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 | |||||
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Total |
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Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 1,600,795 | 806 | 624,179 | 257,809 | 1,609,222 | 4,092,811 |
| 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 | 1,600,795 | 806 | 624,179 | 257,809 | 1,609,222 | 4,092,811 |
| 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) .. | 974,763 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 3,118,048 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 1,600,795 | 806 | 624,179 | 257,809 | 1,609,222 | 4,092,811 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 31 | 91 | 1,033 | 7,891 | 36,672 | 45,718 |
| 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 | 4,144,526 | |||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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.) | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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 on 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 VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| 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): |
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| 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 2024 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-2024 |
(iii) Distributable Amount for 2024 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2024 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2024 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2024: | ||||
| a From 2019....... | ||||
| b From 2020....... | ||||
| c From 2021....... | ||||
| d From 2022....... | ||||
| e From 2023....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2024 distributable amount | ||||
|
i
Carryover from 2019 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2024 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2024 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2024, 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 2024. 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 2025. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2020..... | ||||
| b Excess from 2021..... | ||||
| c Excess from 2022..... | ||||
| d Excess from 2023..... | ||||
| e Excess from 2024..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
| Return Reference | Explanation |
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| FORM 990, PART VI, SECTION A, LINE 2 | DR. BRENT KEELING AND AMY RANIER, BOTH OF WHOM SERVED ON THE ORGANIZATION'S BOARD DURING THE PERIOD COVERED BY THIS FORM 990, SHARE A FAMILY RELATIONSHIP. |
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERS SHALL INITIALLY BE ELECTED BY THE DIRECTORS AT THEIR INITIAL MEETING AND THEREAFTER BY THE MEMBER INSTITUTIONS OF THE CORPORATION AT A MEETING OF SUCH MEMBERS. MEMBERSHIP OF THE CORPORATION SHALL CONSIST OF THE FOLLOWING CLASSES: INSTITUTIONAL AND PROFESSIONAL. MEMBER INSTITUTIONS. INSTITUTIONAL MEMBERSHIP SHALL BE LIMITED TO HOSPITALS AND OTHER HEALTHCARE FACILITIES AND THEIR RESPECTIVE AFFILIATES ("MEMBER INSTITUTIONS") THAT HAVE A PULMONARY EMBOLISM RESPONSE TEAM (PERT) AND THAT OPERATE A PERT CENTER AS SUCH MAY BE DEFINED AND DESIGNATED FROM TIME TO TIME BY THE CONSORTIUM (A "PERT CENTER"). MEMBER INSTITUTIONS SHALL HAVE THE RIGHT TO VOTE AT ALL MEETINGS OF THE CORPORATION. EACH MEMBER INSTITUTION SHALL FILE WITH THE CONSORTIUM, AS LEAST SIXTY (60) DAYS PRIOR TO THE ANNUAL MEETING, THE NAMES OF ITS DELEGATES AND ALTERNATE DELEGATES FOR THE PURPOSES OF EXERCISING ALL OF THE MEMBERSHIP RIGHTS ON BEHALF OF THE MEMBER INSTITUTION. PROFESSIONAL MEMBERS. EACH MEMBER INSTITUTION SHALL HAVE THE RIGHT TO DESIGNATE AT LEAST ONE PROFESSIONAL MEMBER PER YEAR. THE TOTAL NUMBER OF PROFESSIONAL MEMBERS EACH MEMBER INSTITUTION MAY DESIGNATE EACH YEAR SHALL BE FIXED BY THE CONSORTIUM FROM TIME TO TIME. PROFESSIONAL MEMBERSHIP SHALL BE LIMITED TO PHYSICIANS, TECHNOLOGISTS, ADVANCED PRACTITIONERS, AND NURSES WHO ARE ACTIVELY WORKING IN THE FIELD PULMONARY EMBOLISM AT A PERT CENTER. PROFESSIONAL MEMBERS ARE NON-VOTING MEMBERS OF THE CORPORATION AND SHALL OTHERWISE HAVE ALL THE RIGHTS AND PRIVILEGES OF MEMBERSHIP AS DETERMINED BY THE BOARD OF DIRECTORS FROM TIME TO TIME. |
| FORM 990, PART VI, SECTION A, LINE 7A | MEMBER INSTITUTIONS SHALL HAVE THE RIGHT TO ELECT DIRECTORS PROVIDED BY THE ORGANIZATION'S BYLAWS. MEMBERS MAY BE REMOVED WITH OR WITHOUT CAUSE BY A VOTE OF TWO THIRDS (2/3) OF THE MEMBERS THEN IN OFFICE, OR REMOVED FOR CAUSE BY A VOTE OF A MAJORITY OF THE DIRECTORS THEN IN OFFICE. A MEMBER INSTITUTION MAY BE REMOVED FOR CAUSE ONLY AFTER REASONABLE NOTICE AND OPPORTUNITY TO BE HEARD. IN ADDITION, MEMBER INSTITUTIONS MAY REMOVE OR ADD PROFESSIONAL MEMBERS UPON NOTICE TO THE CORPORATION. EXCEPT AS OTHERWISE PROVIDED BY LAW, BY THE ARTICLES OF ORGANIZATION, OR BY THE ORGANIZATION'S BYLAWS, THE BOARD OF DIRECTORS SHALL BE ELECTED AT THE ANNUAL MEETING OF THE MEMBERS IN THE MANNER PRESCRIBED BY LAW, BY THE ARTICLES OF ORGANIZATION, AND BY THE BYLAWS. NOMINATION FOR ELECTION TO THE BOARD OF DIRECTORS MAY BE MADE BY WRITTEN NOMINATION OF THE MEMBERS, THE NOMINATING COMMITTEE OR BY SELF-NOMINATION. NO NOMINATION WILL BE PRESENTED TO THE GENERAL MEMBERSHIP FOR VOTING WITHOUT THE CONSENT OF THE PROPOSED NOMINEE. A DIRECTOR MAY BE REMOVED WITH OR WITHOUT CAUSE BY VOTE OF A MAJORITY OF THE MEMBERS THEN IN OFFICE. ANY VACANCY IN THE BOARD OF DIRECTORS MAY BE FILLED BY THE MEMBERS OR, IN THE ABSENCE OF MEMBER ACTION, BY A MAJORITY OF THE DIRECTORS THEN IN OFFICE, ALTHOUGH LESS THAN A QUORUM, OR BY A SOLE, REMAINING DIRECTOR; EXCEPT THAT VACANCIES RESULTING FROM ENLARGEMENT OF THE BOARD OF DIRECTORS MAY BE FILLED ONLY BY THE MEMBERS AND NOT BY THE DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | MEMBER INSTITUTIONS SHALL HAVE SUCH OTHER POWERS AND RIGHTS AS THE DIRECTORS MAY DESIGNATE. AFFAIRS OF THE CORPORATION SHALL BE MANAGED BY THE BOARD OF DIRECTORS WHICH SHALL HAVE AND MAY EXERCISE ALL THE POWERS OF THE CORPORATION, EXCEPT THOSE POWERS RESERVED TO THE MEMBER INSTITUTIONS BY LAW, THE ARTICLES OF ORGANIZATION, OR THE ORGANIZATION'S BYLAWS. THE ORGANIZATION'S BYLAWS MAY BE AMENDED OR REPEALED UPON THE AFFIRMATIVE VOTE OF THE MEMBER INSTITUTIONS OF THE CORPORATION, PROVIDED THAT THE SUBSTANCE OF ANY SUCH AMENDMENT IS STATED IN THE NOTICE