2017-10-26T09:58:10-05:00 2016-12-31 946214841 Armanino LLP 12657 Alcosta Blvd Ste 500 San Ramon CA 945834600 990 2016-01-01 943062436 Donor Network West DONO 8885709400 12667 Alcosta Blvd No 500 San Ramon CA 94583 CYNTHIA SILJESTROM CEO 5104448500 2017-10-25 1 Katy Brown P00650274 9257902600 2016 2022-09-23 18:48:47Z CYNTHIA SILJESTROM 12667 Alcosta Blvd No 500 San Ramon CA 94583 81437295 0 X donornetworkwest.org X 1987 CA TO SAVE AND IMPROVE LIVES THROUGH ORGAN AND TISSUE DONATION FOR TRANSPLANTATION. 17 16 372 300 0 0 96318 203890 77077048 80967678 164392 195224 165491 6867 77503249 81373659 0 0 0 0 32150220 33130261 0 0 0 42245812 47431772 74396032 80562033 3107217 811626 41943029 46316429 12692719 16062459 29250310 30253970 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 68871543 80158001 Clinical operations provided care for 2,461 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 2016, we recovered 959 organs for transplantation from 291 organ donors and provided tissues for transplantation from 2,311 tissue donors; an estimated 90,598 lives were improved as a result. 1420032 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 nearly 2,500 families whose loved ones became donors in 2016. 672760 809677 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 newly created Donate Life America national registry. In 2016, added 461,695 new names to the registries in our service area through a variety of efforts.In 2016, 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 400+ proactive free media stories that were seen across the country. The results 54% of our organ donors were on the state donor registries. 70964335 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 0 0 0 0 0 0 0 0 0 0 0 0 1 147 0 1 372 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 Nancy Lee Chairperson 4.00 X X 0 0 0 Reece Fawley Secretary-Treasurer 4.00 X X 0 0 0 Michelle Zyromski Director - Chair Elect 4.00 X X 0 0 0 Tim Buckhout Director 4.00 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 Director 4.00 X 0 0 0 John Roberts Director 4.00 X 0 0 0 Jill Sullivan Director 4.00 X 0 0 0 Catherine Lan Tran Director 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 Director 4.00 X 0 0 0 Jim Kiehm Director 4.00 X 0 0 0 Ann White Director (Thru 11/16) 4.00 X 0 0 0 Cynthia D Siljestrom CEO 40.00 X X 416722 0 30617 Denise A Kinder COO 40.00 X 303375 0 44578 Sandra R Mejia CFO 40.00 X 312536 0 31434 Sean Van Slyck VP, Organ Donation Services 40.00 X 280361 0 40375 Nikole Adriane Neidlinger CMO 40.00 X 270346 0 30498 John T Mason VP, IT 40.00 X 254429 0 38014 Mark Borer VP, Quality Systems 40.00 X 237530 0 46617 Angela G Rosati Director, Tissue Program 40.00 X 213381 0 20175 Kim J Patton Director, Clinical Services 40.00 X 197335 0 34229 Colleen M Cieszkowski Director, Hospital and Family 40.00 X 184805 0 25785 Cathy L Olmo Director, Communications 40.00 X 166253 0 31732 Luis F Mayen Director, Procurement 40.00 X 176095 0 18385 Sandra F Olson Controller 40.00 X 158776 0 22267 Sharon Shamoon Clinical Procurement Coordinator 40.00 X 201277 0 28202 Michael Higuera Clinical Procurement Coordinator 40.00 X 161562 0 43920 Laurie Souchek Referral Services Manager 40.00 X 153745 0 42221 Efren Sablan Portal Systems Manager 40.00 X 151991 0 43907 Salvador Guerrero Family Resource Coordinator 40.00 X 149870 0 42722 3990389 0 615678 129 0 1 0 MW Logic Inc 1057 MacArthur Blvd Suite 203 San Leandro CA 94577 Construction 3889977 Transplant Transportation Services Inc PO Box 937 Penngrove CA 94951 Transportation 2631419 LABS Inc PO Box 843224 Kansas City MO 641843224 Laboratory 1416002 Staffing Solutions Group PO Box 398097 San Francisco CA 94139 Staffing Services 403629 Ultra Ex LLC 2633 Barrington Court Hayward CA 94545 Delivery Service 341863 13 111821 92069 203890 Organ Acq Fees 621500 80211759 80211759 Medicare/Medicaid Pmts 900099 518047 518047 Research 621500 237872 237872 80967678 187480 187480 34125 26381 7744 7744 7744 0 111821 37255 -37255 -37255 Other Revenue 900099 44122 44122 44122 81373659 80967678 0 202091 3636229 2626806 1009423 23865136 20737516 3127620 957605 741501 216104 2894977 2594434 300543 1776314 1638487 137827 153610 55071 98539 75268 37634 37634 432309 284348 147961 587809 587809 517165 183469 333696 1640733 978864 661869 2210691 1145895 1064796 4522764 4522764 544389 442581 101808 801997 685999 115998 1149809 988836 160973 Donor Hospital/Import/R 24766845 24766845 Clinical Supplies & Equ 3591427 3591427 Surgeon/Physician Fees 2376932 2376932 Bad Debt 2067492 2067492 1992532 1977117 15415 80562033 70964335 9597698 0 10277665 12078129 2298036 1012471 16314042 17469946 284727 1917547 542805 10536145 1832115 5296273 8704030 1054878 5839466 4996253 0 173190 41943029 46316429 11762473 14540125 930246 1522334 12692719 16062459 X 29241977 30253970 8333 0 29250310 30253970 41943029 46316429 811626 192034 0 X X 0 1 X 1 0 X 171338 328030 157951 96318 136990 890627 60224149 63841055 74258799 77077048 80967678 356368729 60395487 64169085 74416750 77173366 81104668 357259356 0 0 0 357259356 192597 251364 240238 203788 187480 1075467 192597 251364 240238 203788 187480 1075467 9270 125515 64207 190245 119355 508592 60597354 64545964 74721195 77567399 81411503 358843415 0.99560 0.99550 0.00300 0.00310 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1173 1173 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 activities. In 2016, that allocable expense was $1,173. 6893894 415878 6478016 1041716 843992 197724 2600535 572245 2028290 8704030 Corporate Bonds 4251793 F Government Securities 744460 F 4996253 Deferred Lease Payable 1522334 1522334 X 81602948 192034 192034 81410914 -37255 -37255 81373659 80599288 37255 37255 80562033 0 80562033 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, 2016 and 2015, the Organization does not have any significant uncertain tax positions for which a reserve would be necessary. Part XI, Line 4b - Other Adjustments: Special Event Expenses -37,255. Part XII, Line 2d - Other Adjustments: Special Event Expenses 37,255. Donate Life Walk 111821 111821 6113 1110 3863 26169 111821 111821 6113 1110 3863 26169 37255 -37255 X 1 1 X X X 0 0 0 0 0 0 0 0 0 Cynthia D Siljestrom CEO 328423 0 57289 0 31010 0 21200 0 9417 0 447339 0 0 0 Denise A Kinder COO 258779 0 44496 0 100 0 20174 0 24404 0 347953 0 0 0 Sandra R Mejia CFO 257149 0 43268 0 12119 0 20107 0 11327 0 343970 0 0 0 Sean Van Slyck VP, Organ Donation Services 249891 0 25000 0 5470 0 18427 0 21948 0 320736 0 0 0 Nikole Adriane Neidlinger CMO 220245 0 36107 0 13994 0 10596 0 19902 0 300844 0 0 0 John T Mason VP, IT 221000 0 25000 0 8429 0 17200 0 20814 0 292443 0 0 0 Mark Borer VP, Quality Systems 206850 0 30000 0 680 0 16068 0 30549 0 284147 0 0 0 Angela G Rosati Director, Tissue Program 189846 0 14250 0 9285 0 14888 0 5287 0 233556 0 0 0 Kim J Patton Director, Clinical Services 185716 0 11250 0 369 0 14857 0 19372 0 231564 0 0 0 Colleen M Cieszkowski Director, Hospital and Family 173405 0 11250 0 150 0 13872 0 11913 0 210590 0 0 0 Cathy L Olmo Director, Communications 154501 0 11250 0 502 0 12360 0 19372 0 197985 0 0 0 Luis F Mayen Director, Procurement 163724 0 11250 0 1121 0 13098 0 5287 0 194480 0 0 0 Sandra F Olson Controller 142554 0 11250 0 4972 0 11404 0 10863 0 181043 0 0 0 Sharon Shamoon Clinical Procurement Coordinator 192643 0 6138 0 2496 0 9578 0 18624 0 229479 0 0 0 Michael Higuera Clinical Procurement Coordinator 151958 0 6068 0 3536 0 9296 0 34624 0 205482 0 0 0 Laurie Souchek Referral Services Manager 145905 0 7500 0 340 0 11672 0 30549 0 195966 0 0 0 Efren Sablan Portal Systems Manager 139300 0 12500 0 191 0 8358 0 35549 0 195898 0 0 0 Salvador Guerrero Family Resource Coordinator 142307 0 5769 0 1794 0 8098 0 34624 0 192592 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. Form 990, Part I, Line 1 Donor Network West saves and improves lives through organ and tissue donation for transplantation and research. We honor and respect the donor families we serve with compassionate care, and inspire our communities to donate life. We work in close partnership with families, 175 hospitals including 5 transplant centers, 44 coroners/medical examiners and 500+ funeral homes to connect donors to recipients because every donation is a generous gift that can save and heal the life of someone in need. We facilitate the recovery and placement of life-saving organs and tissues such as lungs, heart, liver, kidneys, pancreas, small bowel, skin, heart valves, corneas and musculoskeletal tissues. Donor Network West is the federally designated Organ Procurement Organization serving northern California and Nevada, serving more than 13 million people spanning 100,000 square miles. More than 123,000 people await a life-saving organ transplant in the United States. 10,000 people wait for a lifesaving organ transplant and thousands more for tissue transplants in the Donor Network West service area. 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 Associations of Organ Procurement Organizations utilizing professional consulting services as well as other publicly available salary information to set executive salaries. The Executive Committee to the Board of Directors also reviews any salary increase for the CEO and CFO. 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.