The Costly Effects of an Outdated Organ Donation System

OPO Performance Ratings

OPO Performance Ratings Based on Final Rule

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.

  • Tier 1 (gray) indicates passing;
  • Tier 2 (yellow) indicates underperforming, with the designated service area (DSA) open for competition from higher performing OPOs;
  • Tier 3 (red) indicates failing, leading to the DSA going to a higher performing OPO.

The table also includes the number of patients waiting for organs in each state served by the OPO.

Highest & Lowest Performing OPOs by Location


A map of states, colors by performance

OPO Performance Ratings Based on Final Rule

To meet top 25%
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.

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