CANCER CENTER OF WESTERN WISCONSIN INC: Form 990, tax year 2013
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- Organization
- CANCER CENTER OF WESTERN WISCONSIN INC (EIN 27-3238660)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-13
- IRS object ID
- 201413179349305076
- Schema version
- 2013v3.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-13T15:27:24-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 818 SECOND ST SO SUITE 320 | AddressLine1 |
| City | WAITE PARK | City |
| State | MN | State |
| ZIP Code | 56387 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 273238660 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CANCER CENTER OF WESTERN WISCONSIN INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CANC | BusinessNameControlTxt |
| Phone | 7152432800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 501 HOSPITAL ROAD | AddressLine1 |
| City | NEW RICHMOND | City |
| State | WI | State |
| ZIP Code | 54017 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN TREMBLE | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 7152432800 | PhoneNum |
| Signature | 2014-11-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KRISTIN L SCHMIDT | PreparerPersonNm |
| PTIN | P01487323 | PTIN |
| Phone | 3202035500 | PhoneNum |
| Preparation | 2014-11-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | STEVE MASSEY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 501 HOSPITAL ROAD | AddressLine1 |
| City | NEW RICHMOND | City |
| State | WI | State |
| ZIP Code | 54017 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,635,703 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CC-WW.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2010 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE HEALTH, HEALING AND LIFE FOR THOSE EXPERIENCING CANCER. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 30 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $153,950 | PYContributionsGrantsAmt |
| CY Contributions Grants | $20,735 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,103,093 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $2,614,901 | CYProgramServiceRevenueAmt |
| PY Investment Income | $250,145 | PYInvestmentIncomeAmt |
| CY Investment Income | $67 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $5,507,188 | PYTotalRevenueAmt |
| CY Total Revenue | $2,635,703 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $26,244 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,436,826 | PYOtherExpensesAmt |
| CY Other Expenses | $3,033,049 | CYOtherExpensesAmt |
| PY Total Expenses | $5,436,826 | PYTotalExpensesAmt |
| CY Total Expenses | $3,033,049 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $70,362 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$397,346 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,084,749 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,803,540 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $207,660 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $323,797 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,877,089 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,479,743 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO 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 Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,738,627 | ExpenseAmt |
| Revenue | $1,547,430 | RevenueAmt |
| Desc | RADIATION TREATMENT SERVICES - PROVIDE RADIATION TREATMENT SERVICES THROUGH OUR PARTNERSHIP | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,070,603 | ExpenseAmt |
| Revenue | $1,067,471 | RevenueAmt |
| Desc | ONCOLOGIST SERVICES - PURCHASE OF MD TIME TO SERVE THE OWNER COMMUNITIES | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $148,909 | ExpenseAmt |
| Desc | ONCOLOGY SERVICES; NEW RICHMOND - PROIVDE MEDICAL ONCOLOGY SERVICES IN NEW RICHMOND WISCONSIN | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $2,958,139 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHN TREMBLE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7154830317 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 235 STATE STREET | AddressLine1 |
| City | ST CROIX FALLS | City |
| State | WI | State |
| ZIP Code | 54024 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| STEVE MASSEY | |||||||
| PRESIDENT | 2.00 | 40.00 | Yes (X) | Yes (X) | $0 | $200,216 | $45,761 |
| ALISON PAGE | |||||||
| VICE PRESIDENT | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $219,960 | $20,039 |
| JEFF MEYER | |||||||
| SECRETARY | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $155,199 | $19,161 |
