2017-11-09T14:36:16-06:00 2016-12-31 420714325 RSM US LLP 801 NICOLLET MALL SUITE 1100 MINNEAPOLIS MN 55402 990 2016-01-01 880253675 NEVADA DONOR NETWORK INC NEVA 7027969600 2061 E SAHARA AVENUE LAS VEGAS NV 89104 JOSEPH FERREIRA PRESIDENT/CEO 7027969600 2017-10-04 1 TODD A JACKSON P00092672 6123324300 108.171.131.186 2017-10-04 13:46:34 CD P 01563F10D6676BDC9B96404AA3206AA292B808E6 5AB5DFEC54AF030231DDAA57F2AFD57D98013E0B 2016 2021-01-29 14:40:06Z JOSEPH FERREIRA 2061 E SAHARA AVENUE LAS VEGAS NV 89104 24167035 0 X WWW.NVDONOR.ORG X 1986 NV NEVADA DONOR NETWORK (THE "NETWORK") IS A FEDERALLY DESIGNATED NOT-FOR-PROFIT ORGAN, TISSUE, AND EYE PROCUREMENT ORGANIZATION. THE NETWORK IS RESPONSIBLE FOR THE COORDINATION, RECOVERY, AND DISTRIBUTION OF DONATED HUMAN ORGANS AND TISSUES INTENDED FOR TRANSPLANTATION, MEDICAL EDUCATION AND RESEARCH. THE NETWORK PROVIDES SERVICES TO HOSPITALS AND HEALTHCARE FACILITIES THROUGHOUT NEVADA AND PARTICIPATES IN THE NATIONAL ORGAN AND TISSUE SHARING PROGRAM. 13 13 147 104 0 0 83349 13649 21838449 24134483 3024 18903 866 0 21925688 24167035 3803150 0 0 0 11220231 11860010 0 0 0 9741562 10435317 24764943 22295327 -2839255 1871708 17581821 19808007 11260826 11611018 6320995 8196989 X NEVADA DONOR NETWORK (THE "NETWORK") IS A FEDERALLY DESIGNATED NOT-FOR-PROFIT ORGAN, TISSUE, AND EYE PROCUREMENT ORGANIZATION. THE NETWORK IS RESPONSIBLE FOR THE COORDINATION, RECOVERY, AND DISTRIBUTION OF DONATED HUMAN ORGANS AND TISSUES INTENDED FOR TRANSPLANTATION, MEDICAL EDUCATION AND RESEARCH. THE NETWORK PROVIDES SERVICES TO HOSPITALS AND HEALTHCARE FACILITIES THROUGHOUT NEVADA AND PARTICIPATES IN THE NATIONAL ORGAN AND TISSUE SHARING PROGRAM. 0 0 7309057 14812593 ORGAN RECOVERY FOCUSES ON LIFE SAVING SOLID ORGANS SUCH AS THE HEART, LIVER, LUNGS, INTESTINES, PANCREAS AND KIDNEYS. ORGAN RECOVERY SUPPORTS THE SOLID ORGAN TRANSPLANT PROGRAMS AT UNIVERSITY MEDICAL CENTER AND OTHER TRANSPLANT PROGRAMS ACROSS THE COUNTRY.THE PROGRAM EXPENSES REPORTED ARE DIRECT EXPENSES ONLY AND DO NOT INCLUDE UNALLOCATED EXPENSES, SOME OF WHICH ARE REPORTED IN PROGRAM 4D BELOW. 3802055 7470140 TISSUE AND EYE RECOVERY INCLUDES BONES, TENDONS, SKIN, HEART VALVES, VEINS AND CORNEAS. TISSUES ARE RECOVERED BY THE NETWORK STAFF AND SENT TO VARIOUS ORGANIZATIONS FOR FURTHER PROCESSING AND SUBSEQUENT DISTRIBUTION. THE NETWORK ALSO OPERATES A FULL SERVICE EYE BANK THAT PROVIDES OCULAR TISSUE FOR TRANSPLANTATION. OCULAR TISSUE IS UTILIZED LOCALLY AND SHARED WITH OTHER EYE BANKS THROUGHOUT THE UNITED STATES AND OTHER COUNTRIES THROUGH THE INTERNATIONAL CORNEA PROJECT. THIS PROGRAM INCLUDES THE NORTHERN NEVADA OFFICE THAT ALSO PERFORMS TISSUE AND EYE RECOVERY.THE PROGRAM EXPENSES REPORTED ARE DIRECT EXPENSES ONLY AND DO NOT INCLUDE UNALLOCATED EXPENSES, SOME OF WHICH ARE REPORTED IN PROGRAM 4D BELOW. 1638895 1851750 THE HLA LABORATORY PERFORMS TISSUE TYPING ON POTENTIAL ORGAN DONORS, RECIPIENTS AND LIVING RELATED MATCHES.THE PROGRAM EXPENSES REPORTED ARE DIRECT EXPENSES ONLY AND DO NOT INCLUDE UNALLOCATED EXPENSES, SOME OF WHICH ARE REPORTED IN PROGRAM 4D BELOW. 5046741 NEVADA DONOR NETWORK PROVIDES EDUCATION, AWARENESS AND INFORMATION TO THE MEDICAL COMMUNITY AND GENERAL PUBLIC THROUGH PROFESSIONAL EDUCATION SEMINARS, HOSPITAL IN-SERVICES, CEU PROGRAMS, PUBLIC EDUCATION, HEALTH FAIRS, BEREAVEMENT PROGRAMS, AND SCHOOL PRESENTATIONS. 5046741 17796748 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 1 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 1 1 0 0 0 1 64 0 1 147 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X JASON MAHFOOD 7027969600 2055 E SAHARA AVE LAS VEGAS NV 89104 KATHY SILVER CHAIR 1.00 X X 0 0 0 TRUDY LARSON CHAIR ELECT 1.00 X X 0 0 0 ESTHER-MARIE CARMICHAEL SECRETARY 1.00 X X 0 0 0 CHRIS BOSSE TREASURER 1.00 X X 0 0 0 TODD SKLAMBERG DIRECTOR 1.00 X 0 0 0 STEPHEN C RAYHILL MD DIRECTOR 1.00 X 0 0 0 ANN BURGESS DIRECTOR 1.00 X 0 0 0 BARRY BROWNE MD DIRECTOR 1.00 X 0 0 0 BILL WELCH DIRECTOR 1.00 X 0 0 0 MASON VAN HOUWELING DIRECTOR 1.00 X 0 0 0 AMY MCKINNEY DIRECTOR 1.00 X 0 0 0 LEONARD FREEHOF DIRECTOR 1.00 X 0 0 0 BRIAN BRANNMAN DIRECTOR 1.00 X 0 0 0 JOSEPH FERREIRA PRESIDENT/CEO 40.00 X 373292 0 19897 JASON MAHFOOD CFO 40.00 X 247671 0 36480 SIMON KEITH COO 40.00 X 260858 0 38193 MELISSA BEIN VP OF CLINICAL AFFAIRS 40.00 X 153079 0 17007 KEVIN BURNS MD MEDICAL DIRECTOR HLA LAB 40.00 X 187429 0 4033 LISA MAGARO PROCUREMENT TRANSPLANT COORDINATOR 40.00 X 142029 0 11838 CHRISTINA PANZICA PROCUREMENT TRANSPLANT COORDINATOR 40.00 X 142750 0 16444 BRENT BERGQUIST DIRECTOR OF OCULAR/BUSINESS DEV/DONATION SVCS 40.00 X 135210 0 37106 MATTHEW GRAVES DIRECTOR OF TISSUE RECOVERY 40.00 X 133377 0 17777 AMADO DABU PROCUREMENT TRANSPLANT COORDINATOR 40.00 X 128361 0 24999 1904056 0 223774 23 0 1 0 DESERT OAK DEVELOPMENT 4010 W ALI BABA LANE STE B LAS VEGAS NV 89118 CONTRACTOR SERVICES 2136010 UNIVERSITY MEDICAL CENTER OF SOTHERN NEV 1800 WEST CHARLESTON BLVD LAS VEGAS NV 89102 MEDICAL SERVICES 1370598 VALLEY HEALTH SYSTEMS LLC 8801 WEST SAHARA AVE LAS VEGAS NV 89117 MEDICAL SERVICES 465293 LABS INC PO BOX 843224 KANSAS CITY MO 64184 MEDICAL SERVICES 325823 SUNRISE HOSPITAL & MEDICAL CENTER PO BOX 403399 ATLANTA GA 30384 MEDICAL SERVICES 297454 21 13649 13649 RECOVERY FEES, NET 621500 24132346 24132346 REBATES & REIMBURSEMENTS 621500 2137 2137 24134483 18903 18903 24167035 24134483 0 18903 1341949 1341949 8410407 7832644 577763 205107 192814 12293 1194975 987636 207339 707572 573638 133934 13452 894 12558 34786 2312 32474 707947 525759 182188 63284 25778 37506 529808 121708 408100 626665 385372 241293 450738 285320 165418 732163 474240 257923 227476 99 227377 405879 145971 259908 261450 183806 77644 RECOVERY COSTS 3526266 3526266 MEDICAL SUPPLIES 1145564 1145564 LABORATORY 1099932 1099932 NETWORK DUES AND FEES 175435 58571 116864 434472 228424 206048 22295327 17796748 4498579 0 1535389 3996170 3152516 1459087 6309326 5863741 149431 180172 266673 175710 9084135 2094055 5045379 6990080 1009831 1014118 113276 128929 17581821 19808007 2794516 3052432 1000000 1000000 7466310 7558586 11260826 11611018 X 6320995 8196989 6320995 8196989 17581821 19808007 1871708 4286 0 X 0 1 X 1 0 X 16945 26802 50617 83349 13649 191362 13219237 17976743 19362798 21838449 24134483 96531710 13236182 18003545 19413415 21921798 24148132 96723072 0 0 0 96723072 3324 82 1649 26649 8354 40058 3324 82 1649 26649 8354 40058 13239506 18003627 19415064 21948447 24156486 96763130 0.99960 0.99960 0.00040 0.00040 X 0 0 0 0 0 0 0 0 1 1144 1144 0 PART II-B, LINE 1: PAID DUES TO THE ASSOCIATION OF ORGAN PROCUREMENT ORGANIZATION (AOPO) OF WHICH A SMALL PORTION IS USED FOR LOBBYING. 321081 321081 7066608 1007760 6058848 275721 85829 189892 1410278 1000466 409812 10447 10447 6990080 X PART X, LINE 2: THE NETWORK IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. GENERALLY, THE NETWORK IS NO LONGER SUBJECT TO FEDERAL INCOME TAX RETURN EXAMINATIONS FOR THE YEARS PRIOR TO 2012. THE NETWORK QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION. THE NETWORK IS GENERALLY EXEMPT FROM INCOME TAXES ON RELATED INCOME PURSUANT TO THE APPROPRIATE SECTION OF THE INTERNAL REVENUE CODE. IN THE PREPARATION OF TAX RETURNS, TAX POSITIONS ARE TAKEN BASED ON INTERPRETATION OF FEDERAL, STATE AND LOCAL INCOME TAX LAWS. IN ACCORDANCE WITH THE ACCOUNTING STANDARDS, MANAGEMENT PERIODICALLY REVIEWS AND EVALUATES THE STATUS OF UNCERTAIN TAX POSITIONS AND MAKES ESTIMATES OF AMOUNTS, INCLUDING INTEREST AND PENALTIES, ULTIMATELY DUE OR OWED. NO AMOUNTS HAVE BEEN IDENTIFIED OR RECORDED AS UNCERTAIN TAX POSITIONS. FEDERAL, STATE AND LOCAL TAX RETURNS GENERALLY REMAIN OPEN FOR EXAMINATION BY THE VARIOUS TAXING AUTHORITIES FOR A PERIOD OF THREE TO SIX YEARS. X X X X X X 0 0 0 0 0 1 0 0 0 JOSEPH FERREIRA PRESIDENT/CEO 328702 0 30472 0 14118 0 12626 0 8209 0 394127 0 0 0 JASON MAHFOOD CFO 213594 0 32452 0 1625 0 10852 0 26593 0 285116 0 0 0 SIMON KEITH COO 229641 0 22999 0 8218 0 12564 0 26629 0 300051 0 0 0 MELISSA