2013-12-15T16:29:37-06:00 2013-04-30 390758449 WIPFLI LLP 10000 INNOVATION DRIVE SUITE 250 MILWAUKEE WI 532264837 990 2012-05-01 363572331 NORTHERN ILLINOIS CANCER TREATMENT CTR NORT 8152841111 327 ROUTE 2 DIXON IL 61021 CYNTHIA ZANDER 8152841111 2013-12-16 1 JAY ADKISSON CPA P01360892 4144319300 2013-12-13 2012 2016-03-07 17:11:31Z CYNTHIA ZANDER 327 ROUTE 2 DIXON IL 61021 3467210 0 X WWW.NICANCER.COM X 1988 IL THE CENTER USES HIGHLY SOPHISTICATED EQUIPMENT FOR DIAGNOSIS AND TREATMENT OF CANCER. 7 7 0 7 0 0 10311 1276 4349354 3440538 29790 16853 588 8543 4390043 3467210 23250 19500 0 0 0 0 0 0 0 3875242 3940534 3898492 3960034 491551 -492824 13157341 10492537 3773049 1746955 9384292 8745582 PROVIDED HIGH QUALITY CANCER TREATMENT WITH THE LATEST COMPREHENSNE CANCER TREATMENT TECHNOLOGY IN A WELCOMING, COMFORTABLE AND FRIENDLY ENVIRONMENT. 11,970 PROCEDURES WERE PERFORMED DURING THE YEAR. 0 0 3666313 19500 3449081 PROVIDED HIGH QUALITY CANCER TREATMENT WITH THE LATEST COMPREHENSNE CANCER TREATMENT TECHNOLOGY IN A WELCOMING, COMFORTABLE AND FRIENDLY ENVIRONMENT. 11,970 PROCEDURES WERE PERFORMED DURING THE YEAR. THE CENTER ALSO PROVIDED $516,000 OF CHARITY CARE DURING THE YEAR TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY. 3666313 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 7 0 1 0 0 0 0 0 0 0 0 0 0 0 X 7 7 1 0 0 0 1 1 0 1 1 0 0 1 0 0 1 0 0 0 IL X THE ORGANIZATION 8152841111 327 ROUTE 2 DIXON IL 61021 MARK SCHMELZEL MD 2.00 X 0 0 0 THOMAS MCGLONE MD 2.00 X 0 0 0 OSMANN KHAWAJA MD 2.00 X 0 0 0 JAMES SARVER 5.00 X X 0 0 0 JULIE MANN 5.00 X X 0 0 0 DONNA HOYLE 2.00 X X 0 0 0 CYNTHIA ZANDER 5.00 X X 0 0 0 JON BERENS 40.00 X 172619 0 67911 172619 0 67911 1 0 1 1 CGH MEDICAL CENTER 100 EAST LEFEVRE RD STERLING IL 61081 LEASED EMPLOYEES 942215 SAUK VALLEY CANCER PHYSICIANS 17059 TIMBER DRIVE STERLING IL 61081 PHYSICIAN SERVICES 891602 GE HEALTHCARE 9900 W INNOVATION DR WAUWATOSA WI 53226 MEDICAL SERVICE 337997 VARIAN MEDICAL SYSTEMS 70140 NETWORK PLACE CHICAGO IL 60673 SOFTWARE SUPPORT SERVICES 267450 4 1276 1276 1276 PATIENT TREATMENT REVE 621110 3440538 3440538 3440538 16853 16853 BAD DEBT RECOVERY 900099 8218 8218 MISCELLANEOUS INCOME 900099 325 325 8543 3467210 3449081 0 16853 X 19500 19500 31638 31638 1919621 1665489 254132 90764 90764 19003 19003 732448 724497 7951 7144 7144 121584 121584 817099 817099 117212 117212 MEDICAL SUPPLIES 60057 60057 DUES AND SUBSCRIPTIONS 19977 19977 3987 3987 3960034 3666313 293721 0 68210 75480 3466328 1963095 315709 407941 143304 144725 12661181 5027885 8426790 7633296 737000 268000 13157341 10492537 66265 65425 3601930 1440313 104854 241217 3773049 1746955 X 9384292 8745582 9384292 8745582 13157341 10492537 X -492824 -145886 X 0 1 X 1 0 X X X 0 0 0 CGH MEDICAL CENTER 363479824 6 1 0 KATHERINE SHAW BETHEA HOSPITAL 361000540 3 1 0 2 0 21615 21615 6663853 1074828 5589025 5762043 3811064 1950979 213670 141993 71677 7633296 DUE TO CGH 241217 241217 X 3458992 0 3458992 8218 8218 3467210 3951816 -8218 -8218 3960034 0 3960034 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE CENTER DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE CENTER RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS IN 2013 AND 2012. FEDERAL TAX RETURNS FOR TAX YEARS 2009 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT RECOVERY 8,218. PART XII, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT RECOVERY -8,218. 0 HOME OF HOPE OF THE ROCK RIVER VALLEY INC 1637 PLOCK RD DIXON IL 61021 363572331 501(C)(3) 19500 DONATION TO SUPPORT THE NOT-FOR-PROFIT ORGANIZATION WHO PROVIDE SUPPORT SERVICES TO CANCER PATIENTS. 1 0 0 0 0 0 0 0 0 0 0 JON BERENS 172369 0 250 0 0 0 39759 0 28152 0 240530 0 0 0 SUPPLEMENTAL INFORMATION PART III JON BERENS RECEIVED COMPENSATION FROM CGH MEDICAL CENTER, AN UNRELATED ORGANIZATION, FOR SERVICES AS EXECUTIVE DIRECTOR FOR NORTHERN ILLINOIS CANCER TREATMENT CENTER. COMPENSATION AND OTHER BENEFITS AMOUNTED TO $240,530 IN TOTAL FOR 2012. FORM 990, PART VI, SECTION A, LINE 2 THE BOARD OF DIRECTORS OF NORTHERN ILLINOIS CANCER TREATMENT CENTER HAVE BOARD MEMBERS WHO ARE EMPLOYEES OF CGH MEDICAL CENTER AND KATHERINE SHAW BETHEA HOSPITAL, BOTH OF WHICH, HAVE A 50% EQUITY INTEREST IN THE CENTER. JULIE MANN SERVES ON THE BOARD OF NORTHERN ILLINOIS CANCER TREATMENT CENTER AND IS ALSO AN EMPLOYEE OF KATHERINE SHAW BETHEA HOSPITAL. DONNA HOYLE SERVES ON THE BOARD OF NORTHERN ILLINOIS CANCER TREATMENT CENTER AND IS ALSO A BOARD MEMBER OF KATHERINE SHAW BETHEA HOSPITAL. CINTHIA ZANDER SERVES ON THE BOARD OF NORTHERN ILLINOIS CANCER TREATMENT CENTER AND IS ALSO AN EMPLOYEE OF CGH MEDICAL CENTER. MARK SCHMELZEL, MD SERVES ON THE BOARD OF NORTHERN ILLINOIS CANCER TREATMENT CENTER AND IS ALSO AN EMPLOYEE OF STERLING ROCK FALLS CLINIC A RELATED ENTITY OF CGH MEDICAL CENTER. THOMAS MCGLONE, MD SERVES ON THE BOARD OF NORTHERN ILLINOIS CANCER TREATMENT CENTER AND IS ALSO AN EMPLOYEE OF STERLING ROCK FALLS CLINIC A RELATED ENTITY OF CGH MEDICAL CENTER. OSMANN KHAWAJA, MD SERVES ON THE BOARD OF NORTHERN ILLINOIS CANCER TREATMENT CENTER AND IS ALSO AN EMPLOYEE OF KATHERINE SHAW BETHEA HOSPITAL. FORM 990, PART VI, SECTION A, LINE 6 PER THE ORGANIZATION'S BY LAWS, THERE SHALL BE TWO MEMBERS CGH MEDICAL CENTER AND KATHERINE SHAW BETHEA HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A THE GOVERNING BODY CONSISTS OF 7 DIRECTORS, 3 OF WHICH ARE CHOSEN BY THE BOARD OF DIRECTORS OF CGH MEDICAL CENTER AND 3 OF WHICH ARE CHOSEN BY THE BOARD OF DIRECTORS OF KATHERINE SHAW BETHEA HOSPITAL. THE 7TH MEMBER IS ELECTED BY A MAJORITY VOTE OF THE TOTAL COMBINED MEMBERSHIP. FORM 990, PART VI, SECTION B, LINE 11 A DRAFT COPY OF FORM 990 IS PROVIDED TO THE DIRECTOR AND THE TREASURER OF THE BOARD TO REVIEW THE RETURN. IF THEY AGREE, THEY MAKE COPIES AVAILABLE TO ALL MEMBERS OF THE BOARD FOR REVIEW THEY THEN LET THE RETURN PREPARER KNOW THAT THE RETURN IS READY TO BE PROCESSED. FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS CAN BE OBTAINED UPON REQUEST. OTHER FEES FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 767,148. MANAGEMENT AND GENERAL EXPENSES 254,132. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,021,280. PHYSICIAN CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 898,341. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 898,341. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: PRIOR PERIOD ADJUSTMENT - CGH ADMIN EXPENSES -145,886.