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CANCER CENTER OF WESTERN WISCONSIN INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
CANCER CENTER OF WESTERN WISCONSIN INC (EIN 27-3238660)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-15
IRS object ID
201713199349310951
Schema version
2016v3.0
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)
Return2017-11-15T13:53:44-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1818 SECOND ST SO SUITE 320AddressLine1Txt
CityWAITE PARKCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56387ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN273238660EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CANCER CENTER OF WESTERN WISCONSIN INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCANCBusinessNameControlTxt
Phone7152432800PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1501 HOSPITAL ROADAddressLine1Txt
CityNEW RICHMONDCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54017ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJASON LUHRSPersonNm
Person TitleTREASURERPersonTitleTxt
Phone7152432800PhoneNum
Signature2017-11-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKRISTIN L SCHMIDTPreparerPersonNm
PTINP01487323PTIN
Phone3202035500PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address67.137.57.251IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-11-14IPDt
IP Tm16:18:12IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id39F8DF97AC880308412285B2578205EC56CD9826AtSubmissionCreationDeviceId
At Submission Filing Device IdA7C12AE50CA3DAE1D6FF2ECF9FF31413F0CDE52BAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSTEVE MASSEYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1501 HOSPITAL ROADAddressLine1Txt
CityNEW RICHMONDCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54017ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$2,811,737GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CC-WW.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2010FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionTO IMPROVE HEALTH, HEALING AND LIFE FOR THOSE EXPERIENCING CANCER.ActivityOrMissionDesc
Voting Members Governing Body6VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers20TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$76,078CYContributionsGrantsAmt
PY Program Service Revenue$2,578,596PYProgramServiceRevenueAmt
CY Program Service Revenue$2,585,569CYProgramServiceRevenueAmt
PY Investment Income$175,060PYInvestmentIncomeAmt
CY Investment Income$150,090CYInvestmentIncomeAmt
PY Other Revenue$21,632PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$2,775,288PYTotalRevenueAmt
CY Total Revenue$2,811,737CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$27,065CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,818,834PYOtherExpensesAmt
CY Other Expenses$2,642,666CYOtherExpensesAmt
PY Total Expenses$2,818,834PYTotalExpensesAmt
CY Total Expenses$2,669,731CYTotalExpensesAmt
PY Revenues Less Expenses-$43,546PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$142,006CYRevenuesLessExpensesAmt
Total Assets BOY$1,651,444TotalAssetsBOYAmt
Total Assets EOY$1,987,451TotalAssetsEOYAmt
Total Liabilities BOY$141,870TotalLiabilitiesBOYAmt
Total Liabilities EOY$269,038TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,509,574NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,718,413NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO IMPROVE HEALTH, HEALING AND LIFE FOR THOSE EXPERIENCING CANCER WITH THE COMPASSION THAT DEFINES OUR COMMUNITIES. THIS REGIONAL PARTNERSHIP OF HEALTHCARE ORGANIZATIONS BRINGS HIGH-CALIBER AND TIMELY TREATMENT INTO EACH PATIENT'S FAMILIAR AND TRUSTED HOME COMMUNITY.MissionDesc
Significant New Program SrvcYes (1)SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$1,389,149ExpenseAmt
Grant$0GrantAmt
Revenue$1,418,273RevenueAmt
DescRADIATION TREATMENT SERVICES - PROVIDE RADIATION TREATMENT SERVICES THROUGH OUR PARTNERSHIPDesc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$1,160,219ExpenseAmt
Grant$0GrantAmt
Revenue$1,092,899RevenueAmt
