2020-11-16T15:57:20-06:00 2019-12-31 750786316 WEAVER AND TIDWELL LLP 2300 N FIELD ST STE 1000 DALLAS TX 75201 990 2019-01-01 731281589 LIFESHARE TRANSPLANT DONOR SERVICES OF OKLAHOMA INC LIFE 4058405551 4705 NW EXPRESSWAY OKLAHOMA CITY OK 73132 JEFF ORLOWSKI CEO & PRESIDENT 4058405551 2020-11-16 1 IRA L NEVELOW P00083210 9724901970 70.133.252.160 2020-11-16 08:37:11 CS P E17E0E5389C99D5615AEBC960A838D2A7DFADF7D D1BF0109C11E24D7F307465C30A701DAAE8BAEE1 2019 2021-01-29 14:40:06Z JEFF ORLOWSKI 4705 NW EXPRESSWAY OKLAHOMA CITY OK 73132 32171579 0 X WWW.LIFESHAREOKLAHOMA.ORG X 1984 OK PROVIDES ORGAN AND TISSUE PROCUREMENT SERVICES WITHIN THE STATE OF OKLAHOMA. 15 15 151 64 0 0 1500 0 31648685 31388571 186579 279767 0 0 31836764 31668338 291459 500000 0 0 12584020 13547675 0 0 0 16475671 16342221 29351150 30389896 2485614 1278442 26330568 27767927 5567422 5280165 20763146 22487762 X LIFESHARE TRANSPLANT DONOR SERVICES OF OKLAHOMA, INC. PROVIDES ORGAN AND TISSUE PROCUREMENT SERVICES WITHIN THE STATE OF OKLAHOMA; IDENTIFICATION OF ORGAN AND TISSUE DONORS; SURGICAL EXCISION AND DISTRIBUTIONS OF ORGANS AND TISSUE AND PUBLIC EDUCATION REGARDING ORGAN AND TISSUE DONATIONS. 0 0 18848497 500000 31388571 ORGAN PROCUREMENT AND PLACEMENT WAS PROVIDED FOR 299 KIDNEYS, 119 LIVERS, 19 PANCREAS, 57 HEARTS, AND 64 LUNGS. LIFESHARE ALSO PROVIDED TISSUE PROCUREMENT OF 914 TISSUE DONORS. 18848497 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 65 0 1 151 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 OK X LIFESHARE TRANSPLANT DONOR SERVICES 4058405551 4705 NW EXPRESSWAY OKLAHOMA CITY OK 73132 TOM ANDERSON BOARD DIRECTOR 1.00 X 0 0 0 SAMANTHA DAVIS BOARD DIRECTOR 1.00 X 0 0 0 GINA FLESHER BOARD DIRECTOR 1.00 X 0 0 0 MARY JOHNSON BOARD DIRECTOR 1.00 X 0 0 0 RAJAT KAUL BOARD DIRECTOR 1.00 X 0 0 0 IRFAN KUNDI BOARD DIRECTOR 1.00 X 0 0 0 STEVE MILLER BOARD DIRECTOR 1.00 X 0 0 0 MICHAEL MORRIS BOARD DIRECTOR 1.00 X 0 0 0 ANTHONY SEBASTIAN BOARD DIRECTOR 1.00 X 0 0 0 HARLAN WRIGHT BOARD DIRECTOR 1.00 X 0 0 0 BENJAMIN COWLEY JR CHAIR OF FINANCE COMMITTEE 1.00 X X 0 0 0 ED HEINEN CHAIR OF HR COMMITTEE 1.00 X X 0 0 0 JAMES SHARROCK BOARD VICE CHAIR 1.00 X X 0 0 0 PAMELA SPANBAUER IMMEDIATE PAST CHAIR 1.00 1.00 X X 0 0 0 SUZANNE WHEELER BOARD CHAIR 1.00 1.00 X X 0 0 0 JEFFREY ORLOWSKI PRESIDENT AND CEO 40.00 1.00 X 427559 0 45973 MICHELLE GIBSON VP HUMAN RESOURCES 40.00 X 203500 0 28078 MARTIN BENOIT VP, CFO 40.00 X 218814 0 25730 KATHERINE SMITH VP, COMMUNICATIONS AND FOUNDATION 40.00 1.00 X 183487 0 24393 DARRELL TRAHAN VP, CLINICAL SERVICES 40.00 X 166861 0 24394 CLINT HOSTETLER VP, CLINICAL SERVICES 40.00 X 158732 0 20801 JAN FOUTCH VP, QUALITY SYSTEMS 40.00 X 163837 0 19666 HARVEY SOLOMON RECOVERY SURGEON 40.00 X 360173 0 36463 JEFFREY LEGG HCE 40.00 X 136255 0 19479 ROBERT BASHAW DIRECTOR OF IT & FACILITIES 40.00 X 135947 0 19178 TINA MATHES HCE 40.00 X 129136 0 12913 LOGAN WILKE HCE 40.00 X 128120 0 28274 2412421 0 305342 12 0 1 0 ROGERS WORLDWIDE TRANSPORTATION 8317 NW 109TH STREET OKLAHOMA CITY OK 73162 TRANSPORTATION 135660 MONARCH MARKETING GROUP LLC 4801 GAILLARDIA PKWY STE 200 OKLAHOMA CITY OK 73142 ADVERTISING 132934 CONTINENTAL DEVELOPMENT CO PO BOX 110 TUCSON AZ 85702 MORTGAGE SERVICING 128026 ECL2 CONSULTING SERVICES LLC PO BOX 1731 GRAPEVINE TX 76099 CONSULTING 115114 4 EXTRA-RENAL PROCUREMENT 621991 12946420 12946420 MEDICARE/MEDICAID PAYMENTS 621991 10782762 10782762 TISSUE PROCUREMENT 621991 7444882 7444882 RESEARCH ORGANS 621991 117725 117725 OTHER 621991 96782 96782 31388571 288776 288776 494232 502054 1187 -7822 -1187 -9009 -9009 31668338 31388571 0 279767 X 500000 500000 1711825 877594 834231 8929266 3602307 5326959 1434969 598412 836557 749502 254466 495036 722113 316862 405251 38092 38092 27000 27000 610662 66264 544398 736980 736980 264166 264166 298835 74642 224193 107028 107028 77838 77838 464093 101661 362432 403439 403439 COST OF PROCUREMENT - I 3394803 3394803 COST OF PROCUREMENT - O 1756528 1756528 COST OF PROCUREMENT - O 1533462 1533462 COST OF PROCUREMENT - O 898676 898676 5730619 4872820 857799 30389896 18848497 11541399 0 3690680 2277976 9073849 10226394 6914395 5829047 66106 211015 205753 311520 6919242 2490896 4196574 4428346 2176239 4477675 6972 5954 26330568 27767927 4238612 4014372 1328810 1265793 5567422 5280165 X 20763146 22487762 20763146 22487762 26330568 27767927 1278442 446173 1 0 X X 0 1 X 1 0 X 9712340 9679968 11106836 10448747 10782762 51730653 9712340 9679968 11106836 10448747 10782762 51730653 51730653 97568 102615 97560 146621 288776 733140 52463793 93401802 0.98600 0.98950 X 771990 771990 1365547 223172 1142375 2368996 941720 1427276 2412709 1326004 1086705 4428346 AMERICAN BEACON SMALL CAP VALUE INST 39981 F CARILLON EAGLE SMALL CAP GROWTH INST 39452 F COHEN & STEERS REALTY SHARES INST 55736 F DELAWARE EMERGING MARKETS R-6 59865 F DODGE & COX INTERNATIONAL STOCK 86172 F DODGE & COX STOCK 141635 F FIDELITY CONTRAFUND 145904 F FIDELITY EMERGING MARKETS INDEX FD I 57869 F JOHN HANCOCK FDS ILL DISC VAL MCP I 71126 F METROPOLITAN WEST TOTAL RETURN BOND 277016 F PIMCO INVESTMENT GRD CREDIT BOND I 158509 F PIMCO TOTAL RETURN FUND-INST 274348 F PRIMECAP ODYSSEY STOCK 139389 F TEMPLETON GLOBAL BOND R6 112991 F THORNBURG LIMITED TERM INCOME FUND 214606 F VANGUARD 500 INDEX ADMIRAL 1320279 F VANGUARD EM MK STK LNDX-ADM 58793 F VANGUARD INTERNATIONAL GROWTH ADM 179035 F VANGUARD MID CAP INDEX ADMIRAL 262509 F VANGUARD SHORT TERM INV GRADE ADM 519435 F VANGUARD SHORT TERM TREASURY ADMIRAL 85109 F VANGUARD SIT INTL PRAT-ADM 42204 F VANGUARD SMALL CAP INDEX ADMIRAL 135712 F 4477675 X 32115698 446173 446173 31669525 -1187 -1187 31668338 30391083 1187 1187 30389896 0 30389896 PART X, LINE 2: NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING FINANCIAL STATEMENTS BECAUSE LIFESHARE IS EXEMPT FROM FEDERAL AND STATE TAXES ON INCOME RELATED TO ITS EXEMPT PURPOSE UNDER THE PROVISIONS OF INTERNAL REVENUE CODE SECTION 501(C)(3). PART XI, LINE 4B - OTHER ADJUSTMENTS: RETIREMENT OF ASSETS -1,187. PART XII, LINE 2D - OTHER ADJUSTMENTS: RETIREMENT OF ASSETS 1,187. 1 LIFESHARE FOUNDATION 4705 NW EXPRESSWAY OKLAHOMA CITY OK 73132 821003338 501(C)(3) 500000 PROMOTE ORGAN & TISSUE DONATION AWARENESS 1 0 PART II, LINE 1, COLUMN (H): NAME OF ORGANIZATION OR GOVERNMENT: THE LIFESHARE FOUNDATION PURPOSE OF GRANT OR ASSISTANCE: TO SUPPORT THE ACTIVITIES AND INITIATIVES OF LIFESHARE OF OKLAHOMA TO HELP SAVE MORE LIVES THROUGH ORGAN, EYE AND TISSUE DONATION. THE FOCUS OF THE FOUNDATION IS AWARENESS OF ORGAN, EYE AND TISSUE DONATION, SUPPORT OF TRANSPLANT RECIPIENTS, INCLUDING THOSE WAITING, AND DONOR FAMILIES, AND RESEARCH IN DONATION. X X X 0 0 0 0 0 0 0 0 0 JEFFREY ORLOWSKI PRESIDENT AND CEO 361669 0 57749 0 8141 0 36349 0 9624 0 473532 0 0 0 MICHELLE GIBSON VP HUMAN RESOURCES 188880 0 14620 0 0 0 20350 0 7728 0 231578 0 0 0 MARTIN BENOIT VP, CFO 203213 0 15601 0 0 0 21881 0 3849 0 244544 0 0 0 KATHERINE SMITH VP, COMMUNICATIONS AND FOUNDATION 170067 0 13420 0 0 0 18349 0 6044 0 207880 0 0 0 DARRELL TRAHAN VP, CLINICAL SERVICES 152657 0 14204 0 0 0 16686 0 7708 0 191255 0 0 0 CLINT HOSTETLER VP, CLINICAL SERVICES 151454 0 7278 0 0 0 15873 0 4928 0 179533 0 0 0 JAN FOUTCH VP, QUALITY SYSTEMS 149545 0 14292 0 0 0 16384 0 3282 0 183503 0 0 0 HARVEY SOLOMON RECOVERY SURGEON 358673 0 1500 0 0 0 29319 0 7144 0 396636 0 0 0 JEFFREY LEGG HCE 133755 0 2500 0 0 0 13626 0 5853 0 155734 0 0 0 ROBERT BASHAW DIRECTOR OF IT & FACILITIES 125467 0 10480 0 0 0 13595 0 5583 0 155125 0 0 0 LOGAN WILKE HCE 126620 0 1500 0 0 0 12812 0 15462 0 156394 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE PRESIDENT/CEO REVIEWS THE 990 PRIOR TO THE FILING OF THE RETURN. THE 990 AS FILED IS SHARED WITH THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C THE EMPLOYEES AND THE BOARD MEMBERS SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY. BOARD MEMBERS ARE REQUIRED TO DISCLOSE TO THE BOARD ANY CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST THAT MAY ARISE REGARDING A MATTER UNDER REVIEW BY THE BOARD. BOARD MEMBERS DO NOT PARTICIPATE IN OR VOTE ON MATTERS WHERE THEY HAVE A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION C, LINE 19 LIFESHARE TRANSPLANT DONOR SERVICES OF OKLAHOMA, INC ONLY PROVIDES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS WHEN REQUESTED. THEY DO NOT PUBLISH THIS INFORMATION ON THEIR WEBSITE. FORM 990, PART IX, LINE 24E COST OF PROCUREMENT - SURGEON FEES: PROGRAM SERVICE EXPENSES 778,139. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 778,139. COST OF PROCUREMENT - HOSPITAL LAB: PROGRAM SERVICE EXPENSES 699,131. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 699,131. COST OF PROCUREMENT - TRANSPORTATION OF ORGANS & TISSUE: PROGRAM SERVICE EXPENSES 544,580. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 544,580. COST OF PROCUREMENT - DONOR EVALUATION: PROGRAM SERVICE EXPENSES 502,962. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 502,962. STAFF TRAINING AND SEMINARS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 481,485. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 481,485. COST OF PROCUREMENT - MEDICAL SUPPLIES: PROGRAM SERVICE EXPENSES 323,741. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 323,741. COST OF PROCUREMENT - PHARMACY: PROGRAM SERVICE EXPENSES 293,622. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 293,622. OTHER MISCELLANEOUS: PROGRAM SERVICE EXPENSES 12,310. MANAGEMENT AND GENERAL EXPENSES 257,792. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 270,102. COST OF PROCUREMENT - TRANSPORTATION OF TEAMS: PROGRAM SERVICE EXPENSES 240,202. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 240,202. COST OF PROCUREMENT - ANESTHESIA: PROGRAM SERVICE EXPENSES 216,727. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 216,727. COST OF PROCUREMENT - ICU: PROGRAM SERVICE EXPENSES 213,874. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 213,874. COST OF PROCUREMENT - TISSUE TYPING: PROGRAM SERVICE EXPENSES 198,378. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 198,378. COST OF PROCUREMENT - ORGAN MEDICAL BILL REVIEW: PROGRAM SERVICE EXPENSES 180,745. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 180,745. DONOR DATA SYSTEM: PROGRAM SERVICE EXPENSES 173,711. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 173,711. MEDICAL DIRECTOR FEES: PROGRAM SERVICE EXPENSES 109,375. MANAGEMENT AND GENERAL EXPENSES 36,458. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 145,833. MEDICAL WASTE: PROGRAM SERVICE EXPENSES 113,571. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 113,571. REPAIRS AND MAINTENANCE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 105,738. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 105,738. DUES AND SUBSCRIPTIONS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 104,881. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 104,881. RECRUITMENT COSTS AND EMPLOYEE RELATIONS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 96,202. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 96,202. CALL CENTER COSTS: PROGRAM SERVICE EXPENSES 96,050. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 96,050. COST OF PROCUREMENT - RESPIRATORY THERAPY: PROGRAM SERVICE EXPENSES 83,324. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 83,324. COST OF PROCUREMENT - OTHER EXCISION: PROGRAM SERVICE EXPENSES 46,888. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 46,888. ORGAN & TISSUE RECOVERY COORDINATOR: PROGRAM SERVICE EXPENSES 45,490. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 45,490. TAXES & LICENSES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 37,845. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 37,845. DOUBTFUL ACCOUNTS PROVISION: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES -262,602. FUNDRAISING EXPENSES 0. TOTAL EXPENSES -262,602. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. THE LIFESHARE FOUNDATION 4705 NW EXPRESSWAY OKLAHOMA CITY OK 731325213 821003338 SEE PART VII OK 501(C)(3) LINE 12B, II LIFESHARE TRANSPLANT DONOR SERVICES 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 THE LIFESHARE FOUNDATION B 500000 CASH DONATION SCHEDULE R, PART II TO ASSUME ALL OF THE FUNDRAISING ACTIVITIES OF ITS SUPPORTED ORGANIZATION, IE., THE LIFESHARE TRANSPLANT DONOR SERVICES OF OKLAHOMA, INC. WHICH IS THE FEDERALLY-CERTIFIED ORGAN PROCUREMENT ORGANIZATION FOR THE STATE OF OKLAHOMA.