FURP.ORG / PUBLIC DATA EXPLORER

CRUSADERS CENTRAL CLINIC ASSOCIATION: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
CRUSADERS CENTRAL CLINIC ASSOCIATION (EIN 23-7076080)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-02-09
IRS object ID
201130409349300018
Schema version
2009v1.7
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

FieldValueIRS element (for citing)
Timestamp2011-02-09T13:58:54-06:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1910 E ST LOUIS 200/PO BOX 1190AddressLine1
CitySPRINGFIELDCity
StateMOState
ZIP Code658062523ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN237076080EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CRUSADERS CENTRAL CLINIC ASSOCIATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCRUSNameControl
Phone8154901600Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11200 WEST STATE STREETAddressLine1
CityROCKFORDCity
StateILState
ZIP Code61102ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSAMUEL G MILLERName
TitleCFOTitle
Date Signed2011-02-08DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBrian D ToddName
Phone4178658701Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1CRUSADERS COMMUNITY HEALTHBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonGORDON EGGERS CEONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11200 WEST STATE STREETAddressLine1
CityROCKFORDCity
StateILState
ZIP Code61102ZIPCode
FieldValueIRS element (for citing)
Gross Receipts27655674GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.CRUSADERHEALTH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1972YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionCRUSADER COMMUNITY HEALTH SERVES THE ROCK RIVER VALLEY AREA WITH QUALITY PRIMARY HEALTH CARE FOR ALL PEOPLE IN NEEDActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees342TotalNbrEmployees
Total Nbr Volunteers16TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year8284807ContributionsGrantsPriorYear
Contributions Grants Current Year8211002ContributionsGrantsCurrentYear
Program Service Revenue Prior Year19181447ProgramServiceRevenuePriorYear
Program Service Revenue CY19425442ProgramServiceRevenueCY
Investment Income Prior Year53531InvestmentIncomePriorYear
Investment Income Current Year19230InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year27519785TotalRevenuePriorYear
Total Revenue Current Year27655674TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year15301182SalariesEtcPriorYear
Salaries Etc Current Year16486163SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year8952467OtherExpensePriorYear
Other Expenses Current Year9087959OtherExpensesCurrentYear
Total Expenses Prior Year24253649TotalExpensesPriorYear
Total Expenses Current Year25574122TotalExpensesCurrentYear
Revenues Less Expenses Prior Year3266136RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2081552RevenuesLessExpensesCY
Total Assets BOY20495640TotalAssetsBOY
Total Assets EOY22174406TotalAssetsEOY
Total Liabilities BOY3827481TotalLiabilitiesBOY
Total Liabilities EOY3441648TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY16668159NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY18732758NetAssetsOrFundBalancesEOY
Mission DescriptionSINCE 1972, CRUSADER COMMUNITY HEALTH HAS STRIVED TO ENSURE THAT ALL PERSONS IN OUR COMMUNITY HAVE ACCESS TO QUALITY, PRIMARY HEALTH CARE. SEE SCHEDULE O FOR MORE INFORMATION.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense20982973Expense
Revenue19425442Revenue
DescriptionCRUSADER COMMUNITY HEALTH'S MEDICAL SERVICE MODEL EMPHASIZES HIGH QUALITY SERVICES, CONTINUITY OF CARE, EFFICIENT OPERATIONS, AND CONTINUOUS IMPROVEMENT. MEDICAL SERVICES ARE FOCUSED IN THE AREAS OF PEDIATRICS, FAMILY PRACTICE, INTERNAL MEDICINE, SPECIALTY SERVICES, AND WOMEN'S HEALTH. DENTAL SERVICES PROVIDED INCLUDE: EXAMINATIONS, CLEANINGS, FILLINGS, MINOR ORAL SURGERY PROCEDURES SUCH AS EXTRACTIONS. DURING FY 6/30/10, THE ORGANIZATION PROVIDED APPROXIMATELY 126,000 MEDICAL ENCOUNTERS, AND 20,000 DENTAL ENCOUNTERS. SEE SCHEDULE O FOR ADDITIONAL PROGRAM DESCRIPTIONS.Description
Total Program Service Expense20982973TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109614NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees342NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSAMUEL MILLERNamePerson
Telephone Number8154901600TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11200 WEST STATE STREETAddressLine1
CityROCKFORDCity
StateILState
ZIP Code61102ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
TOM WESTON
DIRECTOR1.0X000
VERN CASSENS
DIRECTOR1.0X000
ANNE MAYOCK
SECRETARY1.0X000X
TODD STEFFEN
TREASURER1.0X000X
PETE ROCHE
VICE CHAIR1.0X000X
DAVID RUFFIN
DIRECTOR1.0X000
GLADYS SANDERS
DIRECTOR1.0X000
JAMES POWERS JR
DIRECTOR1.0X000
LEON HANSEN
CHAIR1.0X000X
CATHERINE BROWN
DIRECTOR1.0X000
DENNIS CASE
DIRECTOR1.0X000
TRISHA COLE
DIRECTOR1.0X000
KENT HARRELL
DIRECTOR1.0X000
PEARL HAWKS
DIRECTOR1.0X000
BARBARA JACKSON
DIRECTOR1.0X000
LINDSAY O'BRIEN
DIRECTOR1.0X000
GORDON EGGERS
PRESIDENT & CEO40.0183071025634X
SAMUEL G MILLER
CFO40.0101339028545X
STEVEN LIDVALL MD
MEDICAL DIRECTOR40.0161524014198X
LISA MALONE MD
PROVIDER40.0325930021572X
TAREK HARB MD
PROVIDER40.0344847021512X
ANTOUN AL KHABBAZ MD
PROVIDER40.036085208333X
ANA ZAVADZKAS MD
PROVIDER40.017734208333X
ANSELMA RAMILO MD
PROVIDER40.0175990022322X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1830895TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation150449TotalOtherCompensation
Number Individuals GT100 K27NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Description Of ServicesDescriptionOfServicesCompensationCompensation
BUTLER BENEFIT SVCS
EMPLOYEE BENEFITS333824
SWEDISH AMERICAN HEALTH MGMT
LAB & OTHER309742
FURST STAFFING SERVICES
TEMPORARY STAFF249138
STENSTROM EXCAVATION BLACKTOP
CONSTRUCTION237472
ECLINICAL WORKS
SOFTWARE TRAINING326059
FieldValueIRS element (for citing)
Number Of Contractors GT100 K7NumberOfContractorsGT100K
Related Organizations432253RelatedOrganizations
Government Grants6670657GovernmentGrants
All Other Contributions1108092AllOtherContributions
Noncash Contributions1097313NoncashContributions
Total Contributions8211002TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PROGRAM SERVICE REVENUE6241001927483319274833
OTHER REVENUE62410076657665
MANAGEMENT FEES624100142944142944
FieldValueIRS element (for citing)
Total Program Service Revenue19425442TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column19230TotalRevenueColumn
Exclusion$19,230ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column27655674TotalRevenueColumn
Related Or Exempt Function Income19425442RelatedOrExemptFunctionIncome
Exclusion$19,230ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total514311Total
Program Services175722ProgramServices
Management And General338589ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total18191Total
Program Services18191ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total13025936Total
Program Services11045611ProgramServices
Management And General1980325ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total83017Total
Program Services68086ProgramServices
Management And General14931ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1983699Total
Program Services1682999ProgramServices
Management And General300700ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total861009Total
Program Services706152ProgramServices
Management And General154857ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total61479Total
Management And General61479ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total55854Total
Management And General55854ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1632126Total
Program Services1062114ProgramServices
Management And General570012ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total23154Total
Management And General23154ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total368629Total
Program Services170131ProgramServices
Management And General198498ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total70568Total
Program Services70000ProgramServices
Management And General568ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total563381Total
Program Services458345ProgramServices
Management And General105036ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total189576Total
Management And General189576ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total16816Total
Management And General16816ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total88862Total
Management And General88862ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1311128Total
Program Services1066684ProgramServices
Management And General244444ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PROVISION FOR BAD DEBTS707948707948
REPAIRS & MAINTENANCE32260126245660145
STAFF TRAINING & CME6811468114
DUES & SUBSCRIPTIONS155769155769
MEDICAL SUPPLIES34055813405581

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total46373Total
Program Services14839ProgramServices
Management And General31534ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total25574122Total
Program Services20982973ProgramServices
Management And General4591149ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2815169BOY
EOY3032339EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2493591BOY
EOY2264036EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY609314BOY
EOY651709EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1570020BOY
EOY2872398EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY433837BOY
EOY586208EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY205944BOY
