2019-10-11T07:05:23-05:00 2018-12-31 381357951 PLANTE & MORAN PLLC 27400 NORTHWESTERN HIGHWAY SOUTHFIELD MI 48034 990 2018-01-01 382772488 ORGAN PROCUREMENT AGENCY OF MICHIGAN ORGA 7349731577 3861 RESEARCH PARK DRIVE ANN ARBOR MI 48108 ANNE KOWALCZYK CFO 7349731577 2019-10-04 1 LYNNE M HUISMANN P00053811 2483522500 2019-10-04 73.161.36.242 2019-10-04 14:16:13 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 EBB51160BF2136090E0706D858221EDFD566B897 2018 2019-02-21 02:37:17Z GIFT OF LIFE MICHIGAN LADORA DILS 3861 RESEARCH PARK DRIVE ANN ARBOR MI 48108 62570500 0 X WWW.GIFTOFLIFEMICHIGAN.ORG X 1971 MI GIFT OF LIFE MICHIGAN IS THE STATE'S FEDERALLY DESIGNATED ORGAN AND TISSUE RECOVERY ORGANIZATION. AS SUCH, IT ASSISTS DONOR FAMILIES DURING THEIR TIME OF GRIEF AND ACTS AS THE INTERMEDIARY BETWEEN HOSPITALS AND TRANSPLANT CENTERS TO PROVIDE LIFE-SAVING, LIFE-IMPROVING ORGANS AND TISSUES FOR TRANSPLANT. THESE "GIFTS" INCLUDE SUCH THINGS AS KIDNEYS, LIVERS, HEARTS, LUNGS, SKIN, TENDONS AND BONE. IN FACT, A SINGLE ORGAN DONOR CAN SAVE UP TO EIGHT LIVES, WHILE A TISSUE DONOR CAN IMPROVE THE LIVES OF UP TO 50 MORE. GIFT OF LIFE ALSO PROMOTES ORGAN, TISSUE AND EYE DONATION AND MAINTAINS THE MICHIGAN ORGAN DONOR REGISTRY ALONG WITH THE MICHIGAN SECRETARY OF STATE DEPARTMENT. THE CONFIDENTIAL DONOR REGISTRY DOCUMENTS A PERSON'S SELFLESS DESIRE TO SAVE OTHERS AFTER HIS OR HER OWN LIFE HAS ENDED. 17 15 260 578 0 0 15544 7596 50746556 59928634 910630 627300 0 0 51672730 60563530 0 0 0 0 21386180 21498347 0 0 0 29941923 35344613 51328103 56842960 344627 3720570 51790316 55044794 15399716 15929466 36390600 39115328 X WE HONOR LIFE THROUGH DONATION. 0 0 48096835 59928634 ACTIVITIES AND ACCOMPLISHMENTS IN 2018 INCLUDED: --FACILITATED 338 ORGAN DONORS, WHICH LED TO 1,087 ORGAN TRANSPLANTS, EACH ONE REPRESENTING NEW LIFE FOR THE RECIPIENT. FACILITATED 1,384 TISSUE DONORS, WHOSE GIFTS MAY HELP CANCER AND BURN VICTIMS WITH RECONSTRUCTIVE SURGERY AND MAY PROVIDE MOBILITY FOR OTHERS WITH ORTHOPEDIC INJURIES. ORGANIZED A CEREMONY THAT PAID TRIBUTE TO THE PREVIOUS YEAR'S ORGAN AND TISSUE DONORS. MORE THAN 900 DONOR FAMILY MEMBERS ATTENDED THE EVENT. --THROUGH ITS STAFF AND VOLUNTEER CORPS, PROVIDED 23,000 SERVICE HOURS FOR PROMOTING DONATION. --SAW 363,178 NEW NAMES ADDED TO THE DONOR REGISTRY, BRINGING THE STATEWIDE TOTAL TO OVER 5.0 MILLION RESIDENTS REPRESENTING 62% OF THE ADULT POPULATION IN THE STATE. CONDUCTED 2800 CRITICAL-CARE IN-SERVICES THAT EDUCATED MORE THAN 40,000 HEALTH CARE INDIVIDUALS ABOUT THE BEST PRACTICES OF ORGAN AND TISSUE DONATION. THROUGH ITS IN-HOUSE LABORATORY, PERFORMED 26,731 CROSS-MATCHES (COMPATIBILITY TESTS) ON 500 POTENTIAL DONORS AND 172 OUT-OF-STATE DONORS. THE TESTS ENSURE THAT PEOPLE RECEIVING THE TRANSPLANTS HAVE THE GREATEST CHANCE OF SUCCESS. 48096835 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 124 0 1 260 1 0 0 0 0 0 0 0 0 0 0 0 0 X 17 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MI X LADORA DILS 7349731577 3861 RESEARCH PARK DRIVE ANN ARBOR MI 48108 ATSUSHI YOSHIDA MD IMMEDIATE PAST CHAIR 5.00 0.00 X X 20523 0 0 JOHN GREEN MHA CHAIR 5.00 0.00 X X 2125 0 0 PAMELA SEXTON TREASURER 3.00 0.00 X X 3461 0 0 ANTHONY KING SECRETARY 5.00 0.00 X X 1322 0 0 MAURICE BINKOW ESQ DIRECTOR 3.00 0.00 X 0 0 0 STEPHEN ECONOMY MBA DIRECTOR 3.00 0.00 X 860 0 0 SHERRIE FARRELL JD DIRECTOR 5.00 0.00 X 0 0 0 JAMES HOOGEBOOM DO DIRECTOR 3.00 0.00 X 0 0 0 DEAN KIM MD DIRECTOR 3.00 0.00 X 1265 0 0 ANNETTE JOE MD DIRECTOR 3.00 0.00 X 0 0 0 KATHLEEN VOGELSANG DIRECTOR 3.00 0.00 X 0 0 0 ANNE MURPHY CHAIR ELECT 3.00 0.00 X X 0 0 0 TIMOTHY MULLIGAN DIRECTOR 3.00 0.00 X 0 0 0 DARLA GRANGER MD DIRECTOR 5.00 0.00 X 26391 0 0 ELIZABETH RUBINSTEIN DIRECTOR 3.00 0.00 X 0 0 0 JOHN MAGEE MD DIRECTOR 3.00 0.00 X 0 0 0 TIM KEENER DIRECTOR 3.00 0.00 X 0 0 0 LADORA DILS CHIEF EXECUTIVE OFFICER 55.00 0.00 X 396414 0 56993 BRUCE NICELY CHIEF CLINICAL OFFICER 50.00 0.00 X 312210 0 36597 ANNE KOWALCZYK CHIEF FINANCIAL OFFICER 52.00 0.00 X 314700 0 49717 CHAK SUM-HO CHIEF LABORATORY OFFICER 50.00 0.00 X 317274 0 49652 MICHAEL HAGAN MD CHIEF QUALITY OFFICER 40.00 0.00 X 244204 0 30020 NATAHALIE LOFTON-DAVIS CHIEF OF ORGANIZATIONAL DEVELOPMENT 45.00 0.00 X 236573 0 23995 STEVEN RUDICH MD MEDICAL DIRECTOR 50.00 0.00 X 280960 0 47903 SHEILA ALSTON CLINICAL DIRECTOR 50.00 0.00 X 207279 0 27731 DAVID GEE IT DIRECTOR 50.00 0.00 X 192130 0 38378 MARK TUDOR SURGICAL CENTER DIRECTOR 50.00 0.00 X 171228 0 36390 DOUGLAS BUTLER HS AND FAMILY SUPPORT DIRECTOR 50.00 0.00 X 168691 0 36122 2897610 0 433498 45 0 1 0 NORA 3815 E MAIN ST SUITE C ST CHARLES IL 60174 TRANSPORTATION 558278 THE SPIEKER COMPANY 8350 FRENONT PIKE PERRYSBURG OH 43551 CONSTRUCTION 417247 BLUELINE CONSULTANTS ONE GATEWAY CENTER SUITE 2600 NEWARK NJ 07102 IT CONSULTANTS 253000 RED AUSTIN'S FUNERAL COACH SERVICE 6780 JACKSON TAYLOR MI 48180 TRANSPORTATION 248838 PRIORITY TRANSPORTATION 1619 CRESCENT POINTE DR SE CALEDONIA MI 49316 TRANSPORTATION 185382 7 7596 7596 ORGAN RECOVERY 621300 27819405 27819405 MEDICARE PAYMENTS 621300 22514675 22514675 TISSUE RECOVERY 621300 8469493 8469493 LAB SERVICES 621300 1125061 1125061 59928634 485648 485648 906016 1242606 823443 1183527 82573 59079 141652 141652 60563530 59928634 0 627300 1915081 908688 1006393 13095991 10350684 2745307 1480879 1111994 368885 3621000 2489774 1131226 1385396 1110457 274939 43414 43414 43584 43584 49452 49452 4865772 4713044 152728 2875890 1993701 882189 256276 256276 542900 227383 315517 2463191 2463191 975235 707819 267416 77351 77351 1436021 633096 802925 262966 262966 IMPORTED ORGAN COSTS 9451937 9451937 DONOR HOSPITAL EXPENSES 7044113 7044113 LAB & MEDICAL SUPPLIES 3178576 3178576 RECIPIENT REGISTRATION 1437173 1437173 340762 275205 65557 56842960 48096835 8746125 0 195 195 5185559 11779933 10293068 8674455 2041439 925893 849199 823850 29566938 7966295 21837007 21600643 11450228 10896679 133621 343146 51790316 55044794 7146251 6839873 8119844 8119844 133621 969749 15399716 15929466 X 36390600 39115328 36390600 39115328 51790316 55044794 3720570 -995842 0 X 0 1 X 1 0 X 6828 13691 22762 15544 7596 66421 42728265 47941941 52857229 50746556 59928634 254202625 42735093 47955632 52879991 50762100 59936230 254269046 0 0 0 254269046 198660 199753 257542 315566 485648 1457169 198660 199753 257542 315566 485648 1457169 42933753 48155385 53137533 51077666 60421878 255726215 0.99430 0.99580 0.00570 0.00420 X 445653 445653 22663885 4350015 18313870 6179676 3616280 2563396 277724 277724 21600643 FLEXIBLE PREMIUM ANNUITY 151955 COST REPORT SETTLEMENT PAYABLE 817794 969749 59440885 -995842 -995842 60436727 126803 126803 60563530 56716157 0 56716157 126803 126803 56842960 PART XI, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT FEES NET WITH REVENUE 49,452. INTEREST EXPENSE RECORDED IN REVENUE 77,351. PART XII, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT FEES NET WITH REVENUE 49,452. INTEREST EXPENSE RECORDED IN REVENUE 77,351. X X X X X 0 0 0 0 0 0 0 0 0 LADORA DILS CHIEF EXECUTIVE OFFICER 361654 0 34760 0 0 0 35954 0 21039 0 453407 0 0 0 BRUCE NICELY CHIEF CLINICAL OFFICER 282983 0 29227 0 0 0 28312 0 8285 0 348807 0 0 0 ANNE KOWALCZYK CHIEF FINANCIAL OFFICER 285417 0 29283 0 0 0 28611 0 21106 0 364417 0 0 0 CHAK SUM-HO CHIEF LABORATORY OFFICER 287757 0 29517 0 0 0 28525 0 21127 0 366926 0 0 0 MICHAEL HAGAN MD CHIEF QUALITY OFFICER 221679 0 22525 0 0 0 21983 0 8037 0 274224 0 0 0 NATAHALIE LOFTON-DAVIS CHIEF OF ORGANIZATIONAL DEVELOPMENT 215270 0 21303 0 0 0 3665 0 20330 0 260568 0 0 0 STEVEN RUDICH MD MEDICAL DIRECTOR 280960 0 0 0 0 0 27500 0 20403 0 328863 0 0 0 SHEILA ALSTON CLINICAL DIRECTOR 190779 0 16500 0 0 0 19089 0 8642 0 235010 0 0 0 DAVID GEE IT DIRECTOR 176559 0 15571 0 0 0 17808 0 20570 0 230508 0 0 0 MARK TUDOR SURGICAL CENTER DIRECTOR 157308 0 13920 0 0 0 15953 0 20437 0 207618 0 0 0 DOUGLAS BUTLER HS AND FAMILY SUPPORT DIRECTOR 155075 0 13616 0 0 0 15673 0 20449 0 204813 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS MADE PUBLIC TO ALL GOVERNING BOARD AND COMMITTEE MEMBERS ON A SHARED PORTAL PRIOR TO FILING. THE FINANCE AND AUDIT COMMITTEE ALSO REVIEW THE 990 SUBSEQUENT TO FILING. A FINAL COPY OF THE 990 IS ON GUIDESTAR.ORG WITH A LINK ON THE ORGANIZATION'S WEBSITE TO THE GUIDESTAR WEBSITE. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS, COMMITTEE MEMBERS, AND EMPLOYEES OF GIFT OF LIFE MICHIGAN ARE COVERED UNDER THE CORPORATE COMPLIANCE POLICY AND CONFLICT OF INTEREST POLICY. ALL PARTIES ARE TRAINED ON AN ANNUAL BASIS AND MUST DECLARE CONFLICT OF INTERESTS AT THAT TIME. EXECUTIVE LEADERSHIP ASSESSES THE LEVEL OF CONFLICT AND IS ALSO ENTRUSTED TO MANAGE THESE CONFLICTS AT EACH BOARD OR COMMITTEE MEETING. MEMBERS WHO HAVE CONFLICTS MUST ABSTAIN FROM VOTING AND THEIR ABSTENTION IS RECORDED IN THE MINUTES. THE AUDIT COMMITTEE ANNUALLY REVIEWS CONFLICTS OF INTEREST FROM EMPLOYEES AND BOARD AND COMMITTEE MEMBERS. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE AND THE AUDIT AND FINANCE COMMITTEE ANNUALLY REVIEW SALARY INCREASES OF ALL SENIOR LEADERSHIP. SALARIES ARE BENCHMARKED AGAINST MARKET SURVEYS WITHIN AND OUTSIDE OF THE ORGAN PROCUREMENT INDUSTRY. OTHER POSITIONS ARE ROUTINELY MEASURED AND BENCHMARKED BY INDUSTRY SURVEYS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNANCE DOCUMENTS ARE SUPPLIED AS REQUESTED BY THE PUBLIC. BOARD AND COMMITTEE MEMBERS AND EMPLOYEES HAVE THIS INFORMATION AVAILABLE TO THEM BY A SHARED WEBSERVER AND INTRANET PORTALS.