2012-05-25T08:50:39-05:00 2011-12-31 421243538 BERGAN PAULSEN & COMPANY PC PO BOX 2100 WATERLOO IA 507042100 990 2011-01-01 421414092 IOWA DONOR NETWORK IOWA 3196653787 550 MADISON AVENUE NORTH LIBERTY IA 52317 SUZANNE CONRAD 3196653787 2012-05-16 1 DAVID RICHTER P00168204 3192346885 2011 2016-02-24 21:20:13Z SUZANNE CONRAD 550 MADISON AVENUE NORTH LIBERTY IA 52317 15532117 0 X WWW.IOWADONORNETWORK.ORG X 1993 IA THE ORGANIZATION FACILITATES BOTH ORGAN AND TISSUE RECOVERY AND SERVES AS THE STATE OF IOWA'S PRIMARY CONTACT FOR ORGAN, TISSUE AND EYE DONATION. 17 17 138 200 0 0 170646 485223 15232685 15019775 18892 15932 31878 -4046 15454101 15516884 0 0 0 0 6593411 7205038 0 0 74351 7181979 8059606 13775390 15264644 1678711 252240 12197039 12731416 3087090 2758910 9109949 9972506 X TRANSFORMING LIVES THROUGH ORGAN AND TISSUE DONATION. 0 0 11672088 15019775 ORGAN AND TISSUE RECOVERYIDN IS A NON-PROFIT 501(c)(3) ORGANIZATION THAT OPERATES AS THE PRIMARY CONTACT FOR ORGAN, TISSUE AND EYE DONATION SERVICES IN THE STATE OF IOWA. THE CENTERS FOR MEDICARE AND MEDICAID SERVICES HAS CERTIFIED IDN TO FUNCTION AS THE SINGLE ORGAN PROCUREMENT ORGANIZATION SERVING THE STATE OF IOWA. IDN ALSO PROVIDES TISSUE RECOVERY SERVICES. IN 2011, ORGAN RECOVERY SERVICES GENERATED $9,049,810 IN REVENUES WHILE TISSUE RECOVERY SERVICES CONTRIBUTED $5,762,719 TOWARD REVENUES. IDN WORKS WITH MORE THAN 100 HOSPITALS ACROSS THE STATE. IT ALSO WORKS CLOSELY WITH THE IOWA LIONS EYE BANK TO PROMOTE EYE DONATION. IN KEEPING WITH ITS GOALS, IDN ENGAGES IN MANY INTERRELATED ACTIVITIES: ORGAN AND TISSUE RECOVERY, ORGAN DISTRIBUTION, PUBLIC EDUCATION, HOSPITAL DEVELOPMENT, AND FAMILY SUPPORT SERVICES.AN IDN DONATION COORDINATOR MANAGES THE IDENTIFICATION, EVALUATION AND MEDICAL MAINTENANCE OF ORGAN AND/OR TISSUE DONORS; INCLUDING ASSISTING AND/OR PERFORMING THE SURGICAL RECOVERY OF ORGANS AND TISSUES, AND COORDINATING THE PLACEMENT AND TRANSPORTATION OF RECOVERED ORGANS. IDN ALSO WORKS WITH IOWA LIONS EYE BANK TO FACILITATE EYE DONATION AND RECOVERY.IDN WAS THE 7TH DONATION SERVICE AREA IN THE UNITED STATES TO DEVELOP A DONOR REGISTRY AND ENACT FIRST PERSON CONSENT LEGISLATION. THE REGISTRY, COMBINED WITH LEGISLATION, ALLOWS IOWANS TO LEGALLY CONSENT TO ORGAN AND TISSUE DONATION PRIOR TO DEATH. THIS PROCESS ALLEVIATES THE STRESS ON SURVIVING FAMILY MEMBERS OF TRYING TO MAKE A DONATION DECISION AT A VERY DIFFICULT TIME, DURING THE LOSS OF A LOVED ONE.IDN HAS BEEN RECOGNIZED BY HRSA AS A TOP PERFORMER IN ORGAN RECOVERY. IOWA DONOR NETWORK IS FULLY ACCREDITED BY THE ASSOCIATION OF ORGAN PROCUREMENT ORGANIZATIONS AND THE AMERICAN ASSOCIATION OF TISSUE BANKS.ANNUALLY, IDN RECEIVES MORE