Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 07-01-2010 and ending 06-30-2011
BCheck if applicable:
CName of organization
CENTRAL DUPAGE PHYSICIAN GROUP
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
27W353 Jewell Rd
 
Room/suite
City or town, state or country, and ZIP + 4
Winfield, IL60190
D Employer identification number

36-3149833
E Telephone number

G Gross receipts $ 52,475,278
F Name and address of principal officer:
J LUKE MCGUINNESS
25 N Winfield Rd
Winfield,IL60190
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
N/A
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1981
M State of legal domicile: IL
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: CENTRAL DUPAGE PHYSICIAN GROUP (CDPG) STRIVES TO DELIVER QUALITY, COST EFFICIENT HEALTH CARE SERVICES TO THE COMMUNITY AND TO COORDINATE, DEVELOP AND SUPPORT QUALITY PATIENT CARE IN PRIMARY CARE FACILITIES.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 3
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 0
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 355
6 Total number of volunteers (estimate if necessary) .... 6 0
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 601,306
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b -23,182
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 14,607,770 16,982,124
9 Program service revenue (Part VIII, line 2g) ......... 22,640,733 34,585,625
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 30,059 41,173
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 927,460 745,462
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 38,206,022 52,354,384
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 26,577,243 37,111,121
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 11,407,877 16,180,647
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 37,985,120 53,291,768
19 Revenue less expenses. Subtract line 18 from line 12...... 220,902 -937,384
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 8,333,368 10,365,630
21 Total liabilities (Part X, line 26)............ 3,052,487 5,908,996
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 5,280,881 4,456,634
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signature
Big Right Arrow
Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4
Big Right Arrow




EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: CENTRAL DUPAGE PHYSICIAN GROUP (CDPG) STRIVES TO DELIVER QUALITY, COST-EFFICIENT HEALTH CARE SERVICES TO THE COMMUNITY AND TO COORDINATE, DEVELOP AND SUPPORT QUALITY PATIENT CARE IN PRIMARY CARE PRACTICE SITES AND SELECT SPECIALTIES FOR THE BENEFIT OF THE COMMUNITY.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 48,453,956 including grants of $ 0 ) (Revenue $ 34,703,615 )
CENTRAL DUPAGE PHYSICIAN GROUP (CDPG) PROVIDES PRIMARY MEDICAL CARE AND PATIENT EDUCATION THROUGH 198,793 PATIENT VISITS AT PRIMARY CARE PHYSICIAN OFFICES LOCATED THROUGHOUT THE COMMUNITY. IN ADDITION, CDPG OFFERS A HOMECARE PHYSICIAN PROGRAM WHICH PROVIDED APPROXIMATELY 4,700 PHYSICIAN HOUSE CALLS TO THE HOMEBOUND IN OUR COMMUNITY. DESPITE THE FACT THAT COSTS FOR THIS PROGRAM EXCEEDED REVENUES BY $398,000, CDPG BELIEVES THAT THIS PROGRAM PROVIDES A VITAL SERVICE TO MEMBERS OF OUR COMMUNITY.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 48,453,956
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II
.........................
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part I
.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part II
...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III ....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IV
...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H.....
20a
 
No
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. .....
20b
 
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..
21
 
No
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III.....
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I......
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II
...........................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III...............
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV
...................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV..
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I
...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
 
No
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2...
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2...........
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VI
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
0
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
355
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
3
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
0
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
 
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
IL
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
James Spear
25 N Winfield Rd
Winfield,IL60190
(630) 933-1600
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (describe hours for related organizations in Schedule O)
(C)
Position (check all that apply)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) MICHAEL VIVODA
CHAIR
1 X   X       0 632,949 41,745
(2) PATRICK TOWNE MD
VICE CHAIR
40 X   X       476,940 0 42,592
(3) MAUREEN TAUS
SEC-TREAS
1 X   X       0 350,714 21,630
(4) J LUKE MCGUINNESS
CEO AND PRESIDENT, CDH-DELNOR HEALTH SYSTEM
1     X       0 1,860,506 39,788
(5) JAMES T SPEAR
CFO & EVP, CDH-DELNOR HEALTH SYSTEM
1     X       0 970,010 48,344
(6) JOSEPH SCHNEIDER
PHYSICIAN
40         X   447,821 0 41,622
(7) SUZANNE BERGEN
PHYSICIAN
40         X   396,390 0 24,479
(8) ANDREW CHENELLE
PHYSICIAN
40         X   728,364 0 40,478
(9) TARAS MASNYK
PHYSICIAN
40         X   616,253 0 41,043
(10) MICHAEL REZAK
PHYSICIAN
40         X   574,436 0 35,524
(11) MICHAEL HOLZHUETER
ASSISTANT SECRETARY
1     X       0 451,263 46,467
(12) KAREN DIERSEN
ASSISTANT SECRETARY
1     X       0 99,916 16,459










Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (describe hours for related organizations in Schedule O)
(C)
Position (check all that apply)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;


























1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 3,240,204 4,365,358 440,171
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet75
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
CDH-DELNOR HEALTH SYSTEM
27W353 JEWELL RD
WINFIELD,IL60190
MANAGEMENT SERVICES 1,330,569
CENTRAL DUPAGE HOSPITAL ASSOCIATION
25 N WINFIELD RD
WINFIELD,IL60190
LABORATORY SERVICES 143,790
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet2
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 16,982,124
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above
1f
 
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 16,982,124
 Program Service Revenue Business Code
2a NET PATIENT CARE REVENUE 621,110 34,585,625 34,585,625    
b
c
d
e
f All other program service revenue . 0 0 0 0
g Total. Add lines 2a–2f........MediumBullet 34,585,625
 Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 36,052     36,052
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross Rents 12,000  
b Less: rental expenses    
c Rental income or (loss) 12,000 0
d Net rental income or (loss).......MediumBullet 12,000     12,000
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 124,815 1,200
b Less: cost or other basis and sales expenses 120,894  
c Gain or (loss) 3,921 1,200
d Net gain or (loss)..........MediumBullet 5,121     5,121
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a BILLING SERVICE REVENUE 900,099 719,296 117,990 601,306  
b RESEARCH GRANT REVENUE 900,099 14,166     14,166
c            
d All other revenue .... 0 0 0 0
e Total. Add lines 11a–11d ......MediumBullet 733,462
12 Total revenue. See Instructions....MediumBullet 52,354,384 34,703,615 601,306 67,339
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21 0  
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 492,762 418,848 73,914  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 31,620,466 29,407,033 2,213,433  
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 1,168,176 1,086,404 81,772  
9 Other employee benefits ....... 2,237,510 2,080,884 156,626  
10 Payroll taxes ........... 1,592,207 1,480,753 111,454  
11 Fees for services (non-employees):        
a Management ...... 1,270,834   1,270,834  
b Legal ......... 100   100  
c Accounting ........... 16,728   16,728  
d Lobbying ........... 0      
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 0      
g Other .......... 812,025 461,618 350,407  
12 Advertising and promotion .... 6,778   6,778  
13 Office expenses ....... 403,024 241,814 161,210  
14 Information technology ...... 40,545 27,165 13,380  
15 Royalties .. 0      
16 Occupancy ........... 2,816,877 2,619,696 197,181  
17 Travel ............ 15,883 15,089 794  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 4,103 2,051 2,052  
20 Interest ........... 0      
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 1,656,858 1,540,878 115,980  
23 Insurance .............. 2,960,656 2,960,656    
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a PATIENT CARE EXPENSE 2,586,093 2,586,093    
b BAD DEBT EXPENSE 690,982 690,982    
c DUES-PHYSICIANS 159,861 159,861    
d CONTINUING MEDICAL EDUCATION 162,389 162,389    
e PURCHASE OF PHYSICIAN PRACTICES 2,446,573 2,446,573    
f All other expenses 130,338 65,169 65,169 0
25 Total functional expenses. Add lines 1 through 24f 53,291,768 48,453,956 4,837,812 0
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation
0      
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year
(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 2,565 1 3,165
2 Savings and temporary cash investments ....... 1,334,514 2 58,817
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net ......... 2,455,728 4 4,118,101
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use ..............   8  
9 Prepaid expenses and deferred charges ............ 8,316 9 247
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 12,380,122
b Less: accumulated depreciation. ..... 10b 8,637,017 4,459,242 10c 3,743,105
11 Investments—publicly traded securities .......... 73,003 11 9,001
12 Investments—other securities. See Part IV, line 11 ...... 0 12 0
13 Investments—program-related. See Part IV, line 11 .. 0 13 0
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 0 15 2,433,194
16 Total assets. Add lines 1 through 15 (must equal line 34)... 8,333,368 16 10,365,630
Liabilities 17 Accounts payable and accrued expenses . 1,029,035 17 2,510,384
18 Grants payable .......... 19,951 18 19,951
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities ..........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 2,003,501 25 3,378,661
26 Total liabilities. Add lines 17 through 25..... 3,052,487 26 5,908,996
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 5,280,881 27 4,456,634
28 Temporarily restricted net assets .....   28  
29 Permanently restricted net assets .....   29  
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 5,280,881 33 4,456,634
34 Total liabilities and net assets/fund balances ..... 8,333,368 34 10,365,630
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
52,354,384
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
53,291,768
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
-937,384
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
5,280,881
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
113,137
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
4,456,634
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
...........................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2010)
Additional Data


Software ID: 10000128
Software Version: v2010.1.0
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
CENTRAL DUPAGE PHYSICIAN GROUP
 
Employer identification number

36-3149833
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization
(ii)
EIN
(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv)
Is the organization in col. (i) listed in your governing document?
(v)
Did you notify the organization in col. (i) of your support?
(vi)
Is the organization in col. (i) organized in the U.S.?
(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . 169,782 161,185 187,762 14,607,770 16,982,124 32,108,623
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... 19,738,855 19,549,906 20,942,805 22,640,733 34,585,625 117,457,924
3 Gross receipts from activities that are not an unrelated trade or business under section 513..           0
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...           0
5 The value of services or facilities furnished by a governmental unit to the organization without charge..           0
6 Total. Add lines 1 through 5. 19,908,637 19,711,091 21,130,567 37,248,503 51,567,749 149,566,547
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...           0
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.           0
c Add lines 7a and 7b.. 0 0 0 0 0 0
8 Public Support (Subtract line 7c from line 6.)           149,566,547
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6... 19,908,637 19,711,091 21,130,567 37,248,503 51,567,749 149,566,547
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. 153,789 111,283 94,734 39,747 48,052 447,605
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.           0
c Add lines 10a and 10b. 153,789 111,283 94,734 39,747 48,052 447,605
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.           0
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)     198,032 280,950 132,156 611,138
13 Total support (Add lines 9, 10c, 11 and 12.). 20,062,426 19,822,374 21,423,333 37,569,200 51,747,957 150,625,290
14
Section C. Computation of Public Support Percentage
15
15
99.300 %
16
16
99.151 %
Section D. Computation of Investment Income Percentage
17
17
0.300 %
18
18
0.446 %
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
OTHER INCOME, SCHEDULE A, PART III, SECTION B, LINE 12, BILLING SERVICE REVENUE: 2006 - NONE; 2007 - NONE; 2008 - 198,032; 2009 - 280,950; 2010 - BILLING SERVICE REVENUE 117,990 AND RESEARCH GRANTS 14,166,
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID: 10000128
Software Version: v2010.1.0
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
CENTRAL DUPAGE PHYSICIAN GROUP
 
Employer identification number

36-3149833
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
CENTRAL DUPAGE PHYSICIAN GROUP
 
Employer identification number

36-3149833
Part I
Contributors (see Instructions)
     
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
CENTRAL DUPAGE PHYSICIAN GROUP
 
Employer identification number

36-3149833
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
CENTRAL DUPAGE PHYSICIAN GROUP
 
Employer identification number

36-3149833
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID: 10000128
Software Version: v2010.1.0
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
CENTRAL DUPAGE PHYSICIAN GROUP
 
Employer identification number

36-3149833
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 4,623,441 4,359,240 4,632,175
b Contributions ........ 32,212 73,315 299,599
c Investment earnings or losses ... 637,454 198,755 -550,985
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........
27,877 7,869 21,549
f Administrative expenses ....      
g End of year balance ...... 5,265,230 4,623,441 4,359,240
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet100.000 %
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................     0
b Buildings ................       0
c Leasehold improvements ............   2,459,134 1,380,414 1,078,720
d Equipment ................   9,920,988 7,256,603 2,664,385
e Other .................       0
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 3,743,105
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) DUE FROM RELATED ORGANIZATIONS 438,835
(2) UNAMORTIZED PRACTICE ACQUISITION COSTS 1,994,359







Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 2,433,194
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes 0
DUE TO RELATED ORGANIZATIONS 3,325,419
UNCLAIMED PROPERTY 53,242







Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 3,378,661
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1 52,354,384
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 53,291,768
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 -937,384
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8 -16,884,000
9 Total adjustments (net). Add lines 4 - 8 ............................. 9 -16,884,000
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 -17,821,384
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 33,008,594
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d 0
e Add lines 2a through 2d ..................... 2e 0
3 Subtract line 2e from line 1..................... 3 33,008,594
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b 19,345,790
c Add lines 4a and 4b....................... 4c 19,345,790
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5 52,354,384
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 50,829,978
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d -2,461,790
e Add lines 2a through 2d...................... 2e -2,461,790
3 Subtract line 2e from line 1..................... 3 53,291,768
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b 0
c Add lines 4a and 4b....................... 4c 0
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5 53,291,768
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
Intended uses of endowment funds Schedule D, Part V, Line 4 THE ENDOWMENT FUNDS ARE HELD BY CENTRAL DUPAGE HEALTH FOUNDATION, A RELATED TAX-EXEMPT ORGANIZATION, AND ARE USED TO SUPPORT CENTRAL DUPAGE HOSPITAL, A RELATED TAX-EXEMPT ORGANIZATION, AND CENTRAL DUPAGE PHYSICIAN GROUP'S HOMECARE PHYSICIAN'S PROGRAMS.
FIN 48 (ASC 740) footnote Schedule D, Part X, Line 2 THE CORPORATIONS APPLY ASC SUBTOPIC 740-10, INCOME TAXES - OVERALL, WHICH ADDRESSES THE DETERMINATION OF HOW TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. UNDER ASC SUBTOPIC 740-10, THE CORPORATIONS MUST RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. ASC SUBTOPIC 740-10 ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST, AND PENALTIES ON INCOME TAXES AND ACCOUNTING IN INTERIM PERIODS AND REQUIRES INCREASED DISCLOSURES. AS OF JUNE 30, 2011, THE CORPORATIONS DO NOT HAVE ANY LIABILITIES FOR UNRECOGNIZED TAX BENEFITS.
Schedule D (Form 990) 2010

