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Segments are created for donor recipient matching. (Robert Becker) ROBERT BECKER

A stranger’s blood was pumped into Rochelle Dyer’s veins almost every week during chemotherapy sessions in 2000.

Since then, she has gotten blood for two stem cell transplants and several other surgeries.

“Whenever I’m in the hospital, I need blood,” said Dyer, lymphoma-free since 2001. 

Her insurance paid the bills, and she didn’t know what the transfusions cost — until last month, when she called the company to ask.

“Wow.”

Two units, or about two pints, of irradiated red blood cells she received during a hip replacement surgery in February showed up on her bill at $1,154.78 — for something two strangers gave away.

Donors gave Lincoln’s Community Blood Bank more than 5,349 gallons of red cells, whole blood and platelets in 2006.

From those donations, the Blood Bank reported revenues of about $10.5 million, more than $10 million of which it used to cover ever-increasing expenses.

The Community Blood Bank and the American Red Cross orchestrate blood collection in the Lincoln area. The Blood Bank, a charitable nonprofit organization founded by the Lancaster County Medical Society, handles the vast majority of local donations.

Former donor David Anderson, who stopped giving blood at the Blood Bank a few years back, said he has unanswered questions about the whole process.

He knows what he has seen in person, what he has heard from former employees and what he has read on the Blood Bank’s tax forms: facilities that he says look like “Hilton hotels” and six-figure salaries for the organization’s higher-ups.

“I always have to wonder, do they really need the blood or do they need the revenue? I just want to know, does the (Blood Bank) need to live as high on the hog as they appear to be?

“To be fair, it’s not just the Blood Bank; it’s the hospitals as well.”

‘Added value’

There is more to the business of blood than cookies and juice.

“We add value to the gift,” Community Blood Bank CEO Phyllis Ericson said. “We’re making a quality product over here. … The public doesn’t think of that time in there to get it on the shelf.”

Today, U.S. hospitals typically pay blood-collection centers more than $200 per unit of red blood cells. Testing, storing, transporting and transfusing that blood can take days and span thousands of miles.

Storage space at the Blood Bank’s East Lincoln location bears an eerie resemblance to the frozen food section at a supermarket, with tags marking each blood type.

From there, Blood Bank employees ship their product to area hospitals, keeping an equal amount on reserve for emergencies. When the reserves go unused for a period of time, they are sent to regions where there is more need.

In the 1930s, hospitals screened donors for disease, then more or less plugged them into recipients.

“We don’t do it the old-fashioned way — hook you up (to the recipient) — anymore,” Ericson said.

Science and cents

Anderson sees the blood he gave as a gift, he said. He was never paid for the donations he began giving after the Sept. 11, 2001, attacks, nor did he expect to be.

But blood is not quantified like other gifts.

It has no actual monetary value, Ericson said, until it is processed and tested. The Blood Bank’s tax forms reflect that, reporting just $14,538 in direct public support for the 2005 fiscal year. All of that was cash.

So where and why does the price tag for donor blood become so hefty?

Expenses, local and national blood center officials say.

Among the costs locally:

* Bags to store leukocyte-reduced blood cells: $25 to $35 each.

* Advertising and recruiting at least 1,000 donors a week in 2005 at Lincoln’s Blood Bank: $330,476. That includes the cookies, juice and sandwiches donors get after giving blood, as well as T-shirts and other items.

* Processing 45,000 units of blood to meet federal safety standards: $3,343,158.

Since 2005 tax forms were filed, the Community Blood Bank has moved most of its testing from Lincoln to Memorial Blood Centers in Minnesota. Several small samples of each unit are sent there, and the rest stays in town.

The intent was to decrease processing costs, Community Blood Bank spokeswoman Joyce Halvorsen said. Whether the effort was successful is not known because the switch just happened this summer.

No employees were laid off when the Blood Bank moved the testing to Minnesota because they were needed for labeling, quality control and other tasks, Halvorsen said.

Minimum processing costs at the Minnesota center are about $55 per unit, said Dr. Jed Gorlin, director of the center. That covers a dozen required tests for blood typing, disease screening and other measures.

Other tests and actions — such as irradiating blood — can more than double that.

“As a comparison,” Halvorsen said, “if all the tests done on a unit of blood were to be ordered by your physician and done individually, the cost would be over $1,000.”

Testing costs are increasing because only four companies make the required chemicals. Two provide one category of reagents used in the tests, and two provide another.

