2018-11-14T09:24:41-06:00 2017-12-31 311119890 Barnes Dennig & Co LTD 150 East Fourth Street Cincinnati OH 45202 990 2017-01-01 311116603 Lifeline of Ohio Organ Procurement Inc LIFE 6142915667 770 Kinnear Rd Columbus OH 43212 Kent Holloway CEO 6142915667 2018-11-06 1 Paula Hume P00537516 5132418313 216.196.129.6 2018-11-06 15:14:49 ES P 1CA9B4A504D0314FA2A13CFD5AFE390DEF715523 1CA9B4A504D0314FA2A13CFD5AFE390DEF715523 2017 2019-02-21 02:37:17Z Kent Holloway 770 Kinnear Rd Columbus OH 43212 24133476 0 X www.lifelineofohio.org X 1984 OH Lifeline of Ohio promotes and coordinates donation of human organs/tissues for transplant, serving the Department of Health and Human Services Centers for Medicare and Medicaid services assigned area of over 3.5 million people. 14 14 112 844 0 0 304071 160943 19480428 22957599 -384108 176118 -30847 73201 19369544 23367861 0 0 0 0 7624189 8045991 37707 23060 23060 10799289 13621485 18461185 21690536 908359 1677325 20328602 21661411 6397595 5958644 13931007 15702767 Lifeline of Ohio's mission is to empower our community to save and heal lives through organ, eye and tissue donation. 0 0 18889825 22957599 Lifeline of Ohio Organ Procurement, Inc. (Lifeline) is an independent, non-profit organization whose purpose is to promote and coordinate the donation of human organs and tissue for tranplantation. Lifeline has been approved by the Centers for Medicare and Medicaid services as the designated organ procurement organization serving 37 Ohio counties along with Wood and Brook counties in West Virginia. Accredited by both the Association of Organ Procurement Organization and the American Association of Tissue Banks, Lifeline services up to 78 hospitals and the communities they serve through its transplant coordinators, surgical technicians and other professional staff. In 2017, Lifeline procured approximately 409 life saving donated organs from approximately 124 donors. 18889825 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 51 0 1 112 1 0 0 0 0 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 1 0 OH X Kent Holloway 6142915667 770 Kinnear Rd Columbus OH 43212 James Wirth Director 1.00 X 0 0 0 Charleta Tavares Director - Joined 9/17 1.00 X 0 0 0 Michelle McKissick Director 1.00 X 0 0 0 Rachel Finney Director 1.00 X 0 0 0 Todd Pesavento Director 1.00 X 0 0 0 Roger Walker Director 1.00 X 0 0 0 Naomi Maletz Director 1.00 X 0 0 0 Sue Jablonski Director 1.00 X 0 0 0 Sean McKibben Director - Joined 9/17 1.00 X 0 0 0 Jeff Klingler Director - Joined 9/17 1.00 X 0 0 0 Ronni Richards Secretary 1.00 X X 0 0 0 Mark Studer Treasurer 1.00 X X 0 0 0 Gene Warman Vice Chair 1.00 X X 0 0 0 Lisa Indest Chair 1.00 X X 0 0 0 Kent Holloway CEO 40.00 X 267442 0 31035 Susan Manganello CFO 40.00 15.00 X 0 166734 25896 Andrew Mullins Chief Clinical Executive 40.00 X 149270 0 1322 Marilyn Pongonis Director of Communications 40.00 X 135851 0 4032 Mindy Zoll Manager of Organ Services 40.00 X 117712 0 1238 April Caudill Manager of Tissue Services 40.00 X 144736 0 3230 Amber Dinopoulos Director of Organizational Development 40.00 X 105428 0 14742 920439 166734 81495 6 0 1 0 Network for Life 770 Kinnear Road Columbus OH 43212 Health Insurance/Mgt Fees 1613673 OSU Surgery LLC 700 Ackerman Rd 350 Columbus OH 43202 Surgeon Fees 742550 Gift of Life - Michigan 3861 Research Park Drive Ann Arbor MI 48108 Organ Procurement 633300 American FDN for Donation 8154 Forest Hill Avenue Richmond VA 23235 Organ Procurement Processing 555804 Lifebanc 4775 Richmond Road Cleveland OH 44128 Organ Procurement 521288 36 35468 125475 160943 Kidney Procurement 621990 7816994 7816994 Liver Procurement 621990 5747364 5747364 TIssue Recovery 621990 3029223 3029223 Lung Procurement 621990 2431812 2431812 Heart Procurement 621990 2393591 2393591 1538615 1538615 22957599 150629 150629 781448 755959 25489 25489 25489 54374 35468 9656 44718 44718 Workers comp rebate 900099 16134 16134 Miscellaneous 900099 11849 11849 Office supply rebate 900099 500 500 28483 23367861 22957599 0 249319 298477 266909 31568 6046083 5457588 588495 227471 186893 40578 994296 816926 177370 479664 394098 85566 55943 55943 30300 30300 24000 24000 23060 23060 21508 21508 860890 132342 728548 336515 200428 136087 421284 34395 386889 406836 361403 45433 219948 182917 37031 150053 82945 67108 655751 543109 112642 107712 107712 Direct Recovery Costs 9254387 9254387 Public Education 695885 695885 Supplies 297272 252322 44950 Dues & Subscriptions 56599 15238 41361 26602 12040 14562 21690536 18889825 2777651 23060 5115184 3755703 46333 16584 3189552 2951875 145382 146263 269798 353019 12579358 3582920 8357334 8996438 3167853 5399644 37166 41885 20328602 21661411 2612280 2352079 3735648 3554841 49667 51724 6397595 5958644 X 13884674 15697922 46333 4845 13931007 15702767 20328602 21661411 X 1677325 85291 9144 X X 0 1 X 1 0 X 133484 105867 145409 304070 160943 849773 13935433 15189647 17049979 19480428 22957599 88613086 14068917 15295514 17195388 19784498 23118542 89462859 10250 10250 0 10250 10250 89452609 53528 156633 153376 122745 150629 636911 53528 156633 153376 122745 150629 636911 12574 13684 4676 6214 28483 65631 14135019 15465831 17353440 19913457 23297654 90165401 0.99210 0.99310 0.00710 0.00610 X 24000 24000 21678684 21702684 1000000 250000 0 0 894369 940316 1000000 1000000 3834685 5752028 21600 24000 24000 24000 93600 223592 235079 250000 250000 958671 1438007 280223 280223 10520124 2233942 8286182 5461 5461 0 1331452 1099075 232377 442098 244442 197656 8996438 Deferred Compensation 51724 51724 X 23450444 85291 18800 104091 23346353 21508 21508 23367861 21678684 9656 9656 21669028 21508 21508 21690536 Part X, Line 2: Lifeline is exempt from income taxes under Section 501 of the Internal Revenue Code and a similar provision of Ohio law. However, Lifeline is subject to federal income tax on any unrelated business taxable income. Lifeline's IRS Form 990 is subject to review and examination by federal and state authorities. Lifeline believes it has appropriate support for any tax positions taken, and therefore, does not have any uncertain income tax positions that are material to the financial statements. Part XI, Line 2d - Other Adjustments: Special event expense 9,656. Change in fair value of interest rate SWAP 27,570. Equity Investment -18,426. Part XII, Line 2d - Other Adjustments: Special event expense 9,656. X X X 1 Ultrafit - USA PO BOX 629 Hilliard OH 43026 Dash for Donation 1 112903 23060 89842 112903 23060 89842 Dash for Donation 89842 35468 54374 108 2930 6618 89842 35468 54374 108 2930 6618 9656 44718 X X X X X X 1 1 0 0 0 0 0 0 0 Kent Holloway CEO 248816 0 18626 0 0 0 31035 0 0 0 298477 0 0 0 Susan Manganello CFO 0 154325 0 12409 0 0 0 5002 0 20894 0 192630 0 0 Andrew Mullins Chief Clinical Executive 136925 0 12345 0 0 0 1322 0 0 0 150592 0 0 0 Part I, Line 4a: Mindy Zoll and April Caudill received severance payments in 2017. Part I, Line 4b: During, 2017, The Organization had a supplemental deferred compensation plan for one of the organization's officers. Kent Holloway, CEO - $25,000 annually through 2020 A County of Fairfield Ohio 316400066 2001-05-23 3800000 Financing Renovations 0 0 0 A 3800000 64352 3735648 2016 0 0 1 1 A 0 0 0 0 0 0 1 A 0 0 0 0 1 1 Fifth Thrid Bank 7.800000000000 0 0 0 0 1 A 1 Form 990, Part VI, Section B, line 11b The audit and finance committee reviewed the Form 990 with the organization's audit firm responsible for its preparation. In addition, the Form 990 was provided to the entire board and after recommendation by the audit and finance committee, approved by the board. Form 990, Part VI, Section B, line 12c The organization, as part of its corporate compliance and ethics program, has adopted a formal Conflict of Interest policy. This policy stipulates the procedure for employee and board member education, guidelines for avoiding conflicts of interest, and the impact of failure to disclose known conflicts. Additionally, the organization expands on its conflict policy by defining its overall corporate compliance program in a separate program, provides a code of conduct policy for all employees and board members, offers a non-retribution/non-retaliation policy to encourage employees and board members to report suspicious or inappropriate activity, has a designated corporate compliance officer, and has a compliance committee of the board that oversees the program. In addition, the organization has a contract with a third party to provide a 24 hour hotline so individuals can anonymously report inappropriate, illegal, or unethical activity. As final checks, all board members in attendance at board meetings and board committee meetings are asked that the beginning of the meeting to disclose any potential conflicts of interest based on the meeting agenda. In addition, the CEO and CFO review all transactions and inquire of board members and employees regarding potential conflicts. Form 990, Part VI, Section B, line 15 The organization routinely reviews compensation for all staff through the participation in an annual industry survey regarding compensation levels and practices to ensure it is competitive and appropriate with its peers. The organization also retains the services of a nationally recognized consulting firm to periodically provide market comparative analysis and surveys for all positions within the organization. CEO compensation is reviewed and approved by an independent compensation committee of the board of directors based on the results of available comparative information and surveys and the CEO's performance with respect to organizational goals. The compensation committee also determines the compensation for the organization's other officers and key employees. Form 990, Part VI, Section C, line 19 The organization's governing documents, conflict of interest policy and financial statements are available to the public if requested for a reasonable matter. Form 990, Part XI, line 9: Change in fair value of interest rate SWAP 27,570. Equity Investment -18,426. Form 990, Part XII, Line 2c: There were no changes to the organization's oversight process or selection process during the tax year. Network for Life 770 Kinnear Rd Columbus OH 43212 454472492 Provide administrative resources OH 501(c)(3) 509(a)(3) LifeCenter 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 Network for Life O 933553 FMV Network for Life M 680120 FMV