2023-11-01T11:04:56-05:00 2022-12-31 366055558 GRANT THORNTON LLP 75 STATE ST 13TH FLOOR BOSTON MA 02109 990 2022-01-01 390807235 VERSITI WISCONSIN INC VERS 4149335000 PO BOX 2178 MILWAUKEE WI 532012178 CHRIS MISKEL PRESIDENT & CEO 4149335000 2023-10-31 1 CHRIS MISKEL 999009999 0 ERIN COUTURE P01390592 6177237900 2023-10-30 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z X CHRIS MISKEL PO BOX 2178 MILWAUKEE WI 532012178 252065697 0 X WWW.VERSITI.ORG X 1947 WI (SEE SCHEDULE O) VERSITI WISCONSIN, INC. (VERSITI WISCONSIN) IS A BLOOD HEALTH INNOVATOR WHO ENHANCES LIVES THROUGH DISCOVERY, DIAGNOSIS AND TREATMENT. VERSITI EXPANDS THE FRONTIERS OF PATIENT HEALTH THROUGH THE INTEGRATION OF SCIENCE, MEDICINE AND SERVICE. 16 15 1301 284 140698 3684 26132948 31822899 167274964 183233449 2701979 5541393 252824 221475 196362715 220819216 12055608 4178503 0 0 82827280 83558410 0 0 0 101147965 119607887 196030853 207344800 331862 13474416 138704162 141863484 29709806 26736333 108994356 115127151 X VERSITI WISCONSIN, INC. (VERSITI) IS A BLOOD HEALTH INNOVATOR WHO ENHANCES LIVES THROUGH DISCOVERY, DIAGNOSIS AND TREATMENT. VERSITI EXPANDS THE FRONTIERS OF PATIENT HEALTH THROUGH THE INTEGRATION OF SCIENCE, MEDICINE AND SERVICE. 0 0 47039347 114000 54057206 VERSITI OPERATES THE COMPREHENSIVE CENTER FOR BLEEDING DISORDERS (CCBD), UNDER A FEDERAL SUBAWARD AGREEMENT OF THE SOCIAL SECURITY ACT. CCBD PROVIDES CRITICAL SERVICES TO BLEEDING AND CLOTTING DISORDER PATIENTS AND THEIR FAMILIES. AS A COVERED ENTITY UNDER THE FEDERAL 340B DRUG DISCOUNT PROGRAM, VERSITI IS ELIGIBLE TO ACCESS CERTAIN SPECIALTY PHARMACEUTICALS AT DISCOUNTED PRICING. PHARMACEUTICAL NET INCOME IS PROGRAM INCOME AND FUNDS ARE RESTRICTED TO ACTIVITIES AND EXPENDITURES THAT FURTHER ELIGIBLE PROJECTS AND PROGRAM OBJECTIVES; INCLUDING PATIENT CARE, EDUCATION, SUPPORT SERVICES, APPROVED GRANT RESEARCH AND OTHER COSTS. VERSITI PROVIDES THESE SPECIALTY PHARMACY PRODUCTS TO HOME CARE PATIENTS AND HOSPITAL SYSTEMS. DURING 2022, 17,695 VIALS OF SPECIALTY PHARMACY PRODUCTS WERE PROVIDED. 41230588 46935 51796636 VERSITI RECRUITS VOLUNTEER BLOOD DONORS, COLLECTS, PROCESSES AND DISTRIBUTES BLOOD AND BLOOD COMPONENTS TO PROVIDE A SAFE AND RELIABLE SUPPLY OF BLOOD FOR HOSPITALS AND OTHER BLOOD CENTERS SERVED. DURING 2022, 153,460 BLOOD UNITS WERE COLLECTED. 33192452 4010500 VERSITI RESEARCH ADVANCES THE SCIENTIFIC AND MEDICAL UNDERSTANDING OF BLOOD BIOLOGY AND BLOOD DISEASE TO IMPROVE HEALTH. DURING 2022, VERSITI HAD 40 INVESTIGATORS. 56692989 7068 77380755 A. VERSITI WISCONSIN, INC. (VERSITI) PROVIDES CLINICAL DIAGNOSTIC TESTING SERVICES TO HOSPITALS, PHYSICIAN OFFICES AND OTHER REFERENCE LABORATORIES. DURING 2022, 130,638 TESTS WERE PERFORMED.B. VERSITI ORGAN AND TISSUE DONATION COMBINES PROCUREMENT SERVICES AND EDUCATION TO ENHANCE THE LIVES OF PATIENTS AND PROVIDES GUIDANCE TO THE FAMILIES OF POTENTIAL DONORS. DURING 2022, 380 ORGANS WERE TRANSPLANTED AND 526 MUSKULOSKELETAL DONORS WERE SEEN.C. VERSITI MEDICAL SERVICES PROVIDES MEDICAL AND THERAPEUTIC SERVICES IN PARTNERSHIP WITH LOCAL HOSPITALS. DURING 2022, 3,668 THERAPEUTIC PROCEDURES WERE PERFORMED.D. VERSITI DONOR TESTING LABORATORY PROVIDES INFECTIOUS DISEASE TESTING TO DETERMINE DONOR SUITABILITY AND PRODUCT SAFETY FOR VERSITI AFFILIATES AND OTHER BLOOD CENTER PARTNERS.THE COMBINED TOTALS FOR DIAGNOSTIC LABORATORY, ORGAN AND TISSUE DONATION, MEDICAL SERVICES, AND DONOR TESTING LABORATORY ARE SUMMARIZED BELOW. 