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
COMMUNITY HEALTH CHARITIES OF ILLINOIS
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
525 WEST MONROE STREET NO 900
 
Room/suite
City or town, state or country, and ZIP + 4
CHICAGO, IL60661
D Employer identification number

36-3243189
E Telephone number

G Gross receipts $ 1,424,869
F Name and address of principal officer:
DAVID SELZER
525 WEST MONROE STREET NO 900
CHICAGO,IL60661
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.HEALTHCHARITIES.ORG/ILLINOIS
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: 1982
M State of legal domicile: IL
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO PROMOTE WELLNESS IN THE WORKPLACE
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 13
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 13
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 5
6 Total number of volunteers (estimate if necessary) .... 6 50
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 1,297,090 1,196,765
9 Program service revenue (Part VIII, line 2g) ......... 411,692 213,100
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 2,151 1,555
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 2,240 13,449
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 1,713,173 1,424,869
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,352,166 944,092
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) 221,005 327,388
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet176,909    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 170,330 227,071
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,743,501 1,498,551
19 Revenue less expenses. Subtract line 18 from line 12...... -30,328 -73,682
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 1,899,080 1,591,825
21 Total liabilities (Part X, line 26)............ 1,385,253 1,151,680
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 513,827 440,145
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
signatureBig 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 + 4Big 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: COMMUNITY HEALTH CHARITIES ILLINOIS IS PART OF A NATIONAL FEDERATION OF AMERICA'S PREMIER HEALTH ORGANIZATIONS THAT HAVE JOINED TOGETHER TO PROMOTE WELLNESS IN THE WORKPLACE. AS THE ILLINOIS AFFILIATE, WE RAISE CHARITABLE CONTRIBUTIONS FOR OUR 43 MEMBER HEALTH CHARITIES, WHILE ALSO SERVING AS A CONDUIT TO HEALTHCARE RESOURCES AND VOLUNTEER OPPORTUNITIES. OVER 100 EMPLOYERS PARTICIPATE IN COMMUNITY HEALTH CHARITIES OF ILLINOIS.EMPLOYEES DESIGNATE THE CHARITY OR CHARITIES WHERE THEY WANT THEIR DONATIONS TO GO, KNOWING THAT THEIR FUNDS WILL BE USED TO PROVIDE RESEARCH, EDUCATION, PATIENT SERVICES AND OUTREACH IN LOCAL COMMUNITIES ACROSS THE STATE.
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 $ 1,215,321 including grants of $ 944,092 ) (Revenue $ 213,100 )
ALLOCATIONS AND PROGRAM SERVICES PROVIDED TO MEMBER HEALTH CHARITIES INCLUDE THE FOLLOWING:(1) FINANCIAL ALLOCATIONS ARE DISTRIBUTED TO MEMBER HEALTH CHARITIES ON A QUARTERLY BASIS. AMOUNTS ARE BASED UPON CONTRIBUTIONS RECEIVED FROM EMPLOYEE GIVING PROGRAMS, COMPLETION OF AGREED UPON NUMBER OF VOLUNTEER HOURS, AND CAMPAIGN DEVELOPMENT ACTIVITIES.(2) PROMOTION OF MEMBER HEALTH CHARITIES' PROGRAMS, SERVICES AND RESOURCES INCLUDES: (A) THE ORGANIZATIONS WEBSITE: MEMBER HEALTH CHARITIES PRESENCE ON THE ORGANIZATION'S WEBSITE INCLUDES A LISTING OF THE PROGRAMS, SERVICES AND RESOURCES AS WELL AS THE EVENTS AND VOLUNTEER OPPORTUNITIES FOR EACH MEMBER; AND (B) THE ORGANIZATION FACILITATES QUARTERLY MEETINGS, AT WHICH THE EXECUTIVE DIRECTORS OF MEMBER HEALTH CHARITIES LEARN ABOUT AND DISCUSS NONPROFIT MANAGEMENT TOPICS. ADDITIONALLY, THE ORGANIZATION ACTS AS A HUB FOR MEMBER HEALTH CHARITIES WANTING TO COLLABORATE WITH THE OTHERS AND SHARE ISSUES, IDEAS AND QUESTIONS.
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$ 1,215,321
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 IClick to see attachment.......................
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 IIClick to see attachment...
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 Click to see attachment....................
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 IVClick to see attachment...................
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
 
No
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.Click to see attachment
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.Click to see attachment
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
 
No
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 Click to see attachment
12a
Yes
 
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
 
No
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.. Click to see attachment
21
Yes
 
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..... Click to see attachment
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................
23
 
No
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...... Click to see attachment
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................ Click to see attachment
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........................... Click to see attachment
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............... Click to see attachment
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 ......................... Click to see attachment
28a
Yes
 
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
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.. Click to see attachment
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.....................
34
 
No
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
3
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
Yes
 
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
5
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
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
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
13
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
13
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
 
No
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
Yes
 
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
 
No
14
Does the organization have a written document retention and destruction policy? .........
14
 
No
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
 
No
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
TIM FISCHER
525 WEST MONROE STREET SUITE 900
CHICAGO,IL60661
(312) 382-0198
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) KERRY FINNEGAN
BOARD CHAIR
 1.00 X   X       0 0 0
(2) PETER BOWER
BOARD VICE CHAIR
 1.00 X   X       0 0 0
(3) JEFFREY STOUT
TREASURER
 1.00 X   X       0 0 0
(4) DAVID TUCKER
SECRETARY
 1.00 X   X       0 0 0
(5) BRIAN MURPHY
BOARD MEMBER
 1.00 X           0 0 0
(6) PAUL DONOHUE
BOARD MEMBER
 1.00 X           0 0 0
(7) SALLY RUECKING
BOARD MEMBER
 1.00 X           0 0 0
(8) JEFFREY M TESKE ESQ
BOARD MEMBER
 1.00 X           0 0 0
(9) MATTHEW BERRAFATO
BOARD MEMBER
 1.00 X           0 0 0
(10) KAREN DEANGELIS
BOARD MEMBER
 1.00 X           0 0 0
(11) MICHAEL SHMARAK
BOARD MEMBER
 1.00 X           0 0 0
(12) PATRICK REEDY
BOARD MEMBER
 1.00 X           0 0 0
(13) JACKIE DOMINQUEZ
BOARD MEMBER
 1.00 X           0 0 0
(14) SUSAN TYBON
BOARD MEMBER
 1.00 X           0 0 0
(15) DAVID SELZER
PRESIDENT & CEO
 40.00     X       117,428 0 5,204




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 117,428 0 5,204
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet1
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
 
No
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
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet0
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		1,196,765
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 1,196,765
Program Service Revenue Business Code
2a DONOR DESIGNATION FEES 900,099 213,100 213,100    
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 213,100
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 1,555     1,555
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory    
b Less: cost or other basis and sales expenses    
c Gain or (loss)    
d Net gain or (loss)..........MediumBullet        
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      
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        
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        
Miscellaneous Revenue Business Code
11a MISCELLANEOUS REVENUE 900,099 13,449     13,449
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 13,449
12 Total revenue. See Instructions....MediumBullet 1,424,869 213,100 0 15,004
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 21 944,092 944,092
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 122,604 67,432 24,521 30,651
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 162,993 60,779 34,709 67,505
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) ....        
9 Other employee benefits ....... 15,709 6,487 3,299 5,923
10 Payroll taxes ........... 26,082 11,660 5,413 9,009
11 Fees for services (non-employees):        
a Management ...... 60,050 31,625 10,646 17,779
b Legal .........        
c Accounting ........... 8,383   8,383  
d Lobbying ...........        
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ......        
g Other ..........        
12 Advertising and promotion .... 8,911 4,010 1,871 3,030
13 Office expenses ....... 22,066 9,930 4,633 7,503
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 38,736 17,431 8,135 13,170
17 Travel ............ 24,290 21,862 1,214 1,214
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 13,833 12,449 692 692
20 Interest ...........        
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 2,177 980 457 740
23 Insurance .............. 1,977 890 415 672
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 CAMPAIGN EXPENSES 32,204 16,102   16,102
b MISCELLANEOUS 7,566 3,408 1,587 2,571
c DUES AND FEES 6,878 6,184 346 348
d
e
f All other expenses        
25 Total functional expenses. Add lines 1 through 24f 1,498,551 1,215,321 106,321 176,909
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 		       
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 .......... 670,266 1 546,891
2 Savings and temporary cash investments .......   2 49,700
3 Pledges and grants receivable, net ......... 1,209,108 3 966,352
4 Accounts receivable, net ......... 50 4 9,000
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 ............ 7,801 9 13,161
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 10,882
b Less: accumulated depreciation. ..... 10b 4,161 8,898 10c 6,721
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 ......   12  
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 2,957 15 0
16 Total assets. Add lines 1 through 15 (must equal line 34)... 1,899,080 16 1,591,825
Liabilities 17 Accounts payable and accrued expenses . 43,670 17 107,360
18 Grants payable .......... 1,341,583 18 1,039,515
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..... 0 25 4,805
26 Total liabilities. Add lines 17 through 25..... 1,385,253 26 1,151,680
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 ..... 513,827 27 440,145
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 ..... 513,827 33 440,145
34 Total liabilities and net assets/fund balances ..... 1,899,080 34 1,591,825
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
1,424,869
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
1,498,551
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
-73,682
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
513,827
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
0
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
440,145
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:  
Software Version:  
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
COMMUNITY HEALTH CHARITIES OF ILLINOIS
 
Employer identification number

36-3243189
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.") .... 1,774,205 1,747,303 1,587,778 1,344,590 1,196,765 7,650,641
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.. 1,774,205 1,747,303 1,587,778 1,344,590 1,196,765 7,650,641
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.           7,650,641
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.. 1,774,205 1,747,303 1,587,778 1,344,590 1,196,765 7,650,641
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. 5,376 6,315 11,390 2,151 1,555 26,787
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.. 3,279 268 17,486 2,240 13,449 36,722
11 Total support (Add lines 7 through 10).           7,714,150
12
12
577,292
13
Section C. Computation of Public Support Percentage
14
14
99.180 %
15
15
99.250 %
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.") .            
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......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
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.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
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...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
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
SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
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
COMMUNITY HEALTH CHARITIES OF ILLINOIS
 
Employer identification number

36-3243189
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
COMMUNITY HEALTH CHARITIES OF ILLINOIS
  		Employer identification number

36-3243189
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
COMMUNITY HEALTH CHARITIES OF ILLINOIS
  		Employer identification number

36-3243189
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
COMMUNITY HEALTH CHARITIES OF ILLINOIS
  		Employer identification number

36-3243189
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:  
Software Version:  
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
COMMUNITY HEALTH CHARITIES OF ILLINOIS
 
Employer identification number

36-3243189
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 ....      
b Contributions ........      
c Investment earnings or losses ...      
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		     
f Administrative expenses ....      
g End of year balance ......      
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet  
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)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
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 .................      
b Buildings ................        
c Leasehold improvements ............        
d Equipment ................   10,882 4,161 6,721
e Other .................        
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 6,721
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








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
ACCRUED PAYROLL 4,805








Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 4,805
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 1,424,869
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 1,498,551
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 -73,682
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  
9 Total adjustments (net). Add lines 4 - 8 ............................. 9 0
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 -73,682
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 515,764
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  
e Add lines 2a through 2d ..................... 2e 0
3 Subtract line 2e from line 1..................... 3 515,764
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 909,105
c Add lines 4a and 4b....................... 4c 909,105
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5 1,424,869
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 589,446
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  
e Add lines 2a through 2d...................... 2e 0
3 Subtract line 2e from line 1..................... 3 589,446
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 909,105
c Add lines 4a and 4b....................... 4c 909,105
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5 1,498,551
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
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND SIMILAR STATE INCOME TAX LAWS. CONTRIBUTIONS TO THE ORGANIZATION QUALIFY AS A CHARITABLE TAX DEDUCTION BY THE CONTRIBUTOR. THE ORGANIZATION ADOPTED THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS ON JULY 1, 2009. NO LIABILITY WAS RECOGNIZED BY THE ORGANIZATION AS A RESULT OF THE IMPLEMENTATION OF THIS STANDARD. THE ORGANIZATION FILES AS A TAX-EXEMPT ORGANIZATION. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, ALL YEARS SINCE INCEPTION COULD BE SUBJECT TO REVIEW BY THE IRS. THE JUNE 30, 2008, 2009, AND 2010 TAX YEARS OF THE ORGANIZATION ARE OPEN FOR EXAMINATION BY THE INTERNAL REVENUE SERVICE.
PART XI, LINE 8 - OTHER ADJUSTMENTS:   RESTATEMENT
PART XII, LINE 4B - OTHER ADJUSTMENTS:   DISTRIBUTIONS TO SPECIFIC AGENCIES 909,105.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:   DONOR DESIGNATIONS - LOCAL 400,445. DONOR DESIGNATIONS - NATIONAL 508,660.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
COMMUNITY HEALTH CHARITIES OF ILLINOIS
 
Employer identification number
36-3243189
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) AIDS RESEARCH FOUNDATION (AMFAR)120 WALL STREET
NEW YORK,NY10005 		13-3163817 501(C)3 8,203   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(2) ALZHEIMER'S ASSOCIATION GREATER ILLINOIS CHAPTER8430 WEST BRYN MAWR
NEW YORK,NY10005 		13-3039601 501(C)3 41,496   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(3) AMC CANCER RESEARCH CENTER ILLINOIS3401 QUEBEC STREET
CHICAGO,IL60631 		84-0402535 501(C)3 9,205   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(4) AMERICAN CANCER SOCIETY ILLINOIS225 NORTH MICHIGAN AVENUE SUITE
3200
CHICAGO,IL60631 		36-2167721 501(C)3 46,166   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(5) AMERICAN DIABETES ASSOCIATION4900 SEMINARY ROAD SUITE 310
DENVER,CO80214 		13-1623888 501(C)3 15,549   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(6) AMERICAN DIABETES ASSOCIATION ILLINOIS30 NORTH MICHIGAN AVENUE
DENVER,CO80207 		13-1623888 501(C)3 47,615   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(7) AMERICAN HEART ASSOCIATION6800 WEST 93RD STREET
CHICAGO,IL60601 		13-5613797 501(C)3 24,296   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(8) AMERICAN LIVER FOUNDATION GREAT LAKES DIVISION ILLINOIS67 EAST MADISON STREET
ALEXANDRIA,VA22311 		36-2883000 501(C)3 7,652   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(9) AMERICAN LUNG ASSOCIATION1301 PENNSYLVANIA AVE NW
CHICAGO,IL60601 		20-4392201 501(C)3 5,492   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(10) AMERICAN LUNG ASSOCIATION OF ILLINOIS - GREATER CHICAGO55 WEST WACKER DRIVE
CHICAGO,IL60602 		20-4392201 501(C)3 13,888   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(11) ARTHRITIS FOUNDATION ILLINOIS GREATER CHICAGO CHAPTER35 EAST WACKER DRIVE
OVERLAND PARK,KS66212 		36-2246715 501(C)3 11,579   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(12) AUTISM SPEAKS1060 STATE ROAD
CHICAGO,IL60601 		20-2329938 501(C)3 9,937   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(13) AUTISM SPEAKS CHICAGOLAND CHAPTER1060 STATE ROAD
CHICAGO,IL60603 		20-2329938 501(C)3 9,686   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(14) BREAST CANCER NETWORK OF STRENGTH ILLINOIS135 SOUTH LASALLE STREET
DES PLAINES,IL60018 		36-3049954 501(C)3 18,828   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(15) CANCER RESEARCH INSTITUTE55 BROADWAY
WASHINGTON,DC200041725 		13-1837442 501(C)3 11,434   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(16) CHILDREN'S HEART FOUNDATION ILLINOIS CHAPTERPO BOX 244
NEW YORK,NY10006 		36-4077528 501(C)3 7,881   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(17) CHILDREN'S MEMORIAL HOSPITAL - ILLINOIS2300 CHILDRENS PLAZA
CHICAGO,IL60601 		36-2170833 501(C)3 38,046   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(18) CROHN'S & COLITIS FOUNDATION ILLINOIS CAROL FISHER CHAPTER2200 EAST DEVON AVENUE
CHICAGO,IL60614 		13-6193105 501(C)3 19,648   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(19) CYSTIC FIBROSIS FOUNDATION ILLINOIS CHAPTER150 NORTH MICHIGAN AVENUE
CHICAGO,IL60601 		13-1930701 501(C)3 12,466   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(20) EASTER SEALS METROPOLITAN CHICAGO1939 WEST 13TH STREET
DES PLAINES,IL60018 		36-2169153 501(C)3 13,710   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(21) EPILEPSY FOUNDATION OF AMERICA8301 PROFESSIONAL PLACE
PRINCETON,NJ08540 		52-0856660 501(C)3 5,185   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(22) EPILEPSY FOUNDATION OF ILLINOIS GREATER CHICAGO17 NORTH STATE STREET
CHICAGO,IL60610 		36-2317619 501(C)3 9,269   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(23) JUVENILE DIABETES RESEARCH FOUNDATION ILLINOIS CHAPTER11 SOUTH LASALLE STREET
PRINCETON,NJ08540 		23-1907729 501(C)3 35,025   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(24) LES TURNER ALS FOUNDATION - ILLINOIS5550 WEST TOUHY AVENUE
LANDOVER,MD20785 		36-2916466 501(C)3 13,003   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(25) LEUKEMIA & LYMPHOMA SOCIETY ILLINOIS CHAPTER651 WEST WASHINGTON BLVD
CHICAGO,IL60603 		13-5644916 501(C)3 27,622   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(26) LITTLE CITY FOUNDATION1760 WEST ALGONQUIN ROAD
CHICAGO,IL60604 		36-2434562 501(C)3 9,233   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(27) LUPUS FOUNDATION OF AMERICA2000 L STREET NW
NEW YORK,NY10006 		43-1131436 501(C)3 5,921   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(28) LUPUS FOUNDATION OF AMERICA ILLINOIS CHAPTER740 NORTH RUSH STREET
LINCOLNSHIRE,IL60069 		23-7287880 501(C)3 18,823   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(29) MARCH OF DIMES FOUNDATION ILLINOIS CHAPTER111 WEST JACKSON BLVD
SKOKIE,IL60077 		13-1846366 501(C)3 17,395   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(30) MENTAL HEALTH AMERICA OF ILLINOIS70 EAST LAKE STREET
CHICAGO,IL60614 		37-0794769 501(C)3 10,888   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(31) MUSCULAR DYSTROPHY ASSOCIATION ILLINOIS1020 WEST 13ST STREET SUITE 310
PALATINE,IL60067 		13-1665552 501(C)3 13,001   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(32) NAMI (NATIONAL ALLIANCE ON MENTAL ILLINESS) ILLINOIS218 WEST LAWRENCE AVENUE
DES PLAINES,IL60018 		36-3305804 501(C)3 5,939   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(33) NATIONAL KIDNEY FOUNDATION OF ILLINOIS215 WEST ILLINOIS STREET
WASHINGTON,DC20036 		36-6009226 501(C)3 19,045   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(34) NATIONAL MULTIPLE SCLEROSIS SOCIETY ILLINOIS CHAPTER525 WEST MONROE
CHICAGO,IL60601 		36-2249887 501(C)3 21,060   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(35) PANCREATIC CANCER ACTION NETWORK1500 ROSECRANS AVENUE
CHICAGO,IL60608 		33-0841281 501(C)3 7,067   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(36) PARKINSONS DISEASE FOUNDATION1359 BROADWAY
LANDOVER,MD20785 		13-1866796 501(C)3 2,197   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(37) PARKINSON'S DISEASE FOUNDATION MIDWEST OFFICE833 WEST WASHINGTON BLVD
SPRINGFIELD,IL62704 		13-1866796 501(C)3 5,625   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(38) SICKLE CELL DISEASE ASSOCIATION OF AMERICA231 EAST BALTIMORE STREET
CHICAGO,IL60602 		23-7175985 501(C)3 8,009   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(39) SICKLE CELL DISEASE ASSOCIATION OF ILLINOIS200 NORTH MICHIGAN AVENUE
CHICAGO,IL60661 		23-7157702 501(C)3 18,038   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(40) SPINAL CORD INJURY ASSOCIATION OF ILLINOIS1032 SOUTH LAGRANGE ROAD
CHICAGO,IL606031344 		36-3149036 501(C)3 18,638   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(41) ST JUDE CHILDRENS RESEARCH HOSPITAL4619 RAVENSWOOD
CHICAGO,IL60607 		35-1044585 501(C)3 173,542   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(42) SUDDEN INFANT DEATH SERVICES ILLINOIS710 EAST OGDEN AVENUE SUITE 550
SKOKIE,IL60077 		36-3848062 501(C)3 6,207   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(43) SUSAN G KOMEN FOR THE CURE5005 LBJ FWY
BALTIMORE,MD21202 		75-1835298 501(C)3 43,773   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
(44) SUSAN G KOMEN FOR THE CURE ILLINOIS CHICAGOLAND AREA AFF8765 WEST HIGGINS ROAD
CHICAGO,IL60661 		36-4111723 501(C)3 26,045   N/A N/A FEDERATED CAMPAIGN PASS THROUGH DISTRIBUTION
2
Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image
44
3
Enter total number of other organizations ................................ . Bullet Image
0
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2010

Schedule I (Form 990) 2010
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE ORGANIZATION RECEIVES AND DISTRIBUTES FEDERATED CAMPAIGN CONTRIBUTIONS DESIGNATED FOR SPECIFIC CHARITIES BY THE DONORS. NO FORMAL MONITORING OF CONTRIBUTIONS IS REQUIRED.
Schedule I (Form 990) 2010


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Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
COMMUNITY HEALTH CHARITIES OF ILLINOIS
 
Employer identification number

36-3243189
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) KELSEY DEANGELIS
  		FAMILY RELATIONSHIP WITH BOARD MEMBER KAREN DEANGELIS 31,040 EMPLOYMENT COMPENSATION   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  




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
COMMUNITY HEALTH CHARITIES OF ILLINOIS
 
Employer identification number

36-3243189
Identifier Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 6   ANY CORPORATION ORGANIZED AS A HEALTH AGENCY AND EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1954, AND ASSOCIATED OR INCORPORATED IN ILLINOIS OR QUALIFIED TO DO BUSINESS IN ILLINOIS, IS ELIGIBLE FOR MEMBERSHIP. THE BOARD OF DIRECTORS DETERMINES OTHER MEMBERSHIP REQUIREMENTS AS DEEMED APPROPRIATE, INCLUDING MEMBERSHIP DUES, IF ANY. ALL MEMBER AGENCIES APPOINT ONE REPRESENTATIVE OR ALTERNATE TO SERVE AS A LIAISON BETWEEN THEIR AGENCY AND THE ORGANIZATION AND ARE ENTITLED TO ONE VOTE ON EACH MATTER SUBMITTED TO A VOTE OF THE GENERAL MEMBERSHIP.
FORM 990, PART VI, SECTION A, LINE 7A   THE MEMBERS ELECT THE BOARD OF DIRECTORS AT THE ANNUAL MEETING.
FORM 990, PART VI, SECTION A, LINE 7B   THE MEMBERS HAVE THE RIGHT TO OVERRULE OR RESCIND ANY BOARD OF DIRECTORS' ACTION UPON A MAJORITY VOTE OF THOSE PRESENT AND VOTING, ONCE A QUORUM HAS BEEN ESTABLISHED, UNLESS AN EXTRAORDINARY MAJORITY IS OTHERWISE SO STIPULATED IN THE BYLAWS. AMENDMENTS TO THE ORGANIZATION'S GOVERNING DOCUMENTS MUST BE APPROVED BY A 2/3 MAJORITY OF MEMBERS PRESENT, ONCE A QUORUM HAS BEEN ESTABLISHED AND UPON RECOMMENDATION OF A MAJORITY VOTE OF THE BOARD, PROVIDED THAT A COPY OF ANY PROPOSED CHANGES HAS BEEN MAILED, EMAILED OR FAXED, AT LEAST THIRTY DAYS IN ADVANCE OF THE MEETING TO VOTING MEMBERS.
FORM 990, PART VI, SECTION B, LINE 11   THE FORM 990 IS DISTRIBUTED TO THE BOARD MEMBERS PRIOR TO THE BOARD MEETING. THE FINANCE COMMITTEE CHAIR PRESENTS THE RETURN AND FIELDS QUESTIONS REGARDING THE FORM. A MOTION IS MADE TO APPROVE THE FORM 990, AND A VOTE IS TAKEN.
  FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY COVERS BOARD MEMBERS AND OFFICERS. COVERED INDIVIDUALS ARE REQUIRED TO DISCLOSE ANNUALLY ALL MATERIAL FINANCIAL INTERESTS THAT COULD RESULT IN POTENTIAL OR ACTUAL CONFLICTS OF INTEREST TO THE BOARD OF DIRECTORS IN WRITING. THESE REPORTS ARE PRESENTED TO THE EXECUTIVE COMMITTEE AND ARE MAINTAINED AS A CONFIDENTIAL PART OF THE ORGANIZATION'S PERMANENT FILE. THE EXECUTIVE COMMITTEE REVIEWS ALL REPORTS FOR POTENTIAL CONFLICTS OF INTEREST AND MAKES RECOMMENDATIONS TO THE BOARD OF DIRECTORS CONCERNING THE POSSIBLE DUALITY OF INTEREST AND ANY MAJOR FINANCIAL INTERESTS. THE BOARD SHALL CONSIDER ALL RECOMMENDATIONS MADE BY THE EXECUTIVE COMMITTEE AND SHALL MAKE THE FINAL DETERMINATION AS TO WHETHER OR NOT A CONFLICT EXISTS. ANY MATTER COMING BEFORE THE BOARD OF DIRECTORS IN WHICH A COVERED INDIVIDUAL HAS A DIRECT CONFLICT OF INTEREST, THE CONFLICTED INDIVIDUAL SHALL DISCLOSE SUCH INTEREST AND PROVIDE THE BOARD OR COMMITTEE WITH ANY AND ALL RELEVANT INFORMATION. THE CONFLICTED INDIVIDUAL SHALL RETIRE FROM THE ROOM IN WHICH THE BOARD (OR COMMITTEE) IS MEETING, SHALL NOT PARTICIPATE IN THE FINAL DELIBERATION OR DECISION REGARDING THE MATTER UNDER CONSIDERATION, AND SHALL REFRAIN FROM ANY VOTE TAKEN ON THE MATTER. THE MINUTES OF THE MEETING DOCUMENT THE DISCLOSURE MADE AND THAT THE CONFLICTED INDIVIDUAL ABSTAINED FROM VOTING.
  FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION FOR THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL IS HANDLED VIA CONTRACT. THE SCOPE AND PRICING OF THE CONTRACTS ARE SET AND APPROVED BY THE BOARD OF DIRECTORS. THE CONTRACTS WERE REVIEWED AGAINST INFORMATION MAINTAINED BY THE NATIONAL OFFICE, OBTAINED THROUGH A 2009 SURVEY BY BLUEWATER GROUP, WHICH SURVEYED NON-PROFITS NATIONALLY AND REGIONALLY AND PROVIDED A DETAILED, SEGMENTED REPORT. THE BOARD CHAIR, VICE CHAIR, AND ONE OTHER DIRECTOR APPOINTED BY A MAJORITY VOTE OF THE BOARD OF DIRECTORS REVIEW THE PRESIDENT & CEO PERFORMANCE. THIS COMMITTEE REPORTS TO AND MAKES RECOMMENDATIONS REGARDING PERFORMANCE AND CHANGES TO COMPENSATION TO THE BOARD OF DIRECTORS. THIS PROCESS WAS LAST UNDERTAKEN IN 2011 FOR THE PRESIDENT & CEO, D. SELZER.
  FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. THE ORGANIZATION'S MOST RECENT FORM 990 AND ANNUAL REPORT (INCLUDING AUDITED FINANCIAL STATEMENTS) ARE AVAILABLE ON THE ORGANIZATION'S WEBSITE AT: WWW.HEALTHCHARITIES.ORG/ILLINOIS.
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:  
Software Version: