lobbying activities. Gillette reimburses certain professional memberships for employees. A portion of such membership dues are used by the professional associations for lobbying activities. Certain Gillette executives engage in lobbying activities including, but not limited to, meeting with government officials and staff at the local, state and federal levels; and meeting with staff from the Minnesota Department of Human Services and Minnesota Department of Health to discuss Medicaid payment arrangements, policies and other legislative issues affecting Gillette. These activities may include providing public testimony on legislation affecting Gillette and provide letters of support for specific legislation. Gillette also provides education to employees on policy issues and initiatives. Through voluntary Gillette Advocacy Internal Network (GAIN), Gillette encourages interested employees to contact government officials about specific legislation on behalf of Gillette. Gillette volunteers, including patients, patient families, and members of the Gillette board of directors also contact government officials about specific legislation on behalf of Gillette. Other activities indirectly related to lobbying include providing lobbyists with patient statistics and demographic information and developing collateral used for lobbying efforts that define Gillette's programs and services.
Schedule C (Form 990) 2021


Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
Gillette Children's Specialty Healthcare
 
Employer identification number

36-3379150
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of 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 advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
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)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, 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 FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 2
Part III
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 its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance .... 5,555,957 4,558,270 3,481,048 3,520,461 3,379,948
b Contributions ... 958,901 955,282 893,622 100,992 305,455
c Net investment earnings, gains, and losses -585,805 446,126 409,366 242,032 -44,439
d Grants or scholarships ... 0 0 0 0 0
e Other expenditures for facilities
and programs ...
681,764 403,721 225,766 382,437 23,083
f Administrative expenses .... 0 0 0 0 97,420
g End of year balance ...... 5,247,289 5,555,957 4,558,270 3,481,048 3,520,461
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet6.500 %
b
Permanent endowment SchDMd Bullet71.300 %
c
Term endowment SchDMd Bullet22.200 %
The percentages on 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 the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
No
(ii) Related organizations .................
3a(ii)
Yes
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment)
(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....   1,115,000 1,115,000
b Buildings ....   72,474,239 23,427,330 49,046,909
c Leasehold improvements   77,934,649 48,303,804 29,630,845
d Equipment ....   101,268,226 81,219,953 20,048,273
e Other .....   2,050,229   2,050,229
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 101,891,256
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 3
Part VII
Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Financial derivatives.........    
(2) Closely-held equity interests........    
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)Beneficial Interest in Net Assets of Subsidiaries 33,265,034
(2)Life Insurance Cash Value 200,000
(3)Investment in Subsidiaries 145,085
(4)Operating Lease Right of Use Assets 32,883,739
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 66,493,858
Part X
Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes  
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 32,987,788
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) 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  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
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  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
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  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
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  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b 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 additional information.
Return Reference Explanation
Part V, Line 4: Gillette Children's Hospital Foundation maintains endowment funds for capital, charity care, patient care, research and education, and unrestricted needs. These funds are used to provide and improve health care and related services to Gillette patients and families.
Part X, Line 2: The Internal Revenue services has determined that the Medical Center and Foundation are tax-exempt entities under Section 501(c)(3) of the Internal Revenue Code ("IRC") and are not private institutions as defined by Section 509(a) of the IRC. There were no unrecognized tax liabilities or uncertain tax positions as of December 31, 2022 and 2021.
Schedule D (Form 990) 2021


Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990.Right pointing arrow large image Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
Name of the organization
Gillette Children's Specialty Healthcare
 
Employer identification number

36-3379150
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in the region (d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in the region
(f) Total expenditures
for and investments
in the region
North America 0 0 Program Services Education and Development 30,283
Europe (Including Iceland & Greenland) 0 0 Program Services Education and Development 1,745
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .... 0 0 32,028
b Total from continuation sheets to Part I ... 0 0 0
c Totals (add lines 3a and 3b) 0 0 32,028
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2022
Schedule F (Form 990) 2022
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)
(c) Region (d) Purpose of
grant
(e) Amount of
cash grant
(f) Manner of
cash
disbursement
(g) Amount
of noncash
assistance
(h) Description
of noncash
assistance
(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......MediumBullet
 
3 Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2022
Schedule F (Form 990) 2022Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant
(e) Manner of cash
disbursement
(f) Amount of
noncash
assistance
(g) Description
of noncash
assistance
(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2022
Schedule F (Form 990) 2022
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 990) 2022
Schedule F (Form 990) 2022
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.
ReturnReference Explanation
Part I, line 3: Expenditures are accounted for on the accrual basis of accounting and denominated in US dollars.
Part III Accounting Method:  
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2022
Additional Data


Software ID:  
Software Version:  



SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
Name of the organization
Gillette Children's Specialty Healthcare
 
Employer identification number

36-3379150
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization'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
 
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
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide 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 during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
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 these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    759,049 0 759,049 0.270 %
b Medicaid (from Worksheet 3, column a) . . . . .     111,132,386 69,105,339 42,027,047 15.060 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     0 0    
d Total Financial Assistance and Means-Tested Government Programs . . . . .     111,891,435 69,105,339 42,786,096 15.330 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     1,998,154 0 1,998,154 0.720 %
f Health professions education (from Worksheet 5) . . .     1,662,758 249,833 1,412,925 0.510 %
g Subsidized health services (from Worksheet 6) . . . .     18,789,739 7,122,561 11,667,178 4.180 %
h Research (from Worksheet 7) .     6,426,545 1,901,011 4,525,534 1.620 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     104,875 0 104,875 0.040 %
j Total. Other Benefits . .     28,982,071 9,273,405 19,708,666 7.070 %
k Total. Add lines 7d and 7j .     140,873,506 78,378,744 62,494,762 22.400 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support   10,000        
4 Environmental improvements            
5 Leadership development and
training for community members
           
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total   10,000        
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
1,284,332
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
128,433
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
3,785,634
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
9,738,442
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-5,952,808
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General Medical and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 Gillette Children's Specialty Healthcare
200 University Avenue East
Saint Paul,MN55101
www.gillettechildrens.org
2025454
X   X X   X        
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 4
Part VFacility 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)
Gillette Children's Specialty Healthcare
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 22
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): See Part V, Section C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Gillette Children's Specialty Healthcare
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
See Part V, Section C
b
See Part V, Section C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 6
Part VFacility Information (continued)

Billing and Collections
Gillette Children's Specialty Healthcare
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Gillette Children's Specialty Healthcare
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
Gillette Children's Specialty Healthcare Part V, Section B, Line 5: The 2022 CHNA survey builds upon the 2019 process, since many issues that Gillette patients and families face are the result of how systems operate (including health insurance, service delivery for complex conditions, community service providers). The process included creating a survey team, defining the community, gathering input from broad community and stakeholders, performing analysis, and identifying and prioritizing needs. Questions were designed to identify emerging priorities, add nuance to existing priorities, and elicit thoughts on addressing priorities. Feedback was gathered from parents, caregivers, and adult patients via online survey to all stakeholders, plus focus groups on a subset of survey respondents. Interviews were also conducted with community stakeholders and Gillette staff.A multi-method evaluation approach was developed to gather feedback from individuals who are familiar with the needs of children and adults with complex medical conditions, including caregivers, community partners, patients, and Gillette staff. The data collection strategies used throughout the assessment included: - Web surveys with caregivers of children receiving services or adult patients- Focus groups with caregivers of children receiving services at Gillette- Key informant interviews with community partner organizations- Key informant interviews with Gillette staffThe full CHNA report is available on the following website: https://www.gillettechildrens.org/assets/2022_CHNA_GilletteReport_final.pdf
Gillette Children's Specialty Healthcare Part V, Section B, Line 11: The primary priority health topic identified during current CHNA was Care Delivery and Coordination. Within that area, there were four specific initiatives identified: (1) Access to virtual care; (2) Care coordination; (3) Support for resource navigation; (4) Transition planning.The following implementation strategies (among others) are currently being implemented by Gillette to address these topics:Access to virtual care- Providing medical virtual care for regional and select states, including virtual clinics in partnership with external organizations.- Assessment of virtual services across greater Minnesota.- Implementing virtual second opinion program- Expanding virtual pediatric expert consultations.- Expanding virtual rehabilitation therapies regionally, nationally and internationally- Develop digital application to deliver synchronous and asynchronous rehab care- Implement virtual joint seating evaluation in greater Minnesota- Develop Gait application to provide services to remote patients.Care coordination- Launch patient navigation team (nurse care manager, patient navigator, and social work) to proactively co-manage complex care plans with patients and families, specifically within the Complex Care Clinic and Cerebral Palsy populations.- Formalize partnerships with external organizations for closed loop referral system to provide peer and family support.Support for resource navigation- Identify local and national organizations whose mission is to educate and provide resources to individuals seeking mental health treatment. Links to websites and other information will be made available on Gillette's external website. Staff information will be provided so staff can direct individuals to this information.Transition planning- Work to provide proactive transition support and resources to all patients age 16 and over and enrolled in the Complex Care Clinic Program. This includes partnership between social work, nurse care manager with families to transition patients to necessary adult medical providers and community resources.- Consider partnerships with adult primary care clinics in the Twin Cities metro and greater Minnesota to establish standard handoff processes for adult patients transitioning to their clinical practice.
Gillette Children's Specialty Healthcare Part V, Section B, Line 13h: If a patient or guarantor appears eligible for the Gillette Assistance Program, but there is no application to make a financial assistance decision, Gillette may make a presumptive eligibility determination, using third-party information to provide a full or partial discount on outstanding self-pay balances.
Part V, Line 7a, Hospital Facility's Website: The full CHNA report and implementation strategy are available on the following website: https://www.gillettechildrens.org/assets/2022_CHNA_GilletteReport_final.pdf
Part V, Line 10a, Link for Implementation Strategy: The full CHNA report and implementation strategy are available on the following website: https://www.gillettechildrens.org/assets/2022_CHNA_GilletteReport_final.pdf
Part V, Line 16a, FAP Website: https://www.gillettechildrens.org/your-visit/patient-services-and-resources/understand-costs-insurance-and-the-gillette-assistance-program/get-help-paying-your-gillette-bills
Part V, Line 16b, FAP Application Website: https://www.gillettechildrens.org/your-visit/patient-services-and-resources/understand-costs-insurance-and-the-gillette-assistance-program/get-help-paying-your-gillette-bills
Part V, Line 16c, FAP Plain Language Summary Website: https://www.gillettechildrens.org/your-visit/patient-services-and-resources/understand-costs-insurance-and-the-gillette-assistance-program/get-help-paying-your-gillette-bills
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital 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?10
Name and address Type of Facility (describe)
1 1 - Gillette Phalen Clinic
435 Phalen Blvd
St Paul,MN55130
Outpatient Clinic
2 2 - Gillette Maple Grove Clinic
9550 Upland Ln North
Maple Grove,MN55369
Outpatient Clinic
3 3 - Gillette Burnsville Clinic
305 East Nicollet Blvd
Burnsville,MN55337
Outpatient Clinic
4 4 - Gillette Mankato Clinic
1421 Premier Drive
Mankato,MN56001
Outpatient Clinic
5 5 - Gillette Willmar Clinic
1303 1st Street South
Willmar,MN56201
Outpatient Clinic
6 6 - Gillette Baxter Clinic
15860 Audubon Way
Baxter,MN56401
Outpatient Clinic
7 7 - Gillette Duluth Clinic
1420 London Road
Duluth,MN55805
Outpatient Clinic
8 8 - Gillette Bemidji Clinic
505 Bunyan Drive NW
Bemidji,MN56601
Outpatient Clinic
9 9 - Gillette St Cloud Clinic
1900 Centracare Circle
St Cloud,MN56303
Outpatient Clinic
10 10 - Gillette Alexandria Clinic
1500 Irving Street
Alexandria,MN56308
Outpatient Clinic
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 10
Part VI
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 any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, 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 the organization 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, files a community benefit report.
Form and Line Reference Explanation
Part I, Line 3c: The Gillette Assistance Program (GAP) provides discounts on eligible costs to eligible patients, up to 100% of total charges and amounts owed. Federal poverty guidelines are used to determine eligibility and discount amounts. Patient applications are reviewed on a case-by-case basis, and policy exceptions may be granted under other specific circumstances where patients and families have difficulty meeting their financial obligations. If patients or guarantors appear eligible for GAP but there is no application on file, Gillette may make presumptive eligible decisions, based on third-party information. Insurance coverage, government benefits and health savings account funds must be used prior to receiving a GAP discount.
Part I, Line 7: Finance assistance at cost is calculated using a cost-to-charge ratio. Other community benefits are calculated using a combination of internal costing methodologies, less direct offsetting revenues, and cost-to-charge ratios. The cost accounting methodologies record revenues and direct expenses for all inpatient and outpatient services for each revenue-producing cost center. All non-revenue-producing cost centers are allocated back to revenue-producing cost centers using applicable statistics to arrive at fully allocated cost for each cost center.
Part II, Community Building Activities: Gillette participates in various community building activities, including participation in community health fairs, creation of newsletters and other collateral related to complex pediatric conditions and treatments, providing information via news releases and interviews with media, and involvement in other programs and activities related to promotion of the public health, such as providing vaccines.
Part III, Line 2: The provision for bad debts is determined using actual experience and management estimates, including historical and expected collections, trends in the healthcare industry, and other factors. Bad debt associated with patient eligible for financial assistance is calculated after discounts have been applied, using the same methodology. In accordance with generally accepted account principles, bad debt is reported net against patient service revenue. Related expense is calculated using the ratio of cost to charges.