BEIN VP OF CLINICAL AFFAIRS 141850 0 10198 0 1031 0 5221 0 12413 0 170713 0 0 0 KEVIN BURNS MD MEDICAL DIRECTOR HLA LAB 186497 0 0 0 932 0 0 0 4512 0 191941 0 0 0 LISA MAGARO PROCUREMENT TRANSPLANT COORDINATOR 139990 0 0 0 2039 0 0 0 12681 0 154710 0 0 0 CHRISTINA PANZICA PROCUREMENT TRANSPLANT COORDINATOR 135761 0 0 0 6989 0 6881 0 10312 0 159943 0 0 0 BRENT BERGQUIST DIRECTOR OF OCULAR/BUSINESS DEV/DONA 125157 0 8355 0 1698 0 7608 0 30462 0 173280 0 0 0 MATTHEW GRAVES DIRECTOR OF TISSUE RECOVERY 123730 0 8041 0 1606 0 8506 0 10242 0 152125 0 0 0 AMADO DABU PROCUREMENT TRANSPLANT COORDINATOR 126284 0 0 0 2077 0 10305 0 15558 0 154224 0 0 0 PART I, LINE 6 THE DIRECTORS AND CEO'S BONUSES WERE ACCRUED BASED ON PRE-DETERMINED GOALS AND OBJECTIVES TIED TO PERFORMANCE METRICS. THE METRICS INCLUDE ORGANIZATIONAL NET INCOME AS WELL AS SPECIFIC STRATEGIC PLAN GOALS. THE BONUS IS A FIXED TARGET PERCENTAGE THAT INCLUDES A CAP. THE CFO AND COO BONUS PAID IS TIED TO PERFORMANCE METRICS AS WELL AS EMPLOYMENT AGREEMENTS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS SENT VIA EMAIL AND REGULAR MAIL TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A POLICY ON CORPORATE COMPLIANCE THAT ALL EMPLOYEES, MEMBERS OF THE GOVERNING AND ADVISORY BOARDS AND MEMBERS OF THEIR IMMEDIATE HOUSEHOLD MUST DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AND ABSTAIN FROM ANY ACTION OR VOTE INVOLVING THE DISCLOSED POTENTIAL OR ACTUAL CONFLICT. TRAINING IS DONE ON AN ANNUAL BASIS FOR BOTH EMPLOYEES AND BOARD MEMBERS AND ALL SIGN-OFF THAT THEY UNDERSTAND AND WILL ADHERE TO POLICY. FORM 990, PART VI, SECTION B, LINE 15 ALL WAGES AND BENEFITS ARE REVIEWED AND APPROVED BY THE BOARD OF TRUSTEES USING AN INDEPENDENT THIRD PARTY SALARY STUDY. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). FORM 990, LINE 6, TOATL NUMBER OF VOLUNTEERS VOLUNTEERS FOR NEVADA DONOR NETWORK ARE OFTEN PERSONALLY CONNECTED TO THE CAUSE AS A TRANSPLANT RECIPIENT, DONOR HERO FAMILY MEMBER, LIVING DONOR, OR GENERAL SUPPORTER. THEY REPRESENT NEVADA DONOR NETWORK IN THE COMMUNITY, EDUCATING THE PUBLIC ABOUT THE IMPORTANCE OF ORGAN, EYE AND TISSUE DONATION BY STAFFING INFORMATION TABLES AT COMMUNITY EVENTS; ASSEMBLING INFORMATION/MAILINGS FOR PUBLIC DISTRIBUTION; AND SHARING THEIR STORY IN VARIOUS PRESENTATIONS AND MEDIA OPPORTUNITIES. NEVADA DONOR NETWORK SUPPORT FOUNDATION INC 2061 EAST SAHARA AVENUE LAS VEGAS NV 89104 472624567 FOUNDATION NV 501(C)(3) LINE 12A, I NEVADA DONOR NETWORK INC 1 BLUE FLAG INC 2061 EAST SAHARA AVENUE LAS VEGAS NV 89104 475262223 INVESTING NV NEVADA DONOR NETWORK INC C 1001467 1.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0