| JOHN TREMBLE | |||||||
| TREASURER | 3.00 | 40.00 | Yes (X) | Yes (X) | $0 | $183,297 | $12,520 |
| MARIAN FULONG | |||||||
| BOARD MEMBER | 1.00 | 40.00 | Yes (X) | $0 | $296,408 | $74,382 | |
| DAVE DOBOSENSKI | |||||||
| BOARD MEMBER | 1.00 | 40.00 | Yes (X) | $0 | $238,560 | $22,824 | |
| MIKE KARUSCHAK | |||||||
| BOARD MEMBER | 1.00 | 40.00 | Yes (X) | $0 | $255,492 | $74,460 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,549,132 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $269,147 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GROUP HEALTH INC | BusinessNameLine1 |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 64059 | AddressLine1 |
| City | ST PAUL | City |
| State | MN | State |
| ZIP Code | 55164 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | ONCOLOGIST SERVICES | ServicesDesc |
| Compensation | $1,070,603 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $20,735 | AllOtherContributionsAmt |
| Total Contributions | $20,735 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| RADIATION TREATMENT | 621110 | $1,547,430 | $1,547,430 |
| PHYSICIAN SERVICES | 621110 | $1,067,471 | $1,067,471 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $2,614,901 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $67 | TotalRevenueColumnAmt |
| Exclusion | $67 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,635,703 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,614,901 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $67 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,300 | TotalAmt |
| Management And General | $1,300 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,238,529 | TotalAmt |
| Program Services | $1,238,529 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,729 | TotalAmt |
| Management And General | $6,485 | ManagementAndGeneralAmt |
| Fundraising | $26,244 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98 | TotalAmt |
| Management And General | $98 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,783 | TotalAmt |
| Management And General | $40,783 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| RADIATION TREATMENT EXP | $1,701,647 | $1,701,647 |
| OTHER EXPENSE | $17,963 | $17,963 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,033,049 | TotalAmt |
| Program Services | $2,958,139 | ProgramServicesAmt |
| Management And General | $48,666 | ManagementAndGeneralAmt |
| Fundraising | $26,244 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $349,630 | BOYAmt |
| EOY | $203,920 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,005 | BOYAmt |
| EOY | $105,352 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $398,900 | BOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $237,970 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $203,917 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $105,356 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $139,344 | BOYAmt |
| EOY | $98,561 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,106,870 | BOYAmt |
| EOY | $1,157,737 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,084,749 | BOYAmt |
| EOY | $1,803,540 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $207,660 | BOYAmt |
| EOY | $323,797 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $207,660 | BOYAmt |
| EOY | $323,797 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,877,089 | BOYAmt |
| EOY | $1,479,743 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,877,089 | BOYAmt |
| EOY | $1,479,743 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,084,749 | BOYAmt |
| EOY | $1,803,540 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$397,346 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Certification | Yes (X) | CertificationInd |
| IRS Written Determination | Yes (X) | IRSWrittenDeterminationInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Supported Org Information SupportedOrgInformationGrp (6 entries)
| EINEIN | Organization TypeOrganizationTypeDesc | Governing Document ListedGoverningDocumentListedInd | Supported Org NotifiedSupportedOrgNotifiedInd | US OrganizedUSOrganizedInd | SupportSupportAmt |
|---|---|---|---|---|---|
| AMERY REGIONAL MEDICAL CENTER INC | |||||
| 390908320 | 3 | Yes (1) | Yes (1) | Yes (1) | $0 |
| BALDWIN AREA MEDICAL CENTER | |||||
| 390808526 | 3 | Yes (1) | Yes (1) | Yes (1) | $0 |
| HUDSON HOSPITAL INC | |||||
| 390804125 | 3 | Yes (1) | Yes (1) | Yes (1) | $0 |
| OSCEOLA MEDICAL CENTER | |||||
| 390773970 | 3 | Yes (1) | Yes (1) | Yes (1) | $0 |