Part III, Line 3: Bad debt attributable to patients that may qualify for financial assistance, but were unable or unwilling to provide necessary eligibility information, or for which presumption eligibility cannot be determined, is estimated based review of accounts classified as bad debt, industry trends, and management judgement.
Part III, Line 4: Gillette's consolidated audited financial statements include footnote disclosures in the Patient Service Revenue and Patient Accounts Receivable sections on pages 11 through 14.
Part III, Line 8: Gillette's mission is to redefine possibilities for children with brain, bone and movement conditions, including provision of services to children and adults with disabilities. In providing these mission-driven services, Gillette incurs losses from the Medicare program. Gillette accepts such losses as part of providing an important public service. Gillette's internal ratio of cost-to-charge was used to calculate the Medicare allowable costs. The entire shortfall amount is considered community benefit, but only a portion is included on Schedule H, Part I, Line 7.
Part III, Line 9b: Gillette is committed to providing medically necessary care to all patients, regardless of their ability to pay. Eligibility for financial assistance and charity care is evaluated on a case-by-case basis in accordance with the Gillette Assistance Plan (GAP) financial assistance policy. For patients who have difficulty meeting their financial obligations, Gillette attempts to qualify patients for public assistance programs or GAP, as appropriate. Requirements for GAP eligibility are detailed in the policy, including completion of an application and verification of income. Gillette attempts to identify patients qualifying for GAP prior to services being performed, though applications are accepted and reviewed at any time during the billing process.The GAP policy and plain language summaries are available to all patients and families at registration at all locations, including self-pay and uninsured patients. Financial counselors and social workers are also available to assist with financial questions related to patient visits. Gillette billing statements contain language referencing the available forms of financial assistance. In situations where debt collection efforts are necessary, leadership approval is required and related correspondence is done in accordance with required extraordinary collection effort language and other legal requirements. All billing and collection is done in accordance with the criteria established for all Minnesota hospitals by the Minnesota attorney general's office.Part V, Section D:Gillette operated four pediatric clinics in the Twin Cities metro area (two in St. Paul, Maple Grove and Burnsville); one adult clinic in St. Paul; seven clinics in greater Minnesota (Alexandria, Baxter, Bemidji, Duluth, Mankato, St Cloud and Willmar); and various collaborations across Minnesota and the Upper Midwest. All clinics are licensed under Gillette Children's Specialty Healthcare.
Part VI, Line 2: Gillette contracted with Wilder Research to complete conduct the 2022 community health needs assessment (CHNA). Wilder also conducted the 2016 and 2019 CHNA surveys, providing continuity in the assessment approach, review of prior identified needs, and current implementation strategy. The current CHNA built on the 2019 process, as many of the issues Gillette children and families face are the result of how systems operate (health insurance, service delivery for complex conditions, community service providers) and meaningful change takes time and ongoing coordination. Gillette expanded its understanding of needs by asking questions to identify emerging priorities, add nuance to existing priorities, and elicit thoughts on addressing priorities.Most Gillette patients are children with special, complex health care needs, as they are at risk for chronic physical, developmental, behavioral, or emotional conditions and require additional health care related services. The primary community is broadly identified as children's teens, and a limited subset of adults living throughout Minnesota and surrounding states, who need specialized care. Gillette serves a medically underserved population, such as those impacted by health disparities and at risk of receiving inadequate care due to geographic, language, financial or other barriers. The data collection process was designed to ensure perspectives of these populations were adequately represented in the CHNA.The following questions guided the assessment process: What are the experiences of caregivers accessing services and supports? What is the journey to diagnose and care for patients and caregivers? What would caregivers and families like to get out of care coordination? How is telehealth working? What are the family's needs? How do Gillette community partners perceive the partnership? How well does Gillette implement policies and practices related to health equity?Gillette also uses using various tools to gather information, such as online surveys, focus groups with families, phone calls, and one-on-one interviews. In addition, Gillette conducts specific assessments when considering new programs or services. Such new programs and services usually arise from suggestions by patients and families, referring physicians, or Gillette's own staff. More generally, Gillette staff members assess community health care needs by the number of patients they see. During 2022, 26,074 children and adults came to Gillette due to the specialized skills and advanced technology Gillette provides for patient needs. Gillette treated patients from all 87 Minnesota counties, 41 U.S. states and territories, and 6 international countries during 2022.Gillette cares for patients who have some of the most complex, rare and traumatic conditions in pediatric medicine, including cerebral palsy, epilepsy, spina bifida, hydrocephalus, complex orthopedic conditions, craniofacial anomalies, genetic disorders, neurological conditions and brain and spinal cord injuries. Care at Gillette is clinically integrated, bringing experts together from multiple areas to coordinate and care for patients from initial diagnosis through the lifetime of their condition, with individualized care planning at the center of our work. This emphasis on the longitudinal aspects of care have differentiated us from traditional health systems. For more than 125 years Gillette has led in the diagnosis and management of complex medical conditions through the development of innovative medical and surgical interventions, proven rehabilitative therapies and the novel application of customized services from compassionate health care professionals, Gillette helps children thrive and live happy, healthy, and productive lives.Over time, the organization anticipates a proportionate increase in children with needs for specialized health care requiring Gillette's unique services. In addition, there are shortages of pediatric specialists in many areas of the five-state Midwest region, which will continue to bring patients to Gillette. By establishing suburban and greater Minnesota clinics, and developing collaborative relationships with other health systems, Gillette has made a concerted effort to meet the needs of patients outside the Twin Cities metro region. Gillette's continuing focus on meeting the needs of underserved and rural populations who require specialized pediatric services will also contribute to steady organizational growth.Gillette is also teaching hospital committed to training the physicians of the future. Because Gillette focuses primarily on specialty care for children who have disabilities and complex medical conditions, it is a regional resource of specialists, technology, facilities and comprehensive services. In 2022, residents and fellows from the University of Minnesota and Henry Ford Health in Detroit spent one to three months under the mentorship of Gillette's medical staff. In many cases, Gillette offers trainees their only exposure during residency to patients who have complex conditions like cerebral palsy or spina bifida, and rare disorders like osteogenesis imperfect or Rett syndrome. Gillette's physician training programs include the specialties of orthopedics, pediatrics, neurodevelopmental pediatrics, and rehabilitation medicine. Gillette has a surgery simulation center that allows teams to practice performing complex procedures and using new technologies. New staff members, medical residents and multidisciplinary teams learn and practice in a true-to-life environment. The result is hands-on education for staff and enhanced safety for patients.Gillette also provides extensive continuing medical education services to physicians and other health care providers in our area of expertise. Participants travel from around the region and globe to learn from Gillette experts each year. These programs also support the ongoing development of referral and partnership arrangements and relationships that direct patients to Gillette for their care. Gillette is fully accredited by the Minnesota Medical Association to provide continuing medical education. Gillette covers the unreimbursed costs of medical education.
Part VI, Line 3: Gillette provides free or reduced-cost medical care to community residents, primarily by:- Providing services at no charge to uninsured patients.- Providing uninsured patients who do not qualify for charity care approximately the same discount as our third party payers.- Covering the difference between public-program payments (primarily Medicare and Medicaid) and the related costs of providing such services.- Providing services to patients who express a willingness to pay but who are unable to do so because of socioeconomic factors.- Coordinating care with a patient's primary-care physician, school, and community agencies.During 2022, a majority of Gillette inpatient stays were patients eligible for or covered under Medical Assistance (Minnesota's Medicaid program). Gillette has a documented policy for providing financial assistance in the form of charity care to patients who are financially without the means to pay for medically necessary care and who satisfy certain requirements. Each patient's situation is evaluated according to relevant circumstances, such as income, assets and other resources. Gillette staff will identify a family's charity-care needs before services are performed, whenever possible, as part of the admission process. Families complete a financial assistance application that Gillette provides. Proof of participation in Medicaid or any other public assistance program indicates that the patient has been deemed financially indigent and, therefore, the patient is not required to provide his/her income on Gillette's assistance application. Gillette may also make presumptive eligibility decisions if application information is not available. In addition to doing so during the admission process, Gillette makes patients aware of financial assistance programs by listing them on patient statements and the Gillette website.
Part VI, Line 4: Gillette provides specialized health care for people who have complex and often rare diagnoses or traumatic injuries. Gillette treated patients from all 87 Minnesota counties in 2022. Some patients come to the Twin Cities for care; while others receive care through our greater Minnesota locations and virtual care options. Gillette staff members also see patients who come to Gillette for care from throughout the U.S. and other countries. During 2022, Gillette served patients from 41 states and territories and 6 international countries, and provided 10,268 virtual care visits.
Part VI, Line 5: Gillette provides a wide variety of benefits to the community. In addition to the care Gillette provides its patients, Gillette provides community benefit by serving as an advocate for children who have complex medical conditions inducing efforts related to increasing access, resources and awareness for those the organization serves. Gillette leadership also participates in Minnesota's Rare Disease Advisory Council to help increase research and education related to rare conditions. Gillette serves as a gathering place for interested citizens (including the board of directors, other volunteers, skilled professionals, patients and families) to address the challenges and needs of children who have conditions affecting the musculoskeletal or neurological systems, to define the needs of the families of those children, and to advocate for support of those families in meeting their needs. Gillette has sponsored support sessions for caregivers of children who have disabilities. Gillette is part of the United Cerebral Palsy (UCP) organization; UCP is devoted to educating, advocating for and providing support services to people who have a spectrum of disabilities. In addition, Gillette is a designated Muscular Dystrophy Association (MDA) Care Center to help people receive the services they need throughout all stages of the condition. MDA is the world's leading nonprofit health agency dedicated to finding treatments and cures for muscular dystrophy and other neuromuscular diseases. Gillette also teams with Family Voices of Minnesota to support Parent to Parent, a network connecting experienced families with families of children who have disabilities, cognitive issues and other health needs and who need emotional support.Patients rely on the organization to address the physical, mental and emotional effects of their disabilities from birth through adulthood. Gillette's Child and Family Services ("CFS") is a team of social workers, psychologists and neuropsychologists, child life specialists, therapeutic recreation specialists and a chaplain. CFS team members work closely with children and families to help them understand their medical care and minimize stress through play, relaxation, and special events and activities. Child life professionals are trained in child development and are part of the multi-disciplinary care team. They partner with the whole family, including siblings, to foster a positive and supportive care experience. Gillette provides educational materials, programs and videos about specific conditions, information services available by telephone (which is free to families and for which Gillette is not reimbursed by insurance programs), and programs to improve the general standards of health in the community. Gillette uses its website and social media channels to share information from its medical experts with the community; topics include working through childhood diagnoses, talking with a child's peers about his or her condition, brain injury prevention, nutrition for children, seasonal safety, and strategies for helping children overcome bullying. Gillette also uses its website and social channels to advocate on behalf of children who have complex conditions.Gillette offers in-hospital schooling to patients who will be hospitalized two weeks or longer during the traditional school year. A partnership between Gillette and St. Paul Public Schools means that children and teens who are recovering from a major surgery or traumatic injury can continue their academic lessons at Gillette. Gillette's classroom is outfitted with the latest technology-including webcams, laptops, a touch-screen computer, and a state-of-the-art SmartBoard. Our teacher works one-on-one with students on lesson plans designed for their unique needs and in collaboration with the student's home district.Gillette funds a program called the Adapted Sports Equipment Fund to help children with disabilities obtain the equipment needed to participate in adapted sports and recreational activities in their communities. Gillette also hosts an annual Adaptive Bike & Sports Expo to help children who have disabilities find customized bicycles and other equipment that meets their unique needs and helps promote independence.In addition, Gillette performs clinical and translational research devoted to finding effective medical interventions for complex conditions and their related effects and to improving outcomes in patients who have disabilities. Gillette researchers were engaged in 120 active studies during 2022. Gillette published 91 peer-reviewed publications in 2022, and conducted 35 research project supported by extramural funding, and 34 studies funded by the Foundation from philanthropy. Clinical and nonclinical research staff members routinely present at medical conferences. Research at Gillette consists of core emphasis areas, all of which seek to improve the lives of children who have disabilities and complex conditions. Gillette operates an aggressive knowledge translation initiative that aims to advance patient outcomes and experience by better incorporating current medical research into ongoing clinical practice.Through community support and generous contributions to Gillette Children's Foundation, Gillette continues to expand, create new services, and research treatments for children with disabilities. The organization's goal remains, as it has for more than 125 years, that of helping children and adults who have disabilities, and their families, to improve their health, achieve greater well-being and enjoy life. In March 2020, the World Health Organization declared the outbreak of a novel strain of coronavirus and related disease (Covid-19) a global pandemic. The resulting social and economic impact on the Gillette and the entire healthcare industry has been significant through 2021 and 2022. Gillette patients have highly complex medical conditions, which are higher risk of developing complications from Covid-19. Gillette has expanded virtual care services, particularly within provider clinics and rehabilitation services, to ensure our patients continue to receive quality, necessary healthcare during the pandemic. Virtual care appointments are made available via both secure video or telephone services. Gillette also collaborates with other local health systems and governments to ensure sufficient health care resources, including beds, staffing, and personal protective equipment, were available to respond to the pandemic. Facilities were enhanced to ensure that appropriate physical distancing, visitor restrictions, health and wellness screening, universal masking, and rigorous sanitizing and disinfection protocols are in place to ensure the continued safety of patients, families, employees and visitors.
Part VI, Line 7, Reports Filed With States MN
Schedule H (Form 990) 2022
Additional Data


