Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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 | ||||||
| 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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 51 | 1,025 | 1,076 | |||
| 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 | 1,796,256 | 2,533,115 | 2,821,546 | 3,102,747 | 2,605,743 | 12,859,407 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | 35,102 | 26,694 | 61,796 | |||
| 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 | 1,796,256 | 2,533,115 | 2,821,546 | 3,137,900 | 2,633,462 | 12,922,279 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 1,000 | 1,000 | ||||
| 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.. | 1,000 | 1,000 | ||||
| 8 | Public support. (Subtract line 7c from line 6.) | 12,921,279 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 1,796,256 | 2,533,115 | 2,821,546 | 3,137,900 | 2,633,462 | 12,922,279 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 8,135 | 23,904 | 35,412 | 59,062 | 126,513 | |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 8,135 | 23,904 | 35,412 | 59,062 | 126,513 | |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 173 | 4,911 | 334 | 597 | 17,130 | 23,145 |
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 1,796,429 | 2,546,161 | 2,845,784 | 3,173,909 | 2,709,654 | 13,071,937 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2020 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2020 |
(iii) Distributable Amount for 2020 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2020 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2020: | ||||
| a From 2015....... | ||||
| b From 2016....... | ||||
| c From 2017....... | ||||
| d From 2018....... | ||||
| e From 2019....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2020 distributable amount | ||||
|
i
Carryover from 2015 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2020 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2020 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2020, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2020. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2021. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2016..... | ||||
| b Excess from 2017..... | ||||
| c Excess from 2018..... | ||||
| d Excess from 2019..... | ||||
| e Excess from 2020..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | TO PROMOTE PUBLIC BENEFIT FROM BETTER PATIENT OUTCOMES THROUGH COLLABORATIVE EDUCATIONAL AND RESEARCH EFFORTS INCLUDING: MAINTENANCE OF A REGISTRY OF INFORMATION AND DATA FROM AND ABOUT CENTERS ACTIVE IN EXTRACORPOREAL LIFE SUPPORT AND THEIR PATIENTS FOR USE BY SCIENTISTS AND CLINICIANS IN AREAS RELATED TO EXTRACORPOREAL LIFE SUPPORT, AND PROVISION OF EDUCATIONAL AND TRAINING PROGRAMS AND INFORMATION ABOUT EXTRACORPOREAL LIFE SUPPORT FOR MEDICAL AND LAY COMMUNITIES. |
| FORM 990, PAGE 2, PART III, LINE 4D | OTHER PROGRAMS: ELSO PROVIDES SEVERAL OTHER PROGRAMS FOR OUR MEMBERS, INCLUDING OUR AWARD OF EXCELLENCE AWARD; DATA REQUESTS AND RELATED REPORTS; BOOK SALES OF ELSOS RED BOOK AND ECMO TRAINING MANUAL TO SUPPORT EDUCATION AND TRAINING; THE ABILITY TO EARN CME AND OTHER CONTINUING EDUCATION FOR OUR PRACTITIONERS; AND OTHER PROGRAMS. |