OF THE MEETING OF MEMBER INSTITUTIONS. ANY BYLAW ADOPTED BY THE DIRECTORS MAY BE AMENDED OR REPEALED BY THE MEMBER INSTITUTIONS. ANY TRANSACTION QUESTIONED ON THE GROUND OF LACK OF AUTHORITY, DEFECTIVE OR IRREGULAR EXECUTION, ADVERSE INTEREST OF A DIRECTOR, OFFICER, OR MEMBER, NONDISCLOSURE, MISCOMPUTATION, OR THE APPLICATION OF IMPROPER PRINCIPLES OR PRACTICES OF ACCOUNTING, OR ON ANY OTHER GROUNDS, MAY BE RATIFIED BEFORE OR AFTER JUDGMENT BY THE BOARD OF DIRECTORS OR BY THE MEMBERS ENTITLED TO VOTE; AND, IF SO RATIFIED, SHALL HAVE THE SAME FORCE AND EFFECT AS IF THE QUESTIONED TRANSACTION HAD BEEN ORIGINALLY DULY AUTHORIZED, AND SUCH RATIFICATION SHALL BE BINDING UPON THE CORPORATION AND SHALL CONSTITUTE A BAR TO ANY CLAIM OR EXECUTION OF ANY JUDGMENT IN RESPECT OF SUCH QUESTIONED TRANSACTION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE ORGANIZATION'S FORM 990 IS PRESENTED TO THE BOARD FOR REVIEW AND APPROVAL BEFORE FILING WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE PERT CONSORTIUM CONFLICT OF INTEREST POLICY IS BASED ON THE BASIC TENET THAT TRANSPARENCY IN THE OPERATIONS AND DECISION-MAKING OF THE ORGANIZATION IS ESSENTIAL TO THE OPTIMAL FUNCTIONING OF THE ORGANIZATION. TO ACHIEVE THE OBJECTIVE OF AVOIDING ANY MISUNDERSTANDING OR DOUBTS BETWEEN AND AMONG MEMBERS OF THE CONSORTIUM REGARDING THE EXISTENCE OF POSSIBLE CONFLICTS, THE CONFLICTS POLICY IS DESIGNED TO BE INCLUSIVE, STRAIGHTFORWARD, AND EASY TO APPLY. THE ORGANIZATION REQUIRES ITS BOARD MEMBERS TO DISCLOSE ANY SITUATIONS WHERE THERE MIGHT ONLY BE A POTENTIAL CONFLICT OR SIMPLY THE APPEARANCE OF A POSSIBLE CONFLICT OF INTEREST. ACCORDINGLY, MEMBERS SHALL PROMPTLY REPORT TO THE BOARD OF DIRECTORS ANY RELATIONSHIP THEY OR IMMEDIATE FAMILY MEMBERS HAVE OF A PERSONAL, PROFESSIONAL, OR ECONOMIC NATURE - INCLUDING, BUT NOT LIMITED TO, ANY OUTSIDE BUSINESS INTEREST, CONSULTING RELATIONSHIP, SPEAKING ENGAGEMENT ARRANGEMENT, OR OTHER FINANCIAL INTEREST WITH AN EXISTING OR POTENTIAL PERT VENDOR OR SPONSOR, OR BUSINESS COMPETITOR OF SUCH A SPONSOR, OR ANY FAMILY OR PERSONAL RELATIONSHIP (ANYTHING BEYOND FRIENDSHIP) - THAT POTENTIALLY DOES OR MAY CREATE AN INTEREST THAT CONFLICTS WITH THE EXCLUSIVE BEST INTERESTS OF PERT. THE CURATIVE FOR CONFLICTS OF INTEREST IS RECUSAL BY THE MEMBER FROM DECISION MAKING WITH REGARD TO THE SUBJECT MATTER THAT GIVES RISE TO THE CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION'S BOARD OF DIRECTORS REVIEWS COMPARABILITY DATA TO DETERMINE THE APPROPRIATE COMPENSATION OF THE ORGANIZATION'S EXECUTIVE DIRECTOR AND FINANCIAL MANAGER. AN OFFICER SHALL BE ENTITLED TO RECEIVE COMPENSATION FOR SERVICES IF SO DETERMINED BY THE BOARD OF DIRECTORS AND IN SUCH AMOUNTS AS THE BOARD OF DIRECTORS MAY FROM TIME TO TIME DETERMINE. OFFICERS SHALL NOT BE PRECLUDED FROM SERVING THE CORPORATION IN ANY OTHER CAPACITY AND RECEIVING REASONABLE COMPENSATION FOR ANY SUCH SERVICES IN SUCH AMOUNTS AS THE BOARD OF DIRECTORS MAY FROM TIME TO TIME DETERMINE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 311,463. MANAGEMENT AND GENERAL EXPENSES 230,979. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 542,442. |
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