| ST CROIX REGIONAL MEDICAL CENTER INC | |||||
| 390890676 | 3 | Yes (1) | Yes (1) | Yes (1) | $0 |
| WESTFIELDS HOSPITAL INC | |||||
| 390808442 | 3 | Yes (1) | Yes (1) | Yes (1) | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 6 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
Schedule D IRS990ScheduleD
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $203,917 | OtherCostOrOtherBasisAmt |
| Depreciation | $105,356 | DepreciationAmt |
| Book Value | $98,561 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $98,561 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENT IN WWRTC | Desc |
| Book Value | $1,157,737 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $1,157,737 | TotalBookValueSecuritiesAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| STEVE MASSEY | ||||||||||||||
| PRESIDENT | $0 | $200,216 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $45,761 | $0 | $245,977 | $0 | $0 |
| ALISON PAGE | ||||||||||||||
| VICE PRESIDENT | $0 | $219,960 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $20,039 | $0 | $239,999 | $0 | $0 |
| JEFF MEYER | ||||||||||||||
| SECRETARY | $0 | $155,199 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $19,161 | $0 | $174,360 | $0 | $0 |
| JOHN TREMBLE | ||||||||||||||
| TREASURER | $0 | $183,297 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $12,520 | $0 | $195,817 | $0 | $0 |
| MARIAN FULONG | ||||||||||||||
| BOARD MEMBER | $0 | $296,408 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $74,382 | $0 | $370,790 | $0 | $0 |
| DAVE DOBOSENSKI | ||||||||||||||
| BOARD MEMBER | $0 | $238,560 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $22,824 | $0 | $261,384 | $0 | $0 |
| MIKE KARUSCHAK | ||||||||||||||
| BOARD MEMBER | $0 | $255,492 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $74,460 | $0 | $329,952 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THIS 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 7A | THE 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 B, LINE 11 | THE FORM 990 IS DISTRIBUTED TO THE BOARD MEMBERS AND APPROVED PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE 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 19 | THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC. |
| FORM 990, PART IX, LINE 11G | INTERIM CANCER DIRECTOR: PROGRAM SERVICE EXPENSES 12,500. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,500. PROVIDER CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 1,070,603. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,070,603. ONCOLOGY SERVICES WESTFIELDS: PROGRAM SERVICE EXPENSES 130,946. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 130,946. CANCER REGISTRY SERVICES: PROGRAM SERVICE EXPENSES 24,480. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,480. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| AMERY REGIONAL MEDICAL CENTER INC | ||||||||||
| 265 GRINFIN STREET EAST | AMERY | WI | 54001 | 390908320 | MEDICAL SERVICES | WI | 501(C)(3) | LINE 3 | N/A | 0 |
| BALDWIN AREA MEDICAL CENTER INC | ||||||||||
| 730 10TH AVENUE | BALDWIN | WI | 540020300 | 390808526 | MEDICAL SERVICES | WI | 501(C)(3) | LINE 3 | N/A | 0 |
| HUDSON HOSPITAL INC | ||||||||||
| 405 STAGELINE ROAD | HUDSON | WI | 54016 | 390804125 | MEDICAL SERVICES | WI | 501(C)(3) | LINE 3 | N/A | 0 |
| OSCEOLA MEDICAL CENTER | ||||||||||
| 2600 65TH AVENUE PO BOX 218 | OSCEOLA | WI | 54020 | 390773970 | MEDICAL SERVICES | WI | 501(C)(3) | LINE 3 | N/A | 0 |
| ST CROIX REGIONAL MEDICAL CENTER INC | ||||||||||
| 235 STATE STREET | ST CROIX FALLS | WI | 54024 | 390890676 | MEDICAL SERVICES | WI | 501(C)(3) | LINE 3 | N/A | 0 |
| WESTFIELDS HOSPITAL INC | ||||||||||
| 8170 33RD AVENUE SOUTH PO BOX 1309 | MINNEAPOLIS | MN | 554011309 | 390808442 | MEDICAL SERVICES | MN | 501(C)(3) | LINE 3 | N/A | 0 |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RADIATION TREATMENT CENTER OF WESTERN WISCONSIN | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6950 FRANCE AVENUE SOUTH SUITE200 | AddressLine1 |
| City | EDINA | City |
| State | MN | State |
| ZIP Code | 55435 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 272836404 | EIN |
| Primary Activities | RADIATION TREATMENT | PrimaryActivitiesTxt |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Predominant Income Type | RADIATION TREATMENT | PredominantIncomeTypeTxt |
| Share Of Total Income | $1,547,430 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $1,157,737 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Ownership | 0.50000 | OwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |