2020-11-12T12:32:31-06:00 2019-12-31 Grant Thornton LLP 100 E Wisconsin Ave Milwaukee WI 53202 990 2019-01-01 390807235 Versiti Wisconsin Inc % PAUL MATSON VERS 4149335000 PO Box 2178 638 North 18th St Milwaukee WI 532012178 CHRIS MISKEL President & CEO 4149335000 2020-11-12 true Michelle L Weber P00556798 4142898200 65.26.236.111 39529020203175000003 2020-11-12 P 9B78095357A78499D8286BCD82111F39E51840A5 6098D55FF0E7CCF9C3E403A7CE8C578524A243B8 2019 2021-01-29 14:40:06Z Chris Miskel 638 N 18th Street Milwaukee WI 532332121 225726576 false X WWW.VERSITI.ORG X 1947 WI RECRUITS BLOOD, STEM CELLS, ORGAN, TISSUE PROVIDES BLOOD, DIAGNOSTIC LAB TESTING, CLINICAL SERVICES & SPECIALTY PHARMACEUTICALS. CONDUCTS RESEARCH. STRIVES TO PROTECT PUBLIC SAFETY. 16 15 1180 352 44148 4713 24177316 24337374 136505835 145399666 2209035 2685170 53099 100954 162945285 172523164 4011063 4539001 0 0 78201716 76918040 0 0 0 84209859 94333476 166422638 175790517 -3477353 -3267353 128457896 123459642 28136746 24016344 100321150 99443298 X RECRUITS BLOOD, STEM CELLS, ORGAN AND TISSUE DONATIONS. PROVIDES BLOOD, DIAGNOSTIC LAB TESTING, CLINICAL SERVICES & SPECIALTY PHARMACEUTICALS. CONDUCTS RESEARCH. STRIVES TO PROTECT PUBLIC SAFETY. false false 41031661 28500 48646480 VERSITI WISCONSIN, INC. (VERSITI WISCONSIN) FULFILLS ITS TAX-EXEMPT PURPOSE BY RECRUITING VOLUNTEER BLOOD DONORS, COLLECTING, PROCESSING AND DISTRIBUTING BLOOD AND BLOOD COMPONENTS TO PROVIDE A SAFE AND STABLE SOURCE FOR CUSTOMERS AT THE 57 HOSPITALS AND OTHER BLOOD CENTERS WE SUPPLY. IN THE YEAR ENDED 2019, THE ORGANIZATION RECRUITED 144,317 DONORS. 28634832 4375000 IN THE INTERCONNECTED WORLD OF SCIENCE AND MEDICINE, RESEARCH IS CRITICAL. VERSITI WISCONSIN'S RESEARCH, PART OF OUR VISION SINCE INCEPTION IN 1947, SPANS BASIC, TRANSLATIONAL AND CLINICAL RESEARCH THAT FOCUSES ON BLOOD AND BLOOD DISORDERS. OUR RESEARCH DISCOVERIES MAKE TANGIBLE CONTRIBUTIONS TO THE CARE OF PATIENTS. 26057968 35372512 VERSITI WISCONSIN FULFILLS ITS TAX-EXEMPT PURPOSE OF PROVIDING DIAGNOSTIC LABORATORY TESTING IN THE AREAS OF HISTOCOMPATIBILITY, TRANSPLANT SEQUENCING, MOLECULAR DIAGNOSTICS, CORE ISOLATION, PLATELET & NEUTROPHIL IMMUNOLOGY, HEMOSTASIS REFERENCE, IMMUNOHEMATOLOGY REFERENCE, TRANSFUSION SERVICES, MOLECULAR ONCOLOGY, RED CELL GENOTYPING AND GENOMICS. 29104230 101750 32963438 COMPREHENSIVE CENTER FOR BLEEDING DISORDERS 14975704 23251 18829671 ORGAN AND TISSUE DONATIONS 9345809 10500 9193414 MEDICAL SERVICES 12769 395187 DONOR TESTING LABORATORY 53438512 135501 61381710 149162973 true true false true false false false false false true true true false false true true false true false false false false false false false false false true false true false false false false false false false false false false false false true true true true false false true 0 0 true 1180 true true true false false false false false false false false false false false X 16 15 false false false false true true true true true false false true true true true true true true true false WI X X PAUL MATSON 4149376349 638 N 18TH ST Milwaukee WI 532332121 X CHRIS MISKEL PRESIDENT & CEO 23.0 32.0 X X 422096 495510 41657 THOMAS ABSHIRE MD EVP MSI & CHIEF MED OFFICER 55.0 0.0 X 577401 0 24817 BRIAN BAUTISTA EVP & CHIEF OPERATING OFFICER 25.0 30.0 X 253620 297726 41657 GILBERT C WHITE MD EVP OF RESEARCH-thru 6/19 37.0 18.0 X 340445 160210 37934 GITESH DUBAL EVP & CHIEF MARKETING OFFICER 25.0 30.0 X 218294 256254 41657 ANTHONY WATKINS EVP & CHIEF FINANCIAL OFFICER 24.0 31.0 X 218080 256011 40559 PETER NEWMAN PHD VP RESEARCH & ASSOC. DIR. BRI. 55.0 0.0 X 414932 0 30513 JAMES WEIDNER EVP & CHIEF HR OFFICER 24.0 31.0 X 178480 209520 41551 MAHRABOON IRANI MD MEDICAL DIR OF THERAPEUTIC SVS 55.0 0.0 X 359726 