THAN 10,000 CALLS FROM IOWA HOSPITALS AND OTHER HEALTH CARE AGENCIES REFERRING POTENTIAL ORGAN AND TISSUE DONORS. IN 2011, IOWA DONOR NETWORK PROVIDED LIFE-SAVING ORGANS TO WAITING RECIPIENTS FROM 50 DONORS. IN ADDITION, LIFE-SAVING AND LIFE-ENHANCING TISSUE WAS RECOVERED FROM 589 TISSUE DONORS.IOWA DONOR NETWORK CONTINUES TO PROVIDE GRIEF SUPPORT TO MORE THAN 1,000 IOWA FAMILIES WHO HAVE LOST A LOVED ONE AND MADE THE GENEROUS DECISION TO DONATE. 1817438 HOSPITAL DEVELOPMENT, PUBLIC EDUCATION, AND DONOR FAMILY SERVICESIDN IS COMMITTED TO MEETING ALL HOSPITALS' EDUCATIONAL NEEDS REGARDING DONATION. THIS INCLUDES: TRAINING IN THE IDENTIFICATION, REFERRAL AND MANAGEMENT OF ORGAN DONORS, SENSITIVITY AND TIMING FOR APPROACHING POTENTIAL DONOR FAMILIES WITH THE OPTION OF DONATION, RESPONSIBILITY IN THE OPERATING ROOM FOR RECOVERIES. THE REFERRAL, FAMILY APPROACH AND RECOVERY PROCESS FOR TISSUE DONATION IS ALSO HANDLED BY IDN.EVERY HOSPITAL IN IOWA HAS AN IDN DEVELOPMENT SPECIALIST (DS) ASSIGNED TO HELP MEET THESE NEEDS. IN 2011 DS STAFF CONDUCTED OVER 65 FORMAL CONTINUING EDUCATION PROGRAMS FOR NURSING STAFF AS WELL AS GREATER THAN 150 INFORMAL EDUCATION SESSIONS WITHIN THE HOSPITALS. DS STAFF WORK WITH HOSPITALS TO DEVELOP POLICIES AND PROCEDURES RELATED TO REFERRAL FOR ORGAN AND TISSUE DONATION. OTHER DUTIES INCLUDE: MEETING WITH HOSPITAL ADMINISTRATION AND PERSONNEL TO ENGAGE SUPPORT FOR ORGAN AND TISSUE DONATION, FOLLOW-UP AFTER EACH ORGAN REFERRAL AND FOLLOW-UP WITH STAFF AFTER EACH ORGAN AND/OR TISSUE RECOVERY.THE DS STAFF ALSO PROVIDE EDUCATIONAL PROGRAMS AND OTHER DONATION-RELATED SERVICES TO MANY OTHER HEALTH CARE AGENCIES IN IOWA INCLUDING THE STATE AND COUNTY MEDICAL EXAMINER OFFICES, EMS SERVICES, AND OTHERS INCLUDED IN THE DONATION REFERRAL AND RECOVERY PROCESS.IDN'S FAMILY SUPPORT SERVICES (FSS) DEPARTMENT PROVIDES SERVICES AND SUPPORT TO ORGAN AND TISSUE DONOR FAMILIES AFTER EACH DONATION HAS OCCURRED. IDN'S PUBLIC EDUCATION IS FOCUSED ON INCREASING DONATION AWARENESS AND ACCEPTANCE OF DONATION THROUGHOUT THE STATE. THIS FUNCTION IS ORGANIZED AND CONDUCTED BY IDN'S PUBLIC AFFAIRS STAFF, WITH THE HELP OF VOLUNTEERS. PUBLIC EDUCATION INCLUDES: PRESENTATIONS TO CIVIC GROUPS, PRESENTATIONS TO WORK PLACES, DRIVER'S EDUCATION AND SPECIAL EVENTS. THE PUBLIC EDUCATION STAFF ALSO HELPED IDN REACH A RECENT MILESTONE OF OVER 1.5 MILLION RESIDENTS SIGNED WITH THE IOWA DONOR REGISTRY. THE REGISTRY CAPTURES THE AUTHORIZATION OF ANYONE IN THE STATE WISHING TO BE A DONOR. IDN PROVIDES RESOURCES TO VOLUNTEER ORGANIZATIONS AND SUPPORT GROUPS THROUGHOUT IOWA: THESE GROUPS ARE COMPOSED OF PEOPLE WAITING FOR TRANSPLANT, DONOR FAMILY MEMBERS, RECIPIENTS