2018-11-14T11:25:33-06:00 2017-12-31 946214841 ARMANINO LLP 12657 ALCOSTA BLVD STE 500 SAN RAMON CA 945834600 990 2017-01-01 943062436 DONOR NETWORK WEST DONO 8885709400 12667 ALCOSTA BLVD NO 500 SAN RAMON CA 94583 SEAN VAN SLYCK INTERIM CEO 5104448500 2018-11-12 1 KATY BROWN P00650274 9257902600 2018-11-12 38.111.205.16 2018-11-12 20:40:00 PS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 A2EF7C6B3EF9173E0A95C57244F2B1B86FE486B2 2017 2019-02-21 02:37:17Z SEAN VAN SLYCK 12667 ALCOSTA BLVD NO 500 SAN RAMON CA 94583 86076649 0 X DONORNETWORKWEST.ORG X 1987 CA TO SAVE AND IMPROVE LIVES THROUGH ORGAN AND TISSUE DONATION FOR TRANSPLANTATION. 17 16 341 300 0 0 203890 210825 80967678 84779306 195224 262795 6867 307106 81373659 85560032 0 0 0 0 33130261 35612673 0 0 0 47431772 49232681 80562033 84845354 811626 714678 46316429 45877392 16062459 14908744 30253970 30968648 X DONOR NETWORK WEST'S MISSION IS TO SAVE AND IMPROVE LIVES THROUGH ORGAN AND TISSUE DONATION FOR TRANSPLANTATION. WE CONCENTRATE OUR EFFORTS ON THE RECOVERY OF VITAL ORGANS, SUCH AS LUNGS, HEART, LIVER, KIDNEYS, PANCREAS, AND SMALL BOWEL FROM DECEASED DONORS. 0 0 74456469 83931513 CLINICAL OPERATIONS PROVIDED CARE FOR 2,874 FAMILIES LAST YEAR DURING AN EMOTIONAL TIME IN THEIR LIVES AS THEY SUFFERED THE LOSS OF THEIR LOVED ONES. FAMILIES WERE EITHER INFORMED OF THEIR LOVED ONE'S DONATION DECISION MADE ON THE STATE DONOR REGISTRY OR AUTHORIZED DONATION FOR THEIR LOVED ONE. THROUGH THEIR GENEROSITY, THOUSANDS OF OTHERS WERE SAVED OR HEALED BECAUSE OF THESE GIFTS OF LIFE.IN 2017, WE RECOVERED 1,025 ORGANS FOR TRANSPLANTATION FROM 307 ORGAN DONORS AND PROVIDED TISSUES FOR TRANSPLANTATION FROM 2,577 TISSUE DONORS; AN ESTIMATED 68,434 LIVES WERE IMPROVED AS A RESULT. 1535185 DONOR FAMILIES ARE CARED FOR THROUGHOUT THE DONATION PROCESS AND FOLLOWING THE DONATION. OUR PROFESSIONAL STAFF PROVIDES SUPPORT AND INFORMATION IN THE MOMENT AND PROVIDES AFTERCARE RESOURCES AND SUPPORT TO DONOR FAMILIES FOR A YEAR POST-DONATION. THREE SEPARATE DONOR FAMILY GATHERINGS HONORED AND CELEBRATED THE DONOR FAMILIES AND THEIR LOVED ONES WHO GAVE THE GIFT OF LIFE THROUGH ORGAN AND TISSUE DONATION. DONOR FAMILY GATHERINGS WERE HELD IN PLEASANTON, RENO AND FRESNO ON THREE SEPARATE DAYS TO ACCOMMODATE 2,874 FAMILIES WHOSE LOVED ONES BECAME DONORS IN 2017. 727316 847793 THE SHORTAGE OF AVAILABLE ORGANS AND TISSUES IS A SERIOUS ISSUE AS 22 PEOPLE NATIONALLY WILL DIE EACH DAY WAITING FOR AN ORGAN TRANSPLANT. PUBLIC EDUCATION EFFORTS ARE FOCUSED ON INCREASING REGISTRATIONS ON THE STATE AUTHORIZED DONOR REGISTRIES IN CALIFORNIA AND NEVADA ALONG WITH THE DONATE LIFE AMERICA NATIONAL REGISTRY. IN 2017, WE ADDED 305,002 NEW NAMES TO THE REGISTRIES IN OUR SERVICE AREA THROUGH A VARIETY OF EFFORTS.IN 2017, THE COMMUNITY EDUCATION DEPARTMENT FOCUSED ON SEVERAL KEY CAMPAIGNS TO INCREASE DONOR REGISTRATIONS. THESE CAMPAIGNS INCLUDED WORKING WITH COMMUNITY HEALTH CLINICS, HIGH SCHOOLS, FAITH ORGANIZATIONS, CONSULATE OFFICES, CIVIC GROUPS AND FOCUSING ON MULTICULTURAL OUTREACH. WE PARTNER WITH OUR DEPARTMENT OF MOTOR VEHICLE OFFICES TO PROVIDE INFORMATION AND DEVELOP RELATIONSHIPS WITH EACH OFFICE TO ENSURE THE RECORDING OF THE DONATION DECISIONS OF MILLIONS OF CALIFORNIAN'S AND NEVADAN'S. MOST DONOR REGISTRATIONS OCCUR AT THE DMV OFFICES AND THROUGH THE ADOPT-A-DMV PROGRAM, OUR STAFF AND VOLUNTEERS REGULARLY VISIT, EDUCATE AND PROVIDE POINT-OF-TRANSACTION REMINDERS TO THE PUBLIC.WE SUCCESSFULLY REACHED MANY MULTICULTURAL COMMUNITY CLINICS WITH INFORMATION AND IN-SERVICES, WORKED WITH HIGH SCHOOL TEACHERS TO INTEGRATE ORGAN AND TISSUE DONATION INFORMATION IN HEALTH/SCIENCE CURRICULUMS AND ENGAGED FAITH LEADERS IN GROWING SUPPORT FOR DONATION IN THEIR CONGREGATIONS. WE DOCUMENTED 300+ PROACTIVE FREE MEDIA STORIES THAT WERE SEEN ACROSS THE COUNTRY. THE RESULTS 56% OF OUR LICENSED/ID HOLDERS ARE ON DONOR REGISTRIES. 76718970 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 162 0 1 341 1 0 0 0 0 0 0 0 0 0 0 X 17 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X SANDRA MEJIA CFO 8885709400 12667 ALCOSTA BLVD STE 500 SAN RAMON CA 94583 MICHELLE ZYROMSKI CHAIRPERSON (START 1/17) 4.00 X X 0 0 0 REECE FAWLEY SECRETARY-TREASURER 4.00 X X 0 0 0 HAMILA KOWNACKI DIRECTOR 4.00 X 0 0 0 LLOYD LACUESTA DIRECTOR 4.00 X 0 0 0 KATHLEEN F LYNAUGH DIRECTOR 4.00 X 0 0 0 JOHN RABKIN MD DIRECTOR 4.00 X 0 0 0 JILL SULLIVAN DIRECTOR 4.00 X 0 0 0 CATHERINE LAN TRAN DIRECTOR (THRU 9/17) 4.00 X 0 0 0 DOLLY B TYAN DIRECTOR 4.00 X 0 0 0 THOMAS CYCYOTA DIRECTOR 4.00 X 0 0 0 MICHAEL PETERSON DIRECTOR 4.00 X 0 0 0 STEPHEN BUSQUE MD DIRECTOR 4.00 X 0 0 0 JAMES KIEHM DIRECTOR 4.00 X 0 0 0 MICHAEL J FERENC MD DIRECTOR (START 2/17) 4.00 X 0 0 0 MICHELLE A JORDEN MD DIRECTOR (START 2/17) 4.00 X 0 0 0 ALISON M KERR DIRECTOR (START 9/17) 4.00 X 0 0 0 CHRIS FREISE MD DIRECTOR (START 2/17) 4.00 X 0 0 0 ERIC L WILLIAMS DIRECTOR (START 2/17) 4.00 X 0 0 0 CYNTHIA D SILJESTROM CEO 40.00 X X 434590 0 28645 SANDRA R MEJIA CFO 40.00 X 342944 0 51433 SEAN VAN SLYCK COO (START 11/17) 40.00 X 302358 0 50439 NIKOLE ADRIANE NEIDLINGER CMO 40.00 X 293766 0 44946 DENISE A KINDER STRATEGIC DEVELOPMENT OFFICER (START 11/17) 40.00 X 276719 0 18351 JOHN T MASON VP, IT 40.00 X 268680 0 41557 MARK BORER VP, QUALITY SYSTEMS 40.00 X 242182 0 40371 ANGELA G ROSATI VP, TISSUE DONATION SERVICES 40.00 X 252056 0 23878 KIM J PATTON DIRECTOR, CLINICAL SERVICE 40.00 X 207875 0 40575 CATHY L OLMO DIRECTOR, COMMUNICATIONS 40.00 X 168740 0 26422 LUIS F MAYEN DIRECTOR, PROCUREMENT SERVICES 40.00 X 190882 0 41701 SANDRA F OLSON CONTROLLER 40.00 X 190111 0 28780 COLLEEN CIESZKOWSKI DIRECTOR OF HOSPITAL AND FAMILY 40.00 X 162245 0 14826 EFREN SABLAN PORTAL SYSTEMS MANAGER 40.00 X 151723 0 53110 SHARON SHAMOON CLINICAL PROCUREMENT COORDINATOR 40.00 X 210651 0 35012 ANTHONY FIORENTINO CLINICAL PROCUREMENT COORDINATOR 40.00 X 183411 0 12397 GWENN SILVA DIRECTOR, FAMILY SERVICES 40.00 X 163689 0 27470 MARIA NAUMAN CLINICAL OPERATIONS MANAGER 40.00 X 134593 0 54192 4177215 0 634105 132 0 1 0 TRANSPLANT TRANSPORTATION SERVICES INC PO BOX 937 PENNGROVE CA 94951 TRANSPORTATION 3203086 LABS INC PO BOX 843224 KANSAS CITY MO 641843224 LABORATORY 2009499 TRANSPLANT CONNECT INC 2701 OCEAN PARK BLVD SANTA MONICA CA 90405 SOFTWARE 333102 DASH LIMOUSINE & SEDAN SERVICE 55 WASHINGTON ST SUITE 104 DALY CITY CA 94015 TRANSPORTATION 264787 SCATES CONSTRUCTION INC 1769 PARK AVE SUITE 200 SAN JOSE CA 95126 CONSTRUCTION 247363 15 106108 104717 210825 ORGAN ACQ FEES 621500 84530987 84530987 RESEARCH 621500 248319 248319 84779306 254236 254236 479275 13333 484049 0 -4774 13333 8559 8559 0 106108 32568 -32568 -32568 OTHER REVENUE 900099 339674 339674 339674 85560032 84779306 0 569901 3796666 3128673 667993 25811924 23658987 2152937 966379 409093 557286 3007680 1416391 1591289 2030024 1870551 159473 214716 88306 126410 83770 41885 41885 1137 1137 561572 272056 289516 620774 620774 526141 202223 323918 1688845 1042512 646333 2084879 999258 1085621 5672118 5672118 710431 538201 172230 1005880 862371 143509 1016189 873923 142266 DONOR HOSPITAL/IMPORT/R 26446893 26446893 CLINICAL SUPPLIES & EQU 3813873 3813873 SURGEON/PHYSICIAN FEES 2620052 2620052 LABORATORY FEES 1985143 1985143 180268 154550 25718 84845354 76718970 8126384 0 12078129 16194875 1012471 2213853 17469946 11965391 284727 284727 542805 503328 11057155 2741733 8704030 8315422 1054878 0 4996253 5726606 173190 673190 46316429 45877392 14540125 13178434 1522334 1730310 16062459 14908744 X 30253970 30968648 30253970 30968648 46316429 45877392 714678 0 X X 0 1 X 1 0 X 328030 157951 96318 203890 210825 997014 63841055 74258799 77077048 80967678 84779306 380923886 64169085 74416750 77173366 81171568 84990131 381920900 0 0 0 381920900 251364 240238 203788 187480 254236 1137106 251364 240238 203788 187480 254236 1137106 125515 64207 190245 44122 339674 763763 64545964 74721195 77567399 81403170 85584041 383821769 0.99500 0.99560 0.00300 0.00300 X 0 0 0 0 0 0 0 0 1 1137 1137 0 PART II-B, LINE 1: THE NATIONAL ORGANIZATION, ASSOCIATION OF ORGAN PROCUREMENT ORGANIZATIONS (AOPO) CONDUCTS LOBBYING ACTIVITIES ON BEHALF OF ALL ORGAN PROCUREMENT ORGANIZATIONS (OPOS) IN THE COUNTRY. A PORTION OF DONOR NETWORK WEST'S DUES IS ALLOCATED TO THOSE ACTIVITES. IN 2017, THAT ALLOCABLE EXPENSE WAS $1,137. 7306679 991707 6314972 2662933 1166808 1496125 1087543 583218 504325 8315422 PUBLICLY TRADED SECURITIES 2174480 F CORPORATE BONDS 2642253 F GOVERNMENT SECURITIES 909873 F 5726606 DEFERRED LEASE PAYABLE 1730310 1730310 X 85560032 0 85560032 0 85560032 84845354 0 84845354 0 84845354 PART X, LINE 2: THE ORGANIZATION IS A QUALIFIED ORGANIZATION EXEMPT FROM FEDERAL AND CALIFORNIA INCOME TAXES UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND SECTION 23701D OF THE CALIFORNIA REVENUE AND TAXATION CODE. THE ORGANIZATION HAS ADOPTED THE PROVISIONS FOR ACCOUNTING FOR UNCERTAIN TAX POSITIONS. IT EVALUATES ITS TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN TO DETERMINE WHETHER THE TAX POSITIONS ARE "MORE-LIKELY-THAN-NOT" OF BEING SUSTAINED BY THE APPLICABLE TAX AUTHORITY. TAX POSITIONS NOT DEEMED TO MEET THE "MORE-LIKELY-THAN-NOT" THRESHOLD ARE RECORDED AS AN EXPENSE IN THE APPLICABLE YEAR. AS OF DECEMBER 31, 2017 AND 2016, THE ORGANIZATION DOES NOT HAVE ANY SIGNIFICANT UNCERTAIN TAX POSITIONS FOR WHICH A RESERVE WOULD BE NECESSARY. DONATE LIFE WALK 106108 106108 9399 1047 1989 20133 106108 106108 9399 1047 1989 20133 32568 -32568 X 1 1 X X X 0 0 0 0 0 0 0 1 0 CYNTHIA D SILJESTROM CEO 351203 0 83237 0 150 0 21400 0 7245 0 463235 0 0 0 SANDRA R MEJIA CFO 272486 0 70308 0 150 0 21400 0 30033 0 394377 0 0 0 SEAN VAN SLYCK COO (START 11/17) 272679 0 29336 0 343 0 20406 0 30033 0 352797 0 0 0 NIKOLE ADRIANE NEIDLINGER CMO 262261 0 26808 0 4697 0 21400 0 23546 0 338712 0 0 0 DENISE A KINDER STRATEGIC DEVELOPMENT OFFICER (START 231073 0 44496 0 1150 0 18006 0 345 0 295070 0 0 0 JOHN T MASON VP, IT 243530 0 25000 0 150 0 18011 0 23546 0 310237 0 0 0 MARK BORER VP, QUALITY SYSTEMS 216702 0 25000 0 480 0 16825 0 23546 0 282553 0 0 0 ANGELA G ROSATI VP, TISSUE DONATION SERVICES 228698 0 23208 0 150 0 16633 0 7245 0 275934 0 0 0 KIM J PATTON DIRECTOR, CLINICAL SERVICE 194392 0 13250 0 233 0 15214 0 25361 0 248450 0 0 0 CATHY L OLMO DIRECTOR, COMMUNICATIONS 157040 0 11250 0 450 0 12657 0 13765 0 195162 0 0 0 LUIS F MAYEN DIRECTOR, PROCUREMENT SERVICES 179152 0 11250 0 480 0 13728 0 27973 0 232583 0 0 0 SANDRA F OLSON CONTROLLER 158661 0 31250 0 200 0 12479 0 16301 0 218891 0 0 0 COLLEEN CIESZKOWSKI DIRECTOR OF HOSPITAL AND FAMILY 162005 0 0 0 240 0 9274 0 5552 0 177071 0 0 0 EFREN SABLAN PORTAL SYSTEMS MANAGER 139073 0 7500 0 5150 0 9730 0 43380 0 204833 0 0 0 SHARON SHAMOON CLINICAL PROCUREMENT COORDINATOR 206741 0 3750 0 160 0 9651 0 25361 0 245663 0 0 0 ANTHONY FIORENTINO CLINICAL PROCUREMENT COORDINATOR 175123 0 3118 0 5170 0 4452 0 7945 0 195808 0 0 0 