NORTHERN ILLINOIS CANCER TREATMENT CENTER: Form 990, tax year 2011
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- Organization
- NORTHERN ILLINOIS CANCER TREATMENT CENTER (EIN 36-3572331)
- Tax period
- 2011-05-01 to 2012-04-30
- Filed
- 2013-03-13
- IRS object ID
- 201340729349300819
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-03-13T16:42:54-05:00 | Timestamp |
| Tax Period End Date | 2012-04-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390758449 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10000 INNOVATION DRIVE SUITE 250 | AddressLine1 |
| City | MILWAUKEE | City |
| State | WI | State |
| ZIP Code | 532264837 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-05-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363572331 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHERN ILLINOIS CANCER TREATMENT CTR | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NORT | NameControl |
| Phone | 8152841111 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 327 ROUTE 2 | AddressLine1 |
| City | DIXON | City |
| State | IL | State |
| ZIP Code | 61021 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JAMES SARVER | Name |
| Title | CHAIRMAN | Title |
| Phone | 8152841111 | Phone |
| Date Signed | 2013-03-12 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JAY ADKISSON CPA | Name |
| PTIN | P01360892 | PTIN |
| Phone | 4144319300 | Phone |
| Date Prepared | 2013-03-12 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JAMES SARVER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 327 ROUTE 2 | AddressLine1 |
| City | DIXON | City |
| State | IL | State |
| ZIP Code | 61021 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 4390043 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.NICANCER.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1988 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | THE CENTER USES HIGHLY SOPHISTICATED EQUIPMENT FOR DIAGNOSIS AND TREATMENT OF CANCER. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 3 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 10311 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 4281334 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 4349354 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 20648 | InvestmentIncomePriorYear |
| Investment Income Current Year | 29790 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 386 | OtherRevenuePriorYear |
| Other Revenue Current Year | 588 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 4302368 | TotalRevenuePriorYear |
| Total Revenue Current Year | 4390043 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 9520 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 23250 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 811079 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 2151132 | OtherExpensePriorYear |
| Other Expenses Current Year | 3875242 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 2971731 | TotalExpensesPriorYear |
| Total Expenses Current Year | 3898492 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1330637 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 491551 | RevenuesLessExpensesCY |
| Total Assets BOY | 12824151 | TotalAssetsBOY |
| Total Assets EOY | 13157341 | TotalAssetsEOY |
| Total Liabilities BOY | 3931410 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 3773049 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 8892741 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 9384292 | NetAssetsOrFundBalancesEOY |
| Mission Description | PROVIDED HIGH QUALITY CANCER TREATMENT WITH THE LATEST COMPREHENSNE CANCER TREATMENT TECHNOLOGY IN A WELCOMING, COMFORTABLE AND FRIENDLY ENVIRONMENT PERFORMED 13,538 PROCEDURES DURING THE YEAR. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 3608366 | Expense |
| Grants | 23250 | Grants |
| Revenue | 4349942 | Revenue |
| Description | PROVIDED HIGH QUALITY CANCER TREATMENT WITH THE LATEST COMPREHENSNE CANCER TREATMENT TECHNOLOGY IN A WELCOMING, COMFORTABLE AND FRIENDLY ENVIRONMENT PERFORMED 13,538 PROCEDURES DURING THE YEAR. | Description |
| Total Program Service Expense | 3608366 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 7 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 3 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 0 | ConflictOfInterestPolicy |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IL | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8152841111 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 327 ROUTE 2 | AddressLine1 |
| City | DIXON | City |
| State | IL | State |
| ZIP Code | 61021 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (8 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| JAMES SARVER | ||||||
| CHAIRMAN | 5.00 | X | X | 0 | 0 | 0 |
| RAY SHARP | ||||||
| VICE PRESIDENT | 5.00 | X | X | 0 | 189000 | 0 |
| JULIE MANN | ||||||
| TREASURER | 8.00 | X | X | 0 | 186762 | 26674 |
| DONNA HOYLE | ||||||
| SECRETARY | 5.00 | X | X | 0 | 0 | 0 |
| JIM SAY | ||||||
| PRESIDENT | 5.00 | X | X | 0 | 0 | 0 |
| THOMAS MCGLONE MD | ||||||
| BOARD MEMBER | 5.00 | X | 0 | 489534 | 12768 | |
| FADI MUSTAPHA MD | ||||||
| BOARD MEMBER | 5.00 | X | 0 | 408754 | 34589 | |
| JON BERENS | ||||||
| EXECUTIVE DIRECTOR | 40.00 | X | 0 | 190000 | 5500 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1464050 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 79531 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| SAUK VALLEY CANCER PHYSICIANS | |||||
| 17059 TIMBER DRIVE | STERLING | IL | 61081 | PHYSICIAN SERVICES | 879803 |
| CGH MEDICAL CENTER | |||||
| 100 EAST LEFEVRE RD | STERLING | IL | 61081 | LEASED EMPLOYEES | 861143 |
| VARIAN MEDICAL SYSTEMS | |||||
| 70140 NETWORK PLACE | CHICAGO | IL | 60673 | SOFTWARE SUPPORT SERVICES | 267450 |
| CLIFTON GUNDERSONCLIFTON LARSON ALLEN | |||||
| 301 SW ADAMS STE 900 | PEORIA | IL | 61656 | ACCOUNTING AND IT SERVICES | 105273 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| All Other Contributions | 10311 | AllOtherContributions |
| Noncash Contributions | 10311 | NoncashContributions |
| Total Contributions | 10311 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT TREATMENT REVE | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 4349354 | TotalRevenueColumn |
| Related Or Exempt Function Income | 4349354 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 4349354 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 29790 | TotalRevenueColumn |
| Exclusion | $29,790 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS INCOME | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 588 | TotalRevenueColumn |
| Related Or Exempt Function Income | 588 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 588 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4390043 | TotalRevenueColumn |
| Related Or Exempt Function Income | 4349942 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $29,790 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23250 | Total |
| Program Services | 23250 | ProgramServices |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24991 | Total |
| Management And General | 24991 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1796366 | Total |
| Program Services | 1542001 | ProgramServices |
| Management And General | 254365 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 87280 | Total |
| Program Services | 87280 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28567 | Total |
| Program Services | 28567 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 675613 | Total |
| Program Services | 664843 | ProgramServices |
| Management And General | 10770 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10120 | Total |
| Program Services | 10120 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 165268 | Total |
| Program Services | 165268 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 844272 | Total |
| Program Services | 844272 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 117191 | Total |
| Program Services | 117191 | ProgramServices |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| MEDICAL SUPPLIES | 52815 | 52815 |
| BAD DEBT EXPENSE | 52810 | 52810 |
| DUES AND SUBSCRIPTIONS | 11905 | 11905 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8044 | Total |
| Program Services | 8044 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3898492 | Total |
| Program Services | 3608366 | ProgramServices |
| Management And General | 290126 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100279 | BOY |
| EOY | 68210 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3052165 | BOY |
| EOY | 3466328 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 385741 | BOY |
| EOY | 315709 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 110107 | BOY |
| EOY | 143304 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 12637576 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 4210786 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9175859 | BOY |
| EOY | 8426790 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 737000 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12824151 | BOY |
| EOY | 13157341 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 56794 | BOY |
| EOY | 66265 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3710000 | BOY |
| EOY | 3601930 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 164616 | BOY |
| EOY | 104854 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3931410 | BOY |
| EOY | 3773049 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8892741 | BOY |
| EOY | 9384292 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8892741 | BOY |
| EOY | 9384292 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12824151 | BOY |
| EOY | 13157341 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 491551 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation (2 entries)
| EINEIN | Type Of OrganizationTypeOfOrganization | Listed In Governing DocListedInGoverningDoc | Supported Organization NotifiedSupportedOrganizationNotified | Organized In USOrganizedInUS | AmountAmount |
|---|---|---|---|---|---|
| CGH MEDICAL CENTER | |||||
| 363479824 | 6 | 1 | 1 | 1 | $0 |
| KATHERINE SHAW BETHEA HOSPITAL | |||||
| 361000540 | 3 | 1 | 1 | 1 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 2 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 0 | SumOfAmounts |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 21615 | OtherCostOrOtherBasis |
| Book Value | 21615 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6663853 | OtherCostOrOtherBasis |
| Depreciation | 888847 | Depreciation |
| Book Value | 5775006 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5752813 | OtherCostOrOtherBasis |
| Depreciation | 3199004 | Depreciation |
| Book Value | 2553809 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 199295 | OtherCostOrOtherBasis |
| Depreciation | 122935 | Depreciation |
| Book Value | 76360 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 8426790 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | BOARD DESIGNATED CASH | Description |
| Book Value | 737000 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 737000 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO CGH | Description |
| Amount | $104,854 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 104854 | TotalOfAmounts |
| Total Revenue | 4390043 | TotalRevenue |
| Total Expenses | 3898492 | TotalExpenses |
| Excess Or Deficit For Year | 491551 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 491551 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 4390043 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 4390043 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 4390043 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 3898492 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 3898492 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 3898492 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE CENTER DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE CENTER RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS IN 2012 AND 2011. FEDERAL TAX RETURNS FOR TAX YEARS 2009 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 0 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOME OF HOPE OF THE ROCK RIVER VALLEY INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1637 PLOCK RD | AddressLine1 |
| City | DIXON | City |
| State | IL | State |
| ZIP Code | 61021 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 363572331 | EINOfRecipient |
| IRC Section | 501(C)(3) | IRCSection |
| Amount Of Cash Grant | 23250 | AmountOfCashGrant |
| Purpose Of Grant | DONATION TO SUPPORT THE NOT-FOR-PROFIT ORGANIZATION WHO PROVIDE SUPPORT SERVICES TO CANCER PATIENTS. | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RAY SHARP | |||||||||||||
| 0 | 189000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 189000 | 0 | 0 |
| JULIE MANN | |||||||||||||
| 0 | 186762 | 0 | 0 | 0 | 0 | 0 | 8260 | 0 | 18414 | 0 | 213436 | 0 | 0 |
| THOMAS MCGLONE MD | |||||||||||||
| 0 | 489534 | 0 | 0 | 0 | 0 | 0 | 11268 | 0 | 1500 | 0 | 502302 | 0 | 0 |
| FADI MUSTAPHA MD | |||||||||||||
| 0 | 405505 | 0 | 3249 | 0 | 0 | 0 | 12250 | 0 | 22339 | 0 | 443343 | 0 | 0 |
| JON BERENS | |||||||||||||
| 0 | 190000 | 0 | 0 | 0 | 0 | 0 | 5000 | 0 | 500 | 0 | 195500 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | THE BOARD OF DIRECTORS OF NORTHERN ILLINOIS CANCER TREATMENT CENTER HAVE BOARD MEMBERS WHO ARE EMPLOYEES OF CGH MEDICAL CENTER AND KATHERINE SHAW BETHEA HOSPITAL, BOTH OF WHICH, HAVE A 50% EQUITY INTEREST IN THE CENTER. JAMES SAY SERVES ON THE BOARD OF NORTHERN ILLINOIS CANCER TREATMENT CENTER AND IS ALSO ON THE BOARD OF CGH MEDICAL CENTER. RAY SHARP SERVES ON THE BOARD OF NORTHERN ILLINOIS CANCER TREATMENT CENTER AND IS ALSO AN EMPLOYEE OF CGH MEDICAL CENTER. DR THOMAS MCGLONE SERVES ON THE BOARD OF NORTHERN ILLINOIS CANCER TREATMENT CENTER AND IS ALSO AN EMPLOYEE OF STERLING ROCK FALLS CLINIC A RELATED ENTITY OF CGH MEDICAL CENTER. DONNA HOYLE SERVES ON THE BOARD OF NORTHERN ILLINOIS CANCER TREATMENT CENTER AND IS ALSO A BOARD MEMBER OF KATHERINE SHAW BETHEA HOSPITAL. | |
| FORM 990, PART VI, SECTION A, LINE 6 | PER THE ORGANIZATION'S BY LAWS, THERE SHALL BE TWO MEMBERS CGH MEDICAL CENTER AND KATHERINE SHAW BETHEA HOSPITAL. | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE GOVERNING BODY CONSISTS OF 8 DIRECTORS, 3 OF WHICH ARE CHOSEN BY THE BOARD OF DIRECTORS OF CGH MEDICAL CENTER AND 3 OF WHICH ARE CHOSEN BY THE KATHERINE SHAW BETHEA HOSPITAL. | |
| FORM 990, PART VI, SECTION B, LINE 11 | A DRAFT COPY OF FORM 990 IS PROVIDED TO THE DIRECTOR AND THE TREASURER OF THE BOARD TO REVIEW THE RETURN. IF THEY AGREE, THEY MAKE COPIES AVAILABLE TO ALL MEMBERS OF THE BOARD FOR REVIEW THEY THEN LET THE RETURN PREPARER KNOW THAT THE RETURN IS READY TO BE PROCESSED. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THESE DOCUMENTS CAN BE OBTAINED UPON REQUEST. | |
| FORM 990, PART VII, COLUMN B | RAY SHARP IS AN EMPLOYEE OF CGH MEDICAL CENTER AND WORKS AN AVERAGE OF 40 HOURS PER WEEK IN THIS CAPACITY. JULIE MANN IS AN EMPLOYEE OF KSB HOSPITAL AND WORKS AND AVERAGE OF 40 HOURS PER WEEK IN THIS CAPACITY. FADI MUSTAPHA IS A PHYSICIAN FOR KSB HOSPITAL AND WORKS AN AVERAGE OF 40 HOURS PER WEEK IN THIS CAPACITY. THOMAS MCGLONE IS PHYSICIAN WORKING FOR CGH MEDICAL CENDER AND WORKS AND AVERAGE OF 40 HOURS PER WEEK IN THIS CAPICTY. | HOURS DEVOTED TO RELATED ORGANIZATION |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|
| CGH MEDICAL CENTER | |||||||||
| 100 E LEFERE RD | STERLING | IL | 61081 | 363479824 | HOSPITAL | IL | GOVT UNIT - SEC 115 | N/A | 0 |
| KSB HOSPITAL | |||||||||
| 403 E 1ST ST | DIXON | IL | 61021 | 361000540 | HOSPITAL | IL | 501(C)(3) | LINE 3 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
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