DCI DONOR SERVICES INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
DCI DONOR SERVICES INC (EIN 58-1990866)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-05-15
IRS object ID
201321359349304817
Schema version
2011v1.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-05-15T11:54:05-07:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN581990866EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1DCI DONOR SERVICES INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlDCIDNameControl
Phone6152345251Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11600 Hayes StreetAddressLine1
Address Line2Suite 300AddressLine2
CityNashvilleCity
StateTNState
ZIP Code37203ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTeresa ThompsonName
TitleChief Financial OfficerTitle
Phone6155643621Phone
Date Signed2013-05-15DateSigned
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJames PerryNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11633 Church StreetAddressLine1
Address Line2Suite 500AddressLine2
CityNashvilleCity
StateTNState
ZIP Code37203ZIPCode
FieldValueIRS element (for citing)
Gross Receipts64929623GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.dcids.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1991YearFormation
State Legal DomicileTNStateLegalDomicile
Activity Or Mission DescriptionDCI Donor Services supports a local focus on donors, donor families, and the lives of those we impact; we are a stable community member serving patients first in all that we do. Our core purpose is to save and enhance lives.ActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members2NbrIndependentVotingMembers
Total Nbr Employees396TotalNbrEmployees
Total Nbr Volunteers150TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year42803142ProgramServiceRevenuePriorYear
Program Service Revenue CY49101978ProgramServiceRevenueCY
Investment Income Prior Year1215InvestmentIncomePriorYear
Investment Income Current Year940InvestmentIncomeCurrentYear
Other Revenue Prior Year5017325OtherRevenuePriorYear
Other Revenue Current Year5185504OtherRevenueCurrentYear
Total Revenue Prior Year47821682TotalRevenuePriorYear
Total Revenue Current Year54288422TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year20763564SalariesEtcPriorYear
Salaries Etc Current Year21655118SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year24620706OtherExpensePriorYear
Other Expenses Current Year28040660OtherExpensesCurrentYear
Total Expenses Prior Year45384270TotalExpensesPriorYear
Total Expenses Current Year49695778TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2437412RevenuesLessExpensesPriorYear
Revenues Less Expenses CY4592644RevenuesLessExpensesCY
Total Assets BOY31167758TotalAssetsBOY
Total Assets EOY33864795TotalAssetsEOY
Total Liabilities BOY20451323TotalLiabilitiesBOY
Total Liabilities EOY18555716TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY10716435NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY15309079NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionDCI Donor Services supports a local focus on donors, donor families, and the lives of those we impact; we are a stable community member serving patients first in all that we do. Our core purpose is to save and enhance lives.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense35334109Expense
Grants0Grants
Revenue54256689Revenue
DescriptionDCI Donor Services, Inc. ("DCIDS") is a not-for-profit 501(c)(3) organization that operates three federally certified Organ Procurement Organizations (OPOs) and a full service Tissue Bank (TB). See schedule O for additional information.Description
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense35334109TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org1TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096198NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees396NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members2NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address1OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonTeresa ThompsonNamePerson
Telephone Number6155643621TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11600 Hayes StreetAddressLine1
Address Line2Suite 300AddressLine2
CityNashvilleCity
StateTNState
ZIP Code37203ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
H Keith Johnson
President8XX25199012341
James Perry
Treasurer0XX08419513073
Ed Attrill
Assistant Treasurer0XX038762329471
Thomas Boyle
Secretary0XX000
William A Sterling
Board Member3X1200000
Cynda Rennie
Board Member0X000
Jill M Grandas
Corporate Executive Director40X230818020025
Teresa Thompson
Chief Financial Officer40X117451017139
Patricia Tencza
Executive Director40206644019759X
Monica Johnson-Tomanka
Executive Director4019745504270X
Louis Barnes
Executive Director40193188013131X
Quinton Beckham
Executive Director40199061014037X
Timothy Kern
Clinical Manager40139744017008X
Kelly Snyder
Sr Director GTP Quality Systems4012824906016X
Deirdre McAdams
Director of Clinical Services40119734016287X
Wayne Dunlap
Director of Operations4011059108351X
William McCartt
Associate Director of Clinical Services40107678016596X
Susan Fredenberg Cross
Executive Director010492000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1892732TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs471818TotalReportableCompFrmRltdOrgs
Total Other Compensation207504TotalOtherCompensation
Number Individuals GT100 K15NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensationAddress Line2AddressOfContractor/AddressUS/AddressLine2
Labs Inc
PO Box 843224Kansas CityMO64184Perform Laboratory Tests1578133
ECI Two Creekside Oaks
PO Box 742566Los AngelesCA90074Landlord365442
UT Medical Group
1407 Union AvenueMemphisTN38104Recovery Surgeons419250Suite 720
Bloodsource
10536 Peter A McCuen BlvdMatherCA95655Perform Laboratory Tests348574
Examworks Review Services
PO Box 492710ReddingCA96049Bill Review Services247660
FieldValueIRS element (for citing)
Number Of Contractors GT100 K16NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Organ Procurement Fees62199148551048485510480$0
OPO Estimated Provider Payment9000995509305509300$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue49101978TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column940TotalRevenueColumn
Related Or Exempt Function Income940RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities0Securities
Other0Other
FieldValueIRS element (for citing)
Gross Sales Of Inventory15795912GrossSalesOfInventory
Cost Of Goods Sold10641201CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column5154711TotalRevenueColumn
Related Or Exempt Function Income5154711RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column30793TotalRevenueColumn
Related Or Exempt Function Income30793RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue30793TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column54288422TotalRevenueColumn
Related Or Exempt Function Income54288422RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1181816Total
Program Services37199ProgramServices
Management And General1144617ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total15889777Total
Program Services11189368ProgramServices
Management And General4700409ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total219056Total
Program Services151777ProgramServices
Management And General67279ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2956176Total
Program Services2048240ProgramServices
Management And General907936ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1408293Total
Program Services975761ProgramServices
Management And General432532ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total150756Total
Program Services0ProgramServices
Management And General150756ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total290901Total
Program Services0ProgramServices
Management And General290901ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1631535Total
Program Services324708ProgramServices
Management And General1306827ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total370193Total
Program Services370193ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total387643Total
Program Services0ProgramServices
Management And General387643ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total125246Total
Program Services0ProgramServices
Management And General125246ManagementAndGeneral
Fundraising0Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1086573Total
Program Services1012326ProgramServices
Management And General74247ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total1442379Total
Program Services463673ProgramServices
Management And General978706ManagementAndGeneral
Fundraising0Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total397540Total
Program Services318032ProgramServices
Management And General79508ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total182431Total
Program Services0ProgramServices
Management And General182431ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total954232Total
Program Services93898ProgramServices
Management And General860334ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total598293Total
Program Services0ProgramServices
Management And General598293ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Organ Procurement152242921522429200
Supplies (Program related)2207548220754800
Communications7818215472222345990
Equipment Rental and Maintenance935785946748411110

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1273492Total
Program Services275198ProgramServices
Management And General998294ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total49695778Total
Program Services35334109ProgramServices
Management And General14361669ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY466902BOY
EOY165132EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY13056005BOY
EOY14048393EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY8820769BOY
EOY10431093EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY572168BOY
EOY615220EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis14478221LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec6117515LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY8077170BOY
EOY8360706EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY174744BOY
EOY150281EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY93970EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY31167758BOY
EOY33864795EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY5672487BOY
EOY5151840EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY3133333BOY
EOY2973333EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY11645503BOY
EOY10430543EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY20451323BOY
EOY18555716EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY10716435BOY
EOY15309079EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY10716435BOY
EOY15309079EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY31167758BOY
EOY33864795EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses4592644ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited0FSAudited
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years40532214CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years48632488CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years50702353CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year57061906CurrentTaxYearMinus1Year
Current Tax Year64897890CurrentTaxYear
Total261826851Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years40532214CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years48632488CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years50702353CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year57061906CurrentTaxYearMinus1Year
Current Tax Year64897890CurrentTaxYear
Total261826851Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total0Total
FieldValueIRS element (for citing)
Public Support Total509261826851PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years45729CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9212CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1342CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1215CurrentTaxYearMinus1Year
Current Tax Year940CurrentTaxYear
Total58438Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years45729CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9212CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1342CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1215CurrentTaxYearMinus1Year
Current Tax Year940CurrentTaxYear
Total58438Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years10079CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years17731CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4057CurrentTaxYearMinus1Year
Current Tax Year30793CurrentTaxYear
Total62660Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years40577943CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years48651779CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years50721426CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year57067178CurrentTaxYearMinus1Year
Current Tax Year64929623CurrentTaxYear
Total261947949Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99954PublicSupportPercentage509
Prior Year Support Percentage0.99962PriorYearSupportPercentage
Investment Income Percentage0.00022InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00025PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509
General ExplanationPart III, Line 12 - Miscellaneous IncomeGeneralExplanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis830783OtherCostOrOtherBasis
Book Value830783BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis3754562OtherCostOrOtherBasis
Depreciation378134Depreciation
Book Value3376428BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis1908674OtherCostOrOtherBasis
Depreciation716654Depreciation
Book Value1192020BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis7984202OtherCostOrOtherBasis
Depreciation5022727Depreciation
Book Value2961475BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value0BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings8360706TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
Payable to Related Organization$4,900,843
Short Term Liabilities$317,266
Line of Credit$4,925,000
Deferred Rent Payable$287,434
FieldValueIRS element (for citing)
Total Of Amounts10430543TotalOfAmounts

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Ed Attrill
0387623000000029471041709400
Jill M Grandas
2308180000000200250250843000
Patricia Tencza
2066440000000197590226403000
Monica Johnson-Tomanka
197455000000042700201725000
Quinton Beckham
1990610000000140370213098000
Louis Barnes
1931880000000131310206319000
Timothy Kern
1397440000000170080156752000
Susan Fredenberg Cross
000010492000000104920000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSchJ_P01_S00_L04Identifier
Return ReferenceSchedule J, Part I, Line 4ReturnReference
ExplanationSusan Fredenberg-Cross received severance payments totaling $104,920.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonDr Oscar GrandasNamePerson
FieldValueIRS element (for citing)
RelationshipFamily member of Jill GrandasRelationship
Amount Of Transaction75000AmountOfTransaction
Description Of TransactionRecovery Surgeon for organizationDescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierSchL_P04_S00_L00Identifier
Return ReferenceSchedule L, Part IVReturnReference
ExplanationDr. Oscar Grandas is a family member to Jill Grandas, who is a key employee of DCI Donor Services. DCI Donor Services compensates Dr. Grandas for services he provides to the organization in his occupation as an organ recovery surgeon.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P03_S00_L04aForm 990, Part III, Line 4aDCI Donor Services, Inc. ("DCIDS") is a not-for-profit 501(c)(3) organization that operates three federally certified Organ Procurement Organizations (OPOs) and a full service Tissue Bank (TB). DCIDS promotes the donation of human organs and tissues, primarily for transplant, through education programs for the general public and health professionals, and through agreements with various hospitals and medical professionals provides the organs and tissues recovered by its member organizations. Each of the OPOs is certified by the Center for Medicare and Medicaid Services and designated by the US Secretary of Health and Human Services to participate in the Federal Medicare Program. Each OPO is an institutional member of both the Association of Organ Procurement Organizations as well as the United Network for Organ Sharing which holds the contract to function as the National Organ Procurement and Transplant Network mandated by federal law. The TB follows requirements set by the Centers for Disease Control, US Food and Drug Administration, as well as the standards established by the American Association of Tissue Banks and is a fully accredited member of that organization as well. Accordingly, the OPOs seek reimbursement for all expenses incurred in coordinating the recovery of organs that are sent to transplanting hospitals and annually file a federal cost report detailing and reconciling its revenue and expenses. The TB derives its cost-covering revenues from hospitals or dentists who are transplanting tissues processed and/or distributed by the TB. All program service expenses of DCIDS are incurred in support of the above stated tax exempt procurement and educational activities. For the year ended September 30, 2012, DCIDS procured 1,215 organs and recovered 2,418 tissue donors for transplantation. In addition, DCIDS sponsored a number of professional seminars for nurses and physicians concerning issues in transplantation, as well as several programs to educate and heighten awareness of the general public concerning organ and tissue donation and transplantation.
F990_P04_S00_L12aForm 990, Part IV, Line 12aDialysis Clinic, Inc. receives annual audited financial statements. The financial statements are presented as consolidated financial statements which includes: Dialysis Clinic, Inc., DCI Donor Services, Boxwood Dialysis LLC, DCI Renal Services of Pittsburgh LLC, and Independent Kidney Cooperative (collectively, "subsidiaries"). The majority of the activity presented in the consolidated financial statements is that of Dialysis Clinic, Inc. when compared to the subsidiaries. Dialysis Clinic, Inc. is a 501(c)(3) tax exempt organization and files Form 990. Each subsidiary files a separate return.
F990_P06_S0A_L06Form 990, Part VI, Section A, Line 6The sole member of the corporation is Dialysis Clinic, Inc.
F990_P06_S0A_L07aForm 990, Part VI, Section A, Line 7aDialysis Clinic, Inc. as the sole member of DCI Donor Services has the power to nominate, elect, appoint, fill vacancies of, and remove members of the Board of Directors of the corporation.
F990_P06_S0A_L07bForm 990, Part VI, Section A, Line 7bDialysis Clinic, Inc. shall have the sole vote on all matters coming before the membership.
F990_P06_S0A_L08bForm 990, Part VI, Section A, Line 8bThere are currently no committees that act on behalf of the governing body.
F990_P06_S0A_L09Form 990, Part VI, Section A, Line 9One officer and two directors cannot be reached at the organization's mailing address: 1) Thomas Boyle, 301 Grant Street, Pittsburgh, PA 15219. 2) William Sterling, 8912 Natalie Ave, Albuquerque, NM 87110. 3) Cynda Rennie, PO Box 7437, Citrus Heights, CA 95621.
F990_P06_S0B_L11bForm 990, Part VI, Section B, Line 11bA draft of Form 990 is supplied to each member of the governing body and adjustments are suggested and completed as necessary. Each board member is mailed a copy of the Form 990 draft and is given an appropriate amount of time to review and comment.
F990_P06_S0B_L12cForm 990, Part VI, Section B, Line 12cOn an annual basis, the Board of Directors sign a conflict of interest statement that states the directors have not violated the conflict of interest policy.
F990_P06_S0B_L15Form 990, Part VI, Section B, Line 15DCI Donor Services belongs to the Association of Organ Procurement Organizations. AOPO completes a yearly survey of all salaried positions within an organ procurement organization, which includes CEO salaries, as well as the salaries for other key positions. This yearly survey is used to determine the salaries for the Executive Director and other key employees.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19DCI Donor Services does not make its governing documents, conflict of interest policy, and financial statements available to the public.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Dialysis Clinic IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11633 Church StreetAddressLine1
Address Line2Suite 500AddressLine2
CityNashvilleCity
StateTNState
ZIP Code37203ZIPCode
FieldValueIRS element (for citing)
EIN620850498EIN
Primary ActivitiesKidney DialysisPrimaryActivities
Legal Domicile StateTNLegalDomicileState
Exempt Code Section501(c)(3)ExemptCodeSection
Public Charity StatusLine 9PublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Dialysis Clinic Inc
j507600Actual records
Dialysis Clinic Inc
o5075000Actual records
Dialysis Clinic Inc
n393482Actual records
Dialysis Clinic Inc
l228452Actual records

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