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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2022
Open to Public
Inspection
Name of the organization
Gillette Children's Specialty Healthcare
 
Employer identification number
36-3379150
Part I
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, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 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 of organization
or government
(b) EIN (c) IRC section
(if applicable)
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
noncash assistance
(h) Purpose of grant
or assistance
(1) American Academy for Cerebral Palsy and Developmental Medicine
555 East Wells St
Milwaukee,WI532023823
62-0692749 501(c)(3) 15,000 0     Program Support
(2) Black Business Enterprises Fund
708 N 1st Street Suite 141
Minneapolis,MN55401
86-3609489 501(c)(3) 14,000 0     Scholarships
(3) Ronald McDonald House Charities Upper Midwest
818 Fulton St SE
Minneapolis,MN55414
41-1313107 501(c)(3) 8,500 0     Program Support
(4) Epilepsy Foundation of Minnesota
7760 France Ave S Suite 210
Minneapolis,MN55435
41-0874541 501(c)(3) 7,500 0     Program Support
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
4
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2022

Schedule I (Form 990) 2022
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients
(c) Amount of
cash grant
(d) Amount of
noncash assistance
(e) Method of valuation (book,
FMV, appraisal, other)
(f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
Part I, Line 2: Gillette periodically grants monies to other exempt organizations which conduct programs that benefit the patients that Gillette serves, as authorized by the Gillette executive leadership team. During calendar year 2022, Gillette made grants to the American Academy for Cerebral Palsy and Developmental Medicine, Black Business Enterprises Fund, Ronald McDonald Charities, St Paul Area Chamber of Commerce, Epilepsy Foundation of Minnesota, Wilson's Image College Scholarship, Children's Surgery International, and other organizations. The grants support the missions and key initiatives of the related organizations.
Schedule I (Form 990) 2022



Additional Data


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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
Name of the organization
Gillette Children's Specialty Healthcare
 
Employer identification number

36-3379150
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
 
No
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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2022

Schedule J (Form 990) 2022
Page 2
Part II
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 on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1Kim Peter
Neurosurgeon
(i)

(ii)
1,223,021
-------------
0
0
-------------
0
68,989
-------------
0
16,165
-------------
0
38,054
-------------
0
1,346,229
-------------
0
0
-------------
0
2Graupman Patrick
Neurosurgeon
(i)

(ii)
1,198,230
-------------
0
0
-------------
0
66,439
-------------
0
16,165
-------------
0
40,535
-------------
0
1,321,369
-------------
0
0
-------------
0
3Song Debbie
Neurosurgeon
(i)

(ii)
1,194,542
-------------
0
1,225
-------------
0
66,094
-------------
0
16,165
-------------
0
39,675
-------------
0
1,317,701
-------------
0
0
-------------
0
4Guillaume Tenner
Orthopedic Surgeon
(i)

(ii)
1,027,681
-------------
0
1,225
-------------
0
69,472
-------------
0
16,165
-------------
0
35,095
-------------
0
1,149,638
-------------
0
0
-------------
0
5Joers Barbara
President & CEO
(i)

(ii)
675,870
-------------
0
254,576
-------------
0
109,448
-------------
0
16,165
-------------
0
34,192
-------------
0
1,090,251
-------------
0
0
-------------
0
6Truong Walter
Orthopedic Surgeon
(i)

(ii)
759,190
-------------
0
0
-------------
0
64,600
-------------
0
16,165
-------------
0
38,220
-------------
0
878,175
-------------
0
0
-------------
0
7Niermann Micah
EVP Medical Affairs
(i)

(ii)
431,752
-------------
0
110,214
-------------
0
66,199
-------------
0
16,165
-------------
0
32,782
-------------
0
657,112
-------------
0
0
-------------
0
8Nolan Patrick
EVP Finance
(i)

(ii)
402,994
-------------
0
100,157
-------------
0
58,598
-------------
0
16,165
-------------
0
34,916
-------------
0
612,830
-------------
0
0
-------------
0
9Montgomery Paula
EVP Administrative Affairs
(i)

(ii)
346,796
-------------
0
89,768
-------------
0
52,591
-------------
0
16,165
-------------
0
39,596
-------------
0
544,916
-------------
0
0
-------------
0
10Getsay Tim
EVP Performance
(i)

(ii)
345,617
-------------
0
86,216
-------------
0
35,106
-------------
0
13,917
-------------
0
37,489
-------------
0
518,345
-------------
0
0
-------------
0
11Harris Thomas
EVP Operations
(i)

(ii)
351,803
-------------
0
47,957
-------------
0
57,803
-------------
0
16,165
-------------
0
33,707
-------------
0
507,435
-------------
0
0
-------------
0
12Brady Karen
VP People
(i)

(ii)
268,402
-------------
0
89,256
-------------
0
21,898
-------------
0
16,165
-------------
0
29,656
-------------
0
425,377
-------------
0
0
-------------
0
13Brill Karen
VP Quality
(i)

(ii)
232,555
-------------
0
69,688
-------------
0
25,502
-------------
0
15,952
-------------
0
22,743
-------------
0
366,440
-------------
0
0
-------------
0
14Bariteau Stephen
EVP Philanthropy
(i)