GWENN SILVA DIRECTOR, FAMILY SERVICES 156039 0 7500 0 150 0 11169 0 16301 0 191159 0 0 0 MARIA NAUMAN CLINICAL OPERATIONS MANAGER 129453 0 4500 0 640 0 10812 0 43380 0 188785 0 0 0 PART I, LINE 1A ALL REGULAR DONOR NETWORK WEST EMPLOYEES MAY RECEIVE UP TO $30 PER MONTH FOR A GYM MEMBERSHIP OR EXERCISE CLASS AS PART OF THE EMPLOYEE HEALTH BENEFIT. PROOF OF PAYMENT IS REQUIRED. REIMBURSEMENT IS PROCESSED THROUGH THE PAYROLL SYSTEM. INITIATION, COUNTRY CLUB AND GOLF FEES ARE EXCLUDED FROM REIMBURSEMENT. PART I, LINE 7 PER 2017 EMPLOYEE HANDBOOK, SECTION 3.8 BONUSES, ANY BONUSES PROVIDED BY DN WEST ARE STRICTLY DISCRETIONARY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS DISTRIBUTED TO THE ENTIRE GOVERNING BODY BEFORE FILING. THE FORM 990 IS REVIEWED AND APPROVED BY THE CHAIR OF THE AUDIT COMMITTEE. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS OF DONOR NETWORK WEST HAS ADOPTED A POLICY ON CONFLICTS OF INTEREST OF ITS BOARD MEMBERS AND EMPLOYEES. DONOR NETWORK WEST IS COMMITTED TO THIS POLICY AND DOES PERFORM AN ANNUAL REVIEW OF THIS POLICY. THE CONFLICT OF INTEREST POLICY COVERS ALL BOARD MEMBERS AND ALL EMPLOYEES. ITEMS COVERED INCLUDE FINANCIAL INTERESTS, INSIDE INFORMATION, GIFTS AND FAVORS, AND DIRECT REPORTING RELATIONSHIPS WITH FAMILY MEMBERS. THERE IS AN ANNUAL BOARD REPORTING PROCESS. EACH BOARD MEMBER SIGNS THE STATEMENT. ANY CONFLICTS FOR THE BOARD SHOULD BE REPORTED TO THE BOARD CHAIR AND ANY CONFLICTS FOR EMPLOYEES SHOULD BE REPORTED TO EITHER THE HR MANAGER. ACTION FOR CONFLICTS VARIES FROM SIMPLE DISCLOSURE TO DIRECTED ACTION. WHERE A POTENTIAL CONFLICT OF INTEREST EXISTS, IT SHALL BE THE RESPONSIBILITY OF THE PERSON INVOLVED OR ANY OTHER PERSON WITH KNOWLEDGE TO NOTIFY THE BOARD OF TRUSTEES OF THE CIRCUMSTANCES RESULTING IN THE POTENTIAL CONFLICT SO THAT THE BOARD OF TRUSTEES CAN PROVIDE SUCH GUIDANCE AND TAKE SUCH ACTION AS IT SHALL DEEM APPROPRIATE. NO TRUSTEE WHO DIRECTLY OR INDIRECTLY IS INVOLVED IN A POTENTIAL CONFLICT IS CONSIDERED, NOR SHALL THE TRUSTEE VOTE ON ANY ACTION OF THE BOARD REGARDING THAT POTENTIAL CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 DONOR NETWORK WEST UTILIZES A COMPREHENSIVE SALARY SURVEY CONDUCTED BY THE ASSOCIATION OF ORGAN PROCUREMENT ORGANIZATIONS. DONOR NETWORK WEST UTILIZES PROFESSIONAL CONSULTING SERVICES AS WELL AS OTHER PUBLICLY AVAILABLE SALARY INFORMATION TO SET EXECUTIVE SALARIES. THE EXECUTIVE COMMITTEE TO THE BOARD OF DIRECTORS REVIEWS ANY SALARY INCREASE FOR THE CEO AND CFO AND MAKES FINAL APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 THE FINANCIAL STATEMENTS, FORM 990 AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE GENERAL PUBLIC. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.