DescONCOLOGIST SERVICES - PURCHASE OF MD TIME TO SERVE THE OWNER COMMUNITIESDesc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$27,065ExpenseAmt
Grant$27,065GrantAmt
Revenue$0RevenueAmt
DescGENETIC COUNSELOR - THE CANCER CENTER OF WESTERN WISCONSIN WAS GRANTED DOLLARS FROM THE OTTO BREMER TRUST TO HELP WITH THE COST OF IMPLEMENTING GENETICS COUNSELING SERVICES IN WESTERN WI. THE GRANT AMOUNT WAS $48,728 AND ALLOWED US TO BRING THE PROGRAM TO A RURAL SETTING. GENETICS IS NEEDED TO HELP PATIENTS AND DOCTORS MAKE TREATMENT DECISIONS TOGETHER. PRIOR TO THE GRANT, THE PATIENTS WOULD HAVE TO DRIVE FOR AT LEAST AN HOUR FOR THE SERVICES.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$0ExpenseAmt
Grant$0GrantAmt
Revenue$74,397RevenueAmt
DescONCOLOGY SERVICES; NEW RICHMOND - PROIVDE MEDICAL ONCOLOGY SERVICES IN NEW RICHMOND WISCONSINDesc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$0TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$0TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$74,397TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$2,576,433TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members6GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Own WebsiteYes (X)OwnWebsiteInd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JASON LUHRSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7152432852PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1535 HOSPITAL RDAddressLine1Txt
CityNEW RICHMONDCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54017ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
STEVE MASSEY
PRESIDENT2.0040.00Yes (X)Yes (X)$0$303,919$0
ALISON PAGE
VICE PRESIDENT1.0040.00Yes (X)Yes (X)$0$293,589$0
TOM GESKERMAN
SECRETARY1.0040.00Yes (X)Yes (X)$0$226,801$0
DAVE DOBOSENSKI
BOARD MEMBER1.0040.00Yes (X)$0$319,653$0
MARIAN FURLONG
BOARD MEMBER1.0040.00Yes (X)$0$338,465$0
DEBRA RUDQUIST
BOARD MEMBER1.0040.00Yes (X)$0$313,468$0
JASON LUHRS
TREASURER2.0040.00Yes (X)$0$204,194$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,000,089TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GROUP HEALTH INCBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 64059AddressLine1Txt
CityST PAULCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55164ZIPCd
FieldValueIRS element (for citing)
ServicesONCOLOGIST SERVICESServicesDesc
Compensation$1,092,899CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
All Other Contributions$76,078AllOtherContributionsAmt
Total Contributions$76,078TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
RADIATION TREATMENT621110$1,418,273$1,418,273
PHYSICIAN SERVICES621110$1,092,899$1,092,899
ONCOLOGY SERVICES WEST621110$74,397$74,397
FieldValueIRS element (for citing)
Total Program Service Revenue$2,585,569TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$150,090TotalRevenueColumnAmt
Exclusion$150,090ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,811,737TotalRevenueColumnAmt
Related Or Exempt Func Income$2,585,569RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$150,090ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$27,065TotalAmt
Program Services$27,065ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$3,808TotalAmt
Management And General$3,808ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,160,219TotalAmt
Program Services$1,160,219ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$13,885TotalAmt
Management And General$13,885ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,340TotalAmt
Management And General$1,340ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$16,993TotalAmt
Management And General$16,993ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescRADIATION TREATMENT EXPDesc
Total$1,389,149TotalAmt
Program Services$1,389,149ProgramServicesAmt

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$57,272TotalAmt
Management And General$57,272ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$2,669,731TotalAmt
Program Services$2,576,433ProgramServicesAmt
Management And General$93,298ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$143,931BOYAmt
EOY$722,784EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$50,053BOYAmt
EOY$61,238EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$709,657BOYAmt