So for each test performed, testing centers have only two options.

“This is a serious problem,” Gorlin said.

The only test not mandated by the FDA is that for Chagas, a parasite that could cause fatal heart disease or muscle weakness. Most blood centers, including the one in Minnesota, err on the side of caution and test for it.

Labor

Ericson, who has led the Community Blood Bank in Lincoln for 18 years, made nearly $160,000 in the 2005 fiscal year, according to tax forms.

That is $15,000 more than the average charity CEO salary nationwide and $25,000 more than the Midwest average, according to a study released Aug. 1 by Charity Navigator, an independent evaluator of nonprofit groups.

Health charity executives nationwide earn an average of $151,556.

Ericson is a blood recipient herself, so she believes in the Blood Bank’s mission.

“I wouldn’t be walking on the face of the earth today if I hadn’t had   donors 20 years ago with a blood supply,” she said.

She also knows she could make more money in the private sector.

“I’m a clinical chemist. I could be working for a pharmaceutical (company),” Ericson said. “I choose to stay in Lincoln, but … I could go across the country.”

Sandra Miniutti, vice president of Charity Navigator, said such charities as the Community Blood Bank typically attract executives with more education and place greater demands on their schedules.

“They tend to be a little bit larger institutions, a little bit more complex,” she said.

Two organizations, the AABB and America’s Blood Centers, or ABC, are industry associations for CEOs like Ericson and their employees.

ABC board President Don Doddridge, who is also the CEO of a community blood center in Florida, works with government representatives and private companies to keep legislation and costs in the local blood bank’s favor.

Doddridge, who is not paid for the work he does for ABC, guessed he could make about twice as much working at a private business — likely a pharmaceutical corporation — than he does as CEO of the Florida blood center.

“I’m here because I believe in the cause. I believe we’re doing something good for our community,” Doddridge said. “If I didn’t, I wouldn’t be here.”

The job of a blood center CEO is different from that of a private business CEO in that there is less emphasis on profit-making and more on creating a quality product, Ericson said in an interview last month.

“I don’t have any stockholders to pay off at the end of the year,” she said. “All I have to do is stay right above red.”

Janette Twait, CEO of the Siouxland Community Blood Bank in Sioux City, Iowa, made $90,596 in 2005, according to Siouxland’s tax returns.

The Siouxland center’s gross receipts were about $1 million higher in 2005 than were the Lincoln Blood Bank’s. In 2007, Twait said, her blood center collected about 51,000 units of blood — about 6,000 more than Lincoln’s center.

Twait has been CEO of the Siouxland Blood Bank for eight years and has held management positions there for more than 30 years.

“I am not totally familiar with the organization of (Lincoln’s) Community Blood Bank, but overall I would understand our organizations to be quite similar,” Twait said in an e-mail.

In 2005, the Siouxland blood center reported having about 127 employees. That same year, Lincoln’s Blood Bank had 85.

The Community Blood Bank in Lincoln now employs 96 people, 83 full time. They include phlebotomists, registered nurses and career scientists.

Labor takes up the largest chunk of the expenses — almost $4.5 million in 2006, at an average of more than $45,000 per person per year.

“We want to recruit talented people,” Ericson said. “They don’t work for free. We are competing out in the marketplace.”

Mary Brown has worked for Lincoln’s Blood Bank for four years and is now a site supervisor.

“I think everybody finds their niche in nursing, and I like the wellness aspect of it,” she said. “We’re working towards a goal to achieve the best product that we can provide for people in dire need.”

Shelby Stubbendick was making roughly $9.70 an hour as a telephone recruiter at the Blood Bank in 2006. She worked there for 2½ years.

Stubbendick said she was fired by the Blood Bank for not meeting a quota she feels was unrealistic: Of 100 to 120 people she called every day, her bosses expected her to set up donation appointments for 30.

“They told us that we had to get the 30 appointments every day — each one of us — or they were gonna let us go. And they only gave us a week to accomplish this.”

She said she and two other employees didn’t make the cut.

The effort to recruit and keep donors is part of everything the Blood Bank does, Halvorsen said.

It’s the reason Stubbendick’s job was such a high-pressure one.

“They call on a regular basis,” Halvorsen said. “We never do cold calling. It’s always someone who’s had a relationship with the Blood Bank.”

Clean floors and juice

Calls from recruiters weren’t the first thing that came to David Anderson’s mind as he rattled off his list of blood business-inspired qualms. Mostly, he was in awe of the Blood Bank’s buildings.

“They look like Hilton hotels rather than Motel 6s,” he said.

The Blood Bank bought its newest building, at 2700 Fletcher Ave., from Farm Bureau Mutual Insurance Co. for $1,950,000 in March, according to the Lancaster County Assessor’s Office. The site opened in June.

In May 2001, the Blood Bank bought a 21,000-square-foot building at 100 N. 84th St. from Berkley Regional Insurance Co. for $2,150,000.

In its annual report, the Blood Bank estimated it faced more than $1.3 million in facilities expenses for 2006, or 12.3 percent of its total expenses.

In 2005, the depreciated total value of land, buildings and equipment owned by the Blood Bank was reported at almost $4.4 million. The Siouxland Blood Bank reported roughly $1 million in such assets.

“If we had dirt on the floor, I don’t think we’d have donors in here,” Halvorsen said. “We enjoy the highest return rate of donors in the United States.”

More than 90 percent of its blood comes from return donors,  Ericson said. Twait said the Siouxland center’s donor retention rates are slightly lower than Lincoln’s Blood Bank.

Donors here averaged 2.9 units of red cells in 2006, according to the Blood Bank’s annual report. The national average was less than 1.5 units per donor.

The Blood Bank does not pay donors, and, Halvorsen said, likely never will. Even when things get down to the wire like they did over the summer.

In early July, the Community Blood Bank and blood centers nationwide issued a critical appeal for donors.

“We’re hoping to see a lot of people who have never donated — or not for a long time,” Halvorsen said at the time. Her wish came true; donors turned out in force.

“Our first goal is that people donate blood,” Halvorsen said.

‘Identity issues’

Until this year, the Community Blood Bank was the only major blood-collection agency working in Lincoln. In January, the American Red Cross announced it would be pursuing blood donations here as well.

Halvorsen was hesitant to address any pairing off between the two organizations, asking: “How can you compete for a gift?”

In a Sept. 21 letter to supporters, however, CEO Ericson directly addressed the Red Cross’ initiative in Lincoln, asking for continued donations to the Blood Bank.

“Several Lincoln businesses, churches and schools have already been contacted by the American Red Cross (ARC) about hosting a blood drive,” it read.

“While the Lincoln ARC Chapter has done a commendable job responding to area disasters, blood donations to Omaha’s ARC Midwest Blood Services do not help patients served by BryanLGH Medical Center, Saint Elizabeth Regional Medical Center or Madonna Rehabilitation Hospital.”

Ericson also said in the letter that anyone asked to host a Red Cross blood drive should contact the Community Blood Bank.

Blood Bank officials say they are the exclusive providers of blood products to most of the area’s nonprofit hospitals.

“Our primary focus — our reason for being in the community — is that we are the blood supplier to our nonprofit hospitals here in Lincoln,” Halvorsen said. “With another blood-collection agency in town, there’s a lot of confusion. … We’ve had some real identity issues.”

Randy Jones, executive director of the Lancaster County Red Cross, said his organization provides blood to the Nebraska Heart Institute and medical centers across the world.

Regardless of who receives the blood, he said, there is no difference in how important the donation is.

“Maybe that life is in Des Moines, Iowa, or Dallas, Texas. I don’t really care,” he said. “It doesn’t matter where people give their blood. The key is people are giving blood to save lives.”

A gift

Mary Sorensen, director of laboratory services at Saint Elizabeth Regional Medical Center, has worked at the hospital for 32 years.

She knows the business of blood as well as anyone.

Most months, she said, Saint Elizabeth uses from 700 to 800 blood products. Transfusions nationwide totaled more than 14 million units in 2004.

“The Community Blood Bank charges us a fee that’s called the processing fee,” she said. “That fee that they charge us, we pass through to the patient that gets the blood.”

The hospital also charges patients varying fees for cross-matching and administering blood.

At a very rough estimate of $500 per transfusion, the nationwide blood trade would be a billion-dollar business.

But the bottom line, Halvorsen said, is getting donations — getting strangers to give on a regular basis to save someone else, like Rochelle Dyer.

“The community determines our existence,” she said. “They’re in the mood to donate, and they need to donate. They’re gonna save a life.”

Reach Zach Pluhacek at 473-7395 or zpluhacek@journalstar.com.

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