| FORM 990, PAGE 6, PART VI, LINE 4 | IN 2020, ELSO CHANGED ITS ARTICLES OF INCORPORATION FROM A MEMBERSHIP TO A DIRECTORSHIP. ARTICLES OF INCORPORATION ARE AVAILABLE UPON REQUEST. IN CONJUNCTION WITH THESE CHANGES, ELSO CHANGED ITS BYLAWS, WHICH ARE AVAILABLE TO THE PUBLIC ON ELSOS WEBSITE: HTTPS://WWW.ELSO.ORG/ABOUTUS/BYLAWS.ASPX. |
| FORM 990, PAGE 6, PART VI, LINE 6 | A) EACH EXTRACORPOREAL LIFE SUPPORT PROGRAM THAT CONTRIBUTES CASES TO ELSO REGISTRY (A "LIMITED DATA SET" FROM PARTICIPATING CENTERS USEFUL FOR QUALITY ASSURANCE PURPOSES) IS CONSIDERED TO BE AN ACTIVE "INSTITUTIONAL MEMBER" OF ELSO. ACTIVE STATUS OF AN INSTITUTIONAL MEMBER IS MAINTAINED FOR AS LONG AS THE INSTITUTIONAL MEMBER REGULARLY CONTRIBUTES CASES TO THE REGISTRY AND PAYS ITS DUES. AN INSTITUTIONAL MEMBER IS INACTIVE IF IT HAS NOT REPORTED ANY CASES TO THE REGISTRY FOR PERIOD OF TWELVE CONSECUTIVE MONTHS, OR IF ITS DUES ARE IN ARREARS FOR MORE THAN SIX MONTHS. B) IN ANY ACTION OF ELSO, WHICH IS TO BE DETERMINED BY VOTE OF THE INSTITUTIONAL MEMBERS, EACH INSTITUTIONAL MEMBER SHALL HAVE ONE VOTE. THE VOTING REPRESENTATIVE SHALL BE THE INSTITUTION MEMBER'S ECLS PROGRAM DIRECTOR OR HIS OR HER DESIGNEE. C) EACH ACTIVE INSTITUTIONAL MEMBER MAY DESIGNATE AS MANY INDIVIDUAL REPRESENTATIVES AS IT WISHES TO PARTICIPATE IN THE VARIOUS ACTIVITIES OF ELSO. INACTIVE INSTITUTIONAL MEMBERS AND THEIR INDIVIDUAL REPRESENTATIVES MAY NOT PARTICIPATE IN THE ACTIVITIES OF ELSO. CORPORATE MEMBERSHIP A) "CORPORATE MEMBERSHIP" MAY BE HELD BY CORPORATIONS WHO ARE ACTIVE IN RESEARCH AND DEVELOPMENT OF EXTRACORPOREAL DEVICES, DRUGS, AND TECHNIQUES. B) EACH CORPORATE MEMBER MAY DESIGNATE AS MANY INDIVIDUAL REPRESENTATIVES AS IT WISHES TO PARTICIPATE IN THE VARIOUS ACTIVITIES OF THE ORGANIZATION. C) CORPORATE MEMBERS SHALL NOT VOTE AND MAY NOT ATTEND STEERING COMMITTEE MEETINGS EXCEPT BY SPECIAL INVITATION OF THE STEERING COMMITTEE. INDIVIDUAL MEMBERSHIP A) INTERESTED INDIVIDUALS WHO ARE RESEARCH SCIENTISTS OR MEMBERS OF REGULATORY OR PUBLIC HEALTH INSTITUTIONS THAT ARE NOT AFFILIATED WITH AN ACTIVE INSTITUTIONAL MEMBER OR CORPORATE MEMBER ARE ELIGIBLE FOR "INDIVIDUAL MEMBERSHIP" B) INDIVIDUAL MEMBERS MAY PARTICIPATE IN ALL THE ACTIVITIES OF ELSO C) INDIVIDUAL MEMBERS SHALL NOT VOTE AND MAY NOT ATTEND STEERING COMMITTEE MEETINGS EXCEPT BY SPECIAL INVITATION OF THE STEERING COMMITTEE. D) APPLICATION FOR INDIVIDUAL MEMBERSHIP MUST BE SPONSORED BY AN INSTITUTIONAL MEMBER AND BE REVIEWED AND APPROVED BY THE STEERING COMMITTEE. |
| FORM 990, PAGE 6, PART VI, LINE 7A | THE OFFICERS AND OTHER BOARD MEMBERS WILL BE ELECTED ANNUALLY BY AN ELECTRONIC VOTE FROM A SLATE OF NOMINEES FOR OPEN POSITIONS PROVIDED BY THE STEERING COMMITTEE. EACH ACTIVE INSTITUTIONAL MEMBER SHALL HAVE ONE VOTE. THE NOMINEES RECEIVING THE MAJORITY OF VOTES FOR EACH VACANT OFFICE SHALL BE ELECTED. THE RESULTS OF THE ELECTION WILL BE REPORTED BY THE THEN SERVING BOARD CHAIRPERSON AT THE NEXT ANNUAL MEETING OF ELSO FOLLOWING THE ELECTION. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 IS REVIEWED BY THE BOARD OF DIRECTORS. ONCE THE BOARD APPROVES THE FORM 990 IS SIGNED AND SUBMITTED. |
