2019-11-15T11:51:45-06:00 2018-12-31 420714325 RSM US LLP 4650 E 53RD ST DAVENPORT IA 528073479 990 2018-01-01 463570900 DONATE LIFE FOUNDATION DONA 3147358200 1110 HIGHLANDS PLAZA DR EAST NO 100 ST LOUIS MO 63110 DIANE BROCKMEIER PRESIDENT/CEO 3147358200 2019-11-14 1 JENIFER L CHASE P01306883 5638884000 66.98.98.135 2019-11-14 11:56:59 CS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 675D3CFE7E917E9C170B433EC367DDD6FD512576 2018 2020-04-17 16:48:07Z MID-AMERICA TRANSPLANT FOUNDATION KEVIN LEE 1110 HIGHLANDS PLAZA DR EAST NO 100 ST LOUIS MO 63110 27895453 0 X WWW.MIDAMERICATRANSPLANT.ORG X 2013 MO TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE AFFECTED BY ORGAN AND TISSUE DONATION AND TRANSPLANTATION. TO TRANSFORM OUR COMMUNITY BY ELIMINATING THE WAITING LIST FOR ORGAN AND TISSUE TRANSPLANTS. 13 13 2 60 0 0 7913661 17496286 52365 48645 8360060 2596580 0 0 16326086 20141511 820297 1701052 0 0 389664 400919 0 0 0 978753 1037264 2188714 3139235 14137372 17002276 59339593 66523773 64077 154698 59275516 66369075 TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE AFFECTED BY ORGAN AND TISSUE DONATION AND TRANSPLANTATION. TO TRANSFORM OUR COMMUNITY BY ELIMINATING THE WAITING LIST FOR ORGAN AND TISSUE TRANSPLANTS. 0 0 2184484 746367 48645 FAMILY HOUSE WAS OPENED IN 2013. IT PROVIDES LODGING ASSISTANCE TO PATIENTS WHO MUST RESIDE CLOSE TO THE TRANSPLANT CENTER WHILE AWAITING A TRANSPLANT OR RECEIVING CARE POST-TRANSPLANT SURGERY. THE MTS FAMILY HOUSE CONTINUALLY REMAINS AT CAPACITY OF 10 PATIENTS. 954685 954685 THE CLINICAL INNOVATION FUND SUPPORTS CLINICAL RESEARCH IN THE AREA OF ORGAN, TISSUE, AND EYE DONATION. 3139169 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 28 0 1 2 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MO X BRETT GORDON 3147358200 1110 HIGHLANDS PLAZA DR EAST NO 100 ST LOUIS MO 63110 BRUCE BACON MD BOARD MEMBER 1.00 X 0 0 0 ELLEN BARNIDGE BOARD MEMBER 1.00 X 1800 0 0 SCOTT BAZOIAN BOARD MEMBER 1.00 X 1500 0 0 WILL CHAPMAN BOARD MEMBER 1.00 X 500 0 0 RICHARD ELLERBRAKE BOARD MEMBER 1.00 X 1500 0 0 JAY GUFFEY CHAIRMAN 1.00 X 1600 0 0 LAUREN ANDREW HICKMAN BOARD MEMBER 1.00 X 1500 0 0 NESA JOSEPH VICE CHAIRMAN 1.00 X 1800 0 0 NICHOLAS KOUCHOUKOS MD BOARD MEMBER 1.00 X 0 0 0 GERALD ORTBALS BOARD MEMBER 1.00 X 1800 0 0 JUDI PHILLIPS BOARD MEMBER 1.00 X 1500 0 0 JACQUELYNN RICHMOND SECRETARY/TREASURER 1.00 X 0 0 0 WILLIAM ROSS MD IMMEDIATE PAST CHAIR 1.00 X 1300 0 0 HARVEY SOLOMON MD BOARD MEMBER 1.00 X 1800 0 0 MARY VIETH BOARD MEMBER 1.00 X 1800 0 0 DIANE BROCKMEIER PRESIDENT/CEO 1.00 X 0 507766 33639 KEVIN LEE EXECUTIVE DIRECTOR 37.50 X 180244 0 22664 198644 507766 56303 0 0 1 0 0 17349110 147176 17496286 FAMILY HOUSE REVENUE 900099 48645 48645 48645 2055957 2055957 8294565 7753942 540623 540623 540623 20141511 48645 0 2596580 1701052 1701052 221308 221308 92647 92647 38477 38477 26805 26739 66 21682 21682 4641 4641 87861 87861 349542 349542 5848 5848 14670 14670 232646 232646 46934 46934 66838 66838 MTS EXPENSE ALLOCATION 150765 150765 RECIPIENT FUND 54791 54791 REPAIRS AND MAITENANCE 15299 15299 PROFESSIONAL DUES 4515 4515 2914 2914 3139235 3139169 66 0 267026 151339 1140 16870 17020 20159 59054407 66335405 59339593 66523773 64077 154698 64077 154698 X 59275516 66369075 59275516 66369075 59339593 66523773 17002276 -9908717 0 X X 0 1 X 1 0 X X 1 MID-AMERICA TRANSPLANT SERVICES 277426306 10 1 0 0 1 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 PART IV, SECTION A, LINE 6: DONATE LIFE FOUNDATION PROVIDES GRANTS, THROUGH ITS CLINICAL INNOVATION FUND, TO SUPPORT INNOVATIVE RESEARCH THAT WILL ADDRESS CLINICAL ISSUES IN THE AREA OF ORGAN AND/OR TISSUE TRANSPLANTATION THAT WILL HAVE A MEASURABLE IMPACT ON THE FIELD IN THREE TO FIVE YEARS. THE FOUNDATION ALSO PROVIDES GRANTS TO ORGANIZATIONS THAT WORK TO RECOVER AND MAKE AVAILABLE HUMAN ORGANS AND TISSUES FOR THE PURPOSE OF TRANSPLANTATION; PROMOTE THE USE OF HUMAN ORGAN AND TISSUE TRANSPLANTS BY HOSPITALS AND OTHER MEDICAL CARE PROVIDERS; EDUCATE THE PUBLIC AND PROFESSIONAL COMMUNITY ABOUT THE USE AND BENEFITS OF HUMAN ORGAN AND TISSUE DONATIONS AND TRANSPLANTS; PROMOTE, IN COOPERATIONS WITH OTHER INTERESTED ORGANIZATIONS, HUMAN ORGAN AND TISSUE DONATIONS; AND, THROUGH THEIR COMMUNITY BENEFIT PROGRAMS, SUPPORT EFFORTS TO REDUCE THE NEED FOR HUMAN ORGAN AND TISSUE TRANSPLANTS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 CASH & CASH EQUIVALENTS 66335405 F 66335405 X 17544931 0 17544931 2596580 2596580 20141511 3211181 71946 71946 3139235 0 3139235 PART X, LINE 2: THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) SECTION 740-10 CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING THE MINIMUM STANDARD A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. THE ORGANIZATION HAS NOT TAKEN ANY UNCERTAIN TAX POSITION THAT SHOULD BE ACCOUNTED FOR UNDER ASC SECTION 740-10. THE ORGANIZATION CONTINUALLY EVALUATES THE EFFECTS OF ALL TAX POSITIONS TAKEN INCLUDING EXPIRING STATUTES OF LIMITATIONS, TAX EXAMINATIONS, UNRELATED BUSINESS INCOME AND NEW AUTHORITATIVE RULINGS. THE ORGANIZATION FILES FEDERAL INFORMATION RETURNS AND INCOME TAX RETURNS IN CONNECTION WITH UNRELATED BUSINESS INCOME. PART XI, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT INCOME 2,596,580. PART XII, LINE 2D - OTHER ADJUSTMENTS: INVESTMENT FEES 71,946. 1 SOUTHERN ILLINOIS UNIVERSITY FOUNDATION 1235 DOUGLAS DRIVE CARBONDALE IL 62901 376024575 501(C)(3) 95347 PROGRAM GRANT ST LOUIS BEREAVEMENT CENTER FOR YOUNG PEOPLE DBA ANNIE'S HOPE 1333 W LOCKWOOD AVE ST LOUIS MO 63122 431801433 501(C)(3) 75000 PROGRAM GRANT CASA DE SALUD 3200 CHOUTEAU AVE ST LOUIS MO 63103 270732049 501(C)(3) 37500 PROGRAM GRANT FAMILY HOSPICE OF BELLEVILLE AREA 5110 WEST MAIN STREET BELLEVILLE IL 62226 371279271 501(C)(3) 72103 PROGRAM GRANT LOST & FOUND GRIEF CENTER 1555 S GLENSTONE AVE SPRINGFIELD MO 65804 431896981 501(C)(3) 123084 PROGRAM GRANT WASHINGTON UNIVERSITY CAMPUS BOX 1082 ONE BROOKINGS DRIVE DRIVE ST LOUIS MO 63130 430653611 501(C)(3) 752580 CLINICAL INNOVATION, RESEARCH SUPPORT BAPTIST MEMORIAL HEALTHCARE FOUNDATION 350 N HUMPHREYS BLVD MEMPHIS TN 38120 581544781 501(C)(3) 50000 PROGRAM GRANT INSTITUTE FOR RESEARCH AND EDUCATION IN FAMILY MEDICINE 722 LOUGHBOROUGH AVE ST LOUIS MO 63111 431863752 501(C)(3) 110750 PROGRAM GRANT SOUTHEAST MISSOURI STATE UNIVERSITY ONE UNIVERSITY PLAZA CAPE GIRARDEU MO 63701 436003569 STATE OF MISSOURI 33080 PROGRAM GRANT INFANT LOSS RESOURCES INC 1120 S SIXTH STREET ST LOUIS MO 63104 431344645 501(C)(3) 26019 PROGRAM GRANT JORDAN VALLEY COMMUNITY HEALTH CENTER 440 E TAMPA STREET SPRINGFIELD MO 65806 431602701 501(C)(3) 112500 PROGRAM GRANT ST LOUIS UNIVERSITY 221 NORTH GRAND BLVD ST LOUIS MO 63103 430654872 501(C)(3) 202105 CLINICAL INNOVATION RESEARCH SUPPORT ST LOUIS COMMUNITY COLLEGE FOUNDATION 3221 MCKELVEY BRIDGETON MO 63044 431374500 501(C)(3) 6984 SCHOLARSHIP SUPPORT 12 1 PART I, LINE 2: GRANT APPLICANTS MUST SUBMIT AN APPLICATION, WHICH IS INDEPENDENTLY REVIEWED BY THE GRANT APPLICATIONS COUNCIL. THE COUNCIL SCORES THE APPLICATION BASED ON FIVE MAIN FACTORS - MISSION ALIGNMENT, COST AND ECONOMICS, RISK, PERFORMANCE MEASURES, AND COMMUNITY IMPACT. COMMUNITY GRANTEES RECEIVE GRANT PAYMENTS IN TWO INSTALLMENTS. THE SECOND INSTALLMENT IS DEPENDENT UPON THE SUBMISSION OF A PROGRESS REPORT, DUE AT THE END OF NOVEMBER. FOR RESEARCH GRANTS, FUNDS ARE ISSUED DIRECTLY TO THE ORGANIZATION FOR USE. RESEARCH REPORTS ARE DUE IN JULY FROM RESEARCH GRANT RECIPIENTS, UNLESS THE PRIMARY INVESTIGATOR HAS REQUESTED AN EXTENSION. THE PRIMARY INVESTIGATORS ARE INVITED TO PRESENT EACH JANUARY AT MID-AMERICA TRANSPLANT'S RESEARCH SYMPOSIUM. FUNDS FOR SCHOLARSHIP SUPPORT GRANTS ARE ISSUED DIRECTLY TO THE SCHOOLS. MID-AMERICA TRANSPLANT REQUESTS A LETTER OF SUPPORT FROM THE ADMINISTRATOR THAT OVERSEES EACH PROGRAM TO SUBSTANTIATE THE USE OF FUNDS. 0 0 0 0 0 0 0 0 0 DIANE BROCKMEIER PRESIDENT/CEO 0 404536 0 94830 0 8400 0 13750 0 19889 0 541405 0 0 KEVIN LEE EXECUTIVE DIRECTOR 151431 0 24336 0 4477 0 7677 0 14987 0 202908 0 0 0 PART I, LINE 3 A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, AND APPROVAL BY THE BOARD AND COMPENSATION COMMITTEE WERE USED TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR BY MID-AMERICA TRANSPLANT, A RELATED ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE 990 WILL BE AVAILABLE TO ALL BOARD MEMBERS PRIOR TO FILING ON THE BOARD MEMBER INTERNET PORTAL. THE FORM 990 IS PREPARED BY THE INDEPENDENT CPA FIRM THAT ALSO CONDUCTS THE ANNUAL AUDIT. THE CEO AND CFO PERFORM AN IN DEPTH REVIEW OF THE 990 AS WELL AS RESPOND TO ALL QUESTIONS AND COMMENTS REGARDING THE 990 BY THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ARE COVERED UNDER THE CONFLICT OF INTEREST POLICY AND MUST ANNUALLY REVIEW THE CONFLICT OF INTEREST POLICY AND DISCLOSE ANY CONFLICTS OF INTEREST. THE CONFLICT OF INTEREST POLICY CONTAINS PROCEDURES FOR DETERMINATION OF WHETHER A CONFLICT EXISTS, FOR ADDRESSING OF CONFLICTS AND FOR DEALING WITH POTENTIAL VIOLATIONS OF THE POLICY. COMPLIANCE WITH THE POLICY IS MONITORED BY MANAGEMENT. FORM 990, PART VI, SECTION B, LINE 15 A POLICY IS IN PLACE THAT INCLUDES ANNUAL REVIEW AND APPROVAL BY THE COMPENSATION COMMITTEE OF MT. THE COMPENSATION COMMITTEE IS COMPRISED OF INDIVIDUALS WITHOUT CONFLICTS OF INTEREST WITH RESPECT TO COMPENSATION REVIEW AND APPROVAL. AN INDEPENDENT EXTERNAL FIRM PROVIDES MARKET COMPETITIVE COMPENSATION DATA FROM COMPARABLE, TAX EXEMPT ORGANIZATIONS AND PUBLISHED SURVEYS AND CONDUCTS A COMPETITIVENESS ASSESSMENT OF MT OFFICERS AND KEY EMPLOYEES TO THE MARKET. THERE IS CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING WITH RESPECT TO THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS. FORM 990, PART VI, SECTION C, LINE 18 N/A FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. FORM 990, PART XII, LINE 2C: THE ORGANIZATION DID NOT CHANGE THE OVERSIGHT OR THE SELECTION PROCESS FROM THE PRIOR YEAR. MID-AMERICA TRANSPLANT SERVICES 1110 HIGHLANDS PLAZA DR EAST STE 10 ST LOUIS MO 63110 237426306 ORGAN PROCUREMENT MO 501(C)(3) LINE 10 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 MID-AMERICA TRANSPLANT SERVICES C 17349110 FAIR MARKET VALUE