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.
Attach to Form 990 or Form 990-EZ. See separate instructions. Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Community Cancer Research Foundation Inc
Employer identification number
35-2146374
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
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(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 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
Provide the following information about the supported organization(s).
(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 monetary support
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
665,108
1,212,825
759,773
757,648
622,691
4,018,045
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
0
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
4
Total. Add lines 1 through 3
665,108
1,212,825
759,773
757,648
622,691
4,018,045
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)..
519,626
6
Public support. Subtract line 5 from line 4.
3,498,419
Section B. Total Support
Calendar year
(or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
7
Amounts from line 4..
665,108
1,212,825
759,773
757,648
622,691
4,018,045
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
175
282
113
30
48
648
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
0
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
0
11
Total support (Add lines 7 through 10).
4,018,693
12
Gross receipts from related activities, etc. (see instructions)
..................
12
13
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.................................................
Section C. Computation of Public Support Percentage
14
Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
87.054 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
86.863 %
16a
33 1/3% support test—2013.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
.......................
b
33 1/3% support test—2012.
If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2013.
If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization
.....................................................
b
10%-facts-and-circumstances test—2012.
If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization
................................................
18
Private foundation.
If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions
.....................................................
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2013.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
........
b
33 1/3% support tests—2012.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
.....
20
Private foundation.
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information.
Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2013
Additional Data
Software ID:
Software Version:
-
TIN:
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.
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Community Cancer Research Foundation Inc
Employer identification number
35-2146374
Return Reference
Explanation
PART III, LINE 4A - PROGRAM SERVICE ACCOMPLISHMENTS