AND OTHER CONCERNED INDIVIDUALS. IDN IS ASSOCIATED WITH SEVERAL PROFESSIONAL ORGANIZATIONS AT THE NATIONAL LEVEL, INCLUDING THE NORTH AMERICAN TRANSPLANT COORDINATIORS ORGANIZATION, THE ASSOCIATION OF ORGAN PROCUREMENT ORGANIZATIONS, THE AMERICAN SOCIETY FOR MULTICULTURAL HEALTH AND TRANSPLANT PROFESSIONALS, THE AMERICAN ASSOCIATION OF TISSUE BANKS AND THE UNITED NETWORK FOR ORGAN SHARING. IN COOPERATION WITH THE GUIDELINES SET FORTH BY THESE PROFESSIONAL ASSOCIATIONS AND GOVERNING BODIES, ALONG WITH THE TRANSPLANT CENTERS ACROSS THE COUNTRY, DONATED ORGANS ARE ALLOCATED EQUITABLY TO TRANSPLANT PATIENTS ACCORDING TO NATIONAL DISTRIBUTION REGULATIONS.IN 2011, THERE WERE OVER 500 HOURS OF PUBLIC EDUCATION GIVEN TO THE RESIDENTS OF IOWA. 13489526 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 44 0 138 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 17 17 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X X ANGELA CALHOUN 3196653787 550 MADISON AVENUE NORTH LIBERTY IA 52317 ROD BRAUN 2.00 X 0 0 0 SARA DROBNICH 2.00 X 0 0 0 JOSEPH KRISTAN CPA 2.00 X X 0 0 0 HENRY RAYHONS 2.00 X 0 0 0 ALAN REED MD 2.00 X 0 0 0 TIM RETZ 2.00 X 0 0 0 WAYNE RICHENBACHER MD 2.00 X 0 0 0 JEAN SHELTON 2.00 X 0 0 0 CHRISTIE THOMAS MD 2.00 X 0 0 0 BOB RICHARD 2.00 X X 0 0 0 JOHN WATSON 2.00 X X 0 0 0 DAVE JAMISON 2.00 X X 0 0 0 MARK MATHIS 2.00 X 0 0 0 SHARON BLANCHE RN 2.00 X 0 0 0 LYNNE LANNING 2.00 X 0 0 0 RICK WILKERSON MD 2.00 X 0 0 0 MAUREEN KEEHNLE 2.00 X 0 0 0 EWA BARDACH 40.00 X 115438 0 23451 SARAH FEWELL 40.00 X 147978 0 20362 SUZANNE CONRAD 40.00 X 196078 0 33915 459494 0 77728 3 0 1 0 UIHC BUSINESS OFFICE 2100 UNIVERSITY CAPITAL CENTRE IOWA CITY IA 522425500 HOSPITAL RECOVERY SERVICES 932418 MIDWEST TRANSPLANT NETWORK PO BOX 843313 KANSAS CITY MO 641843313 ORGAN PROCUREMENT 872076 CARVER AERO INC 5701 GRANDVIEW AVENUE MUSCATINE IA 52761 CHARTER AIR SERVICE 413538 LABS INC PO BOX 712997 CINCINNATI OH 425712997 ORGAN PROCUREMENT 409977 DONOR ALLIANCE 720 S COLORADO BLVD DENVER CO 80246 ORGAN PROCUREMENT 322200 15 7698 477525 438 485223 ORGAN & TISSUE PROCURE 900099 15019775 15019775 15019775 13880 13880 5000 2948 2052 2052 2052 6357 7698 12285 -5928 -5928 MISCELLANEOUS REVENUE 900099 1882 1882 1882 15516884 15019775 0 11886 550040 162473 387567 5257616 4568509 660573 28534 771035 667437 101871 1727 626347 513418 109552 3377 701 701 14200 14200 21000 21000 420464 242440 161141 16883 132540 132540 259318 198121 44500 16697 57134 43557 11303 2274 234613 208331 25138 1144 261952 182166 79264 522 27016 17709 9307 45025 31518 12607 900 169375 148492 19639 1244 154046 144541 9005 500 DIRECT RECOVERY COSTS 5531627 5531627 INDIRECT PROCUREMENT CO 