On March 30th, 2021, the Biden-Harris Administration officially finalized a life-saving rule from November to revise outcome measures for Organ Procurement Organizations (OPOs), the 57 government contractors tasked with coordinating organ donation. The Department of Health and Human Services (HHS) projects that minimum compliance with the rule will save 7,000 lives per year; additionally, projections show that Medicare will save $1 billion per year in foregone dialysis costs for those transplanted. COVID-19 has made these reforms even more urgent, as studies show the virus damages kidneys. Bipartisan congressional leaders have highlighted OPO reform as a critical health equity issue, as current system failures disproportionately harm patients of color. The rule takes effect for the 2022 recertification cycle, and will be updated by HHS as new data becomes available.
The following map and table show how OPOs across the country were categorized in terms of performance in the final rule, based on data from 2018.
The table also includes the number of patients waiting for organs in each state served by the OPO.
To meet top 25% | ||||||||
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OPO | Tier | State(s) | State waitlist | Donors needed | Organs needed | CEO and compensation | Board compensation | Notes |
Legacy of Hope - Alabama | 3 Failing | AL | 1,198 | 26 | 75 | Christopher Meeks N/A |
N/A | OPO executives sentenced to Federal prison in 2012 for fraud; included in House Committee on Oversight and Reform investigation |
Arkansas Regional Organ Recovery Agency | 3 Failing | AR | 243 | 22 | 56 | Alan Cochran $251,689 |
No | |
Donor Network of Arizona | 1 Passing | AZ | 1,613 | - | - | Timothy Brown $630,942 |
Yes | OIG found the OPO overstating organ procurement costs and not reporting proceeds from the sale of research organs. 2019 CEO compensation increased by 17.6% from 2018. |
OneLegacy | 3 Failing | CA - Los Angeles | 21,126 | 133 | 202 | Tom Mone $972,505 |
Yes | OIG found wasteful spending; OPO also subject of 2019 LA Times investigation into tissue processing business; Board Chair paid $100,000 annually; included in House Committee on Oversight and Reform investigation |
Sierra Donor Services | 2 Underperforming | CA - North Central | 21,126 | 11 | 7 | Sean Van Slyck N/A |
N/A | Included in House Committee on Oversight and Reform investigation |
Donor Network West | 2 Underperforming | CA - Northern NV - Northern |
CA - 21,126 NV - 181 |
12 | - | Janice Whaley $532,136 |
No | New CEO led major improvements following leadership change, increasing donations by nearly 30%. |
LifeSharing - A Donate Life Organization | 1 Passing | CA - Imperial, San Diego | 21,126 | - | - | Lisa Stocks N/A |
N/A | |
Donor Alliance | 3 Failing | CO WY |
CO - 1,600 WY - N/A (WY does not have transplant centers, so patients listed in other states) |
- | 81 | Susan Dunn* $653,534 |
No | |
LifeChoice Donor Services | 2 Underperforming | CT MA - Franklin, Hampden, Hampshire Counties |
CT - 1,202 MA - 4,617 |
- | 4 | Alexandra Glazier $554,529 |
No | Included in House Committee on Oversight and Reform investigation |
New England Organ Bank | 1 Passing | CT MA ME NH RI VT |
CT - 1,202 MA - 4,617 ME - 193 NH - 105 RI - 273 VT - 53 |
- | - | Alexandra Glazier $554,529 |
No | Bought private jet in 2018; included in House Committee on Oversight and Reform investigation |
Washington Regional Transplant Community | 1 Passing | DC MD VA |
DC - 1,553 MD - 2,766 VA - 2,473 |
- | - | Lori Brigham $533,289 |
No | |
OurLegacy | 1 Passing | FL - Eastern | 4,962 | - | - | Ginny McBride N/A |
N/A | CEO published support for new OPO rule |
LifeQuest Organ Recovery Services | 3 Failing | FL - Northern | 4,962 | 24 | 134 | Danielle Balbis N/A |
N/A | |
Life Alliance Organ Recovery Agency | 3 Failing | FL - Southern | 4,962 | 71 | 211 | Sam Salama N/A |
N/A | Subject of investigative reporting for quality control issues and workplace violence (see Washington Post and Miami Herald); included in House Committee on Oversight and Reform investigation |
Lifelink of Florida | 1 Passing | FL - West | 4,962 | - | - | Jean A. Davis N/A |
Yes | Parent company LifeLink Foundation has $117M in assets, paid Board Chair $750,000 in 2017; subject of investigative reporting ; included in House Committee on Oversight and Reform investigation |
Lifelink of Georgia | 2 Underperforming | GA SC - Catoosa, Dade, and Walker Counties |
GA - 4,213 SC - 1,369 |
6 | 75 | Dustin Diggs N/A |
Yes | Parent company LifeLink Foundation has $117M in assets, paid Board Chair $750,000 in 2017; subject of investigative reporting ; included in House Committee on Oversight and Reform investigation |
Legacy of Life | 3 Failing | HI | 364 | 3 | 35 | Stephen Kula* $142,729 |
No | |
Iowa Donor Network | 3 Failing | IA NE - Dakota County |
IA - 585 NE - 309 |
15 | 32 | Suzanne Conrad $390,024 |
No | Owns $8M "interest in net assets" of tissue processor Allosource |
Gift of Hope Organ & Tissue Donor Network | 1 Passing | IL IN - Northwest |
IL - 3,881 IN - 1,021 |
- | - | Kevin Cmunt* $690,692 |
No | “Investment in affiliate” worth $24M |
Indiana Donor Network | 3 Failing | IN | 1,021 | 54 | 236 | Kellie Hanner $517,315 |
No | Started private jet business TxJet in 2014; currently subject of Senate oversight inquiry ; included in House Committee on Oversight and Reform investigation |
Midwest Transplant Network | 1 Passing | KS MO - Western |
KS - 412 MO - 1,662 |
- | - | Jan Finn $523,111 |
Yes | |
Kentucky Organ Donor Affiliates | 3 Failing | KY IN - Southern WV - Western |
KY - 938 IN - 1,021 WV - 116 |
54 | 184 | Julie Bergin $316,970 |
No | Included in House Committee on Oversight and Reform investigation |
Louisiana Organ Procurement Agency | 2 Underperforming | LA | 1,976 | - | 23 | Kelly Ranum $344,184 |
No | |
The Living Legacy Foundation of Maryland | 1 Passing | MD | 2,766 | - | - | Charles Alexander $622,940 |
No | |
Gift of Life Michigan | 1 Passing | MI | 2,534 | - | - | Ladora Dils $478,350 |
Yes | Built $14.3M , 40,000 foot surgical center in 2016 |
Lifesource - MN | 2 Underperforming | MN ND SD WI - Western |
MN - 2,590 ND - 144 SD - 338 WI - 1,588 |
12 | 71 | Susan Raether $636,323 |
No | Included in House Committee on Oversight and Reform investigation |
Mid-America Transplant Services | 1 Passing | MO - Eastern AR - Northeast IL - Southern |
MO -1,662 AR - 243 IL - 3,881 |
- | - | Diane Brockmeier $574,635 |
Yes | CEO published support for new OPO rule; $25 million investment in tissue processor Allosource |
Mississippi Organ Recovery Agency | 3 Failing | MS | 901 | 15 | 44 | Kevin Stump $294,459 |
Yes | |
Carolina Donor Services | 3 Failing | NC - Eastern and Central | 3,222 | 69 | 173 | Danielle Niedfelt $333,572 |
No | |
LifeShare of the Carolinas | 1 Passing | NC - Southwestern and Western SC - York County |
NC - 3,222 SC - 1,369 |
- | - | Michael Daniels N/A |
N/A | |
Nebraska Organ Recovery | 1 Passing | NE | 309 | - | - | Kyle Herber $250,379 |
No | |
New Jersey Sharing Network | 2 Underperforming | NJ - Northern and Central | 2,574 | 26 | 15 | Joseph Roth $565,713 |
No | Investigative reporting re. “A lobbyist for the [OPO] created a website that questions the motives of philanthropist and patient organizations that have supported reforms” |
New Mexico Donor Services | 3 Failing | NM | 522 | 6 | 51 | Wayne Dunlap N/A |
N/A | Included in House Committee on Oversight and Reform investigation |
Nevada Donor Network | 1 Passing | NV | 181 | - | - | Joseph Ferreira $474,982 |
No | Has $1.8M investment in related tissue processor |
Center for Donation and Transplant | 3 Failing | NY - Eastern MA - Berkshire County VT |
NY - 8,700 MA - 4,617 VT - 53 |
14 | 18 | James Barba*+ $1,936,866 |
Yes | |
Finger Lakes Donor Recovery Network | 3 Failing | NY - Central | 8,700 | 12 | 47 | Robert Gruenenfelder N/A |
N/A | |
LiveOnNY | 3 Failing | NY - Southern (NYC) | 8,700 | 68 | - | Helen Irving $768,024 |
No | Board Chair published support for new OPO rule |
ConnectLife | 2 Underperforming | NY - Western | 8,700 | - | 7 | Mark Simon $428,864 |
No | Owns $11M stake in tissue processor Allosource |
LifeLine of Ohio | 2 Underperforming | OH - Central WV - Wood and Hancock Counties |
OH - 3,056 WV - 116 |
8 | 47 | Kent Holloway $308,995 |
No | Investigative reporting found board members billing taxpayers for private planes |
LifeBanc | 1 Passing | OH - Northeast | 3,056 | - | - | Gordon Bowen $538,849 |
No | |
Life Connection of Ohio | 3 Failing | OH - Northwest | 3,056 | 2 | 50 | Ron Apswich* $276,372 |
Yes | CEO supportive of reform, led 34% growth in donors in one year when he took over as leader |
LifeCenter Organ Donor Network | 3 Failing | OH - Southwest KY - Northern IN - Southeast |
OH - 3,056 KY - 938 IN - 1,021 |
- | 60 | Barry Massa $310,044 |
No | |
Lifeshare of Oklahoma | 1 Passing | OK | 599 | - | - | Jeffrey Orlowski $462,721 |
No | |
Pacific NW Transplant Bank | 2 Underperforming | OR ID - Western WA - Southwest |
OR - 903 ID - N/A WA - 1,843 |
20 | 36 | Craig Van De Walker N/A |
N/A | |
Gift of Life | 1 Passing | PA - Eastern DE NJ - Southern |
PA - 6,817 DE - 176 NJ - 2,574 |
- | - | Howard Nathan $752,777 |
No | 2017 CEO compensation $2.5M |
Center for Organ Recovery and Education | 2 Underperforming | PA - Western NY - Chemung County WV |
PA - 6,817 NY - 8,700 WV - 116 |
12 | - | Susan Stuart $542,245 |
No | |
Lifelink of Puerto Rico | 1 Passing | PR | 305 | - | - | Guillermina Sanchez N/A |
Yes | Parent company LifeLink Foundation has $117M in assets, paid Board Chair $750,000 in 2017; subject of investigative reporting ; included in House Committee on Oversight and Reform investigation |
Sharing Hope SC | 3 Failing | SC | 1,369 | 6 | 120 | David DeStefano $290,965 |
No | Included in House Committee on Oversight and Reform investigation ; investigative reporting found fatal lapses in patient safety |
Tennessee Donor Services | 2 Underperforming | TN - Central and Eastern GA - Northern KY - Christian County VA - Southwest |
TN - 3,090 GA - 4,213 KY - 938 VA - 2,473 |
4 | 2 | Jill Grandas $318,193 |
Yes | Included in House Committee on Oversight and Reform investigation |
Mid-South Transplant Foundation | 3 Failing | TN - Western AR - Eastern MS - Northern |
TN - 3,090 AR - 243 MS - 901 |
28 | 149 | Kim Van Frank $310,513 |
Yes | |
Southwest Transplant Alliance | 1 Passing | TX | 9,890 | - | - | Patricia Niles $705,285 |
No | CEO published support of new OPO rule |
LifeGift Organ Donation Center | 1 Passing | TX - Northern and Southeast | 9,890 | - | - | Kevin Myer $478,522 |
No | |
Texas Organ Sharing Alliance | 3 Failing | TX - Southern | 9,890 | 30 | 110 | Joseph Nespral $343,738 |
No | |
DonorConnect | 1 Passing | UT ID - Southeastern NV - Elko WY - Western |
UT - 787 ID - N/A NV - 181 WY - N/A |
- | - | Tracy Schmidt $290,079 |
No | |
LifeNet | 3 Failing | VA NC - Currituck County WV - Northwest |
VA - 2,473 NC - 3,222 WV - 116 |
43 | 117 | Rony Thomas+ $1,585,890 |
Yes | Spent $392M on "tissue processing" and $22M on "organ procurement" in 2018; included in House Committee on Oversight and Reform investigation ; 2018 CEO Salary was $1.6 million |
LifeCenter Northwest | 1 Passing | WA AK ID MT |
WA - 1,843 AK - N/A ID - N/A MT - N/A |
- | - | Kevin O’Connor $515,166 |
No | OIG found OPO “did not fully comply with Medicare requirements… on cost report” |
OPO at the U. of Wisconsin | 1 Passing | WI IL - Winnebago County MI - Northwest MN - Houston County |
WI - 1,588 IL - 3,881 MI - 2,534 MN - 2,590 |
- | - | Michael Anderson N/A |
N/A | |
Versiti | 1 Passing | WI - Southeast | 1,588 | - | - | Chris Miskel+ $959,263 |
No |
* indicates CEO from most recent 990 filing no longer serving in role; + indicates CEO runs a parent organization, such as a hospital system or tissue processor, in which the OPO is housed.
Sources: Tiers from CMS OPO final rule published 2020. Organ waitlists as of May 3rd 2021. Financials from most recent available 990s below. 2019: Donor Network Arizona, OneLegacy, Donor Network West, Donor Alliance, LifeChoice Donor Services, New England Organ Bank, Washington Regional Transplant Community, Iowa Donor Network, Gift of Hope Organ & Tissue Donor Network, Indiana Donor Network, Midwest Transplant Network, Kentucky Organ Donor Affiliates, The Living Legacy Foundation, Gift of Life Michigan, Lifesource MN, Mid-America Transplant Services, Mississippi Organ Recovery Agency, New Jersey Sharing Network, Nevada Donor Network, LiveOnNY, ConnectLife, Lifeline of Ohio, LifeBanc, Life Connection of Ohio, LifeCenter Organ Donor Network, Center for Organ Recovery and Education, We Are Sharing Hope SC, Tennessee Donor Services, Mid-South Transplant Services, Texas Organ Sharing Alliance, Intermountain Donor Services (DonorConnect), LifeCenter Northwest, Versiti 2018: Arkansas Regional Organ Recovery Agency, Legacy of Life Hawaii, Louisiana Organ Procurement Agency, Carolina Donor Services, Nebraska Organ Recovery, Center for Donation and Transplant, Lifeshare Transplant Donor Services of Oklahoma, Gift of Life, Southwest Transplant Alliance, LifeGift, LifeNet
Notes: On January 1st 2021, LifeChoice Donor Services and New England Organ Bank merged; taking the total number of OPOs across the U.S. from 58 to 57.
Research supported by Arnold Ventures and Schmidt Futures in partnership with Organize and the Federation of American Scientists.