2020-10-02T16:47:30-05:00 2019-12-31 420714325 RSM US LLP 801 NICOLLET MALL WEST TOWER STE 1100 MINNEAPOLIS MN 554022526 990 2019-01-01 363584029 UPPER MIDWEST ORGAN PROCUREMENT ORGANIZATION INC / LIFESOURCE UPPE 6128006100 2225 WEST RIVER ROAD NORTH MINNEAPOLIS MN 55411 PETER D FARSTAD CAO 6128006100 2020-09-01 1 KACIE MCEWEN P01599614 6123324300 2020-09-01 68.47.31.197 2020-09-01 15:23:15 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 B56786F7D21A8F39D00ED83C272556B8DDCB8C36 2019 2021-01-29 14:40:06Z LIFESOURCE SUSAN RAETHER 2225 WEST RIVER ROAD NORTH MINNEAPOLIS MN 55411 64053858 0 X WWW.LIFE-SOURCE.ORG X 1987 MN SAVE LIVES AND OFFER HOPE AND HEALING THROUGH EXCELLENCE IN ORGAN, TISSUE AND EYE DONATION. 14 14 204 250 0 0 515530 510495 46222408 56116490 1099217 825585 15665 -120454 47852820 57332116 0 0 0 0 16002430 18268765 0 0 0 29066911 34380095 45069341 52648860 2783479 4683256 54349494 62155224 17611724 18955282 36737770 43199942 X LIFESOURCE SAVES LIVES AND OFFERS HOPE AND HEALING THROUGH EXCELLENCE IN ORGAN, EYE AND TISSUE DONATION. 0 0 42168914 55810860 ORGAN, EYE AND TISSUE PROCUREMENT:THE ORGAN, EYE, AND TISSUE PROCUREMENT DEPARTMENTS WORK COLLABORATIVELY WITH HOSPITAL STAFF IN THE LIFESOURCE DONOR SERVICE AREA (MINNESOTA, NORTH DAKOTA, SOUTH DAKOTA, AND A PORTION OF WESTERN WISCONSIN) TO IDENTIFY POTENTIAL ORGAN, EYE AND TISSUE DONORS, PROVIDE SUPPORT TO FAMILIES THROUGHOUT THE DONATION PROCESS, SUPPORT PROTOCOLS ESTABLISHED BY THE UNITED NETWORK FOR ORGAN SHARING TO MATCH THE ORGANS WITH THE INTENDED RECIPIENT, COORDINATE ALL CLINICAL ACTIVITIES AND ARRANGE THE SURGICAL RECOVERY OF ORGANS, TISSUES AND EYES. DONATION COORDINATORS AND TISSUE RECOVERY PERSONNEL, IN CONJUNCTION WITH DONOR SERVICES CENTER STAFF ACQUIRE KNOWN INFORMATION ABOUT AN INDIVIDUAL'S DOCUMENTED DESIGNATION FOR DONATION. IF NO KNOWN DOCUMENTATION EXISTS, THE COORDINATOR WILL WORK WITH THE NEXT-OF-KIN TO OBTAIN AUTHORIZATION FOR DONATION. IN 2019, LIFESOURCE MANAGED 206 ORGAN DONATION CASES, RESULTING IN 635 ORGAN TRANSPLANTS. IN ADDITION, STAFF COORDINATED THE IMPORT AND SUBSEQUENT TRANSPLANT OF 353 ORGANS FROM DONORS OUTSIDE THE LIFESOURCE REGION FOR TRANSPLANTATION IN THE LIFESOURCE REGION. THESE SERVICES SUPPORT THE WORK OF NINE TRANSPLANT PROGRAMS LOCATED IN THE LIFESOURCE SERVICE AREA. LIFESOURCE TISSUE RECOVERY STAFF COORDINATED 789 TISSUE DONATION CASES, RESULTING IN THE TRANSPLANT OF APPROXIMATELY 60,000 TISSUE GRAFTS CONSISTING OF BONE, CONNECTIVE TISSUE, FASCIA, SKIN, VEIN AND HEART VALVES. LIFESOURCE TISSUE RECOVERY STAFF ALSO COORDINATED 567 EYE DONATION CASES, RESULTING IN CORNEAS RECOVERED FOR TRANSPLANT AND RESEARCH. 2812925 HOSPITAL SERVICES: THE HOSPITAL SERVICES DEPARTMENT IS COMMITTED TO MAXIMIZING ORGAN AND TISSUE DONATION BY BUILDING SUCCESSFUL RELATIONSHIPS WITH KEY STAFF MEMBERS OF 279 DONOR HOSPITALS LOCATED THROUGHOUT THE LIFESOURCE REGION. LIFESOURCE HOSPITAL LIAISONS AND CLINICAL HOSPITAL COORDINATORS ARE STRATEGICALLY LOCATED IN MINNEAPOLIS, MN; DULUTH, MN; FARGO, ND; BISMARCK, ND; AND RAPID CITY, SD. THE GOALS OF THIS DEPARTMENT INCLUDE MAINTAINING STRONG WORKING RELATIONSHIPS WITH HOSPITAL STAFF, PROVIDING EDUCATION TO CLINICIANS, ASSISTING HOSPITAL STAFF COMPLY WITH FEDERAL STANDARDS AND ON-SITE SUPPORT DURING DONATION CASES. 1808838 PUBLIC EDUCATION:LIFESOURCE MAINTAINS A STRONG COMMITMENT TO PUBLIC EDUCATION ACTIVITIES DESIGNED TO INCREASE AWARENESS AND UNDERSTANDING ABOUT THE NEED FOR ORGAN AND TISSUE DONATION IN THE LIFESOURCE REGION. THE LIFESOURCE REGION HAS AN OVERALL 70% REGISTERED DONOR RATE, AMONG THE HIGHEST IN THE NATION. THE EDUCATION ACTIVITIES ARE FOCUSED ON DEVELOPING EXTERNAL RELATIONSHIPS FOR THE PURPOSE OF BUILDING SUPPORT FOR DONATION AND POSITIONING LIFESOURCE AS THE DONATION EXPERT IN THE REGION. THIS WORK IS CRITICAL AS THE GROWING NEED FOR ORGANS AND TISSUES WILL NOT BE MET WITHOUT INCREASED PUBLIC SUPPORT AND INDIVIDUALS WHO DESIGNATE THEMSELVES AS DONORS THROUGH THE STATE DRIVER'S LICENSE BUREAUS OR ONLINE STATE DONOR REGISTRY. IN 2019, 250 VOLUNTEERS SUPPORTED THE LIFESOURCE MISSION THROUGH MORE THAN 1,800 HOURS OF HIGH SCHOOL AND COMMUNITY EDUCATION. THE PUBLIC EDUCATION DEPARTMENT ALSO WORKED TO INCREASE DONATION THROUGH MEDIA CAMPAIGNS, COMMUNITY OUTREACH INITIATIVES, GOVERNMENT RELATIONS AND DONOR FAMILY SERVICES. 46790677 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 143 0 1 204 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 MN X PETER D FARSTAD 6128006100 2225 WEST RIVER ROAD NORTH MINNEAPOLIS MN 55411 SUSAN RAETHER CEO 50.00 X 559606 0 66749 PETER FARSTAD CAO 50.00 X 317649 0 54332 JULIE KEMINK COO 50.00 X 270162 0 61856 SUSAN WEESE DIRECTOR OF ORGAN PROCUREMENT 50.00 X 213901 0 40916 DAN LUNN DIRECTOR OF TISSUE SERVICES AND DONOR SERVICES CTR 50.00 X 201834 0 50944 SUSAN LARSON DIRECTOR OF PUBLIC AFFAIRS & HOSPITAL SERVICES 50.00 X 231631 0 22216 MARGARET ROGERS DIRECTOR OF TRANSPLANT CENTER RELATIONS 50.00 X 214030 0 31793 BRENDA WELSCH DIRECTOR OF QUALITY & REGULATION 50.00 X 176208 0 16758 SARA CRIGER CHAIR (JAN-DEC) 5.00 X X 0 0 0 BRUCE KING IMMEDIATE PAST CHAIR (JAN-DEC) 5.00 X X 0 0 0 TIM BJORK VICE CHAIR (JAN-DEC) 5.00 X X 0 0 0 KIM SIMENSEN SEC/TREAS (JAN-DEC) 5.00 X X 0 0 0 KEN ACKERMAN DIRECTOR 5.00 X 0 0 0 CRAIG BROMAN DIRECTOR 5.00 X 0 0 0 GRETCHEN DAHLBERG DIRECTOR (JUL-DEC) 5.00 X 0 0 0 FRAZIER EALES MD DIRECTOR 5.00 X 0 0 0 ALEX HILL PHD DIRECTOR 5.00 X 0 0 0 JERRY LEE DIRECTOR (JUL-DEC) 5.00 X 0 0 0 TIM PRUETT MD DIRECTOR 5.00 X 0 0 0 MEGAN REMARK DIRECTOR 5.00 X 0 0 0 MARK RITCHIE DIRECTOR (JAN-JUN) 5.00 X 0 0 0 TOM SCHWAB MD DIRECTOR 5.00 X 0 0 0 MARSHA SHOTLEY DIRECTOR (JAN-JUN) 5.00 X 0 0 0 MYLYNN TUFTE DIRECTOR 5.00 X 0 0 0 2185021 0 345564 22 0 1 0 AVIATION CHARTER 9960 FLYING CLOUD DRIVE EDEN PRAIRIE MN 55347 CHARTER AVIATION 5514034 GIFT OF HOPE ORGAN & TISSUE 425 SPRING LAKE DRIVE ITASCA IL 60143 IMPORT ORGAN EXPENSE 2479155 VRL EUROFINS 6665 S KENTON STREET STE 205 CENTENNIAL CO 80111 INFECTIOUS DISEASE TESTING 1380694 MIDWEST TRANSPLANT NETWORK 1900 W 47TH PLACE STE 400 WESTWOOD KS 66205 IMPORT ORGAN EXPENSE 1197200 IOWA DONOR NETWORK 320 ADVENTURELAND DR NW ALTOONA IA 50009 ORGAN DONATIONS 874000 65 215915 294580 510495 ORGAN PROC/RSRCH REVENUE 621300 55760652 55760652 OTHER OPERATING INCOME 621300 355838 355838 56116490 694836 694836 36000 0 36000 36000 36000 6603798 6460217 12832 143581 -12832 130749 130749 92027 215915 248693 -156666 -156666 MISC REVENUE 900099 212 212 212 57332116 56116490 0 705131 1359879 818888 540991 13184096 10716976 2467120 821773 673844 147929 1936152 1549184 386968 966865 768875 197990 69376 69376 56899 56899 53625 53625 69868 69868 595092 401718 193374 750523 83776 666747 778403 595217 183186 361835 167291 194544 426662 243927 182735 1398070 1063138 334932 490008 378109 111899 IMPORT ORGAN EXPENSE 15829561 15829561 PROCUREMENT COSTS: ORGA 6580248 6580248 PROCUREMENT COSTS: TRAN 3535065 3535065 PUBLIC AND PROFESSIONAL 1945412 1945412 1439448 1439448 52648860 46790677 5858183 0 7462108 9442907 100876 101481 54430 154650 7516656 8459985 1448972 963366 656705 898636 21761999 5580866 17124246 16181133 12894806 15264143 7090695 10056153 0 632770 54349494 62155224 6310902 7384626 11300822 11570656 17611724 18955282 X 36683340 43146362 54430 53580 36737770 43199942 54349494 62155224 4683256 1778916 0 X 0 1 X 1 0 X 537853 410650 875907 515530 510495 2850435 40533774 45186593 47090149 46224276 56116490 235151282 41071627 45597243 47966056 46739806 56626985 238001717 12308 22667 23780 19715 27369 105839 0 12308 22667 23780 19715 27369 105839 237895878 109455 65312 364061 588512 730836 1858176 109455 65312 364061 588512 730836 1858176 321398 318848 274597 1871 212 916926 41502480 45981403 48604714 47330189 57358033 240776819 0.98800 0.98750 0.00770 0.00520 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 0 1 53625 0 0 53625 0 PART II-B, LINE 1: LIFESOURCE CONDUCTED LOBBYING ACTIVITIES DURING 2019 FOR THE PURPOSE OF LEGISLATIVE MONITORING AND INCREASING ORGAN AND TISSUE DONATION. TOTAL COSTS FOR 2019 WERE $53,625. 2136289 2136289 16699938 3500219 13199719 155910 29119 126791 1764373 1458521 305852 1005489 593007 412482 16181133 CERTIFICATES OF DEPOSIT 9053989 F 457 RESERVE 1002164 C 10056153 FINANCE LEASE OBLIGATIONS 10937886 OPERATING LEASE OBLIGATIONS 632770 11570656 X 59289857 1778916 -69868 1709048 57580809 -248693 -248693 57332116 52827685 248693 248693 52578992 69868 69868 52648860 PART X, LINE 2: THE ORGANIZATION REVIEWED ITS TAX POSITION FOR ALL OPEN TAX YEARS AND CONCLUDED THE PROVISIONS OF ASC 740 DID NOT HAVE AN IMPACT ON ITS FINANCIAL STATEMENT PRESENTATION. GENERALLY, THE ORGANIZATION IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL, STATE AND LOCAL TAX AUTHORITIES FOR THE YEARS BEFORE 2016. PART XI, LINE 2D - OTHER ADJUSTMENTS: INVESTMENT ADVISOR FEES RECLASSED FROM REVENUE TO FUNCTIONAL EXPENSES -69,868. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES RECLASSED TO REVENUE FROM FUNCTIONAL EXPENSES -248,693. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES RECLASSED TO REVENUE FROM FUNCTIONAL EXPENSES 248,693. PART XII, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT ADVISOR FEES RECLASSED FROM REVENUE TO FUNCTIONAL EXPENSES 69,868. GOLF TOURNAMENT 181832 163915 17917 300 2461 16384 8428 0 15863 DONATE LIFE SYMPOSIUM 126110 52000 74110 0 8750 44337 100068 0 52102 307942 215915 92027 300 11211 60721 108496 67965 248693 -156666 X X X X X 0 0 0 0 0 0 0 0 0 SUSAN RAETHER CEO 529928 0 0 0 29678 0 41400 0 35317 0 636323 0 0 0 PETER FARSTAD CAO 308056 0 0 0 9593 0 34652 0 29648 0 381949 0 0 0 JULIE KEMINK COO 266015 0 0 0 4147 0 32244 0 39205 0 341611 0 0 0 SUSAN WEESE DIRECTOR OF ORGAN PROCUREMENT 207912 0 0 0 5989 0 21172 0 29567 0 264640 0 0 0 DAN LUNN DIRECTOR OF TISSUE SERVICES AND DONO 200370 0 0 0 1464 0 20644 0 35766 0 258244 0 0 0 SUSAN LARSON DIRECTOR OF PUBLIC AFFAIRS & HOSPITA 229236 0 0 0 2395 0 22216 0 1890 0 255737 0 0 0 MARGARET ROGERS DIRECTOR OF TRANSPLANT CENTER RELATI 211729 0 0 0 2301 0 21083 0 15254 0 250367 0 0 0 BRENDA WELSCH DIRECTOR OF QUALITY & REGULATION 172911 0 0 0 3297 0 16758 0 1494 0 194460 0 0 0 AVIATION CHARTER SUBSTANTIAL CONTRIBUTOR 5514034 CHARTER AVIATION 0 VRL EUROFINS SUBSTANTIAL CONTRIBUTOR 1380694 INFECTIOUS DISESE TESTING 0 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIR, VICE CHAIR, SECRETARY-TREASURER, A CLINICAL DIRECTOR AND THE IMMEDIATE PAST CHAIR. THE CHAIR SHALL SERVE AS THE CHAIRPERSON OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL EVALUATE THE PERFORMANCE OF THE CHIEF EXECUTIVE OFFICER AND MAKE RECOMMENDATIONS TO THE BOARD REGARDING THE EXECUTIVE COMPENSATION PROGRAM AND FOR THE CHIEF EXECUTIVE OFFICER SUCCESSION PLANNING. ADDITIONALLY, IT SHALL ALSO ACT FOR THE BOARD IN EMERGENCY SITUATIONS BETWEEN BOARD MEETINGS, ONLY WHEN A QUORUM OF THE BOARD CANNOT BE ASSEMBLED EITHER IN PERSON OR THROUGH VARIOUS APPROPRIATE COMMUNICATIONS TECHNOLOGY, EXCEPT AS SUCH AUTHORITY TO ACT FOR THE BOARD IS LIMITED BY STATUTE OR BY ANY LIMITATION IMPOSED BY THE BOARD ON SUCH POWER. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS IN ADVANCE OF THE BOARD OF DIRECTORS MEETING AT WHICH IT IS BEING REVIEWED. AT THE BOARD OF DIRECTORS MEETING THE COMPLETED FORM 990 IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. IN ADDITION, PRIOR TO THE BOARD OF DIRECTORS MEETING, FORM 990 IS PRESENTED TO AND REVIEWED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES COMPLETION OF A CONFLICT OF INTEREST DISCLOSURE FORM BY ALL EMPLOYEES ON AN ANNUAL BASIS. THE CHIEF ADMINISTRATIVE OFFICER REVIEWS ALL CONFLICTS OF INTEREST AND MANAGES ANY CONFLICTS WITH THE INDIVIDUAL AND THEIR MANAGER. FOR EXECUTIVE TEAM AND BOARD OF DIRECTORS, THE CONFLICT OF INTEREST DISCLOSURE IS COMPLETED EACH YEAR AND REVIEWED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. IF A CONFLICT ARISES, THE CHAIR OF THE GOVERNANCE COMMITTEE WILL REPORT THE CONFLICT TO THE WHOLE OF THE GOVERNANCE COMMITTEE AND WORK WITH THE INDIVIDUAL MEMBER TO RESOLVE THE CONFLICT. IF THE CONFLICT CANNOT BE RESOLVED, THE MEMBER WOULD NOT BE ALLOWED TO SERVE ON THE BOARD. FORM 990, PART VI, SECTION B, LINE 15A LIFESOURCE WORKS WITH SULLIVANCOTTER TO CONDUCT AN ANALYSIS OF EXECUTIVE COMPENSATION EVERY YEAR. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS ENGAGES SULLIVANCOTTER AND SERVES AS THE COMPENSATION COMMITTEE. THE RESULTS OF THE COMPENSATION SURVEY ARE PRESENTED TO THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE, IN A CLOSED SESSION AT A BOARD OF DIRECTORS MEETING DISCUSS EXECUTIVE COMPENSATION, AND MAKES THE DETERMINATION OF CEO SALARY AND BENEFITS. THE COMPENSATION COMMITTEE AND BOARD OF DIRECTORS RECOMMENDS AND APPROVES THE CEO SALARY AND BENEFITS. THE COMPENSATION COMMITTEE AND BOARD OF DIRECTORS REVIEWS OTHER EXECUTIVE SALARIES AND BENEFITS, BUT THE CEO HAS THE FINAL APPROVAL FOR THE OTHER EXECUTIVES. FORM 990, PART VI, SECTION C, LINE 19 LIFESOURCE POSTS ITS ANNUAL FINANCIAL AUDIT ON ITS WEBSITE. THE FORM 990 IS AVAILABLE UPON REQUEST OR VIA GUIDESTAR.ORG. THE CONFLICT OF INTEREST POLICY AND OTHER DOCUMENTS ARE AVAILABLE UPON REQUEST AND ARE REVIEWED BY THE CHARITIES REVIEW COUNCIL THROUGH ITS VOLUNTARY ACCREDITATION PROCESS. LIFESOURCE MEETS ALL STANDARDS OF THE CHARITIES REVIEW COUNCIL AND A REPORT ON FINANCE, GOVERNANCE, AND CONFLICT OF INTEREST IS AVAILABLE ON THE CHARITIES REVIEW COUNCIL WEBSITE. DOCUMENTS ARE AVAILABLE FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D).