2011-10-31T13:08:28-05:00 2011-04-30 CLIFTON GUNDERSON LLP 114 E EVERETT DIXON IL 61021 990 2010-05-01 363572331 NORTHERN ILLINOIS CANCER TREATMENT CENTER NORT 8152841111 327 ROUTE 2 DIXON IL 61021 JIM SARVER 8152841111 2011-10-24 1 TODD M ETHERIDGE 8152842285 2010 2016-03-07 17:11:31Z JAMES SARVER 327 ROUTE 2 DIXON IL 61021 4306646 0 X WWW.NICANCER.ORG X 1988 IL THE CENTER USES HIGHLY SOPHISTICATED EQUIPMENT FOR DIAGNOSIS AND TREATMENT OF CANCER 7 1 0 0 0 0 0 0 2853592 4281334 73019 20648 1065 386 2927676 4302368 15700 9520 0 0 0 811079 0 0 0 2621522 2151132 2637222 2971731 290454 1330637 8341051 12824151 778947 3931410 7562104 8892741 X TO PROVIDE COMPASSIONATE CARE TO OUR CANCER PATIENTS UTILIZING THE HIGHEST QUALITY STANDARDS, EQUIPMENT AND TECHNIQUES AVAILABLE FOR RADIATION ONCOLOGY. IN ADDITION, COORDINATE EFFORTS WITH MEDICAL ONCOLOGY, SURGERY, PAIN MANAGEMENT AND OTHER MEDICAL SPECIALITIES SUCH AS PHYSICAL THERAPY, REHABILITATION, SOCIAL AND DIETARY SERVICES FOR THE BETTERMENT OF OUR PATIENTS. THE GOAL IS TO CURE THE CANCER AND IF NOT POSSIBLE, MAXIMIZE LIFE SPAN AND QUALITY OF LIFE. 0 0 2682052 9520 4281720 PROVIDED HIGH QUALITY CANCER TREATMENT WITH THE LATEST COMPREHENSIVE CANCER TREATMENT TECHNOLOGY IN A WELCOMING, COMFORTABLE AND FRIENDLY ENVIRONMENT. PERFORMED 13,867 PROCEDURES DURING THE YEAR. 2682052 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 1 7 0 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 1 1 0 0 0 1 1 0 1 1 0 0 1 0 0 1 1 0 0 IL X CLIFTON GUNDERSON 8152842285 114 EAST EVERETT DIXON IL 61021 X DR MICHAEL IMLER 1.00 X 0 301447 45576 THOMAS P MCGLONE MD FACS 1.00 X 0 420700 31065 JAMES SAY 1.00 X 0 0 0 JIM SARVER 1.00 X 0 0 0 RAY SHARP 1.00 X 0 167999 42257 VERNON FARRELL 1.00 X 0 14949 8132 DONNA HOYLE 1.00 X 0 0 0 JON BERENS 40.00 X 0 184091 53803 THERESA FRIEL-DRAPER 1.00 X 0 157933 47325 0 1247119 228158 0 0 1 0 SAUK VALLEY CANCER PHYSICIANS 17059 TIMBER DRIVE STERLING IL 61081 PHYSICIAN SERVICES 851720 CGH MEDICAL CENTER 100 E LEFEVRE STERLING IL 61081 LEASED EMPLOYEES 811079 VARIAN MEDICAL SYSTEMS INC 3100 HANSEN WAY PALO ALTO CA 943041038 EQUIPMENT MAINTENANCE 178756 3 CANCER TREATMENT NET O 621110 4281334 4281334 4281334 24926 24926 4278 -4278 -4278 -4278 MISCELLANEOUS 900099 386 386 386 4302368 4281720 0 20648 9520 9520 811079 565665 245414 30221 30221 62374 62374 74514 74514 18577 18577 70219 56175 14044 3201 3201 20862 20862 597466 597466 107968 107968 PHYSICIAN FEES 851720 851720 EQUIPMENT MAINTENANCE 225752 225752 BAD DEBTS 28829 28829 DUES AND SUBSCRIPTIONS 10655 10655 48774 48774 2971731 2682052 289679 0 513135 100279 3620248 3052165 329912 385741 29070 110107 12542373 3366514 3848686 9175859 8341051 12824151 36843 56794 3710000 742104 164616 778947 3931410 X 7562104 8892741 7562104 8892741 8341051 12824151 1330637 0 X X 0 1 1 X 0 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 11637 11637 6579306 659342 5919964 5637030 2566780 3070250 314400 140392 174008 9175859 CONSTRUCTION CONTRACT PAYABLE 59977 DUE TO CGH 104639 164616 4302368 2971731 1330637 0 1330637 4306646 0 4306646 -4278 -4278 4302368 2976009 0 2976009 -4278 -4278 2971731 PART XII, LINE 4B - OTHER ADJUSTMENTS: LOSS ON SALE OF ASSETS -4,278. PART XIII, LINE 4B - OTHER ADJUSTMENTS: LOSS ON SALE OF ASSETS -4,278. 0 HOME OF HOPE OF THE ROCK RIVER VALLEY INC 1637 PLOCK RD DIXON IL 61021 363572331 501(C)3 7500 DONATION TO SUPPORT THE NOT-FOR-PROFIT ORGANIZATION WHO PROVIDE SUPPORT SERVICES TO CANCER PATIENTS. X X X X 0 0 0 0 0 0 1 0 0 DR MICHAEL IMLER 0 222927 0 78520 0 0 0 28750 0 16826 0 347023 0 0 THOMAS P MCGLONE MD FACS 0 420700 0 0 0 0 0 7350 0 23715 0 451765 0 0 RAY SHARP 0 167999 0 0 0 0 0 33230 0 9027 0 210256 0 0 JON BERENS 0 184091 0 0 0 0 0 30088 0 23715 0 237894 0 0 THERESA FRIEL-DRAPER 0 151309 0 6624 0 0 0 38298 0 9027 0 205258 0 0 PART I, LINE 6 DR. MICHAEL IMLER AS A DOCTOR FOR KSB HOSPITAL RECEIVED A BONUS BASED ON THE THE NET CASH COLLECTIONS OF HIS INDIVIDUAL PRACTICE. CGH MEDICAL CENTER 50% EQUITY INTEREST 811079 CGH MEDICAL CENTER LEASES EMPLOYEES TO ITS RELATED ORGANIZATIONS, ALL OF WHICH ARE IN HEALTHCARE RELATED ACTIVITIES. FEES PAID TO CGH MEDICAL CENTER ARE FOR THE CENTER'S SHARE OF COMPENSATION AND OTHER BENEFITS OF EMPLOYEES WHO WORK AT THE CENTER. 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, THUS CREATING A BUSINESS RELATIONSHIP. THERESA FRIEL-DRAPER SERVED ON THE BOARD OF NORTHERN ILLINOIS CANCER TREATMENT CENTER UNTIL MARCH OF 2011. SHE IS ALSO AN OFFICER AND EMPLOYEE OF CGH MEDICAL CENTER VERNON FARRELL AND DR. MICHAEL IMLER SERVE ON THE BOARD OF NORTHERN ILLINOIS CANCER TREATMENT CENTER AND WERE ALSO EMPLOYEES OF KATHERINE SHAW BETHEA HOSPITAL. DONNA HOYLE SERVES ON THE BOARD OF NORTHERN ILLINOIS CANCER TREATMENT CENTER AND IS ALSO A BOARD MEMBER OF KATHERINE SHAW BETHEA HOSPITAL. 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. 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 B, LINE 15A ALL WAGE/SALARY RANGES ARE RESEARCHED AND COMPARED TO SELECTED COMPENSATION SURVEY DATA TO DETERMINE REQUIRED MARKET ADJUSTMENTS. POSITION DESCRIPTIONS MUST BE MAINTAINED ON A CURRENT BASIS AND WILL BE USED AS A BASIS OF COMPARISON TO MARKET DATA. THIS PROCESS WILL TAKE PLACE AT LEAST TWICE PER YEAR. ADDITIONAL COMPARISONS WILL BE CONDUCTED ANY TIME THE MARKETPLACE INDICATES PRESSURE ON KEY POSITIONS. OVERALL MARKET ADJUSTMENTS ARE EFFECTIVE THE FIRST FULL PAY OF JULY OF EACH YEAR, WITH ADDITIONAL ADJUSTMENTS MADE AS CONDITIONS SO WARRANT. COMPENSATION FOR THE CORPORATION'S DIRECTOR IS APPROVED BY THE BOARD. 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 DR. MICHAEL IMLER IS A PHYSICIAN WORKING FOR KSB HOSPITAL, AND WORKS 40 HOURS PER WEEK AVERAGE. THOMAS P. MCGLONE IS A PHYSICIAN WORKING FOR CGH MEDICAL CENTER, AND WORKS AN AVERAGE OF 40 HOURS PER WEEK IN THIS CAPACITY. RAY SHARP IS AN EMPLOYEE OF CGH MEDICAL CENTER AND WORKS AN AVERAGE OF 40 HOURS PER WEEK IN THIS CAPACITY. VERNON FARRELL IS AN EMPLOYEE OF KSB HOSPITAL AND WORKS AN AVERAGE OF 20 HOURS PER WEEK IN THIS CAPACITY. THERESA FRIEL-DRAPER IS AN EMPLOYEE OF CGH MEDICAL CENTER AND WORKS AN AVERAGE OF 40 HOURS PER WEEK IN THIS CAPACITY. FORM 990, PART XII, LINE 2C THE ORGANIZATIONS BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND CHOOSES THE INDEPENDENT ACCOUNTANT. CGH MEDICAL CENTER 100 E LEFEVRE RD STERLING IL 61081 363479824 HOSPITAL IL GOVT UNIT - SEC 115 N/A N/A 0 KSB HOSPITAL 403 E 1ST ST DIXON IL 61021 361000540 HOSPITAL IL 501(C)(3) LINE 3 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 CGH MEDICAL CENTER N 811079 CASH