2019-10-21T13:58:06-05:00 2018-12-31 731335926 BARBARA A LEY A PROFESSIONAL CORP 6305 WATERFORD BLVD STE 450 OKLAHOMA CITY OK 73118 990 2018-01-01 731281589 LifeShare Transplant Donor Services of Oklahoma Inc LIFE 4058405551 4705 NW Expressway Oklahoma City OK 73132 Jeff Orlowski Chief Executive Officer 4058405551 2019-10-17 1 Janet Gifford P00303744 4058480255 68.15.98.80 2019-10-21 13:52:36 CD P 9F0F0E482B934AE17FB0FBA6BE7F1B6FE9BFC173 59CB456A1F93CF2D8E9D19871BC3C08D0DAE89CC 2018 2020-01-14 16:20:31Z 4705 NW Expressway Oklahoma City OK 73132 32088630 0 X www.lifeshareoklahoma.org X 1984 OK Provides organ procurement services within the state of Oklahoma. 15 15 142 58 0 0 33628 1500 30471106 31648685 73528 186579 0 0 30578262 31836764 0 291459 0 0 11263605 12584020 0 0 0 16194097 16475671 27457702 29351150 3120560 2485614 23530364 26330568 5065346 5567422 18465018 20763146 LifeShare Transplant Donor Services of Oklahoma, Inc. provides organ procurement services within the state of Oklahoma; identification of organ donors; surgical excision and distributions of organs and public education regarding organ donors. 0 0 23506065 291459 31648685 Organ procurement and placement was provided for 293 kidneys, 132livers, 26 pancreas, 51 hearts, and 84 lungs. LifeShare also provided tissue procurement of 1,038 tissue donors. 23506065 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 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 77 0 1 142 1 0 0 0 0 0 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 ANTHONY SEBASTIAN MD DIRECTOR 0.00 X 0 0 0 BENJAMIN COWLEY MD CHAIR OF FINANCE COMMITTEE 0.00 X X 0 0 0 GINA FLESHER MS RN SECRETARY/TREASURER 0.00 X 0 0 0 HARLAN WRIGHT MD DIRECTOR 0.00 X 0 0 0 IRFAN KUNDI MD DIRECTOR 0.00 X 0 0 0 MICHAEL MORRIS MD DIRECTOR 0.00 X 0 0 0 SAMANTHA WEYRAUCH DAVIS DIRECTOR 0.00 X 0 0 0 STEVE MILLER MD DIRECTOR 0.00 X 0 0 0 TOM ANDERSON DIRECTOR 0.00 X 0 0 0 MARY JOHNSON DIRECTOR 0.00 X 0 0 0 ED HEINEN CHAIR OF HR COMMITTEE 0.00 1.00 X 0 0 0 RAJAT KAUL MD IMMEDIATE PAST CHAIR 0.00 X 0 0 0 SUZANNE WHEELER BOARD VICE CHAIR 0.00 X X 0 0 0 PAMELA SPANBAUER RN BSN MEd BOARD CHAIR 0.48 1.00 X X 0 0 0 JAMES SHARROCK DIRECTOR 0.00 X 0 0 0 MARTIN BENOIT VP,FINANCE 40.00 X 178502 0 36022 JANICE WHALEY EXECUTIVE VP/COO (FORMER) 40.00 X 240315 0 32006 JEFF ORLOWSKI PRESIDENT/CEO 40.00 1.00 X 396771 0 65950 MICHELLE GIBSON VP HUMAN RESOURCES 40.00 X 164547 0 30658 DARRELL TRAHAN VP CLINICAL SERVICES 40.00 X 153492 0 40674 JAN FOUTCH VP OF QUALITY SYSTEMS 40.00 X 161341 0 21710 KATHRYN SMITH VP FOUNDATION 40.00 1.00 X 134263 0 23482 ROBERT BASHAW DIRECTOR OF IT & FACILITIES 40.00 X 121874 0 25229 JEFFREY LEGG HIGHLY COMPENSATED EMPLOYEE 40.00 X 131651 0 20208 CHRISTOPHER HOLLIDAY HIGHLY COMPENSATED EMPLOYEE 40.00 X 104665 0 17707 HARVEY SOLOMON CHIEF SURGEON 40.00 X 243625 0 40008 CHAD MUSE HIGHLY COMPENSATED EMPLOYEE 40.00 X 103188 0 22289 2134234 0 375943 12 0 1 0 MONARCH MARKETING GROUP LLC 200 NW 63RD OKLAHOMA CITY OK 73116 ADVERTISING 310213 ROGER SATCHER 2709 BIANCA CT LAS VEGAS NV 89117 SURGEON FEES 220137 GENESIS CONSULTING LLC 8297 CHAMPIONS GATE BLVD 157 CHAMPIONS GATE FL 33896 SURGEON FEES 211414 PERFORMANCE CONSULTING LLC 2304 N INTERSTATE DRIVE NORMAN OK 73072 CONSULTING 154750 ECL2 CONSULTING SERVICES LLC PO BOX 1731 GRAPEVINE TX 76099 CONSULTING 132552 5 1500 1500 EXTRA-RENAL PROCUREMENT 621991 13079806 13079806 MEDICARE/MEDICAID PAYMENTS 621991 10447247 10447247 TISSUE PROCUREMENT 621991 7750735 7750735 Other 621991 312102 312102 RESEARCH ORGANS 621991 58795 58795 31648685 146621 146621 275059 16765 235933 15933 39126 832 39958 39958 31836764 31648685 0 186579 X 291459 291459 1679733 805401 874332 8093096 6892964 1200132 797898 648550 149348 1354864 1101264 253600 658429 535186 123243 29041 29041 59951 59951 14864 14864 878017 760459 117558 318063 105667 212396 308536 107383 201153 173983 4004 169979 412033 412033 276664 164954 111710 82328 42825 39503 19613 19613 463502 463502 398012 398012 Cost of Procurement-Imp 2487660 2487660 Cost of Procurement-Ope 1689076 1689076 Cost of Procurement-Org 1273522 1273522 Cost of Procurement-Hos 689281 689281 6901525 5906410 995115 29351150 23506065 5845085 0 2522455 3690680 7343362 9073849 7469207 6914395 105997 66106 268025 205753 6224409 2027835 4143026 4196574 1673338 2176239 4954 6972 23530364 26330568 3676587 4238612 1388759 1328810 5065346 5567422 X 18465018 20763146 18465018 20763146 23530364 26330568 2485614 -187486 0 X 1 X 1 X 1 0 X 6613765 9712340 9679968 11106836 10448747 47561656 6613765 9712340 9679968 11106836 10448747 47561656 47561656 59933 97568 102615 97560 146620 504296 48065952 86630133 0.98950 0.98960 X 771990 771990 1365547 188926 1176621 1972637 784949 1187688 2114235 1053960 1060275 4196574 American Beacon Small Cap Value Inst 26699 F Carillon Eagle Small Cap Growth Inst 22616 F Cohen & Steers Realty Shares Inst 13869 F Delaware Emerging Markets R-6 29383 F Dodge & Cox International Stock 57430 F Dodge & Cox Stock 115025 F Fidelity Contrafund 113506 F Metropolitan West Total Return Bond 118437 F PIMCO Investment Grd Credit Bond I 113454 F PIMCO Total Return Fund-Inst 118058 F Primecap Odyssey Stock 104625 F Templeton Global Bond Advisor CL 18369 F Thornburg Limited Term Income Fund 231853 F Vanguard 500 Index Admiral 529791 F Vanguard Developed Markets Index Adm 20132 F Vanguard EM Mk Stk Indx-Adm 19969 F Vanguard International Growth Adm 55730 F Vanguard Mid Cap Index Admiral 134366 F Vanguard Mid Cap Value Index Admiral 23836 F Vanguard S/T Infl Prot-Adm 21550 F Vanguard Short Term INV Grade Adm 231055 F Vanguard Small Cap Index Admiral 56486 F 2176239 31633591 -187484 -14864 -202348 31835939 825 825 31836764 29335461 -825 -825 29336286 14864 14864 29351150 Part XI, Line 2d - Other Adjustments: Brokerage Fees -14,864. Part XI, Line 4b - Other Adjustments: Gain on Sale of Assets 825. Part XII, Line 2d - Other Adjustments: Gain on Sale of Assets -825. Part XII, Line 4b - Other Adjustments: Brokerage Fees 14,864. 1 Tranplant Life Foundation 1595 Galbraith Ave SE Suite 500 Grand Rapids MI 49546 461252372 501(c)(3) 25000 This is a LifeShare sponsor paid to Transplant Life Foundation for the Transplant Games, which occurs every 2 years for tranplant recipient participation. LifeShare supports "Team Oklahoma", a group of organ/tissue recipients who attend these games representing Oklahoma. The LifeShare Foundation 4705 NW Expressway Oklahoma City OK 73132 821003338 501(c)(3) 263965 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. 2 2 X X X 0 0 0 0 0 0 0 0 0 MARTIN BENOIT VP,FINANCE 173185 0 5317 0 0 0 31698 0 4324 0 214524 0 0 0 JANICE WHALEY EXECUTIVE VP/COO (FORMER) 227575 0 12740 0 0 0 27056 0 4950 0 272321 0 0 0 JEFF ORLOWSKI PRESIDENT/CEO 349371 0 47400 0 0 0 56356 0 9594 0 462721 0 0 0 MICHELLE GIBSON VP HUMAN RESOURCES 150642 0 13905 0 0 0 19248 0 11410 0 195205 0 0 0 DARRELL TRAHAN VP CLINICAL SERVICES 145698 0 7794 0 0 0 29264 0 11410 0 194166 0 0 0 JAN FOUTCH VP OF QUALITY SYSTEMS 153608 0 7733 0 0 0 17336 0 4374 0 183051 0 0 0 KATHRYN SMITH VP FOUNDATION 124338 0 9925 0 0 0 17493 0 5989 0 157745 0 0 0 JEFFREY LEGG HIGHLY COMPENSATED EMPLOYEE 128656 0 2995 0 0 0 14285 0 5923 0 151859 0 0 0 HARVEY SOLOMON CHIEF SURGEON 242875 0 750 0 0 0 35878 0 4130 0 283633 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. 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 VII Contact Addresses for Officers, Directors, Etc ANTHONY SEBASTIAN, M.D. - OKLAHOMA TRANSPLANT CENTER 940 NE 13TH STREET STE OKLAHOMA CITY, OK 73104. BENJAMIN COWLEY, M.D. - 800 STANTON L. YOUNG BLVD., STE 5300, OKLAHOMA CITY, OK 73104. GINA FLESHER, M.S., R.N. - 1604 TIMBERCREEK DR., DUNCAN, OK 73533. HARLAN WRIGHT, M.D. - 940 NE 13TH ST., STE. 3000, OKLAHOMA CITY, OK 73104. IRFAN KUNDI, M.D. - 2000 SOUTH WHEELING AVENUE, SUITE 510, TULSA, OK 74104. MICHAEL MORRIS, M.D. - 3300 NW EXPRESSWAY, OKLAHOMA CITY, OK 73112. SAMANTHA WEYRAUCH DAVIS - 320 SOUTH BOSTON AVENUE, SUITE 200, TULSA, OK 74103-3706. STEVE MILLER, M.D. - 10901 EAST 48TH STREET, TULSA, OK 74146. TOM ANDERSON - 5705 N. MACARTHUR, WARR ACRES, OK 73122. MARY JOHNSON - 6161 SOUTH YALE AVE, TULSA, OK 74136. ED HEINEN - 3366 NW EXPRESSWAY, SUITE 800, OKLAHOMA CITY, OK 73112. RAJAT KAUL, M.D. - 1124 SOUTH ST. LOUIS AVENUE, SUITE 200, TULSA, OK 74120. SUZANNE WHEELER - 4200 E SKELLY DR, SUITE 950, TULSA, OK 74135. PAMELA SPANBAUER, R.N., B.S.N., M.Ed. - 5308 NW 118TH CIRCLE, OKLAHOMA CITY, OK 73162. JAMES SHARROCK - 2604 NW 68TH STREET, OKLAHOMA CITY, OK 73116. Form 990, Part IX, line 24e Cost of Procurement-Surgeon Fees: Program service expenses 642,125. Management and general expenses 0. Fundraising expenses 0. Total expenses 642,125. Cost of Procurement-Transportation of Organs and Tissue: Program service expenses 578,812. Management and general expenses 0. Fundraising expenses 0. Total expenses 578,812. Cost of Procurement-Tissue Procurement Expense: Program service expenses 526,492. Management and general expenses 0. Fundraising expenses 0. Total expenses 526,492. Sponsorships: Program service expenses 16,360. Management and general expenses 403,047. Fundraising expenses 0. Total expenses 419,407. Cost of Procurement-Donor Evaluation: Program service expenses 362,184. Management and general expenses 0. Fundraising expenses 0. Total expenses 362,184. Cost of Procurement-Organ Acquisition Non-Recovery: Program service expenses 350,643. Management and general expenses 0. Fundraising expenses 0. Total expenses 350,643. Doubtful Accounts Provision: Program service expenses 320,089. Management and general expenses 0. Fundraising expenses 0. Total expenses 320,089. Cost of Procurement-Anesthesiology: Program service expenses 312,874. Management and general expenses 0. Fundraising expenses 0. Total expenses 312,874. Call Center: Program service expenses 308,444. Management and general expenses 0. Fundraising expenses 0. Total expenses 308,444. Cost of Procurement-Other Acquisition Costs: Program service expenses 296,043. Management and general expenses 0. Fundraising expenses 0. Total expenses 296,043. Human Resources: Program service expenses 0. Management and general expenses 287,446. Fundraising expenses 0. Total expenses 287,446. Cost of Procurement-Pharmacy: Program service expenses 282,375. Management and general expenses 0. Fundraising expenses 0. Total expenses 282,375. Cost of Procurement-Intensive Care Unit: Program service expenses 277,484. Management and general expenses 0. Fundraising expenses 0. Total expenses 277,484. Cost of Procurement-Transportation of Teams: Program service expenses 245,975. Management and general expenses 0. Fundraising expenses 0. Total expenses 245,975. Cost of Procurement-Medical Supplies: Program service expenses 201,988. Management and general expenses 0. Fundraising expenses 0. Total expenses 201,988. Professional Education: Program service expenses 70,812. Management and general expenses 124,782. Fundraising expenses 0. Total expenses 195,594. Cost of Procurement-Tissue Typing: Program service expenses 189,226. Management and general expenses 0. Fundraising expenses 0. Total expenses 189,226. Cost of Procurement-Respiratory Therapy: Program service expenses 186,904. Management and general expenses 0. Fundraising expenses 0. Total expenses 186,904. Donor Data System: Program service expenses 156,563. Management and general expenses 0. Fundraising expenses 0. Total expenses 156,563. Transplant Coordinator Expense: Program service expenses 147,286. Management and general expenses 0. Fundraising expenses 0. Total expenses 147,286. Cost of Procurement-Organ Hospital Bill Review: Program service expenses 141,411. Management and general expenses 0. Fundraising expenses 0. Total expenses 141,411. Cost of Procurement-Medical Waste: Program service expenses 137,949. Management and general expenses 0. Fundraising expenses 0. Total expenses 137,949. Admin & General: Program service expenses 31,633. Management and general expenses 80,333. Fundraising expenses 0. Total expenses 111,966. Memberships and Dues: Program service expenses 14,156. Management and general expenses 74,901. Fundraising expenses 0. Total expenses 89,057. Cost of Procurement-Transplant Coordinator: Program service expenses 78,253. Management and general expenses 0. Fundraising expenses 0. Total expenses 78,253. Uniforms & Linens: Program service expenses 17,089. Management and general expenses 0. Fundraising expenses 0. Total expenses 17,089. Retirement of Assets: Program service expenses 0. Management and general expenses 11,738. Fundraising expenses 0. Total expenses 11,738. Tools & Med Supplies: Program service expenses 3,980. Management and general expenses 5,326. Fundraising expenses 0. Total expenses 9,306. Cost of Procurement-Other Excision Costs: Program service expenses 9,260. Management and general expenses 0. Fundraising expenses 0. Total expenses 9,260. Taxes-Other: Program service expenses 0. Management and general expenses 7,408. Fundraising expenses 0. Total expenses 7,408. Bank Service Charges: Program service expenses 0. Management and general expenses 134. Fundraising expenses 0. Total expenses 134. 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. The LifeShare Foundation 4705 NW Expressway Oklahoma City OK 731325213 821003338 See Schedule O 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 263965 Cash Donation