EOY$443,496EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$203,917LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$203,917LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$16,993BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$730,810BOYAmt
EOY$759,933EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,651,444BOYAmt
EOY$1,987,451EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$141,870BOYAmt
EOY$269,038EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$141,870BOYAmt
EOY$269,038EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,509,574BOYAmt
EOY$1,718,413EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,509,574BOYAmt
EOY$1,718,413EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,651,444BOYAmt
EOY$1,987,451EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$142,006ReconcilationRevenueExpnssAmt
Prior Period Adjustments$66,833PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
IRS Written DeterminationYes (X)IRSWrittenDeterminationInd
Supported Organizations6SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp (6 entries)

EINEINOrganization TypeOrganizationTypeCdGoverning Document ListedGoverningDocumentListedIndSupportSupportAmtOther SupportOtherSupportAmt
AMERY REGIONAL MEDICAL CENTER INC
3909083203Yes (1)$0$0
BALDWIN AREA MEDICAL CENTER
3908085263Yes (1)$0$0
HUDSON HOSPITAL INC
3908041253Yes (1)$0$0
OSCEOLA MEDICAL CENTER
3907739703Yes (1)$0$0
ST CROIX REGIONAL MEDICAL CENTER INC
3908906763Yes (1)$0$0
WESTFIELDS HOSPITAL INC
3908084423Yes (1)$0$0
FieldValueIRS element (for citing)
Supported Organizations Total6SupportedOrganizationsTotalCnt
Support Sum$0SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (1)ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (1)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt Org0OperateBenefitNonSuprtOrgInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$203,917OtherCostOrOtherBasisAmt
Depreciation$203,917DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescINVESTMENT IN WWRTCDesc
Book Value$759,933BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$759,933TotalBookValueSecuritiesAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeGENETICS COUNSELING SERVICESGrantTypeTxt
Recipient102RecipientCnt
Cash Grant$27,065CashGrantAmt
Valuation Method UsedTRACKED THROUGH EPIC SCHEDULING. TOTAL CONSISTS OF ALL VISITS LOGGED.ValuationMethodUsedDesc

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTHE CANCER CENTER OF WESTERN WISCONSIN (CCWW) MANAGEMENT STAFF REVIEW THE MISSION AND PURPOSE OF POTENTIAL GRANTEE ORGANIZATIONS TO ASSURE CONSISTENCY WITH THE CCWW'S MISSION AND PURPOSE. AMOUNTS SUBSEQUENTLY GRANTED ARE SUBJECT TO THE CCWW'S FORMAL SPENDING APPROVAL AND DOCUMENTATION PROCESS BASED ON AMOUNT OF THE EXPENDITURE.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
STEVE MASSEY
PRESIDENT$0$232,699$0$62,168$0$9,052$0$0$0$0$0$303,919$0$0
ALISON PAGE
VICE PRESIDENT$0$276,856$0$16,733$0$0$0$0$0$0$0$293,589$0$0
TOM GESKERMAN
SECRETARY$0$191,442$0$0$0$35,359$0$0$0$0$0$226,801$0$0
DAVE DOBOSENSKI
BOARD MEMBER$0$319,653$0$0$0$0$0$0$0$0$0$319,653$0$0
MARIAN FURLONG
BOARD MEMBER$0$257,841$0$68,848$0$11,776$0$0$0$0$0$338,465$0$0
DEBRA RUDQUIST
BOARD MEMBER$0$245,042$0$59,123$0$9,303$0$0$0$0$0$313,468$0$0
JASON LUHRS
TREASURER$0$167,211$0$30,978$0$6,005$0$0$0$0$0$204,194$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 2THE CANCER CENTER OF WESTERN WISCONSIN WAS GRANTED DOLLARS FROM THE OTTO BREMER TRUST TO HELP WITH THE COST OF IMPLEMENTING GENETICS COUNSELING SERVICES IN WESTERN WI. THE GRANT AMOUNT WAS $48,728 AND ALLOWED US TO BRING THE PROGRAM TO A RURAL SETTING. GENETICS IS NEEDED TO HELP PATIENTS AND DOCTORS MAKE TREATMENT DECISIONS TOGETHER. PRIOR TO THE GRANT, THE PATIENTS WOULD HAVE TO DRIVE FOR AT LEAST AN HOUR FOR THE SERVICES.
FORM 990, PART VI, SECTION A, LINE 6THIS CORPORATION HAS SIX MEMBERS WITH VOTING RIGHTS: AMERY REGIONAL MEDICAL CENTER, INC,; BALDWIN AREA MEDICAL CENTER; HUDSON MEMORIAL HOSPITAL, INC.; OSCEOLA MEDICAL CENTER; ST. CROIX REGIONAL MEDICAL CENTER, INC.; AND WESTFIELDS HOSPITAL,INC.
FORM 990, PART VI, SECTION A, LINE 7ATHE BOARD OF DIRECTORS OF THIS CORPORATION SHALL CONSIST OF THE NUMBER OF DIRECTORS EQUAL TO THE NUMBER OF MEMBERS OF THIS CORPORATION. THE INITIAL BOARD OF DIRECTORS CONSISTS OF THE PERSONS LISTED IN THE ARTICLES OF INCORPORATION OF THIS CORPORATION, WHO SHALL SERVE UNTIL THE CONCLUSION OF THE ANNUAL MEETING OF THE BOARD OF DIRECTORS IN THE YEARS INDICATED IN THE ARTICLES OF INCORPORATION, OR UNTIL THEIR PRIOR DEATH, RESIGNATION OR REMOVAL. UPON THE EXPIRATION OF A DIRECTOR'S TERM, THE MEMBER THAT APPOINTED SUCH DIRECTOR SHALL APPOINT HIS OR HER SUCCESSOR.
FORM 990, PART VI, SECTION A, LINE 8BTHE CENTER DOES NOT HAVE ANY COMMITTEES WITH BROAD AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS DISTRIBUTED TO THE BOARD MEMBERS AND APPROVED PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION REQUIRES ALL BOARD MEMBERS AND OPERATIONS COMMITTEE MEMBERS TO ANNUALLY ACKNOWLEDGE REVIEWING THE CONFLICT OF INTEREST POLICY BY SIGNING THE CONFLICT OF INTEREST STATEMENT. IF A CONFLICT OF INTEREST EXISTS, HE OR SHE SHALL REFRAIN FROM PARTICIPATION IN ANY DECISION ON SUCH A MATTER WITH REMAINING MEMBERS DETERMINING WHETHER A CONFLICT EXISTS. PROCEEDINGS RELATED TO CONFLICTS OF INTEREST ARE DOCUMETNED IN THE MEETING MINUTES OR AS OTHERWISE APPROPRIATE.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC.
FORM 990, PART IX, LINE 11GPROVIDER CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 1,092,899. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,092,899. CANCER REGISTRY SERVICES: PROGRAM SERVICE EXPENSES 67,320. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 67,320.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
AMERY REGIONAL MEDICAL CENTER INC
265 GRINFIN STREET EASTAMERYWI54001390908320MEDICAL SERVICESWI501(C)(3)LINE 3N/A0
BALDWIN AREA MEDICAL CENTER INC
730 10TH AVENUEBALDWINWI540020300390808526MEDICAL SERVICESWI501(C)(3)LINE 3N/A0
HUDSON HOSPITAL INC
405 STAGELINE ROADHUDSONWI54016390804125MEDICAL SERVICESWI501(C)(3)LINE 3N/A0
OSCEOLA MEDICAL CENTER
2600 65TH AVENUE PO BOX 218OSCEOLAWI54020390773970MEDICAL SERVICESWI501(C)(3)LINE 3N/A0
ST CROIX REGIONAL MEDICAL CENTER INC
235 STATE STREETST CROIX FALLSWI54024390890676MEDICAL SERVICESWI501(C)(3)LINE 3N/A0
WESTFIELDS HOSPITAL INC
8170 33RD AVENUE SOUTH PO BOX 1309MINNEAPOLISMN554011309390808442MEDICAL SERVICESMN501(C)(3)LINE 3N/A0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1RADIATION TREATMENT CENTER OF WESTERN WISCONSINBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line16950 FRANCE AVENUE SOUTH SUITE200AddressLine1Txt
CityEDINACityNm
State AbbreviationMNStateAbbreviationCd
ZIP55435ZIPCd
FieldValueIRS element (for citing)
EIN272836404EIN
Primary ActivitiesRADIATION TREATMENTPrimaryActivitiesTxt
Legal Domicile StateMNLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Predominant Income TypeRADIATION TREATMENTPredominantIncomeTypeTxt
Share Of Total Income$179,200ShareOfTotalIncomeAmt
Share Of EOY Assets$278,732ShareOfEOYAssetsAmt
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing Partner0GeneralOrManagingPartnerInd
Ownership0.50000OwnershipPct
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1RADIATION TREATMENT CENTER OF WESTERN WISCONSINBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeMTransactionTypeTxt
Involved$150,000InvolvedAmt
Method Of Amount DeterminationFAIR MARKET VALUEMethodOfAmountDeterminationTxt