STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

RCHN COMMUNITY HEALTH FOUNDATION INC: Form 990PF, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
RCHN COMMUNITY HEALTH FOUNDATION INC (EIN 13-3759663)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-10-20
IRS object ID
201722939349100007
Schema version
2016v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2017-10-20T13:06:31-05:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN221478099PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1COHNREZNICK LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11301 AVENUE OF THE AMERICASAddressLine1Txt
CityNEW YORKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10019ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN133759663EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1RCHN COMMUNITY HEALTH FOUNDATION INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlRCHNBusinessNameControlTxt
Phone2122461122PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line155 BROADWAY SUITE 1502AddressLine1Txt
CityNEW YORKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10006ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
Personfeygele jacobsPersonNm
Person Titlepres & CEOPersonTitleTxt
Phone2122461122PhoneNum
Signature2017-10-19SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTHOMAS LANNINGPreparerPersonNm
PTINP00851654PTIN
Phone2122970400PhoneNum
Preparation2017-09-05PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address209.3.217.20IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-10-19IPDt
IP Tm08:45:24IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device Id90CC17281F34CD083B051E620E31C1B2A26173FCAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
FMV Assets EOY$19,095,810FMVAssetsEOYAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Rcvd Rev And Expnss$250ContriRcvdRevAndExpnssAmt
Schedule B Not RequiredYes (X)ScheduleBNotRequiredInd
Interest On Sav Rev And Expnss$1,336InterestOnSavRevAndExpnssAmt
Interest On Sav Net Invst Incm$1,336InterestOnSavNetInvstIncmAmt
Dividends Rev And Expnss$649,694DividendsRevAndExpnssAmt
Dividends Net Invst Incm$649,694DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss$1,177,945NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$8,056,762GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$1,177,945CapGainNetIncmNetInvstIncmAmt
Total Rev And Expnss$1,829,225TotalRevAndExpnssAmt
Total Net Invst Incm$1,828,975TotalNetInvstIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$445,172CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Net Invst Incm$205,683CompOfcrDirTrstNetInvstIncmAmt
Comp Ofcr Dir Trst Dsbrs Chrtbl$239,489CompOfcrDirTrstDsbrsChrtblAmt
Oth Empl Slrs Wgs Rev And Expnss$543,228OthEmplSlrsWgsRevAndExpnssAmt
Oth Empl Slrs Wgs Net Invst Incm$148,465OthEmplSlrsWgsNetInvstIncmAmt
Oth Empl Slrs Wgs Dsbrs Chrtbl$394,763OthEmplSlrsWgsDsbrsChrtblAmt
Pension Empl Bnft Rev And Expnss$357,291PensionEmplBnftRevAndExpnssAmt
Pension Empl Bnft Net Invst Incm$125,378PensionEmplBnftNetInvstIncmAmt
Pension Empl Bnft Dsbrs Chrtbl$221,767PensionEmplBnftDsbrsChrtblAmt
Legal Fees Rev And Expnss$32,303LegalFeesRevAndExpnssAmt
Legal Fees Net Invst Incm$15,928LegalFeesNetInvstIncmAmt
Legal Fees Dsbrs Chrtbl$15,869LegalFeesDsbrsChrtblAmt
Accounting Fees Rev And Expnss$53,100AccountingFeesRevAndExpnssAmt
Accounting Fees Net Invst Incm$39,825AccountingFeesNetInvstIncmAmt
Accounting Fees Chrtbl Prps$12,600AccountingFeesChrtblPrpsAmt
Other Prof Fees Rev And Expnss$596,378OtherProfFeesRevAndExpnssAmt
Other Prof Fees Net Invst Incm$426,483OtherProfFeesNetInvstIncmAmt
Other Prof Fees Dsbrs Chrtbl$167,908OtherProfFeesDsbrsChrtblAmt
Taxes Rev And Expnss$9,059TaxesRevAndExpnssAmt
Taxes Net Invst Incm$2,059TaxesNetInvstIncmAmt
Taxes Dsbrs Chrtbl$0TaxesDsbrsChrtblAmt
Deprec And Dpltn Rev And Expnss$211,219DeprecAndDpltnRevAndExpnssAmt
Deprec And Dpltn Net Invst Incm$211,219DeprecAndDpltnNetInvstIncmAmt
Occupancy Rev And Expnss$249,139OccupancyRevAndExpnssAmt
Occupancy Net Invst Incm$89,690OccupancyNetInvstIncmAmt
Occupancy Dsbrs Chrtbl$159,939OccupancyDsbrsChrtblAmt
Trav Conf Meeting Rev And Expnss$55,080TravConfMeetingRevAndExpnssAmt
Trav Conf Meeting Net Invst Incm$0TravConfMeetingNetInvstIncmAmt
Trav Conf Meeting Dsbrs Chrtbl$55,080TravConfMeetingDsbrsChrtblAmt
Printing And Pub Rev And Expnss$6,882PrintingAndPubRevAndExpnssAmt
Printing And Pub Net Invst Incm$0PrintingAndPubNetInvstIncmAmt
Printing And Pub Dsbrs Chrtbl$6,882PrintingAndPubDsbrsChrtblAmt
Other Expenses Rev And Expnss$140,446OtherExpensesRevAndExpnssAmt
Other Expenses Net Invst Incm$49,970OtherExpensesNetInvstIncmAmt
Other Expenses Dsbrs Chrtbl$86,079OtherExpensesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$2,699,297TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$1,314,700TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$1,360,376TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$842,125ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$1,167,951ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$3,541,422TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$1,314,700TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$2,528,327TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses-$1,712,197ExcessRevenueOverExpensesAmt
Net Investment Income$514,275NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Sav And Temp Cash Invst BOY$996,666SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$2,176,484SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$2,176,484SavAndTempCashInvstEOYFMVAmt
Prepaid Expenses BOY$302,648PrepaidExpensesBOYAmt
Prepaid Expenses EOY$82,410PrepaidExpensesEOYAmt
Prepaid Expenses EOYFMV$82,410PrepaidExpensesEOYFMVAmt
Corporate Stock BOY$5,859,514CorporateStockBOYAmt
Corporate Stock EOY$4,489,255CorporateStockEOYAmt
Corporate Stock EOYFMV$4,489,255CorporateStockEOYFMVAmt
Corporate Bonds BOY$1,704,332CorporateBondsBOYAmt
Corporate Bonds EOY$1,644,248CorporateBondsEOYAmt
Corporate Bonds EOYFMV$1,644,248CorporateBondsEOYFMVAmt
Other Investments BOY$12,074,123OtherInvestmentsBOYAmt
Other Investments EOY$10,554,117OtherInvestmentsEOYAmt
Other Investments EOYFMV$10,554,439OtherInvestmentsEOYFMVAmt
Land Bldg Equip Cost Or Other Bss$333,659LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$184,685LandBldgEquipAccumDeprecAmt
Land BOY$351,831LandBOYAmt
Land EOY$148,974LandEOYAmt
Land EOYFMV$148,974LandEOYFMVAmt
Total Assets BOY$21,289,114TotalAssetsBOYAmt
Total Assets EOY$19,095,488TotalAssetsEOYAmt
Total Assets EOYFMV$19,095,810TotalAssetsEOYFMVAmt
Accounts Payable BOY$1,019,126AccountsPayableBOYAmt
Accounts Payable EOY$582,529AccountsPayableEOYAmt
Other Liabilities BOY$69,883OtherLiabilitiesBOYAmt
Other Liabilities EOY$65,392OtherLiabilitiesEOYAmt
Total Liabilities BOY$1,089,009TotalLiabilitiesBOYAmt
Total Liabilities EOY$647,921TotalLiabilitiesEOYAmt
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind
Unrestricted BOY$20,200,105UnrestrictedBOYAmt
Unrestricted EOY$18,447,567UnrestrictedEOYAmt
Tot Net Ast Or Fund Balances BOY$20,200,105TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$18,447,567TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$21,289,114TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$19,095,488TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$20,200,105TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses-$1,712,197ExcessRevenueOverExpensesAmt
Other Increases$0OtherIncreasesAmt
Subtotal$18,487,908SubtotalAmt
Other Decreases$40,341OtherDecreasesAmt
Tot Net Ast Or Fund Balances EOY$18,447,567TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp

FieldValueIRS element (for citing)
Gross Sales Price$8,056,762GrossSalesPriceAmt
Cost Or Other Basis$6,878,817CostOrOtherBasisAmt
Gain Or Loss$1,177,945GainOrLossAmt
Gains Minus Excess Or Losses$1,177,945GainsMinusExcessOrLossesAmt
FieldValueIRS element (for citing)
Capital Gain Net Income$1,177,945CapitalGainNetIncomeAmt

Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp

FieldValueIRS element (for citing)
Liable Section4942 Tax0LiableSection4942TaxInd
Adjusted Qlfy Distri Yr1$2,643,586AdjustedQlfyDistriYr1Amt
Net Vl Noncharitable Assets Yr1$23,138,058NetVlNoncharitableAssetsYr1Amt
Distribution Yr10.114253DistributionYr1Rt
Adjusted Qlfy Distri Yr2$3,385,050AdjustedQlfyDistriYr2Amt
Net Vl Noncharitable Assets Yr2$26,898,197NetVlNoncharitableAssetsYr2Amt
Distribution Yr20.125847DistributionYr2Rt
Adjusted Qlfy Distri Yr3$3,177,550AdjustedQlfyDistriYr3Amt
Net Vl Noncharitable Assets Yr3$27,970,934NetVlNoncharitableAssetsYr3Amt
Distribution Yr30.113602DistributionYr3Rt
Adjusted Qlfy Distri Yr4$4,034,403AdjustedQlfyDistriYr4Amt
Net Vl Noncharitable Assets Yr4$29,636,227NetVlNoncharitableAssetsYr4Amt
Distribution Yr40.136131DistributionYr4Rt
Total Distribution0.489833TotalDistributionRt
Average Distribution0.122458AverageDistributionRt
Net Vl Noncharitable Assets$19,375,586NetVlNoncharitableAssetsAmt
Adj Net Vl Noncharitable Assets$2,372,696AdjNetVlNoncharitableAssetsAmt
Net Investment Income Pct$5,143NetInvestmentIncomePctAmt
Adj Nonchrtbl Net Invst Incm Pct$2,377,839AdjNonchrtblNetInvstIncmPctAmt
Qualifying Distributions$2,528,327QualifyingDistributionsAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Domestic Org Meeting Sect4940eYes (X)DomesticOrgMeetingSect4940eInd
Investment Income Excise Tax$5,143InvestmentIncomeExciseTaxAmt
Tax Under Section511$0TaxUnderSection511Amt
Subtotal$5,143SubtotalAmt
Subtitle A Tax$0SubtitleATaxAmt
Tax Based On Investment Income$5,143TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx$9,583EstimatedPlusOvpmtIncmTxAmt
Applied To Es Tax$4,000AppliedToEsTaxAmt
Total Payments And Credits$13,583TotalPaymentsAndCreditsAmt
Overpayment$8,440OverpaymentAmt
Applied To ES Tax$8,440AppliedToESTaxAmt
Refund$0RefundAmt

Statements Regarding Acty StatementsRegardingActyGrp

FieldValueIRS element (for citing)
Legislative Political Acty0LegislativePoliticalActyInd
More Than100 Spent0MoreThan100SpentInd
Form1120 POL Filed0Form1120POLFiledInd
Section4955 Organization Tax$0Section4955OrganizationTaxAmt
Section4955 Managers Tax$0Section4955ManagersTaxAmt
Tax Reimbursed$0TaxReimbursedAmt
Activities Not Previously Rpt0ActivitiesNotPreviouslyRptInd
Changes To Articles Or Bylaws0ChangesToArticlesOrBylawsInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Organization Dissolved Etc0OrganizationDissolvedEtcInd
Section508e Rqr SatisfiedYes (1)Section508eRqrSatisfiedInd
At Least5000 In AssetsYes (1)AtLeast5000InAssetsInd
Org Report Or Register StateNYOrgReportOrRegisterStateCd
Form990 PF Filed With Atty GenYes (1)Form990PFFiledWithAttyGenInd
Private Operating Foundation0PrivateOperatingFoundationInd
New Substantial Contributors0NewSubstantialContributorsInd
Own Controlled Entity0OwnControlledEntityInd
Donor Advised Fund0DonorAdvisedFundInd
Comply With Public Insp RqrYes (1)ComplyWithPublicInspRqrInd
Website AddressWWW.RCHNFOUNDATION.ORGWebsiteAddressTxt
Individual With BooksIgor GoldenbergIndividualWithBooksNm
Phone2122461122PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line155 Broadway Suite 1502AddressLine1Txt
CityNew YorkCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10006ZIPCd
FieldValueIRS element (for citing)
Foreign Accounts Question0ForeignAccountsQuestionInd

Statements Regarding Acty4720 StatementsRegardingActy4720Grp

FieldValueIRS element (for citing)
Sale Or Exch Disqualified Prsn0SaleOrExchDisqualifiedPrsnInd
Brrw Or Lend Disqualified Prsn0BrrwOrLendDisqualifiedPrsnInd
Furn Goods Disqualified Prsn0FurnGoodsDisqualifiedPrsnInd
Pay Comp Disqualified PrsnYes (1)PayCompDisqualifiedPrsnInd
Transfer Ast Disqualified Prsn0TransferAstDisqualifiedPrsnInd
Payment To Government Official0PaymentToGovernmentOfficialInd
Acts Fail To Qlfy As Exceptions0ActsFailToQlfyAsExceptionsInd
Uncorrected Prior Acts0UncorrectedPriorActsInd
Undistributed Income PY0UndistributedIncomePYInd
Business Holdings0BusinessHoldingsInd
Jeopardy Investments0JeopardyInvestmentsInd
Uncorrected PY Jeopardy Invst0UncorrectedPYJeopardyInvstInd
Influence Legislation0InfluenceLegislationInd
Influence Election0InfluenceElectionInd
Grants To Individuals0GrantsToIndividualsInd
Grants To Organizations0GrantsToOrganizationsInd
Noncharitable Purpose0NoncharitablePurposeInd
Transactions Fail To Qlfy As Exc0TransactionsFailToQlfyAsExcInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
DAVID REYNOLDS
55 broadway suite 1502New YorkNY10006chairperson1.00$0$0$0
feygele jacobs
55 broadway suite 1502New YorkNY10006president & CEO35.00$299,957$84,757$0
igor goldenberg
55 broadway suite 1502New YorkNY10006cfo35.00$145,215$23,361$0
LONNY REISMAN MD
55 broadway suite 1502New YorkNY10006BOARD MEMBER1.00$0$0$0
M MONICA SWEENEY MD
55 broadway suite 1502New YorkNY10006BOARD MEMBER1.00$0$0$0
MARTHA WOLFGANG
55 broadway suite 1502New YorkNY10006BOARD MEMBER1.00$0$0$0
SARA ROSENBAUM ESQ
55 broadway suite 1502New YorkNY10006Outgoing Chair/Board Member1.00$0$0$0
THOMAS VAN COVERDEN
55 broadway suite 1502New YorkNY10006SECRETARY1.00$0$0$0

Compensation Highest Paid Empl CompensationHighestPaidEmplGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee BenefitsEmployeeBenefitsAmtExpense AccountExpenseAccountAmt
DAVID HARTZBAND
55 broadway suite 1502New YorkNY10006Director, Technology30.00$164,558$36,874$0
MARK BOGOSIAN
55 broadway suite 1502New YorkNY10006Assoc. Dir-Grants &35.00$121,759$44,340$0
MARJORIE BOMSON
55 broadway suite 1502New YorkNY10006MANAGER-ADMINISTRATI35.00$107,578$31,200$0
BARBARA ALLEN
55 broadway suite 1502New YorkNY10006finance manager35.00$104,719$30,354$0
FieldValueIRS element (for citing)
Other Employee Paid Over50k0OtherEmployeePaidOver50kCnt

Compensation Of Hghst Pd Cntrct CompensationOfHghstPdCntrctGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdService TypeServiceTypeTxtCompensationCompensationAmt
Community Counseling Service
po box 824885philadelphiaPA19182FUNDRAISING$315,000
MIRRAM GROUP LLC
5030 broadway suite 807NEW YORKNY10034MEDIA CONSULTING$60,000
COHNREZNICK LLP
1301 avenue of the americasNEW YORKNY10019AUDIT AND TAX PREPARATION$53,100
FieldValueIRS element (for citing)
Contractor Paid Over50k0ContractorPaidOver50kCnt

Sum Of Program Related Invst SumOfProgramRelatedInvstGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Minimum Investment Return MinimumInvestmentReturnGrp

FieldValueIRS element (for citing)
Average Monthly FMV Of Sec$18,220,336AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$1,450,310AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$19,670,646TotalFMVOfUnusedAssetsAmt
Reduction Claimed$0ReductionClaimedAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$19,670,646AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$295,060CashDeemedCharitableAmt
Net Vl Noncharitable Assets$19,375,586NetVlNoncharitableAssetsAmt
Minimum Investment Return$968,779MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$968,779MinimumInvestmentReturnAmt
Tax Based On Investment Income$5,143TaxBasedOnInvestmentIncomeAmt
Total Tax$5,143TotalTaxAmt
Distributable Before Adj$963,636DistributableBeforeAdjAmt
Recoveries Qualfied Distri$0RecoveriesQualfiedDistriAmt
Distributable Before Ded$963,636DistributableBeforeDedAmt
Deduction From Distributable$0DeductionFromDistributableAmt
Distributable As Adjusted$963,636DistributableAsAdjustedAmt

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

FieldValueIRS element (for citing)
Expenses And Contributions$2,528,327ExpensesAndContributionsAmt
Program Related Invst Total$0ProgramRelatedInvstTotalAmt
Qualifying Distributions$2,528,327QualifyingDistributionsAmt
Pct Sect4940e Org Net Invst Incm$5,143PctSect4940eOrgNetInvstIncmAmt
Adjusted Qualifying Distri$2,523,184AdjustedQualifyingDistriAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$963,636DistributableAsAdjustedAmt
Undistributed Income PY$0UndistributedIncomePYAmt
Total For Prior Years$0TotalForPriorYearsAmt
Excess Distribution Cyov Yr4$2,572,674ExcessDistributionCyovYr4Amt
Excess Distribution Cyov Yr3$1,786,666ExcessDistributionCyovYr3Amt
Excess Distribution Cyov Yr2$2,064,564ExcessDistributionCyovYr2Amt
Excess Distribution Cyov Yr1$1,489,340ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov$7,913,244TotalExcessDistributionCyovAmt
Qualifying Distributions$2,528,327QualifyingDistributionsAmt
Applied To Year1$0AppliedToYear1Amt
Applied To Prior Years$0AppliedToPriorYearsAmt
Treated As Distri From Corpus$0TreatedAsDistriFromCorpusAmt
Applied To Current Year$963,636AppliedToCurrentYearAmt
Remaining Distri From Corpus$1,564,691RemainingDistriFromCorpusAmt
Excess Distri Cyov App CY Corpus$0ExcessDistriCyovAppCYCorpusAmt
Excess Distribution Cyov App CY$0ExcessDistributionCyovAppCYAmt
Total Corpus$9,477,935TotalCorpusAmt
Prior Year Undistributed Incm$0PriorYearUndistributedIncmAmt
Prior Year Deficiency Or Tax$0PriorYearDeficiencyOrTaxAmt
Taxable1$0Taxable1Amt
Taxable2$0Taxable2Amt
Undistributed Income CY$0UndistributedIncomeCYAmt
Corpus Distri170b1 E Or4942g3$0CorpusDistri170b1EOr4942g3Amt
Excess Distri Cyov From Yr5$0ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr$9,477,935ExcessDistriCyovToNextYrAmt
Excess From Year4$2,572,674ExcessFromYear4Amt
Excess From Year3$1,786,666ExcessFromYear3Amt
Excess From Year2$2,064,564ExcessFromYear2Amt
Excess From Year1$1,489,340ExcessFromYear1Amt
Excess From Current Year$1,564,691ExcessFromCurrentYearAmt

Supplementary Information SupplementaryInformationGrp

FieldValueIRS element (for citing)
Only Contri To PreselectedYes (X)OnlyContriToPreselectedInd

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (22 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmt
ACCESS FAMILY CARE
47 NELSON AVENUENeoshoMO64850PCPOPULATION HEALTH MANAGEMENT GRANT$133,333
ADELANTE HEALTