2012-03-30T10:34:41-07:00 2011-09-30 990 2010-10-01 581990866 DCI DONOR SERVICES INC DCID 6152345251 1600 Hayes Street Suite 300 Nashville TN 37203 H Keith Johnson 6153420402 2012-03-30 2010 2016-02-24 21:20:13Z X James Perry 1633 Church Street Suite 500 Nashville TN 37203 57067179 0 X www.dcids.org X 1991 TN DCI Donor Services is committed to saving and improving lives, connecting one life to another through donation and transplantation. 5 2 427 150 0 0 0 0 40738074 42803142 1342 1215 949065 5017325 41688481 47821682 0 0 0 0 19767039 20763564 0 0 0 21789895 24620706 41556934 45384270 131547 2437412 26047635 31167758 17768612 20451323 8279023 10716435 X DCI Donor Services is committed to saving and improving lives, connecting one life to another through donation and transplantation. 0 0 32396859 0 47816410 DCI Donor Services, Inc. ("DCIDS") is a not-for-profit 0 0 0 32396859 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 1 0 1 211 0 1 427 1 0 0 0 0 0 0 X 5 2 0 0 0 0 1 1 1 1 0 1 0 1 1 1 1 1 1 1 1 0 X Teresa Thompson 6155643621 1600 Hayes Street Suite 300 Nashville TN 37203 H Keith Johnson 0 X X 25199 0 10256 James Perry 0 X X 0 609269 19883 Ed Attrill 0 X X 0 262446 12877 James B Riley 0 X X 0 0 0 William A Sterling 0 X 12000 0 0 Cynda Rennie 0 X 0 0 0 Jill M Grandas 40 X 221399 0 17299 Susan Fredenberg Cross 40 X 198449 0 10808 Patricia Tencza 40 X 196952 0 17148 Helen Nelson 40 X 226354 0 17538 Louis Barnes 40 X 185166 0 10821 Kelly Snyder 40 X 190870 0 3799 Timothy Kern 40 X 118675 0 14019 Teresa Thompson 40 X 118136 0 14698 Ginger McIntosh 40 X 106825 0 13489 Quinton Beckham 40 X 105948 0 3842 1705973 871715 166477 13 0 1 0 Labs Inc PO Box 843224 Kansas City MO 64184 Perform Laboratory Tests 1653418 ECI Two Creekside Oaks PO Box 60000 San Francisco CA 94160 Landlord 365053 UT Medical Group 1407 Union Avenue Suite 720 Memphis TN 38104 Recovery Surgeons 305000 Bloodsource 10536 Peter A McCuen Blvd Mather CA 95655 Perform Laboratory Tests 322788 Examworks Review Services PO Box 492710 Redding CA 96049 Bill Review Services 223290 13 0 Organ Procurement Fees 621990 42891008 42891008 0 0 OPO Estimated Provider Cost Paymnet 900099 -87866 -87866 0 0 0 0 0 0 42803142 1215 1215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14258765 9245497 5013268 5013268 0 0 4057 4057 0 0 4057 47821682 47821682 0 0 0 0 0 0 0 0 0 0 1053519 25199 1028320 0 0 0 0 0 15269347 11020053 4249294 0 207402 146647 60755 0 2904621 2053764 850857 0 1328675 939463 389212 0 0 0 0 0 339127 0 339127 0 264458 0 264458 0 0 0 0 0 0 0 0 0 0 0 1430413 307760 1122653 0 218911 218911 0 0 301164 0 301164 0 52617 0 52617 0 0 0 0 0 1041940 977134 64806 0 1332181 418734 913447 0 0 0 0 0 352494 281995 70499 0 117513 0 117513 0 0 0 0 0 892027 96517 795510 0 566748 0 566748 0 Organ Procurement 13186723 13186723 0 0 Supplies (Program Related) 1827994 1827994 0 0 Communications 797896 558233 239663 0 Bad Debt Expense 306324 0 306324 0 Equipment Rental and Maintenance 613853 94517 519336 0 978323 243215 735108 0 45384270 32396859 12987411 0 1040172 466902 0 0 10622610 13056005 0 0 0 5737343 8820769 504243 572168 13239900 5162730 7944060 8077170 0 199207 174744 26047635 31167758 4611855 5672487 0 0 0 0 0 0 3133333 0 13156757 11645503 17768612 20451323 X 0 0 0 0 8279023 10716435 8279023 10716435 26047635 31167758 2437412 0 X 0 0 0 X 37632084 40532214 48632488 50702353 57061906 234561045 0 0 0 0 37632084 40532214 48632488 50702353 57061906 234561045 0 0 0 0 0 0 0 0 0 0 234561045 45729 9212 1342 1215 57498 0 45729 9212 1342 1215 57498 0 10079 17731 4057 31867 37632084 40577943 48651779 50721426 57067178 234650410 0.99962 0.99961 0.00025 0.00026 X General Explanation - Miscellaneous Income 0 830783 830783 0 3754562 252982 3501580 0 1478856 545771 933085 0 7175699 4363977 2811722 0 0 0 0 8077170 0 Payable to Related Organization 7477991 Short Term Liabilities 326508 Line of Credit 3500000 Deferred Rent Payable 341004 11645503 X X X 0 0 0 0 0 0 0 0 0 James Perry 0 609269 0 0 0 0 0 0 0 19883 0 629152 0 Ed Attrill 0 262446 0 0 0 0 0 0 0 12877 0 275323 0 Jill M Grandas 221399 0 0 0 0 0 0 0 17299 0 238698 0 0 Susan Fredenberg Cross 198449 0 0 0 0 0 0 0 10808 0 209257 0 Patricia Tencza 196952 0 0 0 0 0 0 0 17148 0 214100 0 Helen Nelson 226354 0 0 0 0 0 0 0 17538 0 243892 0 Louis Barnes 185166 0 0 0 0 0 0 0 10821 0 195987 0 Kelly Snyder 190870 0 0 0 0 0 0 0 3799 0 194669 0 Dr Oscar Grandas Family of Jill Grandas 43000 Recovery Surgeon for organization 0 SchL_P04_S00_L00 Schedule L, Part IV Part IV, Line 1 - Dr. 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. F990_P03_S00_L04a Form 990, Part III, Line 4a DCI 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 dervies its cost-covering revenues from hospitals or dentists who are transplanting tissues recovered, 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, 2011, DCIDS procured 1,138 organs and recovered 1,997 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 the awareness of the general public concerning organ donation and transplantation. F990_P04_S00_L12a Form 990, Part IV, Line 12a Dialysis 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 seperate return. F990_P06_S0A_L06 Form 990, Part VI, Section A, Line 6 The sole member of the corporation is Dialysis Clinic, Inc. F990_P06_S0A_L07a Form 990, Part VI, Section A, Line 7a Dialysis 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_L07b Form 990, Part VI, Section A, Line 7b Dialysis Clinic, Inc. shall have the sole vote on all matters coming before the membership. F990_P06_S0A_L08b Form 990, Part VI, Section A, Line 8b There are currently no committees that act on behalf of the governing body. F990_P06_S0A_L09 Form 990, Part VI, Section A, Line 9 One officer and two directors cannot be reached at the organizations mailing address: 1) James Riley, 150 N Michigan Ave, Chicago, IL 60601. 2) William Sterling, 8912 Natalie Ave, Albuquerque, NM 87110. 3) Cynda Rennie, PO Box 7437, Citrus Heights, CA 95621. F990_P06_S0B_L11a Form 990, Part VI, Section B, Line 11a A draft of Form 990 is suppllied 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 approximately one month to review and comment. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c On an annual basis, the Board of Directors signs a conflict of interest statement that states the director has not violated the conflict of interest policy. F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 DCI 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 was used to determine the salaries for the executive director and other key employees. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 DCI Donor Services does not make its governing documents, conflict of interest policy, and financial statements available to the public. Dialysis Clinic Inc 1633 Church Street Suite 500 Nashville TN 37203 620850498 Kidney Dialysis TN 501(c)(3) Line 9 N/A 0 0 0 0 0 0 0 0 1 0 1 0 1 0 1 1 1 0 0 Dialysis Clinic Inc j 507600 Actual Records Dialysis Clinic Inc l 228452 Actual records Dialysis Clinic Inc n 332007 Actual records Dialysis Clinic Inc o 7293860 Actual records