| FORM 990, PAGE 6, PART VI, LINE 12C | IN THE EVENT THAT THE BOARD SHOULD ESTABLISH THAT A PROPOSED TRANSACTION OR ARRANGEMENT ESTABLISHES A CONFLICT OF INTEREST, THE BOARD SHALL THEN PROCEED WITH THE FOLLOWING ACTIONS: A)ANY INTERESTED INDIVIDUAL MAY RENDER A REQUEST OR REPORT AT THE BOARD MEETING, BUT UPON COMPLETION OF SAID REQUEST OR REPORT THE INDIVIDUAL SHALL BE EXCUSED WHILE THE BOARD DISCUSSES THE INFORMATION AND/OR MATERIAL PRESENTED, AND THEN VOTES ON THE TRANSACTION OR ARRANGEMENT PROPOSED INVOLVING THE POSSIBLE CONFLICT OF INTEREST. B)THE CHAIRPERSON OF THE BOARD SHALL, IF DEEMED NECESSARY AND APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. C)AFTER EXERCISING DUE DILIGENCE, THE BOARD SHALL DETERMINE WHETHER ELSO CAN OBTAIN WILL REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. D)IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN ELSO'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. IT SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION ARRANGEMENT IN CONFORMITY WITH THIS DETERMINATION. SHOULD THE BOARD HAVE REASONABLE CAUSE TO BELIEVE AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, THE BOARD SHALL THEN INFORM THE INTERESTED PERSON OF THE BASIS FOR SUCH BELIEF AND AFFORD THE INTERESTED PERSON AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE INTERESTED PERSON'S EXPLANATION AND AFTER MAKING FURTHER INVESTIGATION AS MAY BE WARRANTED IN CONSIDERATION OF THE CIRCUMSTANCES, THE BOARD DETERMINES THE INTERESTED PERSON INTENTIONALLY FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. ALL MINUTES OF THE BOARD MEETINGS, WHEN APPLICABLE, SHALL CONTAIN THE FOLLOWING INFORMATION: A)THE NAMES OF ALL THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED. B)THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSIONS, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION WITH THE PROCEEDINGS. |
| FORM 990, PAGE 6, PART VI, LINE 15A | IN DETERMINING THE COMPENSATION OF TOP OFFICIALS, FIRST A MARKET RESEARCH IS CONDUCTED FOR COMPARABLE SALARIES. THE RESULTS OF THE MARKET RESEARCH ARE REVIEWED BY THE STEERING COMMITTEE WHICH THEN MAKES A RECOMMENDATION FOR COMPENSATION TO THE BOARD FOR APPROVAL. |
| FORM 990, PAGE 6, PART VI, LINE 19 | ELSO SHALL KEEP AT ITS PRINCIPAL OFFICE A COPY OF ITS FEDERAL TAX EXEMPTION APPLICATION AND ITS ANNUAL INFORMATION RETURNS FOR THREE YEARS FROM THEIR DATE OF FILING, WHICH SHALL BE OPEN TO PUBLIC INSPECTION AND COPYING TO THE EXTENT REQUIRED BY LAW. |
| FORM 990, PART IX, LINE 11G | STATISTICIAN SUPPORT SERVICES 74,917 0 0 EDUCATION SUPPORT SERVICES 69,990 0 0 CONFERENCE SUPPORT SERVICES 39,175 0 0 OTHER CONTRACT SERVICES 237,501 113,359 0 TOTAL 421,583 113,359 0 |
| FORM 990, PART XI, LINE 9 | LOSSES REPORTED ON RETURN -135,400 COGS 57,919 COGS -57,919 TOTAL -135,400 |
| Software ID: | |
| Software Version: |