0 41657 MATTHEW ANDERSON MD VP & DIAGNOSTIC LAB MED. DIR. 55.0 0.0 X 354758 0 41657 KENNETH FRIEDMAN MD MEDICAL DIRECTOR 55.0 0.0 X 355851 0 37887 JOSHUA J FIELD MD MEDICAL DIRECTOR 55.0 0.0 X 348770 0 41657 LYNNE BRIGGS VP & CHIEF INFORMATION OFFICER 25.0 30.0 X 153436 180120 44457 BART REUTER EVP & GEN. COUNSEL-AS OF 1/19 24.0 31.0 X 145820 171183 40545 BRADLEY PIETZ EVP & Chief Innovation Officer 25.0 30.0 X 141191 165744 25901 MARGARET MCELLIGOT VP & CHIEF QUALITY OFFICER 25.0 30.0 X 131213 154026 36791 MAUREEN KWIECINSKI FORMER EVP & GEN. COUNSEL 0.0 0.0 X 135426 158976 729 COLLEEN MCCARTHY CHIEF OF STAFF & VP ORGAN DON. 25.0 30.0 X 116594 136875 38262 DALE KENT CHAIR 1.0 4.0 X X 0 0 0 L ALAN WHALEY VICE CHAIR 1.0 4.0 X X 0 0 0 MITCHELL G WATT SECRETARY 1.0 3.0 X X 0 0 0 JAMES M RAUH TREASURER 1.0 4.0 X X 0 0 0 CATHY BUCK BOARD MEMBER 1.0 3.0 X 0 0 0 FRED GEILFUSS BOARD MEMBER; LEGAL ADVISOR 1.0 3.0 X 0 0 0 DAVID GINSBURG MD BOARD MEMBER - AS OF 11/19 1.0 3.0 X 0 0 0 GAIL HANSON BOARD MEMBER - AS OF 11/19 1.0 3.0 X 0 0 0 THOMAS HAUSKE JR BOARD MEMBER 1.0 3.0 X 0 0 0 GREGORY LARKIN MD BOARD MEMBER 1.0 4.0 X 0 0 0 ROBERT H MANEGOLD BOARD MEMBER 1.0 4.0 X 0 0 0 JEFFREY S MCDONALD BOARD MEMBER 1.0 3.0 X 0 0 0 RON MILLER BOARD MEMBER - AS OF 1/19 1.0 3.0 X 0 0 0 JOHN PERRAS BOARD MEMBER 1.0 3.0 X 0 0 0 PETER ZIEGLER BOARD MEMBER 1.0 4.0 X 0 0 0 4866133 2642155 649888 124 true true false Medspeed LLC 655 W Grand Avenue Ste 320 ELMHURST IL 60126 Healthcare Transport 2236651 Omnisource Marketing Group 8925 N Meridian St Ste 150 INDIANAPOLIS IN 46260 Marketing 708334 Cerner Corporation PO Box 959156 ST LOUIS MO 63196 Software Support 684691 Medical College of Wisconsin 8701 Watertown Plank Road MILWAUKEE WI 53226 MEDICAL SERVICES 671657 Level 3 Communications PO BOX 910182 DENVER CO 80291 Marketing 579279 52 8874493 13676077 1786804 24337374 BLOOD SERVICES 621500 48645444 48645444 0 0 DIAGNOSTIC LABORATORIES 621500 35372512 35334155 38357 0 PHARMACY 621500 32963438 32963438 0 0 ORGAN AND TISSUE DONATION 621500 18829671 18829671 0 0 MEDICAL SERVICES 621500 9193414 9193414 395187 395187 0 145399666 910718 5791 904927 0 0 30000 34464 -4464 0 -4464 -4464 54943400 53127581 41367 1815819 -41367 1774452 1774452 0 0 0 0 0 0 0 0 0 PATRONAGE DIVIDENDS 900099 55250 0 0 55250 ACQUIRED CASH RECEIPTS 900099 22974 0 0 22974 ENTERPRISE FLEET SERVICES 900099 8470 0 0 8470 18724 1036 0 17688 105418 172523164 145362345 44148 2779297 4539001 4539001 0 0 0 3128082 602218 2525864 0 57508769 50397259 7111510 2845166 2474305 370861 9472999 8042522 1430477 3963024 3328940 634084 0 352108 206098 146010 40227 27392 12835 0 0 0 21177101 22410499 -1233398 0 541308 438406 102902 385036 364420 20616 2883970 1490760 1393210 11701 11701 3831406 1752571 2078835 2179827 1774181 405646 0 312382 307168 5214 0 0 4732892 2858581 1874311 249778 60626 189152 COST OF IMPORTED PRODUCTS 34866179 34866179 0 0 VERSITI SERVICES ALLOCATION 10474277 1588845 8885432 0 MEDICAL LAB SUPPLIES 8988026 8988026 0 0 EQUIPMENT LEASE/MAINTENANCE 1623167 1085800 537367 0 1684091 1547475 136616 175790517 149162973 26627544 0 0 32688 10996001 0 0 1947189 25647851 35425665 0 0 0 0 0 200000 7779785 7577166 1444706 813645 110065571 75144713 37002275 34920858 45568615 28397340 0 13323614 0 0 0 0 18663 821477 128457896 123459642 28084489 18055464 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52257 5960880 28136746 24016344 X 100321150 99443298 0 0 100321150 99443298 128457896 123459642 X -3267353 2305063 84438 X false true X true true true X 20381758 22122317 22711570 24177316 24337374 113730335 0 0 20381758 22122317 22711570 24177316 24337374 113730335 35759853 77970482 677004 1163577 1815274 1592014 904927 6152796 0 0 0 0 4713 4713 0 0 995 2136 104382 107513 119995357 695125110 0.64978 0.65500 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 1196 1196 false Other Activities Part II-B, Line II $1,196 OF THE DUES PAID TO THE ASSOCIATION OF ORGAN PROCUREMENT ORGANIZATIONS HAS BEEN ALLOCATED TO LOBBYING. 77632272 2512261 14163049 4314900 89992682 86045725 301738 -4472887 4242304 77632272 76439806 2294914 11411375 4100370 86045725 72401518 793676 7045041 3800429 76439806 81135521 471114 -5788954 3416163 72401518 0.97760 0.02240 false true true 2722179 2722179 64955568 40934895 24020673 846040 662190 183850 40405000 32781000 7624000 1136784 766628 370156 34920858 INVESTMENT IN CENETRON 13323614 F 13323614 0 LONG TERM RETIREMENT LIABILITIES 5844853 ADDITIONAL INCENTIVES 116027 5960880 X 174529299 2305063 2305063 172224236 298928 298928 172523164 175407151 -383366 -383366 175790517 175790517 Part V ENDOWMENTS THE FILING ORGANIZATION IS A BENEFICIARY OF THE VERSITI BLOOD RESEARCH INSTITUTE FOUNDATIONS ("VBRIF") ENDOWMENT AS A SUPPORTED ORGANIZATION. THE BOARD DESIGNATED ENDOWMENT FUNDS ARE DESIGNATED BY THE BOARD AS ENDOWMENT FUNDS TO ENSURE THE CONTINUING AVAILABILITY OF FUNDS FOR RESEARCH PURPOSES. PART X INCOME TAXES VERSITI, WISCONSIN, ILLINOIS, MICHIGAN, INDIANA AND THE FOUNDATION HAVE ALL RECEIVED TAX DETERMINATION LETTERS CONFIRMING THAT THE ORGANIZATIONS QUALIFY AS TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). THE ORGANIZATION FOLLOWS GUIDANCE THAT CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN, INCLUDING ISSUES RELATING TO FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT. THIS GUIDANCE PROVIDES THAT THE TAX EFFECTS FROM AN UNCERTAIN TAX POSITION CAN ONLY BE RECOGNIZED IN THE FINANCIAL STATEMENTS IF THE POSITION IS MORE LIKELY THAN NOT TO BE SUSTAINED IF THE POSITION WERE TO BE CHALLENGED BY A TAXING AUTHORITY. THE ASSESSMENT OF THE TAX POSITION IS BASED SOLELY ON THE TECHNICAL MERITS OF THE POSITION, WITHOUT REGARD TO THE LIKELIHOOD THAT THE TAX POSITION MAY BE CHALLENGED. VERSITI, WISCONSIN, ILLINOIS, MICHIGAN, INDIANA AND THE FOUNDATION ARE EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3), THOUGH THEY ARE SUBJECT TO TAX ON INCOME UNRELATED TO THEIR EXEMPT PURPOSES, UNLESS THAT INCOME IS OTHERWISE EXCLUDED BY THE IRC. THE ORGANIZATION HAS PROCESSES PRESENTLY IN PLACE TO ENSURE THE MAINTENANCE OF ITS TAX-EXEMPT STATUS; TO IDENTIFY AND REPORT UNRELATED INCOME; TO DETERMINE ITS FILING AND TAX OBLIGATIONS IN JURISDICTIONS FOR WHICH IT HAS NEXUS; AND TO IDENTIFY AND EVALUATE OTHER MATTERS THAT MAY BE CONSIDERED TAX POSITIONS. WISCONSIN AND THE FOUNDATION HAVE FILED FEDERAL AND STATE OF WISCONSIN INCOME TAX RETURNS TO REPORT UNRELATED BUSINESS INCOME THROUGH 2009 AND ARE NO LONGER SUBJECT TO TAX AUTHORITY EXAMINATIONS FOR YEARS PRIOR TO 2010 UNDER THE FEDERAL AND STATE STATUTE. MANAGEMENT HAS DETERMINED THAT THERE IS NO UNRELATED BUSINESS INCOME TO REPORT FOR WISCONSIN FOR 2010 THROUGH 2017, AND INCOME TAX RETURNS ARE NOT REQUIRED TO BE FILED; HOWEVER INCOME TAX RETURNS WERE FILED FOR 2018. THEREFORE, AS THE STATUTE OF LIMITATIONS WILL REMAIN OPEN FOR RETURNS NOT FILED, TAX YEARS 2010 THROUGH 2017, WILL REMAIN OPEN TO AUDIT FOR BOTH FEDERAL AND STATE PURPOSES. MANAGEMENT HAS DETERMINED THAT THE FOUNDATION WILL BE FILING INCOME TAX RETURNS FOR TAX YEARS 2016 AND 2017. THEREFORE, AS THE STATUTE OF LIMITATIONS WILL REMAIN OPEN FOR RETURNS NOT FILED, TAX YEARS 2010 THROUGH 2015, WILL REMAIN OPEN TO AUDIT FOR BOTH FEDERAL AND STATE PURPOSES. MICHIGAN HAS NOT HISTORICALLY FILED ANY UNRELATED BUSINESS INCOME TAX RETURNS; THEREFORE, TAX YEARS REMAIN OPEN FOR YEARS IN WHICH AN INCOME TAX RETURN HAS NOT BEEN FILED; HOWEVER INCOME TAX RETURNS WERE FILED FOR 2018 BUT ARE NOT EXPECTED TO BE FILED FOR 2019. IN YEARS PRIOR TO 2014, ILLINOIS FILED BOTH FEDERAL AND STATE OF ILLINOIS INCOME TAX RETURNS TO REPORT A ZERO AMOUNT OF UNRELATED BUSINESS INCOME. MANAGEMENT HAS DETERMINED THAT THERE IS NO UNRELATED BUSINESS INCOME TO REPORT FOR ILLINOIS FOR TAX YEARS 2014 THROUGH 2017; HOWEVER INCOME TAX RETURNS WERE FILED FOR 2018 BUT ARE NOT EXPECTED TO BE FILED FOR 2019. THEREFORE, AS THE STATUTE OF LIMITATIONS WILL REMAIN OPEN FOR RETURNS NOT FILED, TAX YEARS 2014 THROUGH 2017, WILL REMAIN OPEN TO AUDIT FOR BOTH FEDERAL AND STATE PURPOSES. IN YEARS PRIOR TO 2014, INDIANA FILED FEDERAL UNRELATED BUSINESS INCOME TAX RETURNS TO REPORT A ZERO AMOUNT OF UNRELATED BUSINESS INCOME. IN 2014 THROUGH 2016, INDIANA FILED FEDERAL AND INDIANA RETURNS TO REPORT AN UNRELATED BUSINESS LOSS. IN 2017 AND 2018, INDIANA FILED INCOME TAX RETURNS TO REPORT A ZERO AMOUNT OF UNRELATED BUSINESS INCOME IN ORDER TO MAINTAIN THE PRIOR YEAR NET OPERATING LOSS. INDIANA IS EXPECTED TO FILE INCOME TAX RETURNS FOR 2019. THE STATUTE OF LIMITATIONS WILL REMAIN OPEN FOR BOTH FEDERAL AND STATE PURPOSES FOR ANY RETURNS NOT FILED. VERSITI HAS NOT FILED ANY UNRELATED BUSINESS INCOME TAX RETURNS; THEREFORE THE YEARS SINCE 2012, THE YEAR OF INCEPTION, ARE STILL OPEN TO EXAMINATION. THE ORGANIZATION HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. SALUS HAS BEEN ORGANIZED AS A LIMITED LIABILITY COMPANY AND, ACCORDINGLY, IS NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. ALL INCOME TAX ATTRIBUTES OF THE ENTITY ARE PASSED THROUGH TO ITS SOLE MEMBER, WISCONSIN. THE ENTITY IS INCLUDED IN THE CONSOLIDATED INFORMATION RETURN FILED BY VERSITI. CENETRON IS FORMED AS A LIMITED LIABILITY COMPANY AND HAS ELECTED TO BE TREATED AS A WHOLLY OWNED LLC THAT HAS ELECTED TO BE TREATED AS A C-CORPORATION FOR TAX PURPOSES AND SO IS SUBJECT TO FEDERAL AND STATE INCOME TAXES. INCOME TAXES ARE PROVIDED FOR THE TAX EFFECTS OF TRANSACTIONS REPORTED BY CENETRON AND CONSIST OF TAXES CURRENTLY DUE AND DEFERRED TAXES. DEFERRED TAXES ARE RECOGNIZED FOR DIFFERENCES BETWEEN THE BASIS OF ASSETS AND LIABILITIES FOR FINANCIAL STATEMENT AND INCOME TAX PURPOSES. THE DIFFERENCES RELATED PRIMARILY TO INVENTORY, PROPERTY AND EQUIPMENT, INTANGIBLE ASSETS AND ACCRUED LIABILITIES. THE DEFERRED TAX ASSETS AND LIABILITIES REPRESENT THE FUTURE TAX RETURN CONSEQUENCES OF THOSE DIFFERENCES, WHICH WILL EITHER BE TAXABLE OR DEDUCTIBLE WHEN THE ASSETS AND LIABILITIES ARE RECOVERED OR SETTLED. CENETRON IS SUBJECT TO TAXATION IN THE UNITED STATES AND VARIOUS CERTAIN, LIMITED STATE JURISDICTIONS. THE ORGANIZATION RECOGNIZES, IF NECESSARY, INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS IN THE PROVISION FOR INCOME TAXES. THERE WERE NO INTEREST OR PENALTIES RELATED TO INCOME TAXES THAT HAVE BEEN ACCRUED OR RECOGNIZED AS OF AND FOR THE YEARS ENDED DECEMBER 31, 2019 AND 2018. PART XI, LINE 4B OTHER ADJUSTMENTS RENTAL ACTIVITY EXPENSES $(34,464) LOSS ON ASSET SALE (41,367) CHANGE IN EQUITY IN CENETRON (66,433) RELATED ORGANIZATION SUPPORT 441,192 --------- TOTAL 298,928 PART XII, LINE 2D RECONCILIATION OF EXPENSES RENTAL ACTIVITY EXPENSES $ 34,464 LOSS ON ASSET SALE 41,367 RELATED ORGANIZATION SUPPORT (441,192) BAD DEBT RESERVE ADJUSTMENT (18,005) --------- TOTAL (383,366) true VERSITI BLOOD RESEARCH INSTITUTE FND 638 NORTH 18TH STREET MILWAUKEE WI 53233 391372542 501(c)(3) 4360000 0 RESEARCH GREAT LAKES HEMOPHILIA FOUNDATION INC 638 NORTH 18TH STREET MILWAUKEE WI 53233 237367636 501(c)(3) 101750 PATIENT FINANCIAL ASSISTANCE AMERICAN HEART ASSOCIATION 7272 Greenville Ave Dallas TX 75231 135613797 501(c)(3) 20000 BLOOD RESEARCH MEDICAL COLLEGE OF WISCONSIN 8701 WATERTWON PLANK ROAD MILWAUKEE WI 53226 390806261 501(c)(3) 15000 BLOOD RESEARCH STUDY HEMOSTASIS THROMBOSIS RESEARCH SOCIETY 8733 Watertown Plank Road MILWAUKEE WI 53226 391796672 501(c)(3) 10500 0 HEMOPHILIA RESEARCH UW MEDICAL FOUNDATION 1848 University Ave MADISON WI 537264090 391824445 501(c)(3) 5500 0 ORGAN DONATION SUPPORT 6 Part I, Line 2 PROCEDURE FOR MONITORING USE OF GRANT FUNDS INSIDE U.S. VERSITI WISCONSIN CONTINUES TO PROVIDE GRANT FUNDING TO VERSITI BLOOD RESEARCH INSTITUTE FOUNDATION, INC. AND OTHER TAX-EXEMPT ORGANIZATIONS. THESE FUNDS WILL SUPPORT FUTURE BLOOD RESEARCH AND OTHER INITIATIVES TO SERVE MORE PATIENTS AND REDUCE OVERALL COSTS. MONITORING THE INVESTMENT OF THESE FUNDS, THE DISTRIBUTIONS AND WHAT THESE FUNDS ARE USED FOR IS COMPLETED BY LEADERSHIP OF VERSITI WISCONSIN. X X true true X X X X X true false false false true false true true false CHRIS MISKEL PRESIDENT & CEO 292276 343110 129260 151740 560 660 9016 10584 10147 11910 441259 518004 0 0 THOMAS ABSHIRE MD EVP MSI & CHIEF MED OFFICER 486567 0 84012 0 6822 0 22400 0 2417 0 602218 0 0 0 GILBERT C WHITE MD EVP OF RESEARCH-thru 6/19 280708 132098 55922 26316 3815 1796 15232 7168 10563 4971 366240 172349 0 0 ANTHONY WATKINS EVP & CHIEF FINANCIAL OFFICER 180849 212301 35253 41385 1978 2325 9016 10584 9640 11319 236736 277914 0 0 BRADLEY PIETZ EVP & Chief Innovation Officer 126649 148677 13820 16221 722 846 7918 9294 3997 4692 153106 179730 0 0 GITESH DUBAL EVP & CHIEF MARKETING OFFICER 160046 187878 57861 67923 387 453 9016 10584 10147 11910 237457 278748 0 0 LYNNE BRIGGS VP & CHIEF INFORMATION OFFICER 127052 149148 24831 29148 1553 1824 10304 12096 10147 11910 173887 204126 0 0 MARGARET MCELLIGOT VP & CHIEF QUALITY OFFICER 109886 128994 18467 21678 2860 3354 9808 11511 7117 8355 148138 173892 0 0 JAMES WEIDNER EVP & CHIEF HR OFFICER 133543 156768 43373 50916 1564 1836 8967 10527 10147 11910 197594 231957 0 0 BRIAN BAUTISTA EVP & CHIEF OPERATING OFFICER 195403 229386 57558 67569 659 771 9016 10584 10147 11910 272783 320220 0 0 PETER NEWMAN PHD VP RESEARCH & ASSOC. DIR. BRI. 354174 0 47702 0 13056 0 22400 0 8113 0 445445 0 0 0 MAHRABOON IRANI MD MEDICAL DIR OF THERAPEUTIC SVS 344895 0 9213 0 5618 0 19600 0 22057 0 401383 0 0 0 KENNETH FRIEDMAN MD MEDICAL DIRECTOR 338019 0 12031 0 5801 0 22353 0 15534 0 393738 0 0 0 MATTHEW ANDERSON MD VP & DIAGNOSTIC LAB MED. DIR. 315992 0 37022 0 1744 0 19600 0 22057 0 396415 0 0 0 MAUREEN KWIECINSKI FORMER EVP & GEN. COUNSEL 0 0 15605 18318 119821 140658 0 0 336 393 135762 159369 0 0 COLLEEN MCCARTHY CHIEF OF STAFF & VP ORGAN DON. 103512 121515 12720 14934 362 426 7454 8751 10147 11910 134195 157536 0 0 BART REUTER EVP & GEN. COUNSEL-AS OF 1/19 145096 170331 0 0 724 852 8957 10512 9694 11382 164471 193077 0 0 JOSHUA J FIELD MD MEDICAL DIRECTOR 332330 0 14644 0 1796 0 19600 0 22057 0 390427 0 0 0 Part I, Line 1a Charter Travel Versiti Wisconsin chartered an airplane for all of its directors and one of its officers, Bart Reuter, for the 2019 Board Meeting. The chartered travel expenses are not treated as taxable compensation. Part I, Line 1a BUSINESS CLUB DUES VERSITI WISCONSIN PROVIDES BUSINESS CLUB MEMBERSHIPS FOR THE FOLLOWING EMPLOYEE: GILBERT C. WHITE : $2,470 THE CLUB MEMBERSHIPS ARE NOT TREATED AS TAXABLE COMPENSATION. THE EMPLOYEES USE THESE MEMBERSHIPS FOR BUSINESS MEETINGS OFF SITE AND BUSINESS LUNCHES/DINNERS. ANY PERSONAL EXPENSES INCURRED AT THE CLUB ARE PAID FOR DIRECTLY BY THE EMPLOYEES OR THE EMPLOYEES REIMBURSE THE ENTITY FOR PERSONAL EXPENSES. Part I, Line 4a SEVERANCE PAYMENTS AN INDIVIDUAL LEFT THE ORGANIZATION IN 2018. THE INDIVIDUAL RECEIVED SEVERANCE IN 2019, WHICH IS INCLUDED IN SCHEDULE J, PART II. DUE TO A CONFIDENTIALITY AGREEMENT, NEITHER THE NAME NOR THE AMOUNT WILL BE LISTED. Part I, Lines 5b, 6b and 7 NON-FIXED PAYMENTS INCENTIVE PAYOUT OPPORTUNITIES, BASED ON PERCENTAGE OF BASE PAY RATE, ARE AVAILABLE TO CERTAIN EMPLOYEES OF THE FILING ORGANIZATION. WHILE LEVELS OF THE INCENTIVE PAYOUT OPPORTUNITY ARE FIXED AND DETERMINED PERCANTAGES OF BASED COMPENSATION; THE INCENTIVE PAYOUT IS DETERMINED; IN PART, ON THE CONSOLIDATED REVENUE AND NET EARNINGS OF OPERATING DIVISIONS. THE INCENTIVE PAYOUT IS SUBJECT TO THE REVIEW OF ACCOMPLISHMENTS / OBJECTIVES AND THE ULTIMATE DETERMINATION OF INCENTIVE COMPENSATION IS SUBJECT TO PRESIDENT / CEO AND EXECUTIVE COMMITTEE OF THE BOARD APPROVAL. Part III, Line 4d OTHER PROGRAM SERVICES VERSITI WISCONSIN FULFILLS ITS TAX-EXEMPT PURPOSE IN THREE WAYS: A. VERSITI WISCONSIN OPERATES THE COMPREHENSIVE CENTER FOR BLEEDING DISORDERS (CCBD), UNDER A FEDERAL SUBAWARD AGREEMENT OF THE SOCIAL SECURITY ACT. CCBD PROVIDES CRITICAL SERVES TO BLEEDING & CLOTTING DISORDER PATIENTS & THEIR FAMILIES. AS A COVERED ENTITY UNDER THE FEDERAL 340B DRUG DISCOUNT PROGRAM, Versiti Wisconsin IS ELIGIBLE TO ACCESS CERTAIN PHARMACEUTICALS AT DISCOUNTED PRICING. PHARMACEUTICAL NET INCOME IS PROGRAM INCOME & FUNDS ARE RESTRICTED TO ACTIVITIES & EXPENDITURES THAT FURTHER ELIGIBLE PROJECTS & PROGRAM OBJECTIVES, INCLUDING PATIENT CARE, EDUCATION, SUPPORT SERVICES, APPROVED GRANT RESEARCH & OTHER COSTS. B. ORGAN AND TISSUE DONATION COMBINES PROCUREMENT SERVICES AND EDUCATION TO ENHANCE THE LIVES OF PATIENTS AND PROVIDES GUIDANCE TO THE FAMILIES OF POTENTIAL DONORS. C. MEDICAL SCIENCES INSTITUTE PROVIDES MEDICAL SERVICES INCLUDING CONSULTATION WITH HOSPITALS WE SERVE, SPECIAL PATIENT SERVICES FOR PATIENTS WITH UNIQUE BLOOD DISORDERS INCLUDING PROVIDING COMMUNITY EDUCATION PROGRAMS FOR MEDICAL PROFESSIONALS THROUGH ROUTINE LECTURE SERIES AND THE SPECIALIST IN BLOOD BANKING PROGRAMS. Part VI, Section A, Line 6 MEMBERS OR STOCKHOLDERS VERSITI, INC. IS THE SOLE CORPORATE MEMBER. Part VI, SECTION A, Lines 7a and 7b MEMBER OR STOCKHOLDER POWERS VERSITI, INC. HAS RESERVE POWERS; INCLUDING THE ABILITY TO ELECT A MAJORITY OF DIRECTORS. PART VI, SECTION B, LINE 11B FORM 990 REVIEW VERSITI WISCONSIN UTILIZES GRANT THORNTON LLP TO COMPLETE THE IRS FORM 990 AND RELATED SCHEDULES. FOLLOWING COMPLETION, THEY ARE REVIEWED BY THE CONTROLLER AND CEO. THE DRAFT FORMS ARE THEN REVIEWED BY THE COMPLIANCE AND AUDIT COMMITTEE PRIOR TO SUBMISSION TO THE IRS. THE FULL BOARD IS PROVIDED A COPY OF THE FORM 990 PRIOR TO FILING. PART VI, SECTION B, LINE 12c CONFLICT OF INTEREST POLICY VERSITI WISCONSIN MAINTAINS A WRITTEN CONFLICT OF INTEREST POLICY. ON AN ANNUAL BASIS, CURRENT DIRECTORS AND OFFICERS ARE ASKED TO COMPLETE A DISCLOSURE FORM BASED ON IRS REQUIREMENTS THAT INCLUDES THE FOLLOWING: WHETHER THEY HAVE ANY DIRECT OR INDIRECT RELATIONSHIP EITHER THROUGH BUSINESS OR FAMILY MEMBER WITH THE ORGANIZATION. WHETHER THEY RECEIVED COMPENSATION FROM ANY ORGANIZATION THAT SHARES COMMON OWNERSHIP OR CONTROL WITH THE ORGANIZATION. WHETHER THEY HAVE SERVED AS AN OFFICER, DIRECTOR, KEY EMPLOYEE, PARTNER OR MEMBER OF AN ENTITY (OR SHAREHOLDER OF A PROFESSIONAL CORPORATION) DOING BUSINESS WITH THE ORGANIZATION. THESE ANSWERS ARE ACCUMULATED, SUMMARIZED AND EVALUATED BY MANAGEMENT TO DETERMINE IF ANY CONFLICTS EXIST. IDENTIFIED CONFLICTS ARE ADDRESSED IN ACCORDANCE WITH THE WRITTEN POLICY. Part VI, SECTION B, LINES 15A AND 15B COMPENSATION PROCESS VERSITI AND ITS AFFILIATED BLOOD CENTERS GREATLY VALUE THE GENEROUS CONTRIBUTIONS OF THE INDIVIDUALS AND ORGANIZATIONS THAT SUPPORT OUR MISSION WITHIN THE COMMUNITY WE SERVE. IN ORDER TO ENSURE PROPER STEWARDSHIP OF OUR CHARITABLE RESOURCES, VERSITI AND ITS AFFILIATES FOLLOW A FORMALIZED PROCESS TO CONFIRM THAT COMPENSATION PROVIDED TO OUR EXECUTIVE LEADERSHIP TEAM IS FAIR, REASONABLE, AND NOT EXCESSIVE WHEN COMPARED TO OTHER EXECUTIVES. THIS PROCESS ALSO