Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
TRANSPLANT HOUSE
Employer identification number
26-0585694
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
202,611
505,891
2,408,070
3,116,572
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3..
202,611
505,891
2,408,070
3,116,572
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6
Public Support. Subtract line 5 from line 4.
3,116,572
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
7
Amounts from line 4..
202,611
505,891
2,408,070
3,116,572
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
43,735
47,562
91,297
11
Total support (Add lines 7 through 10).
3,207,869
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public Support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13
Total support (Add lines 9, 10c, 11 and 12.).
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: FUNDRAISING EVENT
SCHEDULE A, PART IV, LIST OF UNUSUAL GRANTS: FUNDING FOR CONSTRUCTION OF HOUSE DATE: 12/31/07 AMOUNT: 3872135. FUNDING FOR CONSTRUCTION OF HOUSE DATE: 12/31/08 AMOUNT: 571469. FUNDING FOR CONSTRUCTION OF HOUSE DATE: 12/31/09 AMOUNT: 95209. FUNDING FOR CONSTRUCTION OF HOUSE DATE: 12/31/10 AMOUNT: 1636194.
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
TRANSPLANT HOUSE
Employer identification number
26-0585694
Identifier
Return Reference
Explanation
MISSION/SIGNIFICANT ACTIVITIES
FORM 990, PART I, LINE 1
GIFT OF LIFE FAMILY HOUSE WAS DEVELOPED TO PROVIDE AFFORDABLE TEMPORARY LODGING AND SUPPORTIVE SERVICES FOR FAMILY MEMBERS OF ADULT AND PEDIATRIC TRANSPLANT PATIENTS WHO TRAVEL TO PHILADELPHIA TO RECEIVE LIFE-SAVING ORGAN TRANSPLANT CARE AT ANY OF THE EIGHT PHILADELPHIA REGIONAL TRANSPLANT CENTERS.
MISSION STATEMENT
FORM 990, PART III, LINE 1
GIFT OF LIFE FAMILY HOUSE WAS DEVELOPED TO PROVIDE AFFORDABLE TEMPORARY LODGING AND SUPPORTIVE SERVICES FOR FAMILY MEMBERS OF ADULT AND PEDIATRIC TRANSPLANT PATIENTS WHO TRAVEL TO PHILADELPHIA TO RECEIVE LIFE-SAVING ORGAN TRANSPLANT CARE AT ANY OF THE EIGHT PHILADELPHIA REGIONAL TRANSPLANT CENTERS.
PROGRAM SERVICE ACCOMPLISHMENT STATEMENT
FORM 990, PART III, LINE 4A
TRANSPLANT HOUSE, D/B/A GIFT OF LIFE FAMILY HOUSE, IS A TAX EXEMPT PENNSYLVANIA NONPROFIT CORPORATION FORMED IN SEPTEMBER 2008 FOR THE PURPOSE OF PROVIDING TEMPORARY LODGING AND SUPPORTIVE SERVICES TO ADULT AND PEDIATRIC TRANSPLANT PATIENTS AND THEIR FAMILY MEMBERS WHO TRAVEL TO PHILADELPHIA FOR THEIR LIFE-SAVING AND LIFE-ENHANCING TRANSPLANT TREATMENT. GIFT OF LIFE FAMILY HOUSE IS AFFILIATED WITH TWO OTHER PENNSYLVANIA NONPROFIT CORPORATIONS, BOTH OF WHICH HAVE BEEN RECOGNIZED AS TAX-EXEMPT UNDER SECTION 501(A) BY REASON OF BEING DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE: GREATER DELAWARE VALLEY SOCIETY OF TRANSPLANT SURGEONS, OPERATING UNDER THE NAME GIFT OF LIFE DONOR PROGRAM AND THE TRANSPLANT FOUNDATION. GIFT OF LIFE DONOR PROGRAM WAS ESTABLISHED IN 1974 TO IMPROVE THE EFFICIENCY OF RECOVERING AND SHARING KIDNEYS TO ITS CONSTITUENTS IN THE TRI-STATE AREA COMPRISED OF EASTERN PENNSYLVANIA, SOUTHERN NEW JERSEY AND DELAWARE. TODAY, GIFT OF LIFE SERVES A POPULATION OF 10 MILLION PEOPLE, ENCOMPASSING MORE THAN 130 ACUTE CARE HOSPITALS AND 15 TRANSPLANT CENTERS WITH 43 ORGAN SPECIFIC TRANSPLANT PROGRAMS. GIFT OF LIFE REMAINS ONE OF THE NATION'S MOST ACTIVE ORGAN PROCUREMENT ORGANIZATIONS AND IN PARTNERSHIP WITH THE HOSPITAL COMMUNITY ACHIEVED MILESTONES IN CALENDAR YEAR 2010 WHEN IT COORDINATED 392 ORGAN DONORS AND FACILITATED 1,553 LIFE-SAVING SOLID ORGANS TRANSPLANTS. SINCE 1974, GIFT OF LIFE DONOR PROGRAM HAS COORDINATED OVER 30,000 ORGAN TRANSPLANTS. IN 1998, GIFT OF LIFE'S BOARD OF DIRECTORS ESTABLISHED THE TRANSPLANT FOUNDATION AS THE CHARITABLE ARM TO SUPPORT ITS PROGRAMS THROUGH EDUCATION, RESEARCH, SERVICES TO DONOR FAMILIES AND RECIPIENTS, AND AS A STEWARD FOR BROADER COMMUNITY AWARENESS AND FUNDRAISING ACTIVITIES REGARDING ORGAN AND TISSUE DONATION. ONE INITIATIVE IDENTIFIED AT THE TIME OF INCORPORATION WAS THE CREATION OF A RONALD MCDONALD HOUSE TYPE OF PROGRAM TO SERVE THE FAMILIES OF PATIENTS AWAITING TRANSPLANTS AND RECEIVING FOLLOW-UP CARE IN THE PHILADELPHIA REGION. IN THE LATE 1990'S, THE BOARDS OF GIFT OF LIFE DONOR PROGRAM AND TRANSPLANT FOUNDATION BEGAN DEFINING THE CONCEPT OF A "TRANSPLANT HOUSE", A PLACE WHERE TRANSPLANT FAMILIES COULD GATHER AND GAIN SUPPORT DURING THEIR MANY TRIPS TO PHILADELPHIA FOR THEIR CARE. SURVEYS CONDUCTED WITH THE REGIONAL TRANSPLANT CENTERS CONFIRMED THE CRITICAL NEED FOR AFFORDABLE OVERNIGHT ACCOMMODATIONS: 1) FOR CALENDAR YEAR 2006 OVER 1,000 TRANSPLANTS WERE PERFORMED AT THE EIGHT (8) PHILADELPHIA-AREA TRANSPLANT CENTERS. OVER 800 OF THESE TRANSPLANTS WERE FROM DECEASED DONORS AND OVER 200 RESULTED FROM LIVING DONORS. 2) A MINIMUM OF 6,500 OVERNIGHT STAYS WERE OUTLINED TO SUPPORT THE ADULT AND PEDIATRIC TARGET POPULATION: A) FAMILIES OF PATIENTS WHO ARE AWAITING OR WHO HAVE RECEIVED AN ORGAN TRANSPLANT; B) LIVING DONORS; C) TRANSPLANT RECIPIENTS WHO TRAVEL TO PHILADELPHIA FOR THEIR ON-GOING FOLLOW-UP CARE. THE LENGTH OF STAY AND NUMBER OF VISITS FOR BOTH FAMILIES AND PATIENTS VARIES DEPENDING ON THE TYPE OF ORGAN TRANSPLANT AND STAGE OF THE PATIENT IN THE TRANSPLANT PROCESS, BUT THE NUMBER OF 1,000 TRANSPLANTS PER YEAR IN THIS REGION HAS BEEN CONSISTENTLY MAINTAINED. INTERVIEWS WITH ADMINISTRATORS AT THE PHILADELPHIA RONALD MCDONALD HOUSE INDICATED AN INCREASED DEMAND FOR THEIR 44 OVERNIGHT ROOMS, AND THE REALITY OF HAVING TO TURN AWAY OVER 800 FAMILIES OF PEDIATRIC PATIENTS IN 2006 DUE TO LACK OF AVAILABLE ROOMS. OVER 30% OF THE PHILADELPHIA RONALD MCDONALD HOUSE ROOMS PER YEAR WERE REPORTED AS BEING USED BY TRANSPLANT-RELATED FAMILIES. BOTH GIFT OF LIFE DONOR PROGRAM AND TRANSPLANT FOUNDATION BOARDS APPROVED MOVING FORWARD WITH THE PURCHASE OF PROPERTY AT 401-415 CALLOWHILL IN JUNE 2007 FOR THE FUTURE SITE OF GIFT OF LIFE FAMILY HOUSE. FUNDS FOR THE LAND PURCHASE WERE PROVIDED BY A GRANT FROM THE TRANSPLANT FOUNDATION. A CAPITAL CAMPAIGN IS UNDERWAY TO FUND THE CONSTRUCTION OF THE BUILDING, AS WELL AS THE FIRST TWO YEARS OF OPERATIONS AND THE CREATION OF AN ENDOWMENT TO SUSTAIN THE PROGRAMMING OF GIFT OF LIFE FAMILY HOUSE. CONSTRUCTION OF GIFT OF LIFE FAMILY HOUSE COMMENCED IN THE FALL OF 2009 WITH AN ANTICIPATED OPENING IN SUMMER, 2011. ONCE COMPLETED, GIFT OF LIFE FAMILY HOUSE WILL PRIMARILY SERVE OUT-OF-TOWN FAMILIES LIVING GREATER THAN 25 MILES FROM THE FAMILY HOUSE WITH A FAMILY MEMBER WHO IS A PATIENT AT ONE OF THE FOLLOWING PHILADELPHIA-AREA TRANSPLANT CENTERS AWAITING TRANSPLANT OR RECEIVING FOLLOW-UP CARE: ALBERT EINSTEIN MEDICAL CENTER THE CHILDREN'S HOSPITAL OF PHILADELPHIA HAHNEMANN UNIVERSITY HOSPITAL LANKENAU HOSPITAL ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN TEMPLE UNIVERSITY HOSPITAL THOMAS JEFFERSON UNIVERSITY HOSPITAL UNIVERSITY OF PENNSYLVANIA HEALTH SYSTEM. GIFT OF LIFE FAMILY HOUSE WILL INCLUDE THIRTY (30) GUEST ROOMS, SERVING UP TO FOUR FAMILY MEMBERS PER ROOM, AND PROVIDE A PLACE WHERE FAMILIES UNDERGOING SIMILAR EXPERIENCES CAN SHARE TIME TOGETHER WHILE THEIR LOVED ONES ARE AWAITING OR UNDERGOING THEIR LIFE-SAVING TRANSPLANT. A LARGE COMMUNAL KITCHEN AND DINING ROOM WILL ALLOW FAMILIES TO INTERACT WITH EACH OTHER AND FIND THE SUPPORT AND STRENGTH THEY NEED TO HELP THEM NAVIGATE THIS EXTREMELY CHALLENGING SITUATION. ADDITIONAL FAMILY HOUSE SERVICES TO BE PROVIDED INCLUDE VAN TRANSPORTATION TO/FROM THE HOSPITALS, SECURE PARKING, LAUNDRY FACILITIES, AN INDOOR PLAYROOM, FITNESS CENTER, WIRELESS COMPUTER/INTERNET ACCESS, AND LIBRARY AND LEARNING RESOURCES. NO MEDICAL SERVICES WILL BE PROVIDED AT GIFT OF LIFE FAMILY HOUSE, RATHER IT IS INTENDED TO BE A COMFORTABLE AND SUPPORTIVE ENVIRONMENT FOR FAMILY MEMBERS. OVERNIGHT OCCUPANCY IS INITIALLY PROJECTED AT 70-80%, WITH AN AVERAGE LENGTH OF STAY ESTIMATED AT 4-5 NIGHTS. FAMILIES WILL BE ASKED TO PAY A GUEST FEE OF $40 PER FAMILY ROOM PER NIGHT TO HELP DEFRAY ACTUAL OPERATING COSTS OF APPROXIMATELY $150-$170 PER ROOM. AND WHILE THIS GUEST FEE IS SIGNIFICANTLY LESS THAN THE AVERAGE NIGHTLY HOTEL RATE OF $190 IN THE PHILADELPHIA AREA, IT IS LIKELY A MAJORITY OF THE FAMILIES WILL BE UNABLE TO PAY THIS NIGHTLY FEE DUE TO THE SIGNIFICANT FINANCIAL IMPACT CAUSED BY THEIR TRANSPLANT CONDITION. ROOM AVAILABILITY IS NOT BASED ON THE FAMILY'S ABILITY TO PAY. LIFELINE PROGRAM BECAUSE OF THE SIGNIFICANT IMPACT TO FAMILY MEMBERS AND CAREGIVERS, INTERIM PROGRAMS HAVE BEEN DEVELOPED TO PROVIDE A "LIFELINE" - BOTH FINANCIAL AND EMOTIONAL - TO THOSE FAMILY MEMBERS AND CAREGIVERS WHO ARE SUPPORTING PATIENTS DURING THIS CHALLENGING TIME. WITH THE GOAL OF PROVIDING ASSISTANCE AND EDUCATIONAL RESOURCES TO FAMILY MEMBERS AND CAREGIVERS SO THAT THEY CAN NAVIGATE THIS DIFFICULT TIME, COMPLIMENTARY GIFT OF LIFE FAMILY HOUSE LIFELINE PROGRAM SERVICES WILL INCLUDE: DISCOUNTED HOTEL ACCOMMODATIONS AT SEVEN (7) AREA HOTELS COMPLIMENTARY NUTRITIONAL SNACKS AND DINNERS CAREGIVER RESOURCES AND EDUCATIONAL MATERIALS ONLINE WEB RESOURCES LIFELINE PROGRAM SERVICES ARE AVAILABLE TO TRANSPLANT PATIENTS AND THEIR FAMILY MEMBERS WHO LIVE IN PHILADELPHIA OR WITHIN THE GIFT OF LIFE SERVICE REGION, AND ARE NOT LIMITED TO ONLY THOSE FAMILIES WHO MIGHT REQUIRE LODGING AT GIFT OF LIFE FAMILY HOUSE. DURING 2010 PROGRAMMING IN THE COMMUNITY WAS INITIATED WITH A FOCUS ON EDUCATION REGARDING NUTRITIONAL SUPPORT AND CAREGIVER STRESS AND MECHANISMS FOR RECOGNIZING AND REDUCING STRESS. ADDITIONALLY, INFORMATION THROUGH THE GIFT OF LIFE FAMILY HOUSE NEWSLETTER WAS DISSEMINATED TO A MAILING LIST OF 40,000 ADDRESSES. GIFT OF LIFE FAMILY HOUSE ADVISORY BOARD IS COMPRISED OF FIFTEEN (15) INDIVIDUALS WHO ARE ORGAN RECIPIENTS AND FAMILY MEMBERS OF TRANSPLANT RECIPIENTS, LIVING DONORS, TRANSPLANT SURGEONS, HEALTHCARE EXECUTIVES AND COMMUNITY REPRESENTATIVES COMMITTED TO OUR MISSION. LEADERSHIP FOR THE GIFT OF LIFE FAMILY HOUSE PROJECT HAS BEEN THOUGHTFULLY SELECTED TO INCLUDE THOSE INDIVIDUALS WHO HAVE BEEN DIRECTLY TOUCHED BY ORGAN DONATION AND THOSE INDIVIDUALS WHO UNDERSTAND THE CRITICAL NEED FOR THE FAMILY HOUSE PROJECT AND HOW IT WILL IMPACT AND IMPROVE PATIENT AND FAMILY SATISFACTION AND SURVIVAL DURING THIS CHALLENGING PERIOD.
NUMBER OF EMPLOYEES REPORTED ON FORM W-3
FORM 990, PART V, LINE 2
THE SALARY EXPENSE AND BENEFITS REPORTED IN PART IX OF FORM 990 ARE AN ALLOCATION FROM A RELATED ENTITY, GREATER DELAWARE VALLEY SOCIETY OF TRANSPLANT SURGEONS (EIN: 23-7388767). THE EMPLOYEES OF THE TRANSPLANT HOUSE ARE REPORTED ON THE FORM W-3 OF THIS RELATED ENTITY.
FORM 990, PART VI, SECTION A, LINE 7A
THE BOARD OF TRANSPLANT FOUNDATION, AN AFFILIATED ENTITY, HAS THE RIGHT TO APPOINT MEMBERS OF THE TRANSPLANT HOUSE GOVERNING BODY.
FORM 990, PART VI, SECTION A, LINE 7B
THE FOLLOWING ACTIONS BY THE BOARD OF DIRECTORS REQUIRE THE WRITTEN APPROVAL OF THE TRANSPLANT FOUNDATION, AN AFFILIATED ENTITY: A) ALTERING, AMENDING OR REPEALING THE ARTICLES OF INCORPORATION AND/OR BYLAWS; B) BORROWING MONEY UNDER TERMS THAT PROVIDE FOR A REPAYMENT PERIOD OF ONE YEAR OR MORE; C) ADOPTING AN OPERATING BUDGET AND/OR A CAPITAL BUDGET; D) INCURRING CAPITAL EXPENDITURES WHICH, IN THE AGGREGATE, ARE IN EXCESS OF $200,000 IN ANY ONE FISCAL YEAR; E) ORGANIZING OR ACQUIRING ANY SUBSIDIARY OR AFFILIATE; F) ACQUIRING, BY WHATEVER MEANS, AN INTEREST IN ANY OTHER ENTITY OR BECOMING A MEMBER OF ANY OTHER NONPROFIT CORPORATION; G) AUTHORIZING OR DESIGNATING OFFICERS OF THE CORPORATION TO EXECUTE A DEED OF ASSIGNMENT FOR THE BENEFIT OF CREDITORS, FILE A VOLUNTARY PETITION IN BANKRUPTCY, FILE AN ANSWER CONSENTING TO THE APPOINTMENT OF A RECEIVER, OR FILE AN ANSWER TO AN INVOLUNTARY PETITION IN BANKRUPTCY; AND H) AUTHORIZING ANY AND ALL TRANSACTIONS THAT CHANGE, OR HAVE THE EFFECT OF CHANGING, THE OWNERSHIP AND/OR CONTROL OF THE CORPORATION, WITH SUCH A TRANSACTION INCLUDING, BUT NOT BEING LIMITED TO ANY PROPOSED ATTEMPT TO MERGE, ACQUIRE OR COMBINE THE CORPORATION WITH ANY OTHER ENTITY, WHETHER SUCH TRANSACTION IS BY CONTRACT, SALE OF ALL OR SUBSTANTIALLY ALL OF ITS ASSETS, OR BY OPERATION OF LAW.
FORM 990, PART VI, SECTION B, LINE 11
FORM 990 WAS REVIEWED WITH THE GOVERNING BODY AT A BOARD MEETING PRIOR TO FILING, AND ALL BOARD MEMBERS RECEIVED A COPY OF THE FINAL FORM 990 PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C
BOARD MEMBERS ARE ANNUALLY REQUIRED TO REVIEW THE CONFLICT OF INTEREST POLICY; DISCLOSE ANY POSSIBLE PERSONAL, FAMILIAL, OR BUSINESS RELATIONSHIP THAT WOULD GIVE RISE TO A CONFLICT OR APPEARANCE OF A CONFLICT; AND ACKNOWLEDGE BY SIGNING THE POLICY THAT HE/SHE IS ACTING IN ACCORDANCE WITH THE LETTER AND SPIRIT OF THE POLICY. THESE SIGNED STATEMENTS AND DISCLOSURES ARE REVIEWED BY THE ORGANIZATION'S VICE PRESIDENT OF ADMINISTRATION AND GENERAL COUNSEL. BOARD MEMBERS MUST REFRAIN FROM VOTING ON ANY TRANSACTION OR OTHER MATTER IN WHICH THE MEMBER HAS A CONFLICT OF INTEREST. MEMBERS MUST ALSO REPORT PROMPTLY TO THE BOARD CHAIRPERSON AND PRESIDENT/CEO ANY FUTURE SITUATION IN WHICH A POSSIBLE CONFLICT OF INTEREST MIGHT ARISE.
FORM 990, PART VI, SECTION B, LINE 15
COMPENSATION IS DETERMINED ANNUALLY BY A COMMITTEE OF THE BOARD WHICH IS COMPRISED OF INDEPENDENT PERSONS. AN INFORMAL PAIRED COMPARISON RANKING AMONG EXISTING GIFT OF LIFE DONOR PROGRAM JOBS COMBINED WITH MARKET-BASED WAGE DATA (WHEN AVAILABLE) IS USED. A PERIODIC REVIEW PERFORMED EVERY TWO YEARS WITH AN INDEPENDENT COMPENSATION CONSULTANT IS ALSO CONDUCTED.
FORM 990, PART VI, SECTION C, LINE 19
THE ORGANIZATION WILL MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
AVERAGE HOURS PER WEEK
FORM 990, PART VII
AVERAGE HOURS PER WEEK LISTED IN PART VII ARE FOR THIS LEGAL ENTITY ONLY. CERTAIN INDIVIDUALS LISTED IN PART VII MAY ALSO DEVOTE TIME TO THE RELATED ORGANIZATIONS LISTED ON SCHEDULE R. TOTAL AVERAGE HOURS PER WEEK FOR ALL RELATED ORGANIZATIONS ARE AS FOLLOWS FOR THE FOLLOWING INDIVIDUALS: PRESIDENT & CEO HOWARD M. NATHAN - 60 HOURS PER WEEK DIRECTOR MICHAEL MORITZ, MD - 2 HOURS PER WEEK DIRECTOR CLYDE F. BARKER, MD - 3 HOURS PER WEEK DIRECTOR JAN L. WEINSTOCK, ESQ. - 60 HOURS PER WEEK
DOCUMENT RETENTION AND DESTRUCTION POLICY
FORM 990, PART VI, LINE 14
THE GOVERNING BODY IS CONSIDERING ADOPTING A COMPREHENSIVE DOCUMENT ADDRESSING THE RETENTION AND DESTRUCTION POLICY.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.