2011-05-10T07:52:02-05:00 2010-12-31 BERGAN PAULSEN & COMPANY PC PO BOX 2100 WATERLOO IA 507042100 990 2010-01-01 421414092 IOWA DONOR NETWORK IOWA 3196653787 550 MADISON AVENUE NORTH LIBERTY IA 52317 SUZANNE CONRAD 3196653787 2011-05-05 DAVID RICHTER 3192346885 2010 2016-03-07 17:11:31Z SUZANNE CONRAD 550 MADISON AVENUE NORTH LIBERTY IA 52317 15472932 0 X WWW.IOWADONORNETWORK.ORG X 1993 IA TRANSFORMING LIVES THROUGH ORGAN AND TISSUE DONATION. 16 16 143 100 0 0 141967 170646 13467105 15232685 6564 18892 -29006 31878 13586630 15454101 0 0 0 0 5742238 6593411 0 0 116938 6775926 7181979 12518164 13775390 1068466 1678711 9019132 12197039 2628782 3087090 6390350 9109949 X TRANSFORMING LIVES THROUGH ORGAN AND TISSUE DONATION. 0 0 10510777 15232685 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 FOR THE STATE OF IOWA. THE CENTERS FOR MEDICARE AND MEDICAID SERVICES HAS CERTIFIED IDN TO FUNCTION AS THE SINGLE ORGAN PROCUREMENT AGENCY SERVING THE STATE OF IOWA. IDN ALSO PROVIDES TISSUE RECOVERY SERVICES. IN 2010, ORGAN RECOVERY SERVICES GENERATED $9,164,147 IN REVENUES WHILE TISSUE RECOVERY SERVICES CONTRIBUTED $5,880,227 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 INDENTIFICATION, 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 TO FACILITATE EYE DONATION AND RECOVERY.IDN WAS THE 7TH DONATION SERVICE AREA IN THE UNITED STATES TO UTILIZE AN ORGAN AND TISSUE DONOR REGISTRY AND FIRST PERSON CONSENT LEGISLATION. THE REGISTRY, COMBINED WITH THE LEGISLATION, ALLOWS IOWANS TO LEGALLY CONSENT TO ORGAN AND TISSUE DONATION PRIOR TO DEATH. THIS PROCESS ALLEVIATES THE STRESS OF SURVIVING FAMILY MEMBERS TRYING TO MAKE A DONATION DECISION AT A VERY DIFFICULT TIME, DURING THE LOSS OF A LOVED ONE.IDN HAS BEEN RECOGNIZED TIME AND TIME AGAIN AS A TOP PERFORMER IN THE FIELD OF ORGAN RECOVERY. THE ASSOCIATION OF ORGAN PROCUREMENT ORGANIZATIONS AND THE AMERICAN ASSOCIATION OF TISSUE BANKS ACCREDIT IDN.DURING ANY PARTICULAR YEAR, IDN RECEIVES MORE THAN 10,000 CALLS FROM IOWA HOSPITALS REFERRING POTENTIAL ORGAN AND TISSUE DONORS. IN 2010, IOWA DONOR NETWORK PROVIDED LIFE-SAVING ORGANS TO WAITING RECIPIENTS FROM 66 DONORS. IN ADDITION, LIFE-SAVING AND LIFE-ENHANCING TISSUE WAS PROCURED FROM 557 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. 1593944 HOSPITAL DEVELOPMENT, PUBLIC EDUCATION, AND DONOR FAMILY SERVICESIDN IS COMMITTED TO MEETING ALL HOSPITAL'S EDUCATIONAL NEEDS REGARDING DONATION. THIS INCLUDES: TRAINING IN THE IDENTIFICATION AND MANAGEMENT OF DONORS, SENSITIVITY AND TIMING FOR APPROACHING POTENTIAL DONOR FAMILIES WITH THE OPTION OF DONATION, RESPONSIBILITY IN THE OPERATING ROOM FOR RECOVERIES AND REQUESTING TISSUE DONATION.EVERY HOSPITAL IN IOWA HAS AN IDN HOSPITAL DEVELOPMENT SPECIALIST (HDS) ASSIGNED TO IT TO HELP MEET THESE NEEDS. THE HDS STAFF ALSO ASSISTS WITH EDUCATIONAL PROGRAMS AND OTHER DONATION-RELATED NEEDS AT ALL OF THE HEALTH CARE FACILITIES IN IOWA. IN 2010 HDS STAFF CONDUCTED OVER 53 FORMAL CONTINUING EDUCATION PROGRAMS FOR NURSING STAFF AS WELL AS NUMEROUS INFORMAL EDUCATION SESSIONS WITHIN THE HOSPITALS. HDS STAFF WORK WITH HOSPITALS TO DEVELOP POLICIES AND PROCEDURES IN ADDITION TO THE DOCUMENTATION NECESSARY FOR ORGAN AND TISSUE DONOR REFERRALS AND RECOVERIES. OTHER DUTIES INCLUDE: MEETING WITH HOSPITAL ADMINISTRATION AND PERSONNEL TO SUPPORT ORGAN AND TISSUE DONATION, FOLLOW-UP AFTER EACH ORGAN REFERRAL AND FOLLOW-UP WITH STAFF AFTER EACH ORGAN AND/OR TISSUE RECOVERY.THROUGH THE EFFORTS OF THE HDS AND PROCUREMENT COORDINATORS, IDN WAS RECOGNIZED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES FOR ACHIEVING TWO OF THREE NATIONAL GOALS RELATED TO ORGAN DONATION IN THE AWARD PERIOD. ADDITIONALLY, THREE OF FIVE IOWA HOSPITALS ELIGIBLE FOR AWARDS WERE RECOGNIZED FOR THEIR ACHIEVEMENTS RELATED TO THE NATIONAL ORGAN DONATION GOALS DURING THE REVIEW PERIOD. IDN MET ALL THREE NATIONAL GOALS DURING THE CALENDAR YEAR 2010. 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. IN 2010, IDN PRODUCED AND DISTRIBUTED AN EDUCATIONAL VIDEO TO ALL DRIVERS EDUCATION INSTRUCTORS IN IOWA. THE VIDEO WAS FILMED SPECIFICALLY TO TARGET IOWANS 14 TO 17 YEARS OF AGE AS THESE YOUNG PEOPLE FACE THE DONATION DECISION AT THE TIME OF OBTAINING A PERMIT OR DRIVERS LICENSE FOR THE FIRST TIME. THE VIDEO ALSO ENSURES THAT DRIVERS EDUCATION INSTRUCTORS COMPLY WITH IOWA LAW IN OFFERING ONE SESSION ON ORGAN DONATION EDUCATION.THE PUBLIC EDUCATION STAFF ALSO HELPED IDN REACH A RECENT MILESTONE OF OVER 1.2 MILLION RESIDENTS SIGNED UP TO THE IOWA DONOR REGISTRY. THE REGISTRY CAPTURES THE CONSENT OF ANYONE IN THE STATE WISHING TO BECOME 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 2010, THERE WERE OVER 500 HOURS OF PUBLIC EDUCATION GIVEN TO THE RESIDENTS OF IOWA. 12104721 1 1 0 1 0 0 0 0 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 1 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 59 0 143 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CO FL GA IL KY MI MN NJ NY PA VA WA MO X X X EWA BARDACH 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 2.00 X 0 0 0 LYNNE LANNING 2.00 X 0 0 0 RICK WILKERSON 2.00 X 0 0 0 EWA BARDACH 40.00 X 113709 0 24871 SARAH FEWELL 40.00 X 159961 0 21479 SUZANNE CONRAD 40.00 X 207623 0 36814 481293 0 83164 3 0 1 0 UIHC BUSINESS OFFICE 2100 UNIVERSITY CAPITAL CENTRE IOWA CITY IA 522425500 HOSPITAL RECOVERY SERVICES 777023 CARVER AERO INC 5701 GRANDVIEW AVENUE MUSCATINE IA 52761 CHARTER AIR SERVICE 482131 MIDAMERICA TRANSPLANT 1110 HIGHLANDS PLAZA DRIVE E 100 SAINT LOUIS MO 631101350 HOSPITAL RECOVERY SERVICES 428500 MIDWEST TRANSPLANT NETWORK PO BOX 843313 KANSAS CITY MO 641843313 ORGAN PROCUREMENT 368600 LABS INC PO BOX 712997 CINCINNATI OH 425712997 SEROLOGY TESTING 332121 13 11370 159276 35 170646 ORGAN & TISSUE PROCURE 900099 15232685 15232685 15232685 15335 15335 8575 5018 3557 3557 3557 6635 11370 13813 -7178 -7178 MISCELLANEOUS REVENUE 