HELPS US ENSURE THAT OUR COMPENSATION PROGRAM SUPPORTS THE RETENTION OF EXPERIENCED, HIGHLY-QUALIFIED EXECUTIVES WHO ARE COMMITTED TO OUR MISSION. THE COMPENSATION COMMITTEE OF THE VERSITI BOARD OF DIRECTORS, ACTING IN ITS CAPACITY AS THE COMPENSATION COMMITTEE, SETS AND MONITORS THE COMPENSATION PHILOSOPHY FOR VERSITI AND THE RELATED ENTITIES THAT IT SUPPORTS, INCLUDING VERSITI WISCONSIN. OTHER THAN THE VERSITI PRESIDENT AND CHIEF EXECUTIVE OFFICER, THE COMPENSATION COMMITTEE DOES NOT INCLUDE MEMBERS OF MANAGEMENT AND IS COMPRISED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A CONFLICT OF INTEREST WITH RESPECT TO VERSITI COMPENSATION ARRANGEMENTS. THE VERSITI PRESIDENT AND CHIEF EXECUTIVE OFFICER RECUSES HER/HIMSELF FROM ALL DISCUSSIONS AND APPROVALS RELATED TO HER/HIS COMPENSATION. THE VERSITI COMPENSATION COMMITTEE REVIEWS EXECUTIVE COMPENSATION ARRANGEMENTS TO ENSURE SUCH ARRANGEMENTS ARE FAIR, REASONABLE, AND NOT EXCESSIVE WHEN COMPARED TO SIMILARLY-SITUATED EXECUTIVES. EXECUTIVE COMPENSATION ARRANGEMENTS ARE REVIEWED FOR REASONABLENESS AND APPROVED BY THE COMPENSATION COMMITTEE ANNUALLY IN ACCORDANCE WITH THE VERSITI REASONABLENESS REVIEW POLICY. IN ORDER TO ASSESS THE REASONABLENESS OF EXECUTIVE COMPENSATION ARRANGEMENTS, THE COMPENSATION COMMITTEE OBTAINS AND REVIEWS APPROPRIATE COMPARABILITY DATA COLLECTED BY THE HUMAN RESOURCE DEPARTMENT AND A QUALIFIED INDEPENDENT COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE ENGAGES A QUALIFIED INDEPENDENT COMPENSATION CONSULTANT ANNUALLY. THE INDEPENDENT CONSULTANT PERFORMS AN ANALYSIS OF COMPENSATION LEVELS AT REGIONAL AND NATIONAL ORGANIZATIONS OF COMPARABLE SIZE, SCOPE AND STRUCTURE; AND PROVIDES THE COMMITTEE WITH COMPREHENSIVE DATA ON THE AVAILABILITY OF SIMILAR SERVICES WITHIN THE GEOGRAPHIC AREA, COMPENSATION SURVEYS, WRITTEN OFFERS FROM SIMILAR INSTITUTIONS, AND OTHER INFORMATION RELEVANT TO COMPARABILITY OF COMPENSATION. THE COMPENSATION COMMITTEE'S REVIEW, RECOMMENDATIONS AND APPROVALS ARE DOCUMENTED CONCURRENTLY IN THE COMMITTEE MINUTES, WHICH ARE SUBSEQUENTLY REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE AS REASONABLE, ACCURATE AND COMPLETE. A COPY OF THE COMPENSATION COMMITTEES MINUTES IS ALSO PROVIDED TO THE VERSITI BOARD OF DIRECTORS. VERSITI AND VERSITI WISCONSIN HAVE INCENTIVE PROGRAMS FOR EXECUTIVES, DIRECTORS, MANAGEMENT, INVESTIGATORS AND STAFF DESCRIBED IN DETAILED WRITTEN POLICIES APPROVED BY THE COMPENSATION COMMITTEE ANNUALLY. EVALUATION AND COMPENSATION REVIEW -CEO - EACH YEAR, THE EXECUTIVE/COMPENSATION COMMITTEE EVALUATES THE CEO'S PERFORMANCE AGAINST ESTABLISHED OBJECTIVES, DETERMINES INCENTIVE PAYMENT AND MERIT INCREASE BASED UPON PERFORMANCE AND MARKET DATA PROVIDED BY THE THIRD PARTY COMPENSATION CONSULTANT, AND WORKS WITH THE CEO TO ESTABLISH OBJECTIVES FOR THE NEXT YEAR. -EXECUTIVES - EACH YEAR, THE VERSITI/VERSITI WISCONSIN CEO REVIEWS THE PERFORMANCE OF EACH EXECUTIVE AND THE ACHIEVEMENT OF THEIR INDIVIDUAL GOALS AND OBJECTIVES. THE VERSITI/VERSITI WISCONSIN CEO PRESENTS HIS/HER RECOMMENDATIONS TO THE COMPENSATION COMMITTEE, WHICH REVIEWS AND APPROVES RECOMMENDED COMPENSATION RANGES, AND APPROVES FINAL SALARY AND INCENTIVE PAYMENTS. EXECUTIVES ARE POSITIONED WITHIN THE APPROPRIATE SALARY RANGE BASED UPON THE: -EXECUTIVE'S KNOWLEDGE, COMPETENCIES, AND EXPERIENCE, -PERFORMANCE OF THE EXECUTIVE'S AREAS OF RESPONSIBILITY, -THE EXECUTIVE'S CONTRIBUTION TO OVERALL PERFORMANCE, -THE IMPORTANCE OF RETAINING THE EXECUTIVE, -INTERNAL EQUITY CONSIDERATIONS, -THE FINANCIAL RESOURCES AVAILABLE, AND -EXECUTIVE BASE SALARY INCREASES PROVIDED IN THE COMPETITIVE MARKET. Part VI, SECTION C, LINE 19 ORGANIZATION'S DOCUMENTS OPEN TO THE PUBLIC THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST TO THE PUBLIC DURING NORMAL BUSINESS HOURS AND AT THE ORGANIZATION'S LOCATION. PART VII AVERAGE HOURS THE HOURS LISTED ON FORM 990, PART VII ARE REPRESENTATIVE OF AN AVERAGE FOR THE OFFICERS AND EXECUTIVE TEAM. EACH INDIVIDUAL PERSON'S WEEKLY TALLY MAY BE GREATER OR LESSER PER WEEK BASED ON THEIR INDIVIDUAL ROLES AND RESPONSIBILITIES WITHIN THE FILING ORGANIZATION AND RELATED PARTIES. THE SALARY PRESENTED FOR THE PRESIDENT AND CEO IS REFLECTIVE OF TOTAL SALARY COMPENSATION FOR SERVICES TO THE FILING ORGANIZATION AND RELATED AFFILIATES. Part XI, Line 9 Other Changes in Net Assets Change in equity in Cenetron $ 66,433 BAD DEBT RESERVE ADJUSTMENT 18,005 --------- TOTAL 84,438 FORM 990 PART IX LINE 11G DESCRIPTION:DONOR TESTING SERVICES TOTAL FEES:7240703 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:3338312 FORM 990 PART IX LINE 11G DESCRIPTION:ANIMAL CARE COSTS TOTAL FEES:1553516 FORM 990 PART IX LINE 11G DESCRIPTION:OPERATING ROOM FEES TOTAL FEES:1028136 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING SERVICES TOTAL FEES:703760 FORM 990 PART IX LINE 11G DESCRIPTION:SHIPPING & TRANSPORTATION TOTAL FEES:653604 FORM 990 PART IX LINE 11G DESCRIPTION:SUBAWARDS TOTAL FEES:610436 FORM 990 PART IX LINE 11G DESCRIPTION:TEMPORARY HELP TOTAL FEES:552091 FORM 990 PART IX LINE 11G DESCRIPTION:PHARMACY TOTAL FEES:544564 FORM 990 PART IX LINE 11G DESCRIPTION:OUTSIDE LAB SERVICES TOTAL FEES:510956 FORM 990 PART IX LINE 11G DESCRIPTION:GRADUATE STUDENT STIPENDS TOTAL FEES:466689 FORM 990 PART IX LINE 11G DESCRIPTION:ICU TOTAL FEES:455485 FORM 990 PART IX LINE 11G DESCRIPTION:LAB TOTAL FEES:370475 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER HOSPITAL CHARGES TOTAL FEES:335777 FORM 990 PART IX LINE 11G DESCRIPTION:FACILITY CHARGES TOTAL FEES:302794 FORM 990 PART IX LINE 11G DESCRIPTION:CARDIOLOGY TOTAL FEES:278347 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL TRANSPORT TOTAL FEES:260786 FORM 990 PART IX LINE 11G DESCRIPTION:CLAIM/BILLING REVIEW TOTAL FEES:250399 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES TOTAL FEES:240636 FORM 990 PART IX LINE 11G DESCRIPTION:ANESTHESIA TOTAL FEES:226444 FORM 990 PART IX LINE 11G DESCRIPTION:OUTSIDE MEDICAL DIRECTOR (OPO) TOTAL FEES:169025 FORM 990 PART IX LINE 11G DESCRIPTION:RESPIRATORY THERAPY TOTAL FEES:161715 FORM 990 PART IX LINE 11G DESCRIPTION:RADIOLOGY TOTAL FEES:157557 FORM 990 PART IX LINE 11G DESCRIPTION:FUNERAL HOME CHARGES TOTAL FEES:132943 FORM 990 PART IX LINE 11G DESCRIPTION:TISSUE DONOR TRANSPORT TOTAL FEES:131019 FORM 990 PART IX LINE 11G DESCRIPTION:PS SUPPLIES TOTAL FEES:107496 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER FEES TOTAL FEES:393436 RCRC INDEPENDENT REVIEW BOARD LLC 2111 W BRAKER LANE SUITE 100 AUSTIN TX 78758 390807235 Review Board TX 704477 1226837 VERSITI WI Versiti Blood Research Institute FND PO Box 2178 638 N 18th St Milwaukee WI 53201 391372542 Supporting WI 501(c)(3) 12B Versiti false Versiti Inc PO Box 2178 638 N 18th St Milwaukee WI 53201 454675354 Supporting WI 501(c)(3) 12B NA false Versiti Illinois Inc 1200 N Highland Ave Aurora IL 60506 364179758 Blood IL 501(c)(3) 10 Versiti false Versiti Michigan Inc PO Box 1704 Grand Rapids MI 49501 381550001 Blood MI 501(c)(3) 10 Versiti false Versiti Indiana Inc 3450 N Meridian St Indianapolis IN 46208 350991629 Blood IN 501(c)(3) 10 Versiti false CENETRON DIAGNOSTICS LLC 2111 W BRAKER LANE SUITE 300 AUSTIN TX 78758 742760677 Labs & Trials TX VERSITI WI C CORP 4195673 14331639 1.00000 true true true true true false false false false false false false true true true true true true false true CENETRON DIAGNOSTICS LLC A 5791 FMV CENETRON DIAGNOSTICS LLC D 700000 FMV CENETRON DIAGNOSTICS LLC L 38357 FMV CENETRON DIAGNOSTICS LLC S 18232 FMV