(ii)
0
-------------
249,569
0
-------------
250
0
-------------
32,183
0
-------------
13,529
0
-------------
30,737
0
-------------
326,268
0
-------------
0
15Sinner Angela
Chief of Staff
(i)

(ii)
217,368
-------------
0
1,225
-------------
0
15,249
-------------
0
10,669
-------------
0
16,285
-------------
0
260,796
-------------
0
0
-------------
0
16Jolley Dennis
VP Development (End 04/22)
(i)

(ii)
72,214
-------------
0
72,160
-------------
0
20,735
-------------
0
8,532
-------------
0
4,432
-------------
0
178,073
-------------
0
0
-------------
0
Schedule J (Form 990) 2022

Schedule J (Form 990) 2022
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
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.
Part I, Line 3: As directed by the Executive Committee of the Board of Directors, an independent consultant periodically provides the Committee with survey data containing recommendations for the President & CEO and other executives. The recommendations 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. Members of the Committee determine the President & CEO salary. The Committee oversees the executive incentive plan, approves incentive plan payouts, and regularly evaluates 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." Actions related to the President & CEO and other executive compensation are discussed and voted upon at Committee meetings, and recorded in meeting minutes.
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 Executive Committee of the Board of Directors.
Schedule J (Form 990) 2022

Additional Data


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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part , line 24a. Provide descriptions,
explanations, and any additional information in Part .
SchKMediumBullet Attach to Form 990.

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
Gillette Children's Specialty Healthcare
 
Employer identification number
36-3379150
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A HOUSING & REDEVELOPMENT AUTHORITY OF THE CITY OF ST PAUL MINNESOTA
 
52-1440935 000000000 05-11-2016 20,000,000 Capital projects at the hospital location   X   X   X
B HOUSING & REDEVELOPMENT AUTHORITY OF THE CITY OF ST PAUL MINNESOTA
 
52-1440935 000000000 09-01-2017 27,880,000 Refund bonds issued 11/12/2009   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 7,155,000 11,350,000    
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 20,000,000 27,880,000    
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 285,535 362,774    
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 19,714,465      
11 Other spent proceeds .............   27,517,226    
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2017
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2020, a current refunding issue)? ........
  X   X        
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2020, an advance refunding issue)? ........
  X X          
16 Has the final allocation of proceeds been made? .......... X   X          
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X          
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 2
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X        
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   X   X        
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X          
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X          
c Are there any research agreements that may result in private business use of bond-financed property? ............. X   X          
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X          
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0 % 0 %    
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0 % 0 %    
6 Total of lines 4 and 5 ............. 0 % 0 %    
7 Does the bond issue meet the private security or payment test? ...   X   X        
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X        
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 sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X          
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X        
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X        
b Exception to rebate? ........ X     X        
c No rebate due? .........   X   X        
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? .....   X   X        
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X        
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X        
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X        
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X          
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X          
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
Schedule K, Part III, Line 3a and 3c Gillette's current management, service, and research contracts with respect to the financed property do not result in private business use.
Schedule K, Part IV, Line 5, Column (b) The question is being answered without regard to a yield-restricted advance refunding escrow financed with the proceeds of the bonds.
Schedule K (Form 990) 2021

Additional Data


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SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
Gillette Children's Specialty Healthcare
 