900099 39056 39056 39056 15454101 15232685 0 50770 608519 190617 417902 4737472 4104892 579761 52819 620928 543339 67736 9853 626492 507101 112609 6782 228 228 13500 13500 21000 21000 426562 301414 109250 15898 89882 89882 259108 208944 28934 21230 73511 62858 10261 392 220815 205109 14679 1027 238988 167880 69580 1528 75084 23978 47738 3368 47604 36179 10473 952 140707 128392 11357 958 147292 141462 5028 802 DIRECT RECOVERY COSTS 4692070 4692070 INDIRECT PROCUREMENT CO 490401 490401 SPECIAL PROJECTS 104250 104250 DUES AND SUBSCRIPTIONS 54449 33067 20897 485 REPAIRS AND MAINTENANCE 28464 24118 4003 343 58064 48768 8795 501 13775390 12104721 1553731 116938 7841 46697 1367767 2855785 22511 172148 3036522 3377211 52022 66455 2964051 625139 1922408 2338912 2610061 3339831 9019132 12197039 1526264 2042028 1102518 1045062 2628782 3087090 X 6370350 9104449 20000 5500 6390350 9109949 9019132 12197039 X 1678711 1040888 X 0 1 1 X 0 X 139940 182749 220460 141967 170646 855762 7883126 8981560 11085498 13467105 15232685 56649974 8023066 9164309 11305958 13609072 15403331 57505736 400 11647 11093 7575 6334 37049 0 400 11647 11093 7575 6334 37049 57468687 79170 73424 19256 5059 15335 192244 79170 73424 19256 5059 15335 192244 111046 58205 5689 9239 39056 223235 8213282 9295938 11330903 13623370 15457722 57921215 0.99220 0.99510 0.00330 0.00420 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 1859127 250020 1609107 87170 33339 53831 717606 341780 375826 2338912 INTEREST IN NET ASSETS OF ALLOSOURCE 3339831 3339831 15454101 13775390 1678711 1040888 1040888 2719599 16523267 1069166 1069166 15454101 0 15454101 13789168 13778 13778 13775390 0 13775390 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, 2010, 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 THE YEARS BEFORE 2007. Part XI, Line 8 - Other Adjustments: REPRESENTS THE CHANGE IN THE ORGANIZATION'S INTEREST IN THE NET ASSETS OF ALLOSOURCE. 1,040,888. Part XII, Line 2d - Other Adjustments: CHANGE OF INTEREST IN ALLOSOURCE NET ASSETS 1,040,888. DECREASE IN TEMPORARILY RESTRICTED NET ASSETS 14,500. DIRECT EXPENSES FROM SCH G LESS IN-KIND AUCTION ITEMS 13,778. Part XIII, Line 2d - Other Adjustments: DIRECT EXPENSES FROM SCHE G LESS IN-KIND AUCTION ITEMS 13,778. RETZ GOLF 18005 11370 6635 300 642 4860 2242 5769 18005 11370 6635 300 642 4860 2242 5769 13813 -7178 X X X X 0 0 0 0 0 0 0 1 0 SARAH FEWELL 149961 0 10000 0 0 0 16393 0 5086 0 181440 0 0 0 SUZANNE CONRAD 176998 0 30625 0 0 0 21375 0 15439 0 244437 0 0 0 Part I, Line 7 THE BONUSES WERE DETERMINED AT THE SOLE DISCRETION OF THE BOARD OF DIRECTORS AND/OR THE CEO AND ARE BASED ON THE EVALUATION OF THEIR 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 0 1 0 0 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 ARRANGEMENTS ARE MAINTAINED BY THE HUMARN 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 NET ASSETS OF ALLOSOURCE. 1,040,888. Total to Form 990, Part XI, Line 5: 1,040,888.