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.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
Weill Cornell Imaging at New York- Presbyterian
Employer identification number
41-2237441
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) 2012
Schedule A (Form 990 or 990-EZ) 2012
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) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6
Public support. Subtract line 5 from line 4.
Section B. Total Support
Calendar year
(or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
7
Amounts from line 4..
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11
Total support (Add lines 7 through 10).
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 2012 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2012.
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—2011.
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—2012.
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—2011.
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) 2012
Schedule A (Form 990 or 990-EZ) 2012
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) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
0
0
0
0
0
0
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......
39,502,823
54,156,697
57,464,743
67,022,186
75,740,944
293,887,393
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
0
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
0
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
6
Total. Add lines 1 through 5.
39,502,823
54,156,697
57,464,743
67,022,186
75,740,944
293,887,393
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
0
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
900,026
0
0
0
900,026
c
Add lines 7a and 7b..
900,026
0
0
0
900,026
8
Public support (Subtract line 7c from line 6.)
292,987,367
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
9
Amounts from line 6...
39,502,823
54,156,697
57,464,743
67,022,186
75,740,944
293,887,393
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
2,000
0
0
0
2,000
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
0
c
Add lines 10a and 10b.
2,000
0
0
0
2,000
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
0
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
..
0
13
Total support. (Add lines 9, 10c, 11, and 12.)..
39,504,823
54,156,697
57,464,743
67,022,186
75,740,944
293,889,393
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 2012 (line 8, column (f) divided by line 13, column (f))
.........
15
0 %
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2011 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2012.
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—2011.
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) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information.
Complete this part to 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) 2012
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.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
Weill Cornell Imaging at New York- Presbyterian
Employer identification number
41-2237441
Identifier
Return Reference
Explanation
Description of Relationships
Form 990, Part VI, Question 2
President Robert J. Min, M.D. and Directors Stephen M. Cohen, Michael Stewart, M.D., Daniel M. Knowles, M.D., Controller Martin Doyle, and CFO/COO Thomas Stokes are all employees of Cornell. Dr. Min is President and Mr. Cohen, Dr. Stewart and Dr. Knowles are each Directors of MRSI Management, Inc. which is one of the two corporate Members. Martin Doyle is Director of Finance of Weill Cornell Physician Organization, and Thomas Stokes is CFO & COO of WCINYP. Director/Treasurer Gary J. Zuar, Secretary Kathleen M. Burke, Assistant Secretary Melissa Welch, and Directors Robert Kelly, M.D., and Laura D. Forese, M.D., M.P.H are all employees of NYPH and President Robert J. Min, M.D. serves as the Radiologist-in-Chief of NYPH (Weill Cornell campus). Dr. Kelly is President , Dr. Forese is Group Senior Vice President & Chief Operating Officer, Mr. Zuar is Senior Vice President and Ms. Burke is Vice President of NYPH and Dr. Forese and Mr. Zuar are Directors of NYP Services, Inc., which is one of the two corporate Members. Melissa Welch, J.D., is the Assistant Secretary for the Office of Corporate Secretary at NYPH Each of the persons listed as the highest compensated employees in Part VII Line 1.b is an employee of Cornell, whose services have been provided to WCINYP through the Medical Services Agreement. FORM 990, PART VI, QUESTION 6 DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS THE ORGANIZATION HAS TWO MEMBERS - NYP SERVICES, INC. AND MRSI MANAGEMENT, INC. FORM 990, PART VI, QUESTION 7A DESCRIPTION OF CLASSES OF PERSONS AND THEIR RIGHTS The corporation has 2 members - NYP Services, Inc., a New York not-for-profit corporation ("NYPS"), and MRSI Management, Inc., a New York not-for-profit corporation ("MRSI"). Notwithstanding any other provision of these By-laws, the members, by their mutual written consent, shall have exclusive authority to take any of the following actions: - Adopting or materially revising the Corporation's business plan; - Approving any new line of business other than such lines specified in the Certificate of Incorporation or the Corporation's business plan; - Approving or funding any subsidiary, or any material investment in a joint venture, affiliate or other organization; - Approving any expenditure of $500,000 or more, or incurring any debt or obligation in excess of $100,000; - Approving any merger or consolidation; - Approving the sale, lease, exchange or other disposition of all or substantially all of the Corporation's assets, other than in dissolution; - Creating any new class or classes of members, or admitting any new member, whether by approving the transfer, assignment or sale of a membership interest or otherwise; - Approving the pledge, encumbrance or disposal of all or any part of a membership interest in the Corporation; - Adopting any amendment, alteration or repeal of all or any part of the Certificate of Incorporation or these By-laws FORM 990, PART VI, QUESTION 7B DESCRIBE CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS CERTAIN DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO APPROVAL BY MRSI MANAGEMENT, INC. AND NYP SERVICES, INC. FORM 990, PART VI, QUESTION 11B DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 THE FORM 990 IS CIRCULATED TO ALL THE BOARD MEMBERS BEFORE SUBMISSION, AND IT IS REVIEWED AND APPROVED FOR FILING BY THE AUDIT COMMITTEE OF THE BOARD. FORM 990, PART VI, QUESTION 12C DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST WEILL CORNELL IMAGING AT NEWYORK-PRESBYTERIAN (WCINYP) ADHERES TO A CONFLICT OF INTEREST (COI) POLICY THAT WAS APPROVED BY THE AUDIT COMMITTEE OF THE BOARD OF TRUSTEES. THE POLICY STATES: "THE PURPOSE OF THE CONFLICT OF INTEREST POLICY, IN ACCORDANCE WITH ARTICLE VII OF THE NEW YORK NOT-FOR-PROFIT CORPORATION LAW, IS TO PROTECT THE INTERESTS OF WEILL CORNELL IMAGING AT NEW YORK- PRESBYTERIAN ("ORGANIZATION") WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN OFFICER, DIRECTOR OR KEY ADMINISTRATOR OF THE ORGANIZATION OR MIGHT RESULT IN A POSSIBLE EXCESS BENEFIT TRANSACTION." THE POLICY INCLUDES INSTRUCTIONS FOR AD-HOC DISCLOSURES AS WELL AS AN ANNUAL PROCESS FOR DISCLOSING AND EVALUATING CONFLICT OF INTEREST. UNDER "DUTY TO DISCLOSE" THE POLICY STATES: "IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIALS FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT." UNDER "DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS" THE POLICY STATES: "AFTER DISCOURSE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS." WITH REGARD TO THE ANNUAL PROCESS THE POLICY STATES: "EACH DIRECTOR, OFFICER, KEY ADMINISTRATOR AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS SHALL ANNUALLY COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE DISCLOSING ANY FINANCIAL INTERESTS SUCH PERSON HAS AS WELL ANY OTHER POTENTIAL CONFLICTS OF INTEREST WITH THE ORGANIZATION THAT THE BOARD MAY INQUIRE ABOUT. THE QUESTIONNAIRE MAY REQUEST INFORMATION, FOR EXAMPLE, ABOUT ANY RELATIONSHIPS SUCH PERSON HAS WITH COMPETITORS OF THE ORGANIZATION. ALL PERSONS COMPLETING THE QUESTIONNAIRE SHALL SIGN A STATEMENT AFFIRMING SUCH PERSON: A. HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, B. HAS READ AND UNDERSTANDS THE POLICY, C. HAS AGREED TO COMPLY WITH THE POLICY, AND D. UNDERSTANDS THE ORGANIZATION IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. FORMS ARE SUBMITTED TO THE COMPLIANCE OFFICER AND ANY FORMS THAT DISCLOSE POTENTIAL CONFLICTS ARE REVIEWED BY THE COMPLIANCE OFFICER AND THE WCINYP PRESIDENT. THEIR RECOMMENDATIONS IN TERMS OF ADJUDICATING ACTUAL OR POTENTIAL CONFLICTS ARE THEN SUBMITTED TO THE AUDIT COMMITTEE FOR FINAL REVIEW AND APPROVAL. LETTERS ARE SENT TO THE INDIVIDUAL WHO SUBMITTED THE FORM ADVISING HIM/HER OF THE REQUIRED COURSE OF ACTION TO RESOLVE OR MANAGE THE CONFLICTS. COPIES ARE SENT TO THE INDIVIDUAL'S SUPERVISOR. FORM 990, PART VI, QUESTION 15A AND 15B OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN THERE ARE NO INDIVIDUALS WHO CURRENTLY RECEIVE COMPENSATION FROM WCINYP. EACH OF THE OFFICERS AND DIRECTORS OF WCINYP ARE FULL TIME EMPLOYEES OF EITHER CORNELL OR NYPH, WHICH ARE EACH NON-PROFIT 501(C)(3) PUBLIC CHARITIES, AND THEIR COMPENSATION ARRANGEMENTS WITH THEIR RESPECTIVE EMPLOYERS ARE SUBJECT TO THE CONFLICT OF INTEREST POLICIES OF THOSE INSTITUTIONS, ARE APPROVED IN ADVANCE BY THE RESPECTIVE BOARDS OF DIRECTORS, ARE SET FORTH IN WRITING, AND ARE BASED ON COMPENSATION SURVEYS OF SIMILAR SITUATED ORGANIZATIONS FOR SIMILAR SERVICES, CURRENT COMPENSATION SURVEYS BY INDEPENDENT FIRMS, AND IN SOME CASES ACTUAL WRITTEN OFFERS FROM SIMILARLY SITUATED ORGANIZATIONS. WCINYP HAS ENTERED INTO A STAFF LEASING AGREEMENT WITH CORNELL, WHICH INCLUDES THE SERVICES OF THE MEDICAL DIRECTOR, WHO ALSO SERVES AS PRESIDENT OF WCINYP, AND WCINYP HAS ENTERED INTO A MEDICAL SERVICES AGREEMENT, WHICH INCLUDES SERVICES OF PHYSICIANS EMPLOYED BY CORNELL. THROUGH THOSE ARRANGEMENTS WHICH WERE APPROVED BY THE WCINYP BOARD OF DIRECTORS, WCINYP REIMBURSES CORNELL FOR ITS COSTS OF EMPLOYING SUCH INDIVIDUALS, WHICH COST TO CORNELL IS DETERMINED BASED ON MARKET CONDITIONS. FORM 990, PART VI, QUESTION 19 AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC EXTERNAL REQUESTS FOR OUR GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE REVIEWED FOR VALIDITY. THESE REQUESTS ARE THEN GRANTED IF DEEMED APPROPRIATE. FORM 990, PART XI, LINE 5 RECONCILIATION OF NET ASSETS OTHER CHANGES IN NET ASSETS OR FUND BALANCE $10,000,000 were given to our Parent Companies, WCMC and NYPH, as part of our "Distribution to Parent Companies." Each parent company was given $5,000,000.
OTHER FEES FOR SERVICES FOR NON-EMPLOYEES
FORM 990 PART IX LINE 11G
DESCRIPTION:OUTSIDE SERVICES TOTAL FEES:689261
OTHER FEES FOR SERVICES FOR NON-EMPLOYEES
FORM 990 PART IX LINE 11G
DESCRIPTION:OUTSIDE PHYSICIANS TOTAL FEES:1464837
OTHER FEES FOR SERVICES FOR NON-EMPLOYEES
FORM 990 PART IX LINE 11G
DESCRIPTION:BILLING SERVICE TOTAL FEES:2153144
OTHER FEES FOR SERVICES FOR NON-EMPLOYEES
FORM 990 PART IX LINE 11G
DESCRIPTION:SERVICE CONTRACTS TOTAL FEES:1225552
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.