531570 531570 SPECIAL PROJECTS 64839 63356 1483 DUES AND SUBSCRIPTIONS 43272 24349 18923 90914 77372 12993 549 15264644 13489526 1700767 74351 46697 43907 2855785 2804872 172148 18111 3377211 3535692 66455 55153 3109669 786136 2338912 2323533 3339831 3950148 12197039 12731416 2042028 1773874 1045062 985036 3087090 2758910 X 9104449 9970006 5500 2500 9109949 9972506 12197039 12731416 X 252240 610317 X 0 1 1 X 0 X 182749 220460 141967 170646 485223 1201045 8981560 11085498 13467105 15232685 15019775 63786623 9164309 11305958 13609072 15403331 15504998 64987668 11647 11093 7575 6334 3617 40266 0 11647 11093 7575 6334 3617 40266 64947402 73424 19256 5059 15335 13880 126954 73424 19256 5059 15335 13880 126954 58205 5689 9239 39056 1882 114071 9295938 11330903 13623370 15457722 15520760 65228693 0.99570 0.99220 0.00190 0.00330 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 21000 21000 0 Explanation of Other Lobbying Activities: Part II-B, Line 1i: IDN RETAINS A LOBBYING FIRM TO DEAL WITH LEGISLATIVE ISSUES RELATED TO ORGAN AND TISSUE DONATION. 300148 300148 1926100 296015 1630085 87170 45792 41378 796251 444329 351922 2323533 INTEREST IN NET ASSETS OF ALLOSOURCE 3950148 3950148 15516884 15264644 252240 610317 610317 862557 16142048 625164 625164 15516884 0 15516884 15276491 11847 11847 15264644 0 15264644 Description of Uncertain Tax Positions Under FIN 48: Part X: INCOME TAX RETURNS ARE SUBJECT TO UNCERTAIN TAX POSITIONS THAT MIGHT NOT BE SUSTAINED UPON EXAMINATION BY TAXING AUTHORITIES. MANAGEMENT ANNUALLY MAKES AN APPROPRIATE EVALUATION OF ANY UNCERTAIN TAX POSITIONS THAT MAY EXIST WITHIN THE ORGANIZATION'S TAX RETURN. AS OF DECEMBER 31, 2011, MANAGEMENT BELIEVES TAHT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT ARE REQUIRED TO BE RECORDED OR DISCLOSED. WITH FEW EXCEPTIONS, THE ORGANIZATION IS NO LONGER SUBJECT TO TAX EXAMINATIONS FOR YEARS BEFORE 2008. Part XI, Line 8 - Other Adjustments: REPRESENTS THE CHANGE IN THE ORGANIZATION'S INTEREST IN THE 610,317. NET ASSETS OF ALLOSOURCE. Part XII, Line 2d - Other Adjustments: CHANGE OF INTEREST IN ALLOSOURCE NET ASSETS 610,317. DECREASE IN TEMPORARILY RESTRICTED NET ASSETS 3,000. DIRECT EXPENSES FROM SCH G LESS IN-KIND AUCTION ITEMS 11,847. Part XIII, Line 2d - Other Adjustments: DIRECT EXPENSES FROM SCHE G LESS IN-KIND AUCTION ITEMS 11,847. X X X X 0 0 0 0 0 0 0 1 0 SARAH FEWELL 147978 0 0 0 0 0 15186 0 5176 0 168340 0 0 0 SUZANNE CONRAD 171631 0 24447 0 0 0 18012 0 15903 0 229993 0 0 0 Part I, Line 7 THE BONUS WAS DETERMINED AT THE SOLE DISCRETION OF THE BOARD OF DIRECTORS AND BASED ON THE EVALUATION OF THE CEO'S PERFORMANCE. CITY OF NORTH LIBERTY IOWA 420926682 2003-05-15 1237500 CAPITAL IMPROVEMENT REVENUE BOND 0 1 0 1237500 1237500 2003 0 0 1 1 0 0 0 0 1 0 0 0 0 0 0 Form 990, Part VI, Section B, line 11 THE IDN CHIEF EXECUTIVE OFFICER PROVIDES THE DRAFT FORM 990 TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS FOR DISCUSSION DURING ITS NEXT MEETING OR CONFERENCE CALL. MEMBERS OF THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS REVIEW ALL INFORMATION PROVIDED IN THE FORM 990 AND MAKE ANY RECOMMENDATIONS FOR CHANGES TO THE CHIEF EXECUTIVE OFFICER. IDN BOARD OF DIRECTORS REVIEW AND VOTE TO APPROVE THE DRAFT FORM 990 PRIOR TO FILING. Form 990, Part VI, Section B, line 12c EACH DIRECTOR, OFFICER, KEY EMPLOYEE, BOARD COMMITTEE MEMBER, AND MEDICAL ADVISORY COMMITTEE MEMBER ANNUALLY SIGNS A STATEMENT, WHICH AFFIRMS SUCH PERSON: (A) HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY. (B) HAS READ AND UNDERSTANDS THE POLICY (C) HAS AGREED TO COMPLY WITH THE POLICY, AND (D) UNDERSTANDS THAT IDN IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. DECLARATION OF CONFLICT ADDED TO ALL BOARD/COMMITTEE AGENDAS. Form 990, Part VI, Section B, line 15 THE MARKET IS SURVEYED EVERY TWO YEARS TO EVALUATE EXISTING WAGE AND SALARY RANGES TO MAINTAIN THE OVERALL INTEGRITY AND COMPETITIVENESS OF OUR MARKET BASED SYSTEM. GENERALLY, THE SERVICES OF A COMPENSATION SPECIALIST ARE USED TO CONDUCT THE SALARY SURVEY AND RECOMMEND ADJUSTMENTS. SALARY INCREASES ARE NOT GRANTED AUTOMATICALLY, BUT ONLY AS A RESULT OF DEMONSTRATED PERFORMANCE, DOCUMENTED BY A JOB-RELATED PERFORMANCE APPRAISAL. THE BOARD ANNUALLY APPROVES THE PERFORMANCE REVEIW OF THE CHIEF EXECUTIVE OFFICER AND ESTABLISHES COMPENSATION BASED ON RECOMMENDATIONS OF THE EXECUTIVE COMMITTEE AND BOARD CHAIR. FOR OFFICERS OR KEY EMPLOYEES, THE BOARD APPROVES APPROPRIATE COMPENSATION AND BENEFIT POLICIES AND PRACTICES. DOCUMENTATION REGARDING THE COMPENSATION ARRANGEMENT IS MAINTAINED BY THE HUMAN RESOURCES MANAGER. PERIODIC REVIEWS ARE CONDUCTED AND AT A MINIMUM INCLUDE THE FOLLOWING SUBJECTS:(A) WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, AND THE RESULT OF ARMS LENGTH BARGAINING,(B) WHETHER COMPENSATON ARRANGEMENTS AND ALL PAYMENTS FOR SERVICES CONFORM TO IDN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE INVESTMENT OR PAYMENTS FOR GOODS AND SERVICES, FURTHER IDN CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT, IMPERMISSIBLE PRIVATE BENEFIT OR IN AN EXCESS BENEFIT TRANSACTION. Form 990, Part VI, Section C, line 19 DOCUMENTS AVAILABLE UPON REQUEST Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: REPRESENTS THE CHANGE IN THE ORGANIZATION'S INTEREST IN THE 610,317. NET ASSETS OF ALLOSOURCE. Total to Form 990, Part XI, Line 5: 610,317.