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
The Mount Sinai Children's Center Foundation Inc
Employer identification number
22-3059294
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)
No
(ii)
A family member of a person described in (i) above?
......................
11g(ii)
No
(iii)
A 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
No
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
(A)
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
136171197
02
Yes
534,317
Total
534,317
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.") ....
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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
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
The Mount Sinai Children's Center Foundation Inc
Employer identification number
22-3059294
Return Reference
Explanation
FORM 990, PART I, LINE 5 & PART V, LINE 2A
MOUNT SINAI HOSPITAL OPERATES ALL PAYROLLS FOR RELATED ENTITIES AND ALL SALARIES ARE ALLOCATED BACK TO THE SEPARATE ENTITIES AND REPORTED AS IF PAID DIRECTLY BY THEM. THE MOUNT SINAI HOSPITAL, ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI, ELMHURST HOSPITAL CENTER AND QUEENS HOSPITAL CENTER UTILIZE A COMMON PAYMASTER UNDER THE HOSPITAL'S TAX IDENTIFICATION NUMBER, WHICH ON A COMBINED BASIS COVERS 21,829 INDIVIDUALS. THE NUMBER OF DIRECT CHILDREN'S CENTER EMPLOYEES IS 1.
FORM 990, PART VI, SECTION A, QUESTION 2
FAMILY/BUSINESS RELATIONSHIPS *TRUSTEES VICKI PANZIER GROSS AND MICHAEL GROSS WERE HUSBAND AND WIFE. THEY ARE BOTH CO-CHAIRS ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES DANIEL AND ELLEN CROWN ARE HUSBAND AND WIFE. TOGETHER, THEY HOLD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES RONALD AND STEPHANIE KRAMER ARE HUSBAND AND WIFE. TOGETHER, THEY HOLD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEE MARK ROWAN IS A MANAGING PARTNER, MARC BECKER IS A PARTNER, JOHN HANNAN IS A PARTNER, AND BARRY COHEN IS A SENIOR MANAGING DIRECTOR OF THE SAME FIRM. *TRUSTEES JENNIFER DEPPE PARKER AND STAN PARKER ARE HUSBAND AND WIFE. *TRUSTEES SALVATORE BOMMARITO AND ALISON MASS BOMMARITO ARE HUSBAND AND WIFE. TOGETHER, THEY HOLD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES GLEN AND DEBBIE AUGUST ARE HUSBAND AND WIFE. TOGETHER, THEY HOLD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES BARRY AND JOYCE COHEN ARE HUSBAND AND WIFE. TOGETHER, THEY HOLD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES MARC BECKER AND CARYN SEIDMAN BECKER ARE HUSBAND AND WIFE. TOGETHER, THEY HOLD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES ISRAEL AND CARYL ENGLANDER ARE HUSBAND AND WIFE. TOGETHER, THEY HOLD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES JOHN AND JUDITH HANNAN ARE HUSBAND AND WIFE. TOGETHER, THEY HOLD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES JOHN AND SUSAN HESS ARE HUSBAND AND WIFE. TOGETHER, THEY HOLD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES STAFFORD BROUMAND AND LAURA TISCH BROUMAND ARE HUSBAND AND WIFE. TOGETHER, THEY HOLD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES JOHN AND NANCY LEVENE ARE HUSBAND AND WIFE. TOGETHER, THEY HOLD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES MARK AND JILL RACHESKY ARE HUSBAND AND WIFE. TOGETHER, THEY HOLD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES STUART AND PAMELA ROTHENBERG ARE HUSBAND AND WIFE. TOGETHER, THEY HOLD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES MARC AND CAROLYN ROWAN ARE HUSBAND AND WIFE. TOGETHER, THEY HOLD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES FREDERIQUE AND RAYMOND SVIDERARE HUSBAND AND WIFE. TOGETHER, THEY HOLD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES JAMES AND MERRYL TISCH ARE HUSBAND AND WIFE. TOGETHER, THEY HOLD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES GREGG AND LISA RECHLER ARE HUSBAND AND WIFE. TOGETHER, THEY HOLD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES LIZZY AND NEIL COLE ARE HUSBAND AND WIFE. TOGETHER, THEY HOLD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES IRA AND JODY SCHWARTZ ARE HUSBAND AND WIFE. TOGETHER, THEY HOLD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES PURNIMA PURI AND RCHARD BARRERA ARE HUSBAND AND WIFE. TOGETHER, THEY HOLD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES JEFFREY AND SUSAN GOLDENBERG ARE HUSBAND AND WIFE. TOGETHER, THEY HELD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES ROBERT LINDHART AND LEORA MOGILNER ARE HUSBAND AND WIFE. TOGETHER, THEY HELD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION. *RAMON AND LILA MURPHY ARE HUSBAND AND WIFE. TOGETHER, THEY HELD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES KURT AND ROCHELLE HIRSCHHORN ARE HUSBAND AND WIFE. TOGETHER, THEY HELD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES HAROLD AND BETH RAUCHER ARE HUSBAND AND WIFE. TOGETHER, THEY HELD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES IAN AND ELLEN HOLZMAN ARE HUSBAND AND WIFE. TOGETHER, THEY HELD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD. *TRUSTEES JESSICA BEATTIE AND KENNETH FIDJE ARE HUSBAND AND WIFE. TOGETHER, THEY HELD ONE VOTE ON THE CHILDREN'S CENTER FOUNDATION BOARD.
FORM 990, PART VI, SECTION A, QUESTION 6
AS DESCRIBED IN THE BY-LAWS, ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI IS THE SOLE MEMBER OF THE MOUNT SINAI CHILDREN'S CENTER FOUNDATION, INC.
FORM 990, PART VI, SECTION A, QUESTIONS 7A & 7B
AS DESCRIBED IN THE BY-LAWS, ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI ELECTS THE BOARD OF DIRECTORS, THUS, CONTROLLING THE CHILDREN'S CENTER FOUNDATION AND PASSING INDIRECT CONTROL OVER THE CHILDREN'S CENTER FOUNDATION TO THE SCHOOL'S RELATED ORGANIZATIONS IN ACCORDANCE WITH SECTION 318 OF THE INTERNAL REVENUE CODE.
FORM 990, PART VI, SECTION B, LINE 11B
FORM 990 PROVIDED TO GOVERNING BODY The Finance Department gathered the relevant information and prepared the tax returns * Our outside auditors, Ernst & Young, participated in the preparation of, and reviewed, all tax returns. * A questionnaire was circulated to all trustees (i.e., directors), officers and key employees in order to elicit the information required to be reported on the tax returns. * A Committee reviewed the responses provided by trustees and certain officers in the questionnaires and assessed additional pertinent facts gathered by the institution in order to evaluate the applicability of IRS reporting requirements. The Review Committee then determined the appropriate trustee (and certain officer) disclosures that should be made on Form 990 based on the recommendations of the Finance Department, the General Counsel's office and the Audit and Compliance Department. These recommendations were reviewed and approved by E&Y. The same process was conducted by the Finance Department, the General Counsel's office, the Audit and Compliance Department and E&Y with respect to the questionnaires submitted by other officers and key employees * The tax returns were presented to the Audit and Compliance Committee of the Board of Trustees with the participation of E&Y, the Finance Department, the General Counsel's office, and the Audit and Compliance Department. The Audit Committee reviewed and approved the tax returns as presented. * The Audit Committee's report of its review of the tax returns and its recommendation to file the returns were presented to, and accepted by, the Executive Committee of the Board of Trustees (the "Executive Committee"). * In addition to authorizing the filing of the tax returns, the Executive Committee directed that the returns, which will be filed on or before November 15, 2014, be provided to all trustees via the trustees' confidential website, and those returns were so provided before being filed.
FORM 990, PART VI, SECTION B, LINE 12C
MONITORING & ENFORCING COMPLIANCE WITH THE POLICY Compliance with the Organization's Business Conflicts of Interest Policy (the "Policy") is required of trustees, employees, medical staff and non-employee members of institutional committees and includes an ongoing duty to disclose potential conflicts. Compliance with the Policy is monitored and enforced regularly and consistently. All disclosures with the potential for conflict are reviewed by an appropriate committee where they are carefully evaluated. When appropriate, a plan, which may involve measures including, but not limited to, recusal from participating in affected transactions, is developed to manage the potential conflict.
FORM 990, PART VI, SECTION B, QUESTIONS 12-14
THE BOARDS OF THE MOUNT SINAI MEDICAL CENTER, ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI AND THE MOUNT SINAI HOSPITAL HAVE ADOPTED ALL POLICIES REFERRED TO IN FORM 990, PART VI, SECTION B QUESTIONS 12 TO 14, WHICH would apply to ALL OWNED/CONTROLLED ENTITIES, INCLUDING THE CHILDREN'S CENTER FOUNDATION.
FORM 990, PART VI, SECTION C, LINE 19
GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC THE ORGANIZATION MAKES ITS BUSINESS CONFLICTS OF INTEREST POLICY AVAILABLE ON ITS WEBSITE (WWW.MOUNTSINAI.ORG) AND MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST.
PART VII, SECTION A
HOURS FOR RELATED ORGANIZATIONS THE FOLLOWING TRUSTEES ARE LISTED AS COUPLES IN SECTION A BUT BOTH PARTIES DO NOT SERVE ON THE BOARD OF RELATED ORGANIZATIONS. HOURS SERVED BY INDIVIDUALS ON THE BOARD OF RELATED ORGANIZATIONS ARE AS FOLLOWS: *GLENN AUGUST - 10 HOURS PER WEEK FOR THE BOARD OF THE MOUNT SINAI MEDICAL CENTER *JOHN HESS - 10 HOURS PER WEEK FOR THE BOARD OF THE MOUNT SINAI HOSPITAL *JAMES TISCH - 9 HOURS PER WEEK FOR THE BOARD OF THE MOUNT SINAI HOSPITAL
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.