2013-03-13T16:42:54-05:00 2012-04-30 390758449 WIPFLI LLP 10000 INNOVATION DRIVE SUITE 250 MILWAUKEE WI 532264837 990 2011-05-01 363572331 NORTHERN ILLINOIS CANCER TREATMENT CTR NORT 8152841111 327 ROUTE 2 DIXON IL 61021 JAMES SARVER 8152841111 2013-03-12 1 JAY ADKISSON CPA P01360892 4144319300 2013-03-12 2011 2016-02-25 16:41:14Z JAMES SARVER 327 ROUTE 2 DIXON IL 61021 4390043 0 X WWW.NICANCER.COM X 1988 IL THE CENTER USES HIGHLY SOPHISTICATED EQUIPMENT FOR DIAGNOSIS AND TREATMENT OF CANCER. 7 3 0 0 0 0 0 10311 4281334 4349354 20648 29790 386 588 4302368 4390043 9520 23250 0 0 811079 0 0 0 0 2151132 3875242 2971731 3898492 1330637 491551 12824151 13157341 3931410 3773049 8892741 9384292 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. 0 0 3608366 23250 4349942 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. 3608366 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 7 0 0 0 0 0 0 0 0 0 0 0 0 X 7 3 1 0 0 0 1 1 0 1 1 0 0 1 0 0 1 0 0 0 IL X THE ORGANIZATION 8152841111 327 ROUTE 2 DIXON IL 61021 X JAMES SARVER 5.00 X X 0 0 0 RAY SHARP 5.00 X X 0 189000 0 JULIE MANN 8.00 X X 0 186762 26674 DONNA HOYLE 5.00 X X 0 0 0 JIM SAY 5.00 X X 0 0 0 THOMAS MCGLONE MD 5.00 X 0 489534 12768 FADI MUSTAPHA MD 5.00 X 0 408754 34589 JON BERENS 40.00 X 0 190000 5500 0 1464050 79531 0 0 1 0 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 4 10311 10311 10311 PATIENT TREATMENT REVE 621110 4349354 4349354 4349354 29790 29790 MISCELLANEOUS INCOME 900099 588 588 588 4390043 4349942 0 29790 23250 23250 24991 24991 1796366 1542001 254365 87280 87280 28567 28567 675613 664843 10770 10120 10120 165268 165268 844272 844272 117191 117191 MEDICAL SUPPLIES 52815 52815 BAD DEBT EXPENSE 52810 52810 DUES AND SUBSCRIPTIONS 11905 11905 8044 8044 3898492 3608366 290126 0 100279 68210 3052165 3466328 385741 315709 110107 143304 12637576 4210786 9175859 8426790 0 737000 12824151 13157341 56794 66265 3710000 3601930 164616 104854 3931410 3773049 X 8892741 9384292 8892741 9384292 12824151 13157341 491551 0 X 0 1 1 X 0 X X X 0 0 0 CGH MEDICAL CENTER 363479824 6 1 1 1 0 KATHERINE SHAW BETHEA HOSPITAL 361000540 3 1 1 1 0 2 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 21615 21615 6663853 888847 5775006 5752813 3199004 2553809 199295 122935 76360 8426790 BOARD DESIGNATED CASH 737000 737000 DUE TO CGH 104854 104854 4390043 3898492 491551 491551 4390043 0 4390043 0 4390043 3898492 0 3898492 0 3898492 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: 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. 0 HOME OF HOPE OF THE ROCK RIVER VALLEY INC 1637 PLOCK RD DIXON IL 61021 363572331 501(C)(3) 23250 DONATION TO SUPPORT THE NOT-FOR-PROFIT ORGANIZATION WHO PROVIDE SUPPORT SERVICES TO CANCER PATIENTS. 1 0 0 0 0 0 0 0 0 0 0 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 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. HOURS DEVOTED TO RELATED ORGANIZATION 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. 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 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0