56692989 7068 77380755 178155376 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 0 0 1 1301 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 16 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X X BRIAN MALANEY 4149335000 638 N 18TH ST MILWAUKEE WI 532332121 X CHRIS MISKEL PRESIDENT & CEO 21.00 34.00 X X 567313 783433 50894 BRIAN BAUTISTA EVP & CHIEF OPERATING OFFICER 22.00 33.00 X 297280 410530 51630 BART REUTER EVP & GENERAL COUNSEL 21.00 34.00 X 274726 379387 60544 GITESH DUBAL EVP & CHIEF MARKETING OFFICER 22.00 33.00 X 250616 346087 52363 ANTHONY WATKINS EVP & CHIEF FINANCIAL OFFICER 16.00 28.00 X 247116 341253 58277 MICHAEL DEININGER MD EVP & CHIEF SCIENTIFIC OFFICER 48.00 7.00 X 530569 58951 37160 BRADLEY PIETZ EVP & CHIEF LABORATORY OFFICER 22.00 33.00 X 201772 278637 58097 JAMES WEIDNER EVP & CHIEF HR OFFICER 22.00 33.00 X 197254 272400 50698 PETER NEWMAN PHD VP RESEARCH & ASSOC DIR BRI 55.00 0.00 X 473785 0 35247 LYNNE BRIGGS VP & CHIEF INFORMATION OFFICER 22.00 33.00 X 180005 248581 58761 MATTHEW ANDERSON MD VP & DIAGNOSTIC LAB MED DIR 55.00 0.00 X 413296 0 58939 LYNN M MALEC MD SENIOR MEDICAL DIRECTOR 55.00 0.00 X 388848 0 43141 KATHLEEN E PUCA MD SENIOR MEDICAL DIRECTOR 55.00 0.00 X 379642 0 47686 BOB MONTGOMERY MD SENIOR INVESTIGATOR 55.00 0.00 X 357566 0 36940 ALEXANDRA PIEPER VP & CHIEF QUALITY OFFICER 22.00 33.00 X 137522 189912 49780 MARGARET MCELLIGOTT FORMER VP & CHIEF QUALITY OFFICER 22.00 33.00 X 133917 184935 30199 BARBARA BRYANT EVP & CHIEF MED OFF - AS OF 11/2022 54.00 1.00 X 195264 0 4469 JOSHUA J FIELD MD SR MED DIR(INT CH MED OFF)-THRU 4/22 54.00 1.00 X 138846 0 13788 THOMAS HAUSKE JR CHAIR 1.00 5.00 X X 0 0 0 FRED GEILFUSS VICE CHAIR; LEGAL ADVISOR 1.00 4.00 X X 0 0 0 SHERRY HUSA SECRETARY 1.00 4.00 X X 0 0 0 JOHN PERRAS TREASURER 1.00 4.00 X X 0 0 0 COREEN DICUS-JOHNSON JD BOARD MEMBER 1.00 4.00 X 0 0 0 DAVID GINSBURG MD BOARD MEMBER 1.00 4.00 X 0 0 0 GAIL HANSON BOARD MEMBER 1.00 4.00 X 0 0 0 DALE KENT BOARD MEMBER 1.00 4.00 X 0 0 0 ROBERT H MANEGOLD BOARD MEMBER 1.00 5.00 X 0 0 0 JEFFEREY S MCDONALD BOARD MEMBER 1.00 4.00 X 0 0 0 RON MILLER BOARD MEMBER 1.00 4.00 X 0 0 0 KATHY THORNTON-BIAS BOARD MEMBER 1.00 4.00 X 0 0 0 GREG WESLEY BOARD MEMBER 1.00 4.00 X 0 0 0 L ALAN WHALEY BOARD MEMBER 1.00 4.00 X 0 0 0 PETER ZIEGLER BOARD MEMBER 1.00 4.00 X 0 0 0 5365337 3494106 798613 160 1 1 0 MEDICAL COLLEGE OF WISCONSIN INC 8701 WATERTOWN PLANK RD MILWAUKEE WI 53226 PHYSICIAN SERVICES 3094799 CERNER CORPORATION 2800 ROCKCREEK PARKWAY NORTH KANSAS CITY MO 64117 SOFTWARE SUPPORT 749518 MILWAUKEE REGIONAL MEDICAL CENTER 8700 WATERTOWN PLANK RD MILWAUKEE WI 53226 FACILITY SERVICES 609711 COVERALL NORTH AMERICA INC 350 SW 12TH AVENUE DEERFIELD BEACH FL 33442 CLEANING SERVICES 506082 GIFT OF HOPE 425 SPRING LAKE DRIVE ITASCA IL 60143 ORGAN RECOVERY SERVICES 488840 17 8273184 21118751 2430964 31822899 PHARMACY 621500 54057206 54057206 BLOOD SERVICES 621500 51795488 51795488 DIAGNOSTIC LABORATORIES 621500 40658823 40658823 ORGAN AND TISSUE DONATION 621500 19999163 19999163 MEDICAL SERVICES 621500 12039912 12039912 4682857 4530647 152210 183233449 1484098 1484098 30000 41881 -11881 -11881 -11881 35201775 60120 31058137 146463 4143638 -86343 4057295 4057295 SHARED SERVICE FEE 900099 140698 140698 ACQUIRED CASH RECEIPTS 900099 91000 91000 INSURANCE INTEREST 900099 1148 1148 510 510 233356 220819216 183082387 140698 5773232 X 4178503 4178503 3476227 1461518 2014709 146600 146600 62360026 53631794 8728232 3103124 2653698 449426 9832424 8323232 1509192 4640009 3891118 748891 274937 152591 122346 27698 27698 6009 6009 23146671 22058858 1087813 450441 152793 297648 135651 118645 17006 2178379 1601494 576885 13080 13080 4662204 2758882 1903322 2060184 1854618 205566 436014 381045 54969 392 392 4062108 2457691 1604417 143606 83660 59946 COST OF IMPORTED PROD 46664817 46664817 MEDICAL LAB SUPPLIES 18902826 18902826 VERSITI SERVICES ALLOC 12616284 3652881 8963403 EQUIPMENT LEASE/MAINT 2147109 1675861 471248 1679477 1485379 194098 207344800 178155376 29189424 0 563832 1225979 0 0 2901523 3463590 30228519 35985416 0 0 0 0 0 0 8059655 9531534 718454 586811 111520895 80420844 31861842 31100051 46206579 40113083 17373710 17881849 0 0 733790 939531 56258 1035640 138704162 141863484 20617119 18514949 0 0 385588 329670 0 0 0 0 0 0 0 0 0 0 8707099 7891714 29709806 26736333 X 108994356 115127151 108994356 115127151 138704162 141863484 X 13474416 -7849759 508138 X 0 1 X 1 1 1 X 24177316 24337374 26647932 26132948 31822899 133118469 24177316 24337374 26647932 26132948 31822899 133118469 38716630 94401839 1592014 904927 1862957 1963086 1514098 7837082 4713 4416 3620 3684 16433 2136 104382 100852 121241 91510 420121 141392105 790140289 0.66770 0.64850 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: PATRONAGE DIVIDENDS - 2018 AMOUNT: $ 0. 2019 AMOUNT: $ 55,250. 2020 AMOUNT: $ 31,405. 2021 AMOUNT: $ 0. 2022 AMOUNT: $ 0. COPY FEES - 2018 AMOUNT: $ 1,329. 2019 AMOUNT: $ 455. 2020 AMOUNT: $ 0. 2021 AMOUNT: $ 0. 2022 AMOUNT: $ 510. MISCELLANEOUS - 2018 AMOUNT: $ 807. 2019 AMOUNT: $ 17,233. 2020 AMOUNT: $ 197. 2021 AMOUNT: $ 12,241. 2022 AMOUNT: $ 0. ACQUIRED CASH RECEIPTS - 2018 AMOUNT: $ 0. 2019 AMOUNT: $ 22,974. 2020 AMOUNT: $ 69,250. 2021 AMOUNT: $ 109,000. 2022 AMOUNT: $ 91,000. ENTERPRISE FLEET SERVICES - 2018 AMOUNT: $ 0. 2019 AMOUNT: $ 8,470. 2020 AMOUNT: $ 0. 2021 AMOUNT: $ 0. 2022 AMOUNT: $ 0. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 0 0 1 27698 27698 0 PART II-B, LINE 1: PAID STAFF OR MANAGMENT GENERAL COUNSEL PROVIDES LOBBYING SERVICES TO THE FILING ORGANIZATION. HOWEVER, SUCH EXPENSES ARE PAID FOR BY VERSITI INC., THE FILING ORGANIZATION'S PARENT. OTHER ACTIVITIES $8,115 OF THE DUES PAID TO THE ASSOCIATION OF ORGAN PROCUREMENT ORGANIZATIONS AND $19,583 OF OTHER EXPENSES PAID WERE ALLOCATED TO LOBBYING ACTIVITIES. 112901289 848275 -13361785 5620807 94766972 99612019 1371435 16077669 4159834 112901289 89992682 4494881 9457908 4333452 99612019 77632272 2512261 14163049 4314900 89992682 86045725 301738 -4472887 4242304 77632272 0.97880 0.02120 0 1 1 4268493 4268493 65816861 47158597 18658264 814021 720539 93482 38705852 31964486 6741366 1915668 577222 1338446 31100051 INVESTMENT IN CENETRON 17881849 F 17881849 LONG TERM RETIREMENT LIABILITIES 7103722 LEASE LIABILITY 602613 ADDITIONAL INCENTIVES 185379 7891714 X 213459112 -7849759 -7849759 221308871 6009 -495664 -489655 220819216 207326317 -12474 -12474 207338791 6009 6009 207344800 PART V, LINE 4: ENDOWMENTS THE FILING ORGANIZATION IS A BENEFICIARY OF THE VERSITI BLOOD RESEARCH INSTITUTE FOUNDATION'S ("VBRIF") ENDOWMENT AS A SUPPORTED ORGANIZATION. THE BOARD DESIGNATED ENDOWMENT FUNDS ARE DESIGNATED BY THE BOARD AS ENDOWMENT FUNDS TO ENSURE THE CONTINUING AVAILABILITY OF FUNDS FOR RESEARCH PURPOSES. PART X, LINE 2: INCOME TAXES VERSITI, WISCONSIN, ILLINOIS, MICHIGAN, INDIANA AND THE FOUNDATION HAVE ALL RECEIVED TAX DETERMINATION LETTERS CONFIRMING THAT THE ORGANIZATIONS QUALIFY AS TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). THE ORGANIZATION FOLLOWS GUIDANCE THAT CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN, INCLUDING ISSUES RELATING TO FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT. THIS GUIDANCE PROVIDES THAT THE TAX EFFECTS FROM AN UNCERTAIN TAX POSITION CAN ONLY BE RECOGNIZED IN THE FINANCIAL STATEMENTS IF THE POSITION IS MORE LIKELY THAN NOT TO BE SUSTAINED IF THE POSITION WERE TO BE CHALLENGED BY A TAXING AUTHORITY. THE ASSESSMENT OF THE TAX POSITION IS BASED SOLELY ON THE TECHNICAL MERITS OF THE POSITION, WITHOUT REGARD TO THE LIKELIHOOD THAT THE TAX POSITION MAY BE CHALLENGED. VERSITI, WISCONSIN, ILLINOIS, MICHIGAN, INDIANA AND THE FOUNDATION ARE EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3), THOUGH THEY ARE SUBJECT TO TAX ON INCOME UNRELATED TO THEIR EXEMPT PURPOSES, UNLESS THAT INCOME IS OTHERWISE EXCLUDED BY THE IRC. THE ORGANIZATION HAS PROCESSES PRESENTLY IN PLACE TO ENSURE THE MAINTENANCE OF ITS TAX-EXEMPT STATUS; TO IDENTIFY AND REPORT UNRELATED INCOME; TO DETERMINE ITS FILING AND TAX OBLIGATIONS IN JURISDICTIONS FOR WHICH IT HAS NEXUS; AND TO IDENTIFY AND EVALUATE OTHER MATTERS THAT MAY BE CONSIDERED TAX POSITIONS. THE ORGANIZATION FILES FEDERAL AND STATE INCOME TAX RETURNS TO REPORT UNRELATED BUSINESS INCOME WHERE APPLICABLE, AND WITH FEW EXCEPTIONS, THOSE PERIODS GENERALLY REMAIN OPEN THREE YEARS FOR FEDERAL PURPOSES AND FOUR YEARS FOR STATE PURPOSES. THE STATUTE OF LIMITATIONS WILL REMAIN OPEN FOR ANY YEARS WHERE RETURNS WERE NOT FILED. THE ORGANIZATION HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. SALUS HAS BEEN ORGANIZED AS A LIMITED LIABILITY COMPANY AND, ACCORDINGLY, IS NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. ALL INCOME TAX ATTRIBUTES OF THE ENTITY ARE PASSED THROUGH TO ITS SOLE MEMBER, WISCONSIN. THE ENTITY IS, HOWEVER, SUBJECT TO TEXAS FRANCHISE TAX. THE ENTITY IS INCLUDED IN THE CONSOLIDATED INFORMATION RETURN FILED BY VERSITI. CENETRON HAS BEEN ORGANIZED AS A WHOLLY OWNED LLC THAT HAS ELECTED TO BE TREATED AS A C-CORPORATION FOR TAX PURPOSES AND SO IS SUBJECT TO FEDERAL AND STATE INCOME TAXES. INCOME TAXES ARE PROVIDED FOR THE TAX EFFECTS OF TRANSACTIONS REPORTED BY CENETRON AND CONSIST OF TAXES CURRENTLY DUE AND DEFERRED TAXES. DEFERRED TAXES ARE RECOGNIZED FOR DIFFERENCES BETWEEN THE BASIS OF ASSETS AND LIABILITIES FOR FINANCIAL STATEMENT AND INCOME TAX PURPOSES. THE DIFFERENCES RELATE PRIMARILY TO INTANGIBLE ASSETS. THE DEFERRED TAX ASSETS AND LIABILITIES REPRESENT THE FUTURE TAX RETURN CONSEQUENCES OF THOSE DIFFERENCES, WHICH WILL EITHER BE TAXABLE OR DEDUCTIBLE WHEN THE ASSETS AND LIABILITIES ARE RECOVERED OR SETTLED. CENETRON IS SUBJECT TO TAXATION IN THE UNITED STATES AND THE STATE OF TEXAS. THE ORGANIZATION RECOGNIZES, IF NECESSARY, INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS IN THE PROVISION FOR INCOME TAXES. THERE WERE NO MATERIAL INTEREST OR PENALTIES RELATED TO INCOME TAXES THAT HAVE BEEN ACCRUED OR RECOGNIZED AS OF AND FOR THE YEARS ENDED DECEMBER 31, 2022 AND 2021. PART XI, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT IN AFFILLIATE BALANCE SHEET AMOUNT 800,000. CHANGE IN EQUITY IN CENETRON -1,308,138. LOSS ON DISPOSITION OF FIXED ASSETS -86,343. SHARED SERVICE FEE ALLOCATION 140,698. RENTAL ACTIVITY EXPENSES -41,881. PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPOSITION OF FIXED ASSETS 86,343. SHARED SERVICE FEE ALLOCATION -140,698. RENTAL ACTIVITY EXPENSES 41,881. 1 VERSITI BLOOD RESEARCH INSTITUTE FOUNDATION INC PO BOX 2178 638 N 18TH STREET MILWAUKEE WI 532012178 391372542 501(C)(3) 4010000 0 RESEARCH GREAT LAKES HEMOPHILIA FOUNDATION INC 638 N 18TH ST MILWAUKEE WI 53233 237367636 501(C)(3) 114000 0 PATIENT FINANCIAL ASSISTANCE AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVE DALLAS TX 75231 135613797 501(C)(3) 15000 0 RESEARCH 3 PART I, LINE 2: PROCEDURE FOR MONITORING USE OF GRANT FUNDS INSIDE U.S. VERSITI WISCONSIN CONTINUES TO PROVIDE GRANT FUNDING TO VERSITI BLOOD RESEARCH INSTITUTE FOUNDATION, INC. AND OTHER TAX-EXEMPT ORGANIZATIONS. THESE FUNDS WILL SUPPORT FUTURE BLOOD RESEARCH AND OTHER INITIATIVES TO SERVE MORE PATIENTS AND REDUCE OVERALL COSTS. MONITORING THE INVESTMENT OF THESE FUNDS, THE DISTRIBUTIONS AND WHAT THESE FUNDS ARE USED FOR IS COMPLETED BY LEADERSHIP OF VERSITI WISCONSIN. X 0 0 0 0 0 1 1 1 1 1 0 CHRIS MISKEL PRESIDENT & CEO 312928 432138 245284 338726 9101 12569 8610 11890 12767 17627 588690 812950 0 0 BRIAN BAUTISTA EVP & CHIEF OPERATING OFFICER 187049 258306 101298 139887 8933 12337 8302 11466 13382 18480 318964 440476 0 0 BART REUTER EVP & GENERAL COUNSEL 163903 226345 101365 139980 9458 13062 8967 12383 16463 22731 300156 414501 0 0 GITESH DUBAL EVP & CHIEF MARKETING OFFICER 151042 208580 90469 124932 9105 12575 8610 11890 13383 18480 272609 376457 0 0 ANTHONY WATKINS EVP & CHIEF FINANCIAL OFFICER 153673 212214 83094 114748 10349 14291 8967 12383 15510 21417 271593 375053 0 0 MICHAEL DEININGER MD EVP & CHIEF SCIENTIFIC OFFICER 445591 49510 30177 3353 54801 6088 14454 1606 18990 2110 564013 62667 0 0 BRADLEY PIETZ EVP & CHIEF LABORATORY OFFICER 116609 161031 75466 104214 9697 13392 8742 12072 15658 21625 226172 312334 0 0 JAMES WEIDNER EVP & CHIEF HR OFFICER 125651 173519 61003 84242 10600 14639 8967 12383 12326 17022 218547 301805 0 0 PETER NEWMAN PHD VP RESEARCH & ASSOC DIR BRI 365971 0 80380 0 27434 0 24400 0 10847 0 509032 0 0 0 LYNNE BRIGGS VP & CHIEF INFORMATION OFFICER 126521 174721 51161 70652 2323 3208 10248 14152 14432 19929 204685 282662 0 0 MATTHEW ANDERSON MD VP & DIAGNOSTIC LAB MED DIR 349658 0 60750 0 2888 0 21350 0 37589 0 472235 0 0 0 LYNN M MALEC MD SENIOR MEDICAL DIRECTOR 311334 0 75810 0 1704 0 11301 0 31840 0 431989 0 0 0 KATHLEEN E PUCA MD SENIOR MEDICAL DIRECTOR 331605 0 18400 0 29637 0 24400 0 23286 0 427328 0 0 0 BOB MONTGOMERY MD SENIOR INVESTIGATOR 314465 0 18360 0 24741 0 12593 0 24347 0 394506 0 0 0 ALEXANDRA PIEPER VP & CHIEF QUALITY OFFICER 121091 167220 0 0 16431 22692 8610 11890 12298 16982 158430 218784 0 0 MARGARET MCELLIGOTT FORMER VP & CHIEF QUALITY OFFICER 65313 90193 58330 80550 10274 14192 6057 8366 6626 9150 146600 202451 0 0 BARBARA BRYANT EVP & CHIEF MED OFF - AS OF 11/2022 76464 0 50000 0 68800 0 4119 0 350 0 199733 0 0 0 JOSHUA J FIELD MD SR MED DIR(INT CH MED OFF)-THRU 4/22 93924 0 27220 0 17702 0 4534 0 9254 0 152634 0 0 0 PART I, LINE 1A PERSONAL SERVICES VERSITI WISCONSIN PROVIDED MOVING EXPENSES FOR THE FOLLOWING EMPLOYEES: MICHAEL DEININGER, M.D. $36,441 AND BARBARA BRYANT $67,893. THE MOVING EXPENSES ARE TREATED AS TAXABLE COMPENSATION. PART I, LINE 3 TOP MANAGEMENT'S COMPENSATION THE EXECUTIVE COMMITTEE OF THE VERSITI BOARD OF DIRECTORS, ACTING IN ITS CAPACITY AS THE COMPENSATION COMMITTEE, SETS AND MONITORS THE COMPENSATION PHILOSOPHY FOR VERSITI AND THE RELATED ENTITIES THAT IT SUPPORTS, INCLUDING VERSITI WISCONSIN. OTHER THAN THE VERSITI PRESIDENT AND CHIEF EXECUTIVE OFFICER, THE EXECUTIVE COMMITTEE DOES NOT INCLUDE MEMBERS OF MANAGEMENT. TO ENSURE THAT THE COMMITTEE IS COMPRISED OF INDIVIDUALS WHO DO NOT HAVE A CONFLICT OF INTEREST WITH RESPECT TO VERSITI COMPENSATION ARRANGEMENTS, ONE MEMBER OF THE COMMITTEE RECUSES HIMSELF FROM DISCUSSIONS AND APPROVALS RELATED TO COMPENSATION; IN ADDITION, THE VERSITI PRESIDENT AND CHIEF EXECUTIVE OFFICER RECUSES HER/HIMSELF FROM ALL DISCUSSIONS AND APPROVALS RELATED TO HER/HIS COMPENSATION. THE VERSITI EXECUTIVE COMMITTEE REVIEWS EXECUTIVE COMPENSATION ARRANGEMENTS TO ENSURE SUCH ARRANGEMENTS ARE FAIR, REASONABLE, AND NOT EXCESSIVE WHEN COMPARED TO SIMILARLY-SITUATED EXECUTIVES. EXECUTIVE COMPENSATION ARRANGEMENTS ARE REVIEWED FOR REASONABLENESS AND APPROVED BY THE EXECUTIVE COMMITTEE ANNUALLY IN ACCORDANCE WITH THE VERSITI REASONABLENESS REVIEW POLICY. IN ORDER TO ASSESS THE REASONABLENESS OF EXECUTIVE COMPENSATION ARRANGEMENTS, THE EXECUTIVE COMMITTEE OBTAINS AND REVIEWS APPROPRIATE COMPARABILITY DATA COLLECTED BY THE HUMAN RESOURCE DEPARTMENT AND/OR A QUALIFIED INDEPENDENT COMPENSATION CONSULTANT. THE EXECUTIVE COMMITTEE ENGAGES A QUALIFIED INDEPENDENT COMPENSATION CONSULTANT ANNUALLY. THE INDEPENDENT CONSULTANT PERFORMS AN ANALYSIS OF COMPENSATION LEVELS AT REGIONAL AND NATIONAL ORGANIZATIONS OF COMPARABLE SIZE, SCOPE AND STRUCTURE; AND PROVIDES THE COMMITTEE WITH COMPREHENSIVE DATA ON THE AVAILABILITY OF SIMILAR SERVICES WITHIN THE GEOGRAPHIC AREA, COMPENSATION SURVEYS, WRITTEN OFFERS FROM SIMILAR INSTITUTIONS, AND OTHER INFORMATION RELEVANT TO COMPARABILITY OF COMPENSATION. THE EXECUTIVE COMMITTEE'S REVIEW, RECOMMENDATIONS AND APPROVALS ARE DOCUMENTED CONCURRENTLY IN THE COMMITTEE MINUTES, WHICH ARE SUBSEQUENTLY REVIEWED AND APPROVED BY THE EXECUTIVE COMMITTEE AS REASONABLE, ACCURATE AND COMPLETE. THE COMMITTEE CHAIR VERBALLY COMMUNICATES TO THE VERSITI BOARD OF DIRECTORS A CONFIRMATION OF COMPENSATION REASONABLENESS AND THE OVERALL DUE DILIGENCE PROCESS. VERSITI AND VERSITI WISCONSIN HAVE INCENTIVE PROGRAMS FOR EXECUTIVES, DIRECTORS, MANAGEMENT, INVESTIGATORS AND STAFF DESCRIBED IN DETAILED WRITTEN POLICIES APPROVED BY THE EXECUTIVE COMMITTEE ANNUALLY. EVALUATION AND COMPENSATION REVIEW -CEO - EACH YEAR, THE EXECUTIVE COMMITTEE EVALUATES THE CEO'S PERFORMANCE AGAINST ESTABLISHED OBJECTIVES, DETERMINES INCENTIVE PAYMENT AND MERIT INCREASE BASED UPON PERFORMANCE AND MARKET DATA PROVIDED BY THE THIRD PARTY COMPENSATION CONSULTANT, AND WORKS WITH THE CEO TO ESTABLISH OBJECTIVES FOR THE NEXT YEAR. -EXECUTIVES - THE BOARD OF DIRECTORS HAS DELAGATED TO THE VERSITI/VERSITI WISCONSIN CEO THE PERFORMANCE ASSESSMENT AND COMPENSATION DECISIONS FOR HIS/HER TEAM AND LEADERS ELIGIBLE FOR THE VERSITI LEADERSHIP INCENTIVE PLAN. DURING THE MAY MEETING, THE EXECUTIVE COMMITTEE REVIEWS THE INCENTIVES (SHORT AND LONG-TERM) PAYOUTS AND MERIT INCREASES ASSIGNED TO THE EXECUTIVE TEAM AS PART OF THE ANNUAL COMPENSATION REASONABILITY REVIEW CONDUCTED BY AON CONSULTANTS. THE EXECUTIVE COMMITTEE REVIEWS AND APPROVES THE SALARY INCREASES AND INCENTIVE PAYOUTS OF THE CEO BEFORE PAYMENT. EXECUTIVES ARE POSITIONED WITHIN THE APPROPRIATE SALARY RANGE BASED UPON THE: -EXECUTIVE'S KNOWLEDGE, COMPETENCIES, AND EXPERIENCE, -PERFORMANCE OF THE EXECUTIVE'S AREAS OF RESPONSIBILITY, -THE EXECUTIVE'S CONTRIBUTION TO OVERALL PERFORMANCE, -THE IMPORTANCE OF RETAINING THE EXECUTIVE, -INTERNAL EQUITY CONSIDERATIONS, -THE FINANCIAL RESOURCES AVAILABLE, AND -EXECUTIVE BASE SALARY INCREASES PROVIDED IN THE COMPETITIVE MARKET. PART I, LINE 5A, 5B, 6A, 6B AND 7. NON-FIXED PAYMENTS INCENTIVE PAYOUT OPPORTUNITIES, BASED ON PERCENTAGE OF BASE PAY RATE, ARE AVAILABLE TO CERTAIN EMPLOYEES OF THE FILING ORGANIZATION. WHILE LEVELS OF THE INCENTIVE PAYOUT OPPORTUNITY ARE FIXED AND DETERMINED PERCENTAGES OF BASE COMPENSATION, THE INCENTIVE PAYOUT IS DETERMINED, IN PART, ON THE CONSOLIDATED REVENUE AND NET EARNINGS OF OPERATING DIVISIONS. THE INCENTIVE PAYOUT IS SUBJECT TO THE REVIEW OF ACCOMPLISHMENTS/OBJECTIVES AND THE ULTIMATE DETERMINATION OF INCENTIVE COMPENSATION IS SUBJECT TO PRESIDENT/CEO AND EXECUTIVE COMMITTEE OF THE BOARD APPROVAL. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS VERSITI, INC. IS THE SOLE CORPORATE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A MEMBER OR STOCKHOLDER POWERS VERSITI, INC. HAS RESERVE POWERS; INCLUDING THE ABILITY TO ELECT A MAJORITY OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B REFER TO NARRATIVE LISTED IN LINE 7A. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW VERSITI WISCONSIN UTILIZES GRANT THORNTON LLP TO COMPLETE THE IRS FORM 990 AND RELATED SCHEDULES. FOLLOWING COMPLETION, THEY ARE REVIEWED BY THE ORGANIZATION'S MANAGEMENT. THE DRAFT FORMS ARE THEN REVIEWED BY THE AUDIT AND COMPLIANCE COMMITTEE PRIOR TO SUBMISSION TO THE IRS. THE FULL BOARD IS PROVIDED A COPY OF THE FORM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY VERSITI WISCONSIN MAINTAINS A WRITTEN CONFLICT OF INTEREST POLICY. ON AN ANNUAL BASIS, CURRENT DIRECTORS AND OFFICERS ARE ASKED TO COMPLETE A DISCLOSURE FORM BASED ON IRS REQUIREMENTS THAT INCLUDES THE FOLLOWING: WHETHER THEY HAVE ANY DIRECT OR INDIRECT RELATIONSHIP EITHER THROUGH BUSINESS OR FAMILY MEMBER WITH THE ORGANIZATION. WHETHER THEY RECEIVED COMPENSATION FROM ANY ORGANIZATION THAT SHARES COMMON OWNERSHIP OR CONTROL WITH THE ORGANIZATION. WHETHER THEY HAVE SERVED AS AN OFFICER, DIRECTOR, KEY EMPLOYEE, PARTNER OR MEMBER OF AN ENTITY (OR SHAREHOLDER OF A PROFESSIONAL CORPORATION) DOING BUSINESS WITH THE ORGANIZATION. THESE ANSWERS ARE ACCUMULATED, SUMMARIZED AND EVALUATED BY MANAGEMENT TO DETERMINE IF ANY CONFLICTS EXIST. IDENTIFIED CONFLICTS ARE ADDRESSED IN ACCORDANCE WITH THE WRITTEN POLICY. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION PROCESS VERSITI AND ITS AFFILIATED BLOOD CENTERS GREATLY VALUE THE GENEROUS CONTRIBUTIONS OF THE INDIVIDUALS AND ORGANIZATIONS THAT SUPPORT OUR MISSION WITHIN THE COMMUNITY WE SERVE. IN ORDER TO ENSURE PROPER STEWARDSHIP OF OUR CHARITABLE RESOURCES, VERSITI AND ITS AFFILIATES FOLLOW A FORMALIZED PROCESS TO CONFIRM THAT COMPENSATION PROVIDED TO OUR EXECUTIVE LEADERSHIP TEAM IS FAIR, REASONABLE, AND NOT EXCESSIVE WHEN COMPARED TO OTHER EXECUTIVES. THIS PROCESS ALSO HELPS US ENSURE THAT OUR COMPENSATION PROGRAM SUPPORTS THE RETENTION OF EXPERIENCED, HIGHLY-QUALIFIED EXECUTIVES WHO ARE COMMITTED TO OUR MISSION. THE EXECUTIVE COMMITTEE OF THE VERSITI BOARD OF DIRECTORS, ACTING IN ITS CAPACITY AS THE COMPENSATION COMMITTEE, SETS AND MONITORS THE COMPENSATION PHILOSOPHY FOR VERSITI AND THE RELATED ENTITIES THAT IT SUPPORTS, INCLUDING VERSITI WISCONSIN. FORM 990, PART VI, SECTION C, LINE 19 ORGANIZATION'S DOCUMENTS OPEN TO THE PUBLIC THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST TO THE PUBLIC DURING NORMAL BUSINESS HOURS AND AT THE ORGANIZATION'S LOCATION. PART VII: AVERAGE HOURS THE HOURS LISTED ON FORM 990, PART VII ARE REPRESENTATIVE OF AN AVERAGE FOR THE OFFICERS AND EXECUTIVE TEAM. EACH INDIVIDUAL PERSON'S WEEKLY TALLY MAY BE GREATER OR LESSER PER WEEK BASED ON THEIR INDIVIDUAL ROLES AND RESPONSIBILITIES WITHIN THE FILING ORGANIZATION AND RELATED PARTIES. THE SALARY PRESENTED FOR THE PRESIDENT AND CEO IS REFLECTIVE OF TOTAL SALARY COMPENSATION FOR SERVICES TO THE FILING ORGANIZATION AND RELATED AFFILIATES. FORM 990, PART IX, LINE 11G SUBAWARDS: PROGRAM SERVICE EXPENSES 5,741,787. TOTAL EXPENSES 5,741,787. DONOR TESTING: PROGRAM SERVICE EXPENSES 5,382,703. TOTAL EXPENSES 5,382,703. SHIPPING & TRANSPORTATION: PROGRAM SERVICE EXPENSES 1,390,321. MANAGEMENT AND GENERAL EXPENSES 213,710. TOTAL EXPENSES 1,604,031. ANIMAL CARE COSTS: PROGRAM SERVICE EXPENSES 1,319,100. TOTAL EXPENSES 1,319,100. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 962,433. MANAGEMENT AND GENERAL EXPENSES 351,449. TOTAL EXPENSES 1,313,882. GRADUATE STUDENT STIPENDS: PROGRAM SERVICE EXPENSES 841,354. TOTAL EXPENSES 841,354. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 313,168. MANAGEMENT AND GENERAL EXPENSES 427,721. TOTAL EXPENSES 740,889. OPERATING ROOM: PROGRAM SERVICE EXPENSES 670,097. TOTAL EXPENSES 670,097. IRB CONTRACTOR FEES: PROGRAM SERVICE EXPENSES 660,688. TOTAL EXPENSES 660,688. TEMPORARY HELP: PROGRAM SERVICE EXPENSES 469,255. TOTAL EXPENSES 469,255. OUTSIDE LAB SERVICE: PROGRAM SERVICE EXPENSES 451,793. TOTAL EXPENSES 451,793. ICU: PROGRAM SERVICE EXPENSES 395,818. TOTAL EXPENSES 395,818. LAB: PROGRAM SERVICE EXPENSES 360,171. TOTAL EXPENSES 360,171. OTHER HOSPITAL CHARGES: PROGRAM SERVICE EXPENSES 341,009. TOTAL EXPENSES 341,009. PHARMACY: PROGRAM SERVICE EXPENSES 314,531. TOTAL EXPENSES 314,531. CLAIM/BILLING REVIEW: PROGRAM SERVICE EXPENSES 298,712. TOTAL EXPENSES 298,712. CARDIOLOGY: PROGRAM SERVICE EXPENSES 258,952. TOTAL EXPENSES 258,952. RADIOLOGY: PROGRAM SERVICE EXPENSES 252,469. TOTAL EXPENSES 252,469. TRANSLATION SERVICE: PROGRAM SERVICE EXPENSES 236,886. TOTAL EXPENSES 236,886. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 226,923. TOTAL EXPENSES 226,923. FACILITY CHARGES: PROGRAM SERVICE EXPENSES 216,913. TOTAL EXPENSES 216,913. ANESTHESIA: PROGRAM SERVICE EXPENSES 153,943. TOTAL EXPENSES 153,943. RESPIRATORY THERAPY: PROGRAM SERVICE EXPENSES 124,258. TOTAL EXPENSES 124,258. NON-MARKETING PRINTING COSTS: PROGRAM SERVICE EXPENSES 101,682. MANAGEMENT AND GENERAL EXPENSES 2,701. TOTAL EXPENSES 104,383. CUSTOMER TESTING: PROGRAM SERVICE EXPENSES 99,068. TOTAL EXPENSES 99,068. FUNERAL HOME CHARGES: PROGRAM SERVICE EXPENSES 80,436. TOTAL EXPENSES 80,436. PS SUPPLIES: PROGRAM SERVICE EXPENSES 75,620. TOTAL EXPENSES 75,620. RECORD STORAGE: PROGRAM SERVICE EXPENSES 3,900. MANAGEMENT AND GENERAL EXPENSES 67,137. TOTAL EXPENSES 71,037. GLOBAL MOBILITY: PROGRAM SERVICE EXPENSES 59,991. TOTAL EXPENSES 59,991. LICENSES, PERMITS, & HOSP FEES: PROGRAM SERVICE EXPENSES 49,498. MANAGEMENT AND GENERAL EXPENSES 6,870. TOTAL EXPENSES 56,368. PUBLICATION SERVICES: PROGRAM SERVICE EXPENSES 36,070. MANAGEMENT AND GENERAL EXPENSES 96. TOTAL EXPENSES 36,166. EDUCATION: PROGRAM SERVICE EXPENSES 14,732. MANAGEMENT AND GENERAL EXPENSES 15,667. TOTAL EXPENSES 30,399. DNA SEQUENCING: PROGRAM SERVICE EXPENSES 28,427. TOTAL EXPENSES 28,427. OUTSIDE CORE LAB CHARGES: PROGRAM SERVICE EXPENSES 24,252. TOTAL EXPENSES 24,252. PHARMACY DISPENSING FEE: PROGRAM SERVICE EXPENSES 23,013. TOTAL EXPENSES 23,013. EMPLOYMENT RECRUITMENT FEES: PROGRAM SERVICE EXPENSES 18,598. TOTAL EXPENSES 18,598. BANK ACCOUNT FEES: PROGRAM SERVICE EXPENSES 14,804. MANAGEMENT AND GENERAL EXPENSES 2,462. TOTAL EXPENSES 17,266. OUTSIDE MEDICAL DIRECTOR (OPO): PROGRAM SERVICE EXPENSES 13,650. TOTAL EXPENSES 13,650. STEM CELL PROCESSING: PROGRAM SERVICE EXPENSES 12,967. TOTAL EXPENSES 12,967. OUTSIDE SALARY & FRINGES: PROGRAM SERVICE EXPENSES 7,657. TOTAL EXPENSES 7,657. LAUNDRY COSTS: PROGRAM SERVICE EXPENSES 6,221. TOTAL EXPENSES 6,221. NON-HOSPITAL BUSINESS DEVELOPMENT: PROGRAM SERVICE EXPENSES 4,988. TOTAL EXPENSES 4,988. FORM 990, PART XI, LINE 9: CHANGE IN EQUITY IN CENETRON 1,308,138. INVESTMENT IN AFFILIATE BALANCE SHEET AMOUNT -800,000. 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