EOY116935EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis18666532LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec7795099LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY10591156BOY
EOY10871433EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1776609BOY
EOY1779348EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY20495640BOY
EOY22174406EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2249664BOY
EOY2185388EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY65089BOY
EOY123656EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1512728BOY
EOY1132604EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY3827481BOY
EOY3441648EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY14487554BOY
EOY16593489EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1473764BOY
EOY1400440EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY706841BOY
EOY738829EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY16668159BOY
EOY18732758EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY20495640BOY
EOY22174406EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteerstrueVolunteers
Paid Staff Or ManagementtruePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MemberstrueMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorstrueDirectContactLegislators
Rallies DemonstrationstrueRalliesDemonstrations
Other ActivitiestrueOtherActivities
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierOTHER LOBBYINGIdentifier
Return ReferenceSCHEDULE C, PART II-B QUESTION 1IReturnReference
ExplanationTHE ORGANIZATION PAYS DUES TO NACHC AND IPHCA. A PORTION OF THESE DUES MAY BE ATTRIBUTABLE TO LOBBYING PURPOSES. PERIODICALLY, MANAGEMENT AND BOARD MEMBERS WRITE LETTERS AND MAKE PRESENTATIONS ON HEALTH CARE RELATED MATTERS TO EDUCATE ELECTED OFFICIALS AND THE PUBLIC. A DE MINIMIS AMOUNT OF FUNDS ARE SPENT ON THESE ACTIVITIES (LESS THAN $5,000).Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis508247OtherCostOrOtherBasis
Book Value508247BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis12881288OtherCostOrOtherBasis
Depreciation4532803Depreciation
Book Value8348485BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis124099OtherCostOrOtherBasis
Depreciation49640Depreciation
Book Value74459BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis4446535OtherCostOrOtherBasis
Depreciation2942921Depreciation
Book Value1503614BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis706363OtherCostOrOtherBasis
Depreciation269735Depreciation
Book Value436628BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings10871433TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
INTEREST IN NET ASSETS OF CHF1749348
ESTIMATED DUE FROM 3RD PARTIES30000
FieldValueIRS element (for citing)
Total Book Value Other Assets1779348TotalBookValueOtherAssets
Total Revenue27655674TotalRevenue
Total Expenses25574122TotalExpenses
Excess Or Deficit For Year2081552ExcessOrDeficitForYear
Other-$16,953OtherAmount
Total Adjustments-16953TotalAdjustments
Excess Or Deficit Per FS2064599ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt27638721TotRevenueEtcAuditedFinclStmt
Other Revenues-16953OtherRevenues
Revenue Not Rptd F990-16953RevenueNotRptdF990
Revenue Subtotal27655674RevenueSubtotal
Total Revenue Per Form99027655674TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt25574122TotExpensesEtcAuditedFinclStmt
Expenses Subtotal25574122ExpensesSubtotal
Total Expenses Per Form99025574122TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
CHANGE IN INTEREST IN CRUSADER HEALTH FOUNDATION (CHF)SCHEDULE D, PART XI, LINE 8 - PART XII LINE 2A DECREASE IN INTEREST IN CRUSADER HEALTH FOUNDATION WAS REPORTED ON THE AUDIT REPORT BUT NOT ON THE 990. THE NET EFFECT WAS A DECREASE IN NET ASSETS OF 16,953. CHANGE IN TEMPORARILY RESTRICTED NET ASSETS OF CHF - <48,941> CHANGE IN PERMANENTLY RESTRICTED NET ASSETS OF CHF - 31,988 TOTAL CHANGE IN NET ASSETS OF CHF <16,953>
UNCERTAIN TAX POSITIONSSCHEDULE D, PART X, LINE 2THE ORGANIZATION ADOPTED THE PROVISIONS OF FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. BECAUSE NO MATERIAL UNCERTAIN TAX POSITIONS WERE IDENTIFIED, A DISCLOSURE WAS NOT INCLUDED IN THE FOOTNOTES TO THE FINANCIAL STATEMENTS.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgtrueCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgs
GORDON EGGERS
1471490147840211380282202281202087050
STEVEN LIDVALL MD
148340000131840001419801757220
LISA MALONE MD
32569300023706002151203475020
TAREK HARB MD
3446310002160002151203663590
ANTOUN AL KHABBAZ MD
360636000216000833303691850
ANA ZAVADZKAS MD
1763300001012000833301856750
ANSELMA RAMILO MD
17498000010100176202056001983120

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SOCIAL CLUB DUESSCHEDULE J, PART I, LINE 1ATHE ORGANIZATION PAID DUES ON BEHALF OF THE CEO, GORDON EGGERS, TO THE UNIVERSITY CLUB. THE TOTAL AMOUNT PAID FOR FY 2010 WAS $1,155.
BONUSESSCHEDULE J, PART I, QUESTION 6A & 7A PORTION OF THE CEO'S PERFORMANCE INCENTIVE IS BASED ON ACHIEVING CERTAIN FINANCIAL PERFORMANCE. THE CFO RECEIVED A DISCRETIONARY PERFORMANCE INCENTIVE.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonROSE EGGERSNamePerson
FieldValueIRS element (for citing)
RelationshipSPOUSE OF G. EGGERSRelationship
Amount Of Transaction18191AmountOfTransaction
Description Of TransactionSEE SCHEDULE ODescriptionOfTransaction
Sharing Of RevenuesfalseSharingOfRevenues

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Works Of ArtWorksOfArt
Art Historical TreasuresArtHistoricalTreasures
Art Fractional InterestArtFractionalInterest
Books And PublicationsBooksAndPublications
Clothing And Household GoodsClothingAndHouseholdGoods
Cars And Other VehiclesCarsAndOtherVehicles
Boats And PlanesBoatsAndPlanes
Intellectual PropertyIntellectualProperty
Securities Publicly TradedSecuritiesPubliclyTraded
Securities Closely Held StockSecuritiesCloselyHeldStock
Securities Prtnrshp Trust IntrstsSecuritiesPrtnrshpTrustIntrsts
Securities MiscellaneousSecuritiesMiscellaneous
Qualified Contrib Hist StructQualifiedContribHistStruct
Qualified Contrib OtherQualifiedContribOther
Real Estate ResidentialRealEstateResidential
Real Estate CommercialRealEstateCommercial
Real Estate OtherRealEstateOther
CollectiblesCollectibles
Food InventoryFoodInventory

Drugs And Medical Supplies DrugsAndMedicalSupplies

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions3NumberOfContributions
Noncash Contribs Rptd F9901108092NoncashContribsRptdF990
Method Of Determining RevenuesFMVMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
TaxidermyTaxidermy
Historical ArtifactsHistoricalArtifacts
Scientific SpecimensScientificSpecimens
Archaeological ArtifactsArchaeologicalArtifacts
Number Of8283 Received0NumberOf8283Received
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftstrueReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

FieldValueIRS element (for citing)
IdentifierPHARMACEUTICAL DONATIONSIdentifier
Return ReferenceSCHEDULE M, PART I, LINE 20ReturnReference
ExplanationTHE ORGANIZATION RECEIVED DONATIONS FROM FOUR VENDORS DURING FISCAL YEAR 2010. THE CONTRIBUTIONS WERE FOR VARIOUS DONATED PHARMACEUTICALS MAINLY FROM PFIZER, ASTRAZENECA, AND ELI LILLY.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
MISSION STATEMENT & PROGRAM SERVICESFORM 990, PART III, PROGRAM SERVICESSINCE 1972, CRUSADER COMMUNITY HEALTH HAS STRIVED TO ENSURE THAT ALL PERSONS IN OUR COMMUNITY HAVE ACCESS TO QUALITY, PRIMARY HEALTH CARE. CRUSADER COMMUNITY HEALTH IS A COMMUNITY-BASED, NOT-FOR-PROFIT CORPORATION, WHOSE MISSION IS TO SERVE THE NORTHWEST ILLINOIS AREA WITH QUALITY, PRIMARY HEALTH CARE FOR ALL PEOPLE IN NEED. CRUSADER COMMUNITY HEALTH PLAYS A VITAL HEALTH CARE ROLE IN THIS COMMUNITY, SERVING PATIENTS UNABLE TO AFFORD THE RISING COST OF HEALTH CARE. WHILE THERE ARE NO RESTRICTIONS ON WHO CAN UTILIZE ITS SERVICES, CRUSADER SPECIALIZES IN SERVING MEDICALLY UNDERSERVED INDIVIDUALS - THE HOMELESS, FAMILIES IN POVERTY, HIGH-RISK PREGNANT WOMEN, PERSONS WITH HIV/AIDS, THE ELDERLY AND THOSE WITH CHRONIC DISEASES. WITHOUT CRUSADER, A BROAD AND GROWING SEGMENT OF THE COMMUNITY WOULD FAIL TO RECEIVE THE PRIMARY HEALTH CARE THAT REDUCES THE COST OF CATASTROPHIC ILLNESS. THE COMMUNITY'S DEMAND FOR AFFORDABLE HEALTH CARE THROUGH CRUSADER IS GROWING RAPIDLY. LAST YEAR OVER 43,000 INDIVIDUALS RECEIVED CRUSADER'S CARE. APPROXIMATELY 97 PERCENT OF CRUSADER COMMUNITY HEALTH PATIENTS HAVE INCOMES AT OR BELOW 200 PERCENT OF THE FEDERAL POVERTY LEVEL. APPROXIMATELY 30 PERCENT HAVE NO HEALTH INSURANCE AND ANOTHER 60 PERCENT ARE MEDICAID RECIPIENTS. MEDICAL SERVICES ARE PROVIDED ON AN AFFORDABLE SLIDING DISCOUNT BASIS AND INTEGRATE HEALTH PROMOTION AND DISEASE PREVENTION INTO A PROGRAM OF COMPREHENSIVE HEALTH CARE. DURING THE YEAR ENDED JUNE 30, 2010, CRUSADER COMMUNITY HEALTH PROVIDED SLIDING SCALE DISCOUNTS AND CHARITY CARE TOTALING $4.9 MILLION. IN ADDITION, THE ORGANIZATION DISPENSED DONATED PHARMACEUTICALS TO ELIGIBLE PATIENTS TOTALING $1.1 MILLION. PROGRAM SERVICES OFFERED AT CRUSADER COMMUNITY HEALTH THE MEDICAL DEPARTMENT OFFERS A FULL ARRAY OF PRIMARY MEDICAL CARE SERVICES FOR PATIENTS OF ALL AGES. MEDICAL SERVICES ARE FOCUSED IN THE AREAS OF PEDIATRICS, FAMILY PRACTICE, INTERNAL MEDICINE, SPECIALTY SERVICES AND WOMEN'S HEALTH. PEDIATRICS THE PEDIATRIC DEPARTMENT OFFERS A WIDE RANGE OF SERVICES FOR CHILDREN, INCLUDING CARE FOR NEWBORNS THROUGH ADOLESCENCE. CRUSADER COMMUNITY HEALTH UTILIZES BOARD-CERTIFIED PEDIATRICIANS, FAMILY PRACTITIONERS, NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS TO DELIVER CARE FOR CHILDREN. SOME OF THE SERVICES AVAILABLE INCLUDE: IMMUNIZATIONS, WELL-CHILD CHECKS, LEAD SCREENING, ATTENTION DEFICIT DISORDER (ADD), ASTHMA EDUCATION AND TREATMENT AND MEDICAL TREATMENT FOR ACUTE CONDITIONS. FOR ADULT PATIENTS, CRUSADER PROVIDES PREVENTIVE CARE AND DIAGNOSIS AND TREATMENT FOR A WIDE RANGE OF ACUTE AND CHRONIC DISEASES. CARE IS DELIVERED THROUGH A TEAM OF BOARD-CERTIFIED MEDICAL PROVIDERS. SOME OF THE SPECIFIC SERVICES AVAILABLE INCLUDE: CHRONIC DISEASE MANAGEMENT, MEDICAL TREATMENT FOR ACUTE CONDITIONS, PHYSICALS, DIABETES EDUCATION AND TREATMENT, HEALTH EDUCATION SERVICES, ASTHMA EDUCATION AND TREATMENT, IMMUNIZATIONS, PULMONARY FUNCTION TESTING, LABORATORY SERVICES, MINOR INJURY CARE AND THE EARLY DIAGNOSIS AND TREATMENT OF MEMORY DISORDERS. WOMEN'S HEALTH SERVICES THE WOMEN'S HEALTH SERVICES DEPARTMENT PROVIDES PRENATAL CARE, WELL-WOMEN EXAMS, CANCER SCREENING AND FOLLOW-UP, AND GYNECOLOGIC SERVICES. SERVICES ARE PROVIDED BY A TEAM OF OBSTETRICIANS, FAMILY PRACTITIONERS AND NURSE PRACTITIONERS. SPECIALTY SERVICES A WIDE RANGE OF SPECIALTY SERVICES ARE AVAILABLE TO CRUSADER COMMUNITY HEALTH PATIENTS, SOME OF WHICH INCLUDE: PODIATRY, ORTHOPEDICS, PAIN MANAGEMENT, INFECTIOUS DISEASE AND DERMATOLOGY. DENTISTRY SERVICES DENTAL SERVICES FOR CHILDREN ARE AVAILABLE AT ALL CRUSADER COMMUNITY HEALTH LOCATIONS. ADULT SERVICES ARE CURRENTLY OFFERED ONLY AT THE WEST STATE STREET AND BROADWAY LOCATIONS. DENTAL SERVICES INCLUDE: - EXAMINATIONS - CLEANINGS - FILLINGS - MINOR ORAL SURGERY PROCEDURES SUCH AS EXTRACTIONS OPTOMETRY SERVICES THE OPTOMETRY CENTER PROVIDES COMPLETE EYE EXAMINATIONS, SCREENINGS FOR DIAGNOSIS OF CATARACTS AND GLAUCOMA, AND CORRECTIVE LENS PRESCRIPTIONS. ALL SERVICES ARE PROVIDED BY ILLINOIS-LICENSED OPTOMETRISTS. IN ADDITION, THE DEPARTMENT OPERATES AN OPTICAL DISPENSARY FOR CORRECTIVE LENSES AND EYEGLASS FRAMES. THROUGH SPECIAL MEMORIAL DONATIONS, NEW OPTICAL EQUIPMENT WAS RECENTLY ADDED TO THE DEPARTMENT, INCLUDING AN AUTO-REFRACTOR, A NON-CONTACT TACHOMETER AND INSTRUMENTS TO MAKE IT EASIER TO DELIVER SERVICES TO THOSE CONFINED TO WHEELCHAIRS. PHARMACY A FULL-SERVICE PHARMACY IS AVAILABLE WITHIN EACH ROCKFORD LOCATION AND A MEDICATION DISPENSARY IS AVAILABLE AT THE BEVIDERE LOCATION. THE CRUSADER COMMUNITY HEALTH PHARMACY OFFERS PATIENTS ACCESS TO LOW COST PRESCRIPTION MEDICATIONS. A MEDICATION SUBSIDY COORDINATOR IS AVAILABLE TO ASSIST ELIGIBLE PATIENTS OBTAIN PRESCRIBED MEDICATIONS AT A LOW COST THROUGH A VARIETY OF PROGRAMS. HIV SERVICES SINCE 1991, THE LIVING WITH HIV PROGRAM OF CRUSADER COMMUNITY HEALTH HAS PROVIDED SERVICES TO INDIVIDUALS WITH HIV/AIDS. EMBRACING THE GOAL OF ASSURING CLIENT ACCESS TO MEDICAL CARE, THE PROGRAM ALSO PROVIDES ASSISTANCE WITH TRANSPORTATION, LINKAGE TO SOCIAL SERVICE PROGRAMS, COUNSELING, PSYCHIATRIC SERVICES, AND OBTAINING MEDICATIONS. SERVICES ARE PRIMARILY PROVIDED AT CRUSADER COMMUNITY HEALTH ON WEST STATE STREET. ON AN ANNUAL BASIS, THE PROGRAM PROVIDES SERVICES TO APPROXIMATELY 300 INDIVIDUALS WITH HIV/AIDS. SERVICES ARE OFFERED CONFIDENTIALLY IN A CARING AND SUPPORTIVE ENVIRONMENT. IN ADDITION TO PROVIDING SERVICES THROUGH ITS PHYSICIAN STAFF, CRUSADER COMMUNITY HEALTH CONTRACTS WITH ROCKFORD INFECTIOUS DISEASE ASSOCIATES TO PROVIDE ADDITIONAL SUPPORT. OTHER SERVICES ARE OFFERED THROUGH A NURSE PRACTITIONER, NURSES, CASE MANAGERS, A LICENSED CLINICAL SOCIAL WORKER, AND A CONTRACTED PSYCHIATRIST. HOMELESS SERVICES CRUSADER COMMUNITY HEALTH'S HEALTH CARE FOR THE HOMELESS PROGRAM WAS ESTABLISHED IN 1988. ITS MISSION IS TO PROVIDE COMPREHENSIVE MEDICAL CARE FOR HOMELESS INDIVIDUALS WITHIN THE ROCKFORD AREA. THE PROGRAM CONSISTS OF PHYSICIANS, DENTISTS, NURSE PRACTITIONERS, NURSES AND CASE MANAGERS COMMITTED TO HELPING CLIENTS ACCESS MEDICAL SERVICES. SERVICES ARE PROVIDED WITHIN CRUSADER COMMUNITY HEALTH AND AT A VARIETY OF SITES THROUGHOUT THE COMMUNITY. HEALTH EDUCATION THE DIVISION OF CLINICAL QUALITY (DCQ) ENSURES CLINICAL EXCELLENCE FOR PATIENTS OF CRUSADER COMMUNITY HEALTH. DCQ OFFERS INTENSIVE CASE MANAGEMENT SERVICES FOR PATIENTS LIVING WITH CHRONIC DISEASES INCLUDING DIABETES, ASTHMA, CONGESTIVE HEART FAILURE (CHF), AND OBESITY (WEIGHT MANAGEMENT). DCQ OFFERS EDUCATION SERVICES IN BOTH A CLASSROOM SETTING AND ONE-TO-ONE SESSIONS IN BOTH ENGLISH AND SPANISH. THE CLINICAL STAFF OF THE PROGRAM INCLUDES A NURSE WHO IS A CERTIFIED DIABETES EDUCATOR, A REGISTERED DIETITIAN, A RESPIRATORY THERAPIST, AND A CLINICAL PHARMACIST (TO PROVIDE MEDICATION MANAGEMENT SERVICES). IN ADDITION, DCQ OFFERS COMMUNITY PROGRAMS THROUGHOUT THE AREA (PRIMARILY WINNEBAGO, BOONE AND STEPHENSON COUNTIES). COMMUNITY SERVICES INCLUDE BLOOD GLUCOSE SCREENINGS FOR DIABETES THROUGH THE COSMOPOLITAN / CRUSADER COMMUNITY HEALTH MOBILE DIABETES PROGRAM AND PUBLIC SPEAKING ENGAGEMENTS ON A VARIETY OF HEALTH RELATED TOPICS.
PROCESS FOR 990 REVIEWFORM 990, PART VI, QUESTION 11BTHE CFO REVIEWS THE FORM 990. A PRESENTATION OF THE RETURN IS MADE BY THE CFO TO THE FINANCE COMMITTEE OF THE BOARD AND THE CEO. A FINAL DRAFT OF THE RETURN IS MADE AVAILABLE TO ALL BOARD MEMBERS BEFORE FILING.
CONFLICT OF INTEREST MONITORINGFORM 990, PART VI, QUESTION 12CTHE CORPORATION SHALL PROHIBIT STAFF MEMBERS, CONSULTANTS OR MEMBERS OF THE BOARD OF DIRECTORS FROM USING THEIR POSITION FOR PURPOSES THAT ARE, OR GIVE THE APPEARANCE OF BEING, MOTIVATED BY A DESIRE FOR PRIVATE FINANCIAL GAIN FOR THEMSELVES OR OTHERS WITH WHOM THEY HAVE FAMILY BUSINESS OR OTHER TIES. BOARD MEMBERS AND EXECUTIVE MANAGEMENT SHALL DISCLOSE IN WRITING (AND UPDATE YEARLY) ALL BUSINESS AND FAMILY RELATIONSHIPS WHICH MIGHT POTENTIALLY CREATE A CONFLICT. IN ADDITION, THE INDIVIDUAL STAFF MEMBER WITH AN ACTUAL OR POTENTIAL CONFLICT SHALL BE PROHIBITED FROM INVOLVEMENT IN THE SELECTION, AWARD AND ADMINISTRATION OF ANY SUCH CONTRACT; A CONFLICTED BOARD MEMBER SHALL DISQUALIFY HIMSELF/HERSELF FROM VOTING AND COMMENTING ON THE CONTRACTOR'S SELECTION AND ANY MONITORING OR OVERSIGHT FUNCTION.
PROCESS FOR DETERMINING COMPENSATIONFORM 990, PART VI, QUESTION 15A & 15BIN JANUARY 2010, THE CEO'S COMPENSATION REVIEW WAS CONDUCTED BY THE EXECUTIVE COMMITTEE OF THE BOARD, WITH APPROVAL BY THE FULL BOARD. THE ILPCA AND NACHC COMPENSATION SURVEY WERE USED AS COMPARABILITY DATA. THE PROCESS WAS DOCUMENTED IN A REPORT ISSUED BY THE EXECUTIVE COMMITTEE MINUTES AND THE BOARD MINUTES OF THE ORGANIZATION. IN JUNE 2010, THE OTHER OFFICER'S AND KEY EMPLOYEES' COMPENSATION REVIEWS WERE CONDUCTED BY THE CEO, WITH APPROVAL BY THE EXECUTIVE COMMITTEE OF THE BOARD, OF THE PROCESS USED TO ESTABLISH THEIR COMPENSATION. THE ILPCA AND NACHC COMPENSATION SURVEY WERE USED AS COMPARABILITY DATA. THE PROCESS WAS DOCUMENTED BY THE CEO AND THE EXECUTIVE COMMITTEE APPROVAL WAS DOCUMENT IN THE JUNE 2010 EXECUTIVE COMMITTEE MINUTES OF THE ORGANIZATION.
DISCLOSURE OF DOCUMENTSFORM 990, PART VI, QUESTION 19THE ORGANIZATION WOULD MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE DOCUMENTS WOULD BE AVAILABLE FOR VIEWING AT THE ORGANIZATIONS OFFICE.
BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONSSCHEDULE L, PART IVROSE EGGERS IS THE SPOUSE OF GORDON EGGERS, PRESIDENT & CEO. SHE IS A PART-TIME NURSE PRACTIONER FOR THE ORGANIZATION. THE AMOUNT OF THE TRANSACTION REPORTED ON SCHEDULE L, PART VI, COLUMN D, REPRESENTS THE AMOUNT PAID IN SALARY AND BENEFITS. THE COMPENSATION AMOUNT PAID IS REVIEWED ANNUALLY BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS TO ENSURE IT IS IN COMPLIANCE WITH THE ORGANIZATIONS COMPENSATION SETTING POLICIES.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1CRUSADERS HEALTH FOUNDATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11200 WEST STATE STREETAddressLine1
CityROCKFORDCity
StateILState
ZIP Code61102ZIPCode
FieldValueIRS element (for citing)
EIN363259761EIN
Primary ActivitiesFUNDRAISINGPrimaryActivities
Legal Domicile StateILLegalDomicileState
Exempt Code Section501(c)(3)ExemptCodeSection
Public Charity Status11aPublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiestrueReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
CRUSADER COMMUNITY HEALTH FOUNDATION
a2500
CRUSADER COMMUNITY HEALTH FOUNDATION
c432253
CRUSADER COMMUNITY HEALTH FOUNDATION
N142947