FISCAL YEAR END 2014 COMMUNITY CANCER RESEARCH FOUNDATION, INC. (CCRF) ACTIVITIES (JULY 1, 2013 THROUGH JUNE 30, 2014)- THE COMMUNITY CANCER RESEARCH FOUNDATION, INC. RELIES ON PUBLIC CONTRIBUTIONS TO HELP OFFSET THE COSTS OF CONDUCTING CLINICAL TRIALS AND OFFERING SUPPORT SERVICES. THROUGH FINANCIAL AND RESOURCE DONATIONS OF MANY INDIVIDUALS AND ORGANIZATIONS, THESE SERVICES HAVE BEEN POSSIBLE. IN ADDITION, THE COMMUNITY HEALTHCARE SYSTEM HOSPITALS PROVIDE FINANCIAL AND PERSONNEL SUPPORT FOR MANY OF THE ACTIVITIES OF THE FOUNDATION. FOUNDATION ACTIVITIES: THE FOUNDATION CONTINUOUSLY SEEKS OPPORTUNITIES TO EDUCATE THE PUBLIC AND PROFESSIONALS ABOUT THE LATEST IN CANCER CARE AND SUPPORTS CLINICAL TRIALS IN THE COMMUNITY SO INDIVIDUALS DIAGNOSED WITH CANCER DO NOT ALWAYS HAVE TO TRAVEL TO DISTANT HOSPITALS TO RECEIVE THIS TYPE OF TREATMENT. PROGRAMS HELD THIS YEAR INCLUDED: ANNUAL SPRING SYMPOSIUM-CANCER UPDATE 2014 HELD ON MARCH 15, 2014 FOR HEALTHCARE PROFESSIONALS: EXPERT SPEAKERS EDUCATED PROFESSIONALS ON LUNG CANCER SCREENING, TARGETED THERAPIES, AND TRIPLE NEGATIVE BREAST CANCER RESEARCH. VARIOUS MEMBERS OF THE FOUNDATION PATICIPATED ON THE CANCER COMMITTEE FOR BOTH COMMUNITY HOSPITAL AND ST. MARY MEDICAL CENTER. THE COMMITTEE WORKED TO PLAN THE ACTIVITIES OF THE CANCER PROGRAM AND HELPED TO MAINTAIN AND IMPROVE PRACTICE STANDARDS TO MEET THE CRITERIA OUTLINED BY THE AMERICAN COLLEGE OF SURGEONS. CANCER RESEARCH DEPARTMENT ACTIVITIES - THE CANCER RESEARCH DEPARTMENT STAFF PARTICIPATED IN THE FOLLOWING PROGRAMS DURING THIS PAST FISCAL YEAR: THE CANCER RESEARCH DEPARTMENT OFFERS A NUMBER OF CLINICAL TRIALS LOCALLY THROUGH THE NATIONAL CANCER INSTITUTE COOPERATIVE GROUPS. THE DEPARTMENT TRANSITIONED INTO THE NEW NATIONAL CLINICAL TRIAL SYSTEM, BECOMING A MEMBER OF NRG ONCOLOGY, A LARGE COOPERATIVE GROUP OF THE NATIONAL CANCER INSTITUTE. DR. MOHAMAD KASSAR WAS APPOINTED CO-MEDICAL DIRECTOR OF THE CANCER RESEARCH DEPARTMENT, SHARING ADMINISTRATIVE RESPONSIBILITIES WITH ERWIN ROBIN, MD. ALL STAFF PARTICIPATED IN LOCAL HEALTH FAIRS, CANCER SCREENINGS AND LECTURES. FUNDRAISING EVENTS: ANNUAL PERENNIAL BALL HELD IN MAY 2014: MAJOR FUNDRAISER FOR THE FOUNDATION HELD IN THE SPRING. THIS YEAR'S EVENT WAS HELD AGAIN AT THE HILTON IN CHICAGO, ILLINOIS WITH APPROXIMATELY 500 IN ATTENDANCE. THE EVENT RAISED OVER $210,000 FOR RESEARCH AND $10,000 FOR THE CANCER RESOURCE CENTRE. TREE LIGHTING CEREMONY: THIS YEAR'S EVENT RAISED ALMOST $12,000 FOR CANCER RESEARCH. DR. JANICE ZUNICH WAS THE HONORED GUEST AT THE TREE LIGHTING. DR. ZUNICH IS A MEDICAL GENETICIST ON STAFF WHO IS INVOLVED WITH RESEARCH AT INDIANA UNIVERSITY NORTHWEST. CANCER RESOURCE CENTRE ROMP AND ROLL: THE CANCER RESOURCE CENTRE'S MAIN FUNDRAISING EVENT WAS WELL ATTENDED WITH OVER 1,000 INDIVIDUALS PRESENT. THIS YEAR'S EVENT RAISED ALMOST $100,000. FRIENDS OF THE CANCER RESOURCE CENTRE: THIS AUXILIARY GROUP CONTINUED TO SUPPORT THE CANCER RESOURCE CENTRE BY CREATING A PARTNER FUNDRAISER WITH OTHER NON-PROFIT ORGANIZATIONS, RAISING FUNDS FOR BOTH. A COMMUNITY EVENT CALLED "HOLIDAY 101" WAS ADDED THIS YEAR. IN TOTAL, THE FRIENDS GROUP RAISED OVER $22,000 FOR THE CENTRE. COMMUNITY SUPPORT: IF NOT FOR COMMUNITY SUPPORT, IT WOULD BE DIFFICULT TO CONTINUE TO FULFILL OUR MISSION. WE ARE THANKFUL FOR THE MANY COMMUNITY GROUPS AND BUSINESSES WHO CONTINUE TO SUPPORT OUR ORGANIZATION AND ACCOUNT FOR A LARGE PART OF OUR INCOME. WE HAVE HAD NUMEROUS INDIVIDUALS AND ORGANIZATIONS HOLD FUNDRAISERS FOR OUR BENEFIT AND WE TRULY APPRECIATE THEIR SELFLESS EFFORTS. IN ADDITION, THE COMMUNITY HEALTHCARE SYSTEM AND A NUMBER OF ITS ENTITIES CONTRIBUTE NOT ONLY MONETARILY, BUT THROUGH THE TIME AND TALENTS OF MANY EMPLOYEES. CANCER RESOURCE CENTRE ACTIVITIES: DURING THE PAST FISCAL YEAR THE CANCER RESOURCE CENTRE SAW 541 NEW VISITORS MAKING UP 3,619 VISITS. IN TOTAL, THE FREE SERVICES OF THE CANCER RESOURCE CENTRE HAVE BEEN UTILIZED BY 4,704 INDIVIDUALS MAKING A TOTAL OF 33,747 VISITS SINCE IT OPENED ITS DOORS IN 2003. THE CANCER RESOURCE CENTRE, WHICH WAS OPENED JUNE 1, 2003 CONTINUES TO GROW AND EXPAND SERVICES. NEW PROGRAMS IMPLEMENTED THIS YEAR INCLUDED THE FOLLOWING: CARING FOR THE CAREGIVER SUPPORT GROUP CHAKRA CRYSTAL BOWL SOUND HEALING INSPIRATIONS FROM THE GARDEN OPEN HOUSE GUIDED IMAGERY LAUGHTER WITH YOGA REIKI OUTDOORS STRESS MANAGEMENT UNDERSTANDING METASTATIC CANCER (LECTURE) HEALTHY MOUTH LECTURE HEALTHY EATING, HEALTHY COOKING, NUTRITION FOR LIFE LECTURES AND DEMONSTRATIONS HOLIDAY DECORATIONS DEMONSTRATION ROAD TO FINANCIAL SUCCESS LECTURE UKELELE GROUP NETWORKING SHIP (SENIOR HEALTH INSURANCE PROGRAM) LECTURE CANCER CARE WEBCAST FUTURE DIRECTIONS: COMMUNITY CANCER RESEARCH FOUNDATION, INC. WILL FOCUS ON THE FOLLOWING GOALS FOR THE UPCOMING YEAR: INCREASE INVESTIGATORS AT EACH HOSPITAL INCREASE PATIENT ACCRUAL ON CLINICAL TRIALS TO MEET AMERICAN COLLEGE OF SURGEONS CRITERIA OF 3% AT COMMUNITY HOSPITAL AND 4% AT ST. MARY MEDICAL CENTER BEGIN A WALKING PROGRAM AT THE CANCER RESOURCE CENTRE WORK IN COLLABORATION WITH THE CANCER COMMITTEES AND BREAST LEADERSHIP PROGRAMS AT COMMUNITY HOSPITAL AND ST. MARY MEDICAL CENTER TO TRANSITION TO A NAVIGATION OF CANCER PATIENTS THROUGHOUT THEIR DISEASE WORK IN COLLABORATION WITH THE CANCER COMMITTEES AND BREAST LEADERSHIP PROGRAMS AT COMMUNITY HOSPITAL AND ST. MARY MEDICAL CENTER TO ASSIST INDIVIDUALS DIAGNOSED WITH CANCER THROUGH SURVIVORSHIP PROVIDE INVESTIGATORS WITH TOOLS TO HELP THEM IDENTIFY PATIENTS FOR POTENTIAL ENTRY INTO CLINICAL TRIALS CONTINUE TO SEEK INNOVATIVE MEANS OF ENGAGING INDIVIDUALS WITH CANCER AND THEIR LOVED ONES AT THE CANCER RESOURCE CENTRE, PROVIDING NEEDED SERVICES FREE OF CHARGE
PART VI, LINE 2 - FAMILY OR BUSINESS RELATIONSHIPS
FRANKIE FESKO IS A FAMILY MEMBER OF DONALD S. POWERS AND DONALD P. FESKO. ROSIE NGO IS A FAMILY MEMBER OF ELIZABETH YEE.
PART VI, LINE 6 - MEMBERS OR STOCKHOLDERS
MUNSTER MEDICAL RESEARCH FOUNDATION, INC. (MMRF) IS THE SOLE MEMBER OR STOCKHOLDER.
PART VI, LINE 7A - WHO HAS THE POWER TO ELECT MEMBERS OF GOVERNING BODY
MUNSTER MEDICAL RESEARCH FOUNDATION,INC. (MMRF) IS THE PARENT COMPANY OF COMMUNITY CANCER RESEARCH FOUNDATION, INC. AND HAS CONTROL TO ELECT MEMBERS TO THEIR GOVERNING BODY.
PART VI, LINE 7B - GOVERNENCE DECISIONS RESERVED OTHER THAN GOVERNING BODY
MUNSTER MEDICAL RESEARCH FOUNDATION, INC. IS THE PARENT COMPANY OF COMMUNITY CANCER RESEARCH FOUNDATION, INC. AND HAS RIGHTS TO APPROVE DECISIONS MADE BY COMMUNITY CANCER RESEARCH FOUNDATION, INC.
PART VI, LINE 11B - GOVERNING BODY 990 REVIEW PROCESS
THE 990 IS SUBMITTED TO THE SR VP AND SYSTEM CFO FOR REVIEW, ONCE THIS REVIEW IS COMPLETE THE RETURNS ARE THEN PRESENTED TO SENIOR LEADERSHIP FOR REVIEW. THE 990 IS THEN REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM AND THEN POSTED TO A SECURE WEBSITE TO ALLOW THE BOARD OF DIRECTORS TO REVIEW PRIOR TO FILING.
PART VI, LINE 12C - PROCESS TO MONITOR CONFLICT OF INTEREST
AS PART OF THE ORGANIZATION'S ANNUAL MONITORING & ENFORCEMENT PROCEDURE RELATING TO ITS CONFLICT OF INTEREST POLICY, ALL CONFLICT OF INTEREST QUESTIONNAIRES ARE REVIEWED BY THE VP OF CORPORATE COMPLIANCE AND THOSE OFFICERS, DIRECTORS, OR KEY EMPLOYEES WHO DO NOT RETURN OR FULLY COMPLETE THE QUESTIONNAIRE ARE CONTACTED TO RECONCILE THE OMISSION.
PART VI, LINE 19 - PUBLIC AVAILABILITY OF FS, COI POLICY, & GOVERNING DOCS
COMMUNITY CANCER RESEARCH FOUNDATION, INC. DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. IN ACCORDANCE WITH BOND COVENANTS, COMMUNITY CANCER RESEARCH FOUNDATION, INC. THROUGH COMMUNITY FOUNDATION OF NORTHWEST INDIANA MAKES ITS FINANICAL STATEMENTS AND DISCLOSURES AVAILABLE TO THE PUBLIC THROUGH THE EMMA DATABASE.
FORM 990 PART IX LINE 11G
DESCRIPTION:OUTSIDE SERVICES TOTAL FEES:70244
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.