2022-08-11T09:23:51-05:00 2021-12-31 FORVIS LLP 201 N Illinois Street Indianapolis IN 46204 990 2021-01-01 311285637 Life Connection of Ohio % AMY VARNER LIFE 4198934891 3661 BRIARFIELD BLVD Suite 105 MAUMEE OH 43537 MATTHEW WADSWORTH PRESIDENT AND CEO 4198934891 2022-11-15 true MATTHEW WADSWORTH 999009999 NICOLE B FISHBACK P01279475 3173834000 2022-11-15 3 2021 2022-09-23 18:48:47Z MATTHEW WADSWORTH 3661 BRIARFIELD BLVD105 MAUMEE OH 43537 30686409 false X WWW.LIFECONNECTIONOFOHIO.ORG X 1989 OH TO SECURE ORGAN AND TISSUE DONORS AND COORDINATE TRANSPLANT SERVICES. 13 11 114 59 0 0 1228598 206261 18874166 29884045 84421 129406 0 0 20187185 30219712 20000 251534 0 0 6643540 11386899 0 0 0 11848382 16214293 18511922 27852726 1675263 2366986 14302025 20899179 1439406 5628501 12862619 15270678 SECURE ORGAN AND TISSUE DONORS; COORDINATE TRANSPLANT SERVICES. false false 20049666 251534 29884045 PROCUREMENT COORDINATION AND ORGAN ACQUISITION - TO FACILITATE AND COORDINATE PROCUREMENT AND TRANSPLANT SERVICES INCLUDING DONOR IDENTIFICATION AND CARE, ACQUIRING, REMOVING, AND MAINTAINING ORGANS FOR TRANSPLANTATION, AND WORK DONE WITH DONOR FAMILIES 3164118 PUBLIC EDUCATION - WORKING WITH GENERAL PUBLIC TO INCREASE AWARENESS OF ORGAN AND TISSUE DONATION. 23213784 true true false true false false false false false false true false false false false false false true false false false false false false false false false true false true false false false false false false false false false false false false false true true true false false true 35 0 true 114 true false false false false false false false false false false false false X 13 11 false false false false true true true true true false false true true true true true true true true false X AMY VARNER 4198934891 3661 BRIARFIELD BLVD 105 MAUMEE OH 43537 MATTHEW WADSWORTH PRESIDENT AND CEO 50.0 1.0 X 351655 0 52449 MICHAEL R COUCH VP of Clinical Operations 45.0 0.0 X 193451 0 47104 AARON T SULE EMPLOYEE 45.0 0.0 X 155660 0 44080 DARREN LAHRMAN Chief Operating Officer 45.0 0.0 X 179246 0 14633 KIMBERLY A ZARUCA DIR of Hospital SRV(END 09/10) 45.0 0.0 X 158839 0 21786 AMY VARNER END 1221 DIRECTOR OF FINANCE 45.0 1.0 X 114340 0 46306 KENNETH L JILES SR EMPLOYEE 45.0 0.0 X 123009 0 36441 CHRISTINE STEINBERG BEG 0713 Chief Financial Officer 45.0 1.0 X 127930 0 17335 JOHN J LESKOVAN DO FACOS DIRECTOR 1.0 0.0 X 40000 0 0 MICHAEL REES MD PHD CHAIRMAN 1.0 0.0 X X 39000 0 0 STEVEN BURDETTEMDFIDSAFACP DIRECTOR 1.0 0.0 X 0 0 0 KEITH SCHLENDER PHD VICE CHAIRMAN 1.0 0.0 X X 0 0 0 MARK R BONNELL MD SECRETARY 1.0 0.0 X X 0 0 0 WILLIAM K RUNDELL JR MD PAST CHAIRMAN (END 05/31) 1.0 0.0 X 0 0 0 J COLBY KING CIMA DIRECTOR (END 05/31) 1.0 0.0 X 0 0 0 DAVID M SMITH MD TREASURER (END 05/31) 1.0 0.0 X 0 0 0 MARGARET DUNN MD MBA FACS DIRECTOR (END 05/31) 1.0 0.0 X 0 0 0 MICHELLE ADKINS MSN RN DIRECTOR 1.0 0.0 X 0 0 0 RHEA ROWSER MD DIRECTOR (END 05/31) 1.0 0.0 X 0 0 0 PUNEET SINDHWANI MD DIRECTOR 1.0 0.0 X 0 0 0 ROBERTO COLON MD DIRECTOR (BEG 06/01) 1.0 0.0 X 0 0 0 KRISTINA KEAN DIRECTOR (BEG 06/01) 1.0 0.0 X 0 0 0 COREY LEBER DIRECTOR (BEG 06/01) 1.0 0.0 X 0 0 0 JENNIFER RANLY DIRECTOR (BEG 06/01) 1.0 0.0 X 0 0 0 MICHAEL UHL DIRECTOR (BEG 06/01) 1.0 0.0 X 0 0 0 ABE SUTTON DIRECTOR (BEG 06/01) 1.0 0.0 X 0 0 0 1483130 0 280134 21 false true false MIAMI VALLEY HOSPITAL 1 WYOMING ST DAYTON OH 45409 ORGAN ACQUISITION 1398933 ST VINCENT MEDICAL CENTER 2213 CHERRY ST TOLEDO OH 43608 ORGAN ACQUISITION 1063859 AMFDT 8154 FOREST HILL AVE SUITE 3 RICHMOND VA 23235 DONOR IMPORTS/EXP 2524622 THE TOLEDO HOSPITAL 2142 N COVE BLVD TOLEDO OH 43606 ORGAN ACQUISITION 670247 TRINITY AIR MEDICAL 1437 W AUTO DRIVE TEMPE AZ 85284 TRANSPORTATION 628924 36 206261 206261 ORGAN PROCUREMENT 621990 29884045 29884045 29884045 109786 109786 0 0 0 0 0 486317 0 466166 531 20151 -531 19620 19620 0 0 0 0 0 0 0 0 0 0 30219712 29884045 129406 251534 251534 0 0 0 743248 568294 174954 0 7931667 6064626 1867041 603393 461360 142033 1435547 1316321 119226 673044 528890 144154 0 97807 97807 23750 23750 24157 24157 0 13804 13804 860367 230290 630077 226898 202292 24606 172650 78722 93928 570834 101166 469668 0 349817 349817 357224 185995 171229 0 110156 86139 24017 24294 24294 0 40349 40349 115109 115109 HOSPITAL COSTS 6330532 6330532 EVALUATION AND PRESERVATION 1983067 1983067 IMPORTED ORGAN COSTS 4442620 4442620 PROVIDER AUDIT FEES 184678 184678 286180 197258 88922 27852726 23213784 4638942 0 200 0 8968364 5025208 0 0 4944351 7741917 0 0 0 0 0 5592000 91089 64801 187948 282261 1711889 589339 110073 1122550 0 1070442 0 0 0 0 0 0 0 0 14302025 20899179 1439406 3846072 0 0 0 0 0 0 0 0 0 0 0 0 0 1782429 0 0 1439406 5628501 X 12862619 15270678 0 0 12862619 15270678 14302025 20899179 2366986 41073 X false true X true false X 219014 221998 223594 1228598 206261 2099465 8439330 10326643 13206427 18874166 29884045 80730611 0 0 0 8658344 10548641 13430021 20102764 30090306 82830076 0 0 0 82830076 37932 85083 158755 94549 109786 486105 0 37932 85083 158755 94549 109786 486105 0 0 8696276 10633724 13588776 20197313 30200092 83316181 0.99417 0.99358 0.00583 0.00642 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 24157 24157 false PART II-B, LINE 1, LOBBYING ACTIVITIES: LIFE CONNECTION PAYS MEMBERSHIP DUES TO THE ASSOCIATION OF ORGAN PROCUREMENT ORGANIZATIONS. OF THESE DUES, $2,557 WAS DEEMED BY AOPO TO BE LOBBYING EXPENSES. LIFE CONNECTION PAID $21,600 IN FEES TO THE FITZGIBBON GROUP. THESE LOBBYING EXPENSES ARE INTENDED TO FURTHER THE ORGANIZATION'S MISSION AT A GOVERNMENTAL LEVEL. 0 327134 248350 78784 0 528748 340989 187759 0 856007 856007 1122550 30260785 41073 41073 30219712 30219712 27852726 27852726 27852726 SCHEDULE D, PART X, LINE 2: ASC 740 DISCLOSURE: THE ORGANIZATION HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. THE ORGANIZATION HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. true KIDNEY FOUNDATION OF NORTHWEST OHIO 3100 W CENTRAL AVENUE SUITE 150 TOLEDO OH 43606 341133682 501(C)(3) 35000 ORGAN ASSISTANCE LIFE CONNECTION OF OHIO FOUNDATION LLC 3661 BRIARFIELD BLVD MAUMEE OH 43537 853616758 501(C)(3) 116534 NEW BUILDING THE UNIVERSITY OF TOLEDO 2801 W BNACROFT ST MS319 TOLEDO OH 43606 346101483 501(C)(3) 100000 DEVELOPMENT OF TRANSPLANT PROGRAM 3 SCHEDULE I, PART I, LINE 2: PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE US: LIFE CONNECTION OF OHIO PROVIDED GRANTS TO LIFE CONNECTION OF OHIO FOUNDATION LLC. THE FOUNDATION IS A SUPPORTING ORGANIZATION AND HAS A SHARED BOARD AND CONSOLIDATED FINANCIAL STATEMENTS. X X X X X true false false false false false false false false MATTHEW WADSWORTH PRESIDENT AND CEO 287940 0 14100 0 49615 0 23200 0 29249 0 404104 0 0 0 MICHAEL R COUCH VP of Clinical Operations 173633 0 6524 0 13294 0 15530 0 31574 0 240555 0 0 0 DARREN LAHRMAN Chief Operating Officer 159204 0 542 0 19500 0 12708 0 1925 0 193879 0 0 0 KIMBERLY A ZARUCA DIR of Hospital SRV(END 09/10) 124691 0 7380 0 26768 0 10053 0 11733 0 180625 0 0 0 AARON T SULE EMPLOYEE 137628 0 8056 0 9976 0 12507 0 31573 0 199740 0 0 0 KENNETH L JILES SR EMPLOYEE 115419 0 2470 0 5120 0 9889 0 26552 0 159450 0 0 0 AMY VARNER END 1221 DIRECTOR OF FINANCE 97755 0 6316 0 10269 0 9249 0 37057 0 160646 0 0 0 SCHEDULE J, PART I, LINE 4A SEVERANCE AND NONQUALIFIED RETIREMENT PLAN: KIM ZARUCA RECIEVED A SEVERANCE OF $24,482. FORM 990, PART VI, SECTION A, LINE 6 AND LINE 7A MEMBERS OR STOCKHOLDERS: The members have the right to: (a) elect and remove directors at will, with or without cause (b) amend or repeal the articles of incorporation, (c) dissolve or terminate the existence of the corporation (d) to merge the corporation. FORM 990, PART VI, SECTION A, LINE 7B GOVERNANCE DECISIONS SUBECT TO APPROVAL BY MEMBERS: The members have the right to: (a)elect and remove directors at will, with or without cause (b)amend or repeal the articles of incorporation, (c)dissolve or terminate the the existence of the corporation, and (d)to merge the corporation. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW FORM 990: THE 990 IS REVIEWED BY THE PRESIDENT AND CEO, CFO, AND THE DIRECTOR OF FINANCE PRIOR TO FILING. COPIES OF THE FORM 990 ARE PROVIDED BY EMAIL TO ALL THE BOARD OF DIRECTORS FOR THEIR REVIEW PRIOR TO THE FILING OF THE FORM 990. THE RETURN WAS REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: CONFLICT OF INTEREST POLICY IS REVIEWED AT LEAST ANNUALLY WITH THE BOARD OF DIRECTORS AND EMPLOYEES. A Designated Person who has a Conflict of Interest arising out of or related to a Transaction or Claim shall be excused from the meeting before any deliberations or voting concerning the authorization of the Transaction or the assertion of the Claim, provided that the Designated Person shall make the disclosure required by this provision, respond to questions from the Board or committee, and be counted in determining the presence of a quorum at any meeting of the Board or committee. Any Transaction involving a Conflict of Interest shall be fair and reasonable to the corporation. The Designated Person will at all times act with good faith toward the corporation. FORM 990, PART VI, SECTION B, LINE 15A AND 15B PRESIDENT/CEO AND OFFICER COMPENSATION: The CEO's compensation was last reviewed and approved by the governing board December 2021 with a compensation change effective January 2022. COMPENSATION OF OTHER MANAGEMENT EMPLOYEES WERE LAST REVIEWED DECEMBER 2021 AND ARE DETERMINED BY THE PRESIDENT AND CEO WITH CONSULTATION WITH THE BOARD OF DIRECTORS AND SALARY SURVEYS. FORM 990, PART VI, SECTION C, LINE 19: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABILITY: APPROPRIATE DOCUMENTS ARE PROVIDED UPON WRITTEN REQUEST TO THE CEO. LIFE CONNECTION OF OHIO - FOUNDATION 3661 BRIARFIELD BLVD SUITE 105 MAUMEE OH 43537 853616758 HOSPITAL FDN. OH 501(C)(3) LINE 7 true false true false true false false false false false false false true false false false false false false false LIFE CONNECTION OF OHIO - FOUNDATION B 116534 ACTUAL COST LIFE CONNECTION OF OHIO - FOUNDATION D 1600000 ACTUAL COST