Employer identification number

36-3379150
Return Reference Explanation
FORM 990, PART III, LINE 4A, DESCRIPTION OF PROGRAM SERVICE: Orthopedics: Gillette is home to nationally and internationally recognized leaders in pediatric orthopedics. Gillette's staff treats patients who have complex orthopedic problems resulting from cerebral palsy, traumatic brain injuries, neuromuscular conditions, trauma-related fractures, and strokes. Gillette staff members see patients who have permanent joint contractures, extra or missing fingers or toes, brittle-bone disease, and clubfoot. The staff also creates prostheses and treats patients with complex leg-and arm-length discrepancies. Orthopedic surgeons treat children with scoliosis and other spine disorders. Gillette doctors also see patients who have joint disease, joint-overuse symptoms, and other musculoskeletal conditions. Neurosciences: Gillette's neurology and neurosurgery providers provide expert clinical care for children with neurologic conditions and offer a breadth and depth of subspecialty care to provide the most accurate diagnoses and advanced treatments available for patients with conditions including Chiari malformations, hydrocephalus, spina bifida, epilepsy, neuromuscular conditions such as muscular dystrophy and spinal muscular atrophy, rare conditions such as Rett Syndrome, and neurological complications resulting from other complex conditions. Craniofacial Services: Gillette's experts diagnose and treat children with congenital or acquired conditions involving the head and neck. These conditions, often resulting from a genetic anomaly and occurring frequently with other comorbid conditions, require an integrated care team including surgeons, physical, speech and occupational therapists, dental and orthodontics, as well as specialized orthoses. Unique service offerings include the Gillette CranioCap orthosis, a custom-made brace for the skull that corrects deformational plagiocephaly. For many children with cleft lips and palates, orthodontists custom-make Gillette's OrthoCleft retainer, a presurgical appliance that brings gum segments together, reducing the gap in the mouth, and improves sucking and eating abilities for some children awaiting surgery. Both the CranioCap orthosis and OrthoCleft retainer are registered trademarks of Gillette and are used nationally. Gillette's staff also treats children who have hemangiomas and vascular malformations. Rehabilitation: Gillette provides comprehensive inpatient rehabilitation care, as well as outpatient rehabilitation services. As a major referral destination, our pediatric rehabilitation program is one of the largest in the upper Midwest. We also offer the nation's highest concentration of board-certified pediatric rehabilitation medicine specialists, all in a family-centered environment. Our inpatient unit offers comprehensive medical rehabilitation services to children and teens who sustain brain and spinal cord injuries, require post-surgical rehabilitation needs, or have other complex medical conditions requiring rehabilitation services. Gillette Children's Specialty Healthcare has a history of accreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF) for pediatric inpatient rehabilitation and our pediatric brain injury specialty program Gillette is one of the few hospitals in the country with these designations. We also provide outpatient services for such patients after discharge. Gillette provides specialized physical therapy, occupational therapy, speech and language pathology and audiology services to patients who have a wide variety of conditions, including cerebral palsy, spinal bifida, orthopedic conditions and other complex medical issues. Gillette also provides aquatic therapy for patients who have neurological and musculoskeletal problems. Complex Pediatric and Subspecialty Services: Gillette's pediatric staff offers the region's most comprehensive program for the diagnosis and management of infants and children who have a wide variety of complex medical conditions. Complex Care physicians coordinate care across multiple services and serve as a single point of contact for families and primary care providers, managing the overall health of a child with medical complexity. Pediatricians are supported by medical specialists in areas such as rheumatology, endocrinology, integrative and palliative medicine, genetics, and infectious diseases. Level I Pediatric Trauma Center: In 2009, a collaborative effort between Gillette and Regions Hospital resulted in recognition by the American College of Surgeons as the State of Minnesota's first Level I Pediatric Trauma Center. To be certified as a Level I Pediatric Trauma Center, Regions in collaboration with Gillette had to meet the requirements of adult trauma centers while fulfilling pediatric guidelines, including additional specialists and critical care patient volumes. While Regions cares for critically injured adult patients, injured children are transferred to Gillette's Pediatric Intensive Care Unit, where a team of Gillette and Regions specialists provide critical care and medical intervention. Specialized Ancillary Services: Gillette also provides an array of highly specialized ancillary services that are interwoven into our delivery of a complete system of care for those we serve, including: Gait and Motion Analysis: Gillette operates one of the world's busiest and most respected pediatric clinical gain and motion analysis centers. The James R. Gage Center for Gait and Motion Analysis is known worldwide for expertise in diagnosing and planning treatments for people who have disorders affecting their gait and ability to control movement. Using innovative computer technology, motion analysis captures movements, muscle activity and forces that help physicians understand and recognize how orthopedic, neurological and muscular conditions can hinder motions that are critical to daily living. Information from gait analysis-together with imaging scans, medical history and the results of other evaluations-helps physicians recommend the best treatments for a wide variety of conditions that disrupt movement. Gillette's gait lab is one of the busiest labs in the world, performing 464 gait and motion analyses during 2022 on patients from around the world. Orthotics, Prosthetics and Seating: Gillette is one of the Twin Cities' largest providers of custom-made orthotics, prosthetics and seating (wheelchair and related mobility support) services. Gillette employs certified prosthetists and orthotists, who identify, design and manufacture customized equipment for correcting skeletal disorders, providing skeletal support, managing muscle tone, and fostering independence. Gillette's staff provides customized braces, artificial limbs, assistive communication devices, protective headgear, specialized seating, and customized wheelchair construction and modifications. Rehabilitation Therapies: Gillette employs physical, occupational and speech/language therapists with extensive training in the therapeutic treatment and rehabilitation of children and adults with compels neurological and musculoskeletal conditions. Specializations include intensive brain and spinal cord injury rehabilitation, Schroth therapy for scoliosis (spinal curvature), augmentative and alternative communication for individuals without the ability to speak, food and swallowing therapy for individuals post-tracheotomy, and speech and language therapy for children after the repair of cleft lip, palate or major facial reconstruction. Virtual Care: Gillette expanded its virtual care program to accommodate patient needs, particularly during the evolving coronavirus pandemic. The launch of virtual rehabilitation therapies and expanded virtual clinics resulted in over 10,268 virtual care visits provided in 2022. In 2020, the International Hospital Federation, in partnership with the World Health Organization, compiled and shared a summary report about new ways of delivering health care while responding to the COVID-19 pandemic. Gillette's successful launch of the virtual rehabilitation therapies was included in that report as a case study showing innovation in health care. Care Management Services: The complexity of the conditions managed by Gillette medical providers require a high level of scheduling, insurance, and coordination with other services including schools, social service providers, and transportation providers. Gillette's care management team, in collaboration with other areas of the hospital, provide a range of supports and services to families to help them proactively manage their child's care.
FORM 990, PART III, LINE 4A, DESCRIPTION OF PROGRAM SERVICE: Dental Care: Because few traditional dentists have the facilities, equipment or trained staff to serve people who have disabilities, Gillette offers outpatient care from dentists and orthodontists who understand the unique needs of people who have complex conditions. Dental services designed specifically for this patient population are important, as many disabilities make it difficult for patients to be seen by a traditional dentist, and there is a strong link between physical health and oral health. People who have cerebral palsy, for example, might have muscles that involuntarily move and tighten, impeding the ability to brush and floss daily. Gillette also offers orthodontia and dental services for children born with cleft lip and/or palate or other craniofacial anomalies. Gillette has custom exam chairs designed to meet the needs of people who have conditions, a station suited for patients who use wheelchairs, and sedation for patients who are unable to tolerate dental procedures without it. Child and Family Services: Gillette's Child and Family Services (CFS) is a team of social workers, psychologists and neuropsychologists, child life specialists, therapeutic recreation specialists and a chaplain. CFS team members work closely with children and families to help them understand their medical care and minimize stress through play, relaxation, and special events and activities. Child life professionals are trained in child development and are part of the multi-disciplinary care team. They partner with the whole family, including siblings, to foster a positive and supportive care experience. Gillette has received numerous awards, recognition, and maintains numerous accreditations, partnerships, and memberships, including the following: During 2022, Gillette launched the Gillette Children's Cerebral Palsy Institute, harnessing over 125 years of clinical leadership, advocacy, and research to transform care for cerebral palsy. This was possible through generous donor support for research. Gillette was named the first Level 1 Specialty Children's Surgery-Musculoskeletal verified surgical center in the nation by the American College of Surgeons. Gillette celebrated the grand opening of Gateway Plaza, which creates a central space to welcome Gillette families, offers proximate parking for Gillette employees, and opens the door to future clinical expansion. Families are also able to enjoy a new accessible children's play space at the new facility. To help amplify our story and broaden our reach, Gillette refreshed its mission, vision and brand and reaffirmed our status as a global beacon for children living with brain, bone and movement conditions. Gillette joined the Rare Disease Diversity Coalition to partner in advocating for equitable access, care, research, and treatment. Gillette also built a coalition of partners to advocate for the formal recognition of Disability Pride Month, and celebrated Disability Pride Game Days with the Minnesota Twins. Gillette was recognized as one of 28 health care systems nationwide to earn a spot in the American Medical Association's Joy in Medicine Health System Recognition Program. In 2021, Gillette partnered with the Amputee Coalition, the nation's leading nonprofit organization dedicated to empowering people affected by limb loss or limb difference. Gillette is one of the few pediatric hospitals, and the only pediatric partner in the five-state area surrounding Minnesota, to achieve this. Gillette is one of 15 institutions across the U.S. honored with the International Rett Syndrome Foundation's Center of Excellence designation or redesignation. This award recognizes Gillette's continued dedication to providing best-in-class care for Rett Syndrome, a rare neurological and developmental disorder. Joint Commission: Gillette has earned and maintained the Joint Commission's Gold Seal of Approval since 2008. To be eligible, organizations must undergo an on-site survey at least once every three as a symbol of quality. Rehabilitation: Gillette's inpatient rehabilitation program has maintained accreditation by the Commission on Accreditation of Rehabilitation Facilities ("CARF") since 1992. Gillette's pediatric brain injury specialty program is also accredited by CARF. In 2019, CARF issued a three-year accreditation to Gillette. Gillette is the region's largest pediatric rehabilitation program and is one of only three pediatric programs in Minnesota accredited by CARF. In addition, Gillette is one of eight health care providers in the country with designations in pediatric inpatient rehabilitation and brain injury. Quality: In 2019, the National Committee for Quality Assurance awarded Gillette the Patient Centered Specialty Practice Recognition for orthopedic practices at their St. Paul campus, Minnetonka Clinic, Maple Grove Clinic and Burnsville Clinic. Gillette is the first pediatric health care organization in Minnesota receive this distinction. Patient Safety: The Children's Hospitals' Solutions for Patient Safety National Children's Network recognized Gillette with "Navigator" status in 2018. Gillette is one of only thirteen to be recognized with this status out of over 130 hospitals in the network. Additionally, Gillette was recognized in 2020 for meeting all three patient safety measure, which was achieved by only 16 of 140 participating hospitals. Orthotics and Prosthetics: The American Board for Certification in Orthotics, Prosthetics and Pedorthics, the national accrediting body for the orthotic and prosthetic professions, has certified each of Gillette's prosthetists and orthotists. Gait and Motion: In 2009, the Commission for Motion Laboratory Accreditation named Gillette's Center for Gait and Motion Analysis the nation's first accredited motion analysis laboratory. Health Care Home: In 2019, Gillette's Complex Care Specialty Clinic was certified as a Health Care Home for medically complex patients. Patient Safety: Committed to continuous improvement, Gillette participates in the Solutions for Patient Safety (SPS), a national collaborative of hospitals throughout the U.S. focused on eliminating adverse health events and patient harm. As part of the SPS collaboration, Gillette developed and implements best practices for preventing 13 patient safety issues, called healthcare-acquired conditions. Through its presurgical preparation program, discharge planning program, and telehealth nursing services, Gillette identifies patients at risk of complications and develops plans to reduce those risks. These efforts have paid off in reducing the incidence of healthcare-acquired conditions. Gillette continues its harm prevention work to include preventing serious employee injuries, focusing on preventing workplace violence events, slips/trips/falls overexertion injuries and patient behavioral events. Gillette also implemented daily casting rounds to prevent and identify pressure injuries in patients with casts or orthoses.
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 had a business relationship during the year: David Bestler, Marlon Cush, John Ellenberger, David Fettig, Jeffrey Freyer, Linda Ireland, Barbara Joers, John Liddicoat, William McDonald, Julie Neville, Pete Rhodes, Sharifa Garcia, Angela Sinner, Rulon Stacey, Phillip Trier, Kathy Tune.
Form 990, Part VI, Section B, line 11b Gillette staff, including representatives from finance, legal, communications and administration departments, completed the return and related documentation. Gillette's accounting firm compiled the return. Gillette's chief executive officer and chief financial officer reviewed the draft documents before filing. Gillette provided a copy of Form 990 to each member of the governing body before filing. After all reviews were complete, the final return was presented to and approved by the Finance and Investment Committee and the Board of Directors prior to filing.
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 all outside activities that involve potential conflicts of interest. 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 supervisor 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 As directed by the Executive Committee of the Board of Directors, an independent consultant periodically provides the committee with survey data containing recommendations for the President & 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 President & CEO salary and the salary ranges for other executives. The Committee oversees the executive incentive plan, approves incentive plan payouts, and regularly evaluates 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 reviews and approves the salary offers for contract and employed physicians, oversees payments under any incentive compensation plans, and evaluates all transactions with "disqualified persons."
Form 990, Part VI, Section C, line 19 Gillette posted its annual report and summarized financial statements to its public website. The annual report was also provided to certain outside entities, including the Minnesota Hospital Association and Children's Hospital Association; Children's Miracle Network Hospitals partner organizations; donors; and prospective donors. Email directing to the online annual report was sent to Gillette employees, volunteers, patients, and families. Form 990s are available from the states of Minnesota and Wisconsin, Guidestar.org, and the Internal Revenue Service. Gillette discloses financial statements to bondholders, Minnesota Hospital Association 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 IX, line 11g Personnel Contracts: Program service expenses 17,427,566. Management and general expenses 323,661. Fundraising expenses 0. Total expenses 17,751,227. Regions Services: Program service expenses 4,051,770. Management and general expenses 512,764. Fundraising expenses 0. Total expenses 4,564,534. Temp Staffing: Program service expenses 2,971,339. Management and general expenses 506,178. Fundraising expenses 0. Total expenses 3,477,517. Interpreter Services: Program service expenses 699,729. Management and general expenses 0. Fundraising expenses 0. Total expenses 699,729. Other Services: Program service expenses 4,443,280. Management and general expenses 3,302,814. Fundraising expenses 0. Total expenses 7,746,094.
Form 990, Part XI, line 9: Change in Beneficial Interest in Net Assets of Foundation -6,915,801. Other nonoperating losses -185,444.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
Gillette Children's Specialty Healthcare
 
Employer identification number

36-3379150
Part I
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 (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity

(1) Gillette Community Care LLC
200 University Ave E
St Paul,MN55101
86-1381227
Health Care & Social Assistance MN -64,876 145,085 Gillette Children's Specialty Healthcare
 










Part II
Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)Gillette Children's Hospital Foundation
200 University Ave E

St Paul,MN55101
41-1200302
Health Care MN 501(c)(3) 7 Gillette Children's Specialty Healthcare
 
Yes
 












For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership 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)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No












Part IV
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-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) Capernaum Pediatric Therapy Inc

200 University Ave E
St Paul,MN55101
41-1618385
Health Care MN Gillette Children's Specialty Healthcare
 
S -30,929 760,405 100.000 %   No












Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 3
Part V
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.
Yes
No
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 .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
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)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) Gillette Children's Hospital Foundation

C 11,582,371 Fair Market Value
(2) Gillette Children's Hospital Foundation

Q 554,520 Fair Market Value
(3) Capernaum Pediatric Therapy Inc

Q 73,858 Fair Market Value



Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 4
Part VI
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 gross revenue) 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 or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference Explanation
Schedule R (Form 990) 2021

Additional Data


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