Additional Data


Software ID: 10000128
Software Version: v2010.1.0




Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
CENTRAL DUPAGE PHYSICIAN GROUP
 
Employer identification number

36-3149833
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
Yes
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) MICHAEL VIVODA (i)
(ii)
0
411,400
0
202,500
0
19,049
0
20,431
0
21,314
0
674,694
0
0
(2) PATRICK TOWNE MD (i)
(ii)
475,756
0
0
0
1,184
0
20,125
0
22,467
0
519,532
0
0
0
(3) MAUREEN TAUS (i)
(ii)
0
234,699
0
115,150
0
865
0
19,314
0
2,316
0
372,344
0
0
(4) J LUKE MCGUINNESS (i)
(ii)
0
869,673
0
660,247
0
330,586
0
20,500
0
19,288
0
1,900,294
0
0
(5) JAMES T SPEAR (i)
(ii)
0
652,645
0
315,000
0
2,365
0
20,298
0
28,046
0
1,018,354
0
0
(6) JOSEPH SCHNEIDER (i)
(ii)
428,999
0
0
0
18,822
0
20,500
0
21,122
0
489,443
0
0
0
(7) SUZANNE BERGEN (i)
(ii)
378,604
0
0
0
17,786
0
18,096
0
6,383
0
420,869
0
0
0
(8) ANDREW CHENELLE (i)
(ii)
711,054
0
0
0
17,310
0
20,500
0
19,978
0
768,842
0
0
0
(9) TARAS MASNYK (i)
(ii)
614,623
0
0
0
1,630
0
18,011
0
23,032
0
657,296
0
0
0
(10) MICHAEL REZAK (i)
(ii)
566,912
0
0
0
7,524
0
16,807
0
18,717
0
609,960
0
0
0
(11) MICHAEL HOLZHUETER (i)
(ii)
0
283,195
0
150,000
0
18,068
0
0
0
46,467
0
497,730
0
0





Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
Tax indemnification and gross-up payments Schedule J, Part I, Line 1a EMPLOYEES, INCLUDING INTERESTED PERSONS, RECEIVED A $104 GIFT CARD IN RECOGNITION OF CENTRAL DUPAGE HOSPITAL, A RELATED TAX-EXEMPT ORGANIZATION, ACHIEVING A NATIONAL AWARD. THIS WAS TREATED AS TAXABLE COMPENSATION AND GROSSED-UP IN THE EMPLOYEES' W-2.
Supplemental nonqualified retirement plan Schedule J, Part I, Line 4b THE CHIEF EXECUTIVE OFFICER PARTICIPATES IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. PURSUANT TO THIS PLAN, DURING CY 2010, $300,000 WAS CONTRIBUTED, IMMEDIATELY VESTED, AND DISTRIBUTED. ALL ASPECTS OF THE CHIEF EXECUTIVE OFFICER'S COMPENSATION, INCLUDING CONTRIBUTIONS TO THE SUPPLEMENTAL RETIREMENT PLAN, ARE REVIEWED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS AND SUPPORTED BY CONSULTANTS ENGAGED BY SUCH COMMITTEE.
METHODS USED TO ESTABLISH THE COMPENSATION OF TOP MANAGEMENT OFFICIALS SCHEDULE J, PART I, LINE 3 THE ORGANIZATION RELIED ON CDH-DELNOR HEALTH SYSTEM, A RELATED TAX-EXEMPT ORGANIZATION, WHICH USED A COMPENSATION COMMITTEE, COMPARABILITY DATA, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE, TO DETERMINE THE COMPENSATION OF ITS CEO.
COMPENSATION CONTINGENT ON NET EARNINGS SCHEDULE J, PART I, LINES 5, 6 AND 7 CENTRAL DUPAGE PHYSICIAN GROUP (CDPG) MAINTAINS AN INCENTIVE PLAN (MYSTEP) AS A COMPONENT OF COMPENSATION FOR ITS EMPLOYEES, INCLUDING EMPLOYED INTERESTED PERSONS. THE INCENTIVE PORTION OF THE COMPENSATION IS INCLUDED IN THE COMPENSATION REVIEW CONDUCTED BY THE COMPENSATION COMMITTEE OF THE CDH-DELNOR HEALTH SYSTEM BOARD OF DIRECTORS, AS DESCRIBED IN SCHEDULE O FOR FORM 990 CORE, PART VI, LINE 15. THE PURPOSE OF MYSTEP IS TO ALIGN EMPLOYEES' INTERESTS WITH THE GOALS AND OBJECTIVES OF CDH-DELNOR HEALTH SYSTEM AND ALL RELATED ORGANIZATIONS BY PROVIDING FINANCIAL INCENTIVES LINKED TO THE CONTINUING AND SUSTAINABLE SUCCESS OF THE ORGANIZATIONS. FINANCIAL INCENTIVES ARE PAID BASED ON A SERIES OF MEASURES THAT INCLUDE: (I) PATIENT SATISFACTION; (II) FINANCIAL PERFORMANCE; AND (III) DEPARTMENTAL/TEAM-SPECIFIC GOALS. OVERALL ADMINISTRATION OF MYSTEP IS THE RESPONSIBILITY OF THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THIS INCENTIVE PROGRAM DOES NOT MEET THE STANDARDS AS SET OUT IN SCHEDULE J, PART I FOR LINES 5, 6 OR 7.
NON-FIXED PAYMENTS SCHEDULE J, PART I, LINE 7 MOST EMPLOYED PHYSICIANS, INCLUDING THE MAJORITY OF THE EMPLOYED INTERESTED PERSONS, ARE COMPENSATED USING A PAY MATRIX WHICH APPROXIMATES EARNINGS AT THE PHYSICIAN'S LEVEL OF PRODUCTIVITY AS BENCHMARKED BY THE MEDICAL GROUP MANAGEMENT ASSOCIATION (MGMA). FOR CERTAIN PHYSICIANS, AN ADDITIONAL STIPEND IS PAID FOR PERFORMANCE OF ADMINISTRATIVE DUTIES. IN ADDITION, SOME EMPLOYED PHYSICIANS PARTICIPATE IN AN INCENTIVE PROGRAM UNDER WHICH ADDITIONAL COMPENSATION MAY BE EARNED BASED ON ACHIEVEMENT OF ESTABLISHED GOALS FOR PRODUCTIVITY, PATIENT SATISFACTION, QUALITY AND CITIZENSHIP. EMPLOYEES PARTICIPATING IN THIS INCENTIVE PROGRAM DO NOT PARTICIPATE IN THE MYSTEP PROGRAM DESCRIBED IN THE SUPPLEMENTAL NARRATIVE. THIS COMPENSATION PROGRAM DOES NOT MEET THE STANDARDS AS SET OUT IN SCHEDULE J, PART I FOR LINES 7.
Schedule J (Form 990) 2010

Additional Data


Software ID: 10000128
Software Version: v2010.1.0
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
CENTRAL DUPAGE PHYSICIAN GROUP
 
Employer identification number

36-3149833
Identifier Return Reference Explanation
Significant changes to organizational documents Form 990, Part VI, Section A, Line 4 ON MARCH 31, 2011, CENTRAL DUPAGE HEALTH, THE SOLE MEMBER OF THIS FILING ORGANIZATION, MERGED WITH DELNOR-COMMUNITY HEALTH SYSTEM. CENTRAL DUPAGE HEALTH CHANGED ITS NAME TO CDH-DELNOR HEALTH SYSTEM AT THE MERGER. THE BYLAWS FOR CENTRAL DUPAGE PHYSICIAN GROUP WERE AMENDED AT THE TIME OF THE MERGER TO REFLECT THE NEW NAME OF THE SOLE MEMBER ORGANIZATION.
Classes of members or stockholders Form 990, Part VI, Section A, Line 6 THE SOLE MEMBER OF CENTRAL DUPAGE PHYSICIAN GROUP IS CDH-DELNOR HEALTH SYSTEM, A RELATED TAX-EXEMPT ORGANIZATION. MANAGEMENT DUTIES PROVIDED BY CDH-DELNOR HEALTH SYSTEM INCLUDE OPERATIONAL, STRATEGIC, BUDGETING AND LONG-RANGE PLANNING DUTIES, AS WELL AS FINANCE, INTERNAL AUDIT, PERSONNEL, TREASURY AND MARKETING SERVICES. THE INDIVIDUALS PROVIDING THESE SERVICES, INCLUDING THE CEO, CFO, AND OTHER SENIOR MANAGEMENT, ARE EMPLOYEES OF AND COMPENSATED BY CDH-DELNOR HEALTH SYSTEM. CDPG PAYS A MANAGEMENT SERVICES FEE TO CDH-DELNOR HEALTH SYSTEM.
Members or stockholders electing members of governing body Form 990, Part VI, Section A, Line 7a CDH-DELNOR HEALTH SYSTEM, THE SOLE MEMBER AND PARENT ORGANIZATION, HAS THE POWER TO ELECT OR REMOVE ALL OF THE DIRECTORS OF CENTRAL DUPAGE PHYSICIAN GROUP.
Decisions requiring approval by members or stockholders Form 990, Part VI, Section A, Line 7b CERTAIN DECISIONS OF THE CENTRAL DUPAGE PHYSICIAN GROUP'S (CDPG) GOVERNING BODY ARE SUBJECT TO APPROVAL BY CDH-DELNOR HEALTH SYSTEM, AS THE SOLE MEMBER OF CDPG. THE MEMBER'S AUTHORITY INCLUDES THE POWER TO AMEND, ALTER, RESTATE OR REPEAL THE BYLAWS OF THE CORPORATION; TO NEGOTIATE AND EXECUTE CONTRACTS ON BEHALF OF THE CORPORATION; TO ADOPT A PLAN OF MERGER, CONSOLIDATION OR CORPORATE REORGANIZATION INVOLVING THE CORPORATION; TO ADOPT A PLAN OF DISSOLUTION OR LIQUIDATION OF THE CORPORATION AND DISTRIBUTION OF ITS ASSETS; AND, TO AMEND, ALTER, RESTATE OR REPEAL THE ARTICLES OF INCORPORATION OF THE CORPORATION. ACTIONS BY THE BOARD OF DIRECTORS REQUIRING THE APPROVAL OF THE SOLE MEMBER INCLUDE: ADOPTION OF CAPITAL AND OPERATING BUDGETS; ADOPTION AND EXECUTION OF A STRATEGIC PLAN; AND, AUTHORIZATION OF A CAPITAL EXPENDITURE IN EXCESS OF THE LIMITS ESTABLISHED BY THE SOLE MEMBER FROM TIME TO TIME.
Review of form 990 by governing body Form 990, Part VI, Section B, Line 11a PRIOR TO FILING, A DRAFT OF THE COMPLETED FORM 990 IS REVIEWED BY OUTSIDE TAX ADVISORS AND INTERNAL MANAGEMENT. AFTER THAT REVIEW IS COMPLETE, THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS OF CDH-DELNOR HEALTH SYSTEM (SOLE MEMBER OF FILING ORGANIZATION) FOR ADDITIONAL REVIEW AND COMMENT.
Conflict of interest policy Form 990, Part VI, Section B, Line 12c THE CENTRAL DUPAGE PHYSICIAN GROUP'S (CDPG) OFFICERS AND DIRECTORS ARE EMPLOYEES OF CDH-DELNOR HEALTH SYSTEM , PARENT ORGANIZATION FOR THE FILING ORGANIZATION. EACH YEAR, ALL EMPLOYEES OF CDH-DELNOR HEALTH SYSTEM AND ITS RELATED ORGANIZATIONS ARE REQUIRED TO REVIEW THE CONFLICT OF INTEREST POLICY AND TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT. IN ADDITION, THE POLICY REQUIRES THAT EMPLOYEES DISCLOSE POTENTIAL CONFLICTS THAT MAY ARISE BETWEEN ANNUAL STATEMENTS THROUGH SUPPLEMENTARY DISCLOSURES. BOTH THE ANNUAL STATEMENTS AND THE SUPPLEMENTARY DISCLOSURES ARE REVIEWED AND EVALUATED BY CDH-DELNOR HEALTH SYSTEM'S DIRECTOR OF INTERNAL AUDIT AND COMPLIANCE. THE DIRECTOR IS DELEGATED THE RESPONSIBILITY TO DETERMINE WHETHER A POTENTIAL CONFLICT IS AN ACTUAL CONFLICT, AND FURTHER TO RECOMMEND AND IMPLEMENT, WHERE APPROPRIATE, CONFLICT MITIGATION STRATEGIES. COMPLETION RESULTS ARE PROVIDED TO THE AUDIT & FINANCE COMMITTEE OF THE CDH-DELNOR HEALTH SYSTEM BOARD OF DIRECTORS.
Process used to establish compensation of top management official Form 990, Part VI, Section B, Line 15a THE FILING ORGANIZATION'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS AND KEY EMPLOYEES ARE EMPLOYEES OF CDH-DELNOR HEALTH SYSTEM, A RELATED TAX-EXEMPT ORGANIZATION AND SOLE MEMBER OF THE FILING ORGANIZATION. THE COMPENSATION COMMITTEE OF THE CDH-DELNOR HEALTH SYSTEM BOARD OF DIRECTORS IS COMPRISED OF INDEPENDENT COMMITTEE MEMBERS AND IS DELEGATED THE RESPONSIBILITY FOR REVIEWING THE COMPENSATION OF THE ORGANIZATION'S EXECUTIVES (INCLUDING THE CHIEF EXECUTIVE OFFICER) AND OTHER KEY EMPLOYEES. THE PROCESS INCLUDES ENGAGING AN INDEPENDENT COMPENSATION CONSULTANT TO ASSIST IN DETERMINING THE APPROPRIATENESS OF COMPENSATION, WHICH INCLUDES REVIEWING COMPARABLE COMPENSATION STUDIES FOR SIMILARLY QUALIFIED PERSONS IN COMPARABLE ORGANIZATIONS TO SUPPORT ITS DECISION-MAKING PROCESS. THE COMPENSATION COMMITTEE ROUTINELY REPORTS TO THE FULL BOARD OF DIRECTORS ITS COMPENSATION RELATED ACTIVITIES, AND MAY FROM TIME TO TIME RECOMMEND MATTERS FOR THE FULL BOARD OF DIRECTORS CONSIDERATION (E.G., THE ESTABLISHMENT OF ANY NEW COMPENSATION OR BENEFIT PLAN). THE COMPENSATION COMMITTEE CONDUCTS A FORMAL REVIEW FOR THE ORGANIZATION'S EXECUTIVES ON AN ANNUAL BASIS, AND MAY MAKE DECISIONS RELATED TO COMPENSATION AND BENEFITS THROUGHOUT THE YEAR. THE COMPENSATION COMMITTEE LAST RECEIVED AN INDEPENDENT CONSULTANT'S REPORT SUPPORTING THE REASONABLENESS OF THE ORGANIZATION'S EXECUTIVES' COMPENSATION IN JANUARY, 2011.
Process used to establish compensation of other officers/key employees Form 990, Part VI, Section B, Line 15b SEE THE NARRATIVE FOR FORM 990, PART VI, LINE 15A.
Public Disclosure Form 990, Part VI, Section C, Line 19 VARIOUS PUBLIC AND PRIVATE ENTITIES MAY REQUIRE THE FILING OF SUCH DOCUMENTS AS PART OF A REGULATORY OR CONTRACTUAL COMMITMENT, AND AS A RESULT OF SUCH OBLIGATIONS, CERTAIN OF THESE MATERIALS MAY, IN FACT, BE AVAILABLE TO THE PUBLIC. OUTSIDE OF SUCH DISCLOSURE, THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT ROUTINELY MADE AVAILABLE BY THE ORGANIZATION TO THE PUBLIC. NOTABLY, FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE NOT REQUIRED TO BE DISCLOSED PURSUANT TO IRC SECTION 6104.
CONTEMPORANEOUS DOCUMENTATION OF MEETINGS BY COMMITTEES FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES THAT HAVE THE AUTHORITY TO ACT ON BEHALF OF CENTRAL DUPAGE PHYSICIAN GROUP, THEREFORE, THIS QUESTION HAS BEEN INTENTIONALLY LEFT BLANK.
COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES FORM 990, PART VII, SECTION A, LINE 1(A), COLUMN (B) THE DIRECTORS/OFFICERS LISTED ON PART VII, LINE 1A PROVIDE LEADERSHIP AND MANAGEMENT TO THE FILING ORGANIZATION AND TO ALL OTHER RELATED ORGANIZATIONS WITHIN THE CDH-DELNOR HEALTH SYSTEM OF HEALTHCARE ORGANIZATIONS (SEE SCHEDULE R, PART II). THE COMPENSATION INFORMATION REPORTED IN PART VII REFLECTS THE INDIVIDUALS' FULL COMPENSATION FOR SERVICE PROVIDED TO ALL RELATED ORGANIZATIONS. CDH-DELNOR HEALTH, AS PARENT AND SOLE MEMBER OF THESE RELATED ORGANIZATIONS, PROVIDES MANAGEMENT SERVICES TO ALL. DUE TO THE OVERLAP OF THE MANAGEMENT OF THESE ORGANIZATIONS, THERE IS NO MEANINGFUL METHOD IN WHICH TO ESTIMATE THE HOURS DEVOTED SPECIFICALLY TO ANY ONE OF THE RELATED ORGANIZATIONS. THEREFORE AN ESTIMATE OF 1 HOUR PER WEEK IS REPORTED AS BEING DEVOTED TO THIS FILING ORGANIZATION BY THOSE INDIVIDUALS. ONE LISTED PERSON, PATRICK TOWNE, IS EMPLOYED BY CENTRAL DUPAGE PHYSICIAN GROUP AND IS COMPENSATED FOR THE PHYSICIAN SERVICES HE PROVIDES.
Other changes in net assets or fund balances Form 990, Part XI, Line 5 NET UNREALIZED GAINS (LOSSES) ON INVESTMENTS - 113137;
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID: 10000128
Software Version: v2010.1.0
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
CENTRAL DUPAGE PHYSICIAN GROUP
 
Employer identification number

36-3149833
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income



(e)
End-of-year assets


(f)
Direct controlling
entity



















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section



(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled organization
Yes No
(1) CDH-DELNOR HEALTH SYSTEM

27W353 JEWELL RD

WINFIELD,IL60190
36-3099698
MANAGEMENT IL 501(C)(3) 11 - Type II NA
 
 
No
(2) CENTRAL DUPAGE HOSPITAL ASSOCIATION

25 N WINFIELD RD

WINFIELD,IL60190
36-2513909
HOSPITAL IL 501(C)(3) 3 CDH-DELNOR HEALTH SYSTEM
 
 
No
(3) CENTRAL DUPAGE HEALTH FOUNDATION

27W353 JEWELL RD

WINFIELD,IL60190
36-4401289
FUNDRAISING IL 501(C)(3) 7 CDH-DELNOR HEALTH SYSTEM
 
 
No
(4) COMMUNITY NURSING SERVICE OF DUPAGE COUNTY

690 E NORTH AVENUE

CAROL STREAM,IL60188
36-6080833
HOME HEALTH IL 501(C)(3) 9 CDH-DELNOR HEALTH SYSTEM
 
 
No
(5) PAHCS II

27W353 JEWELL RD

WINFIELD,IL60190
36-3887234
OCCUP. HEALTH IL 501(C)(3) 9 CDH-DELNOR HEALTH SYSTEM
 
 
No
(6) CENTRAL DUPAGE SPECIAL HEALTH

27W353 JEWELL RD

WINFIELD,IL60190
36-4310557
PHARMACY IL 501(C)(3) 9 CDH-DELNOR HEALTH SYSTEM
 
 
No
(7) DELNOR-COMMUNITY HEALTHCARE FOUNDATION

300 RANDALL ROAD

GENEVA,IL60134
36-3347004
HEALTH CARE IL 501(C)(3) 7 CDH-DELNOR HEALTH SYSTEM
 
 
No
(8) DELNOR-COMMUNITY RESIDENTIAL LIVING INC

300 RANDALL ROAD

GENEVA,IL60134
36-4156211
HEALTH CARE IL 501(C)(3) 9 CDH-DELNOR HEALTH SYSTEM
 
 
 
(9) LIVING WELL CANCER RESOURCE CENTER

300 RANDALL ROAD

GENEVA,IL60134
16-1727774
HEALTH CARE IL 501(C)(3) 7 CDH-DELNOR HEALTH SYSTEM
 
 
No
(10) DELNOR-COMMUNITY HOSPITAL

300 RANDALL ROAD

GENEVA,IL60134
36-3484281
HEALTH CARE IL 501(C)(3) 3 CDH-DELNOR HEALTH SYSTEM
 
 
No
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No
(1) TRI-CITIES IMCARE

300 RANDALL ROAD
GENEVA,IL60134
27-1942888
HEALTH CARE IL DELCOM
 
RELATED                
(2) TRI-CITIES DIALYSIS

1300 WATERFORD DR LOWER LEVEL
AURORA,IL60504
36-4272042
HEALTH CARE IL DELCOM
 
RELATED                
(3) TRI-CITIES SURGERY

345 DELNOR DRIVE
GENEVA,IL60134
51-0551673
HEALTH CARE IL DELCOM
 
RELATED                
(4) VALLEY INFUSION

300 RANDALL ROAD
GENEVA,IL60134
36-4289319
HEALTH CARE IL DELNOR HOSPITAL
 
RELATED                
(5) TRI-CITIES CANCER

300 RANDALL ROAD
GENEVA,IL60134
36-4009336
HEALTH CARE IL DELCOM
 
RELATED                
(6) FVFPDELNOR PROPERTIES

300 RANDALL RD
GENEVA,IL60134
45-1147062
PROPERTY MANAGEMENT IL DELCOM
 
EXCLUDED                


Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



(b)
Primary activity



(c)
Legal domicile
(state or
foreign
country)
(d)
Direct controlling
entity


(e)
Type of entity
(C corp, S corp,
or trust)

(f)
Share of total income



(g)
Share of
end-of-year
assets

(h)
Percentage
ownership


(1) DELCOM CORPORATION AND SUBSIDIARY
300 RANDALL ROAD
GENEVA,IL60134
36-3334711
HEALTH MGMT IL CDH-DELNOR HEALTH SYSTEM
 
C CORPORATION      
(2) DUPAGE HEALTH SERVICES INC
27W353 JEWELL RD
WINFIELD,IL60190
36-3270521
INVESTING DE CDH-DELNOR HEALTH SYSTEM
 
C CORPORATION      










Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization
(b)
Transaction
type(a-r)
(c)
Amount involved
(d)
Method of determining amount involved
(1)
(2)

(3)

(4)

(5)

(6)

Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Are all
partners
section
501(c)(3)
organizations?
(e)
Share of
end-of-year
assets
(f)
Disproprtionate allocations?
(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065)
(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


Software ID: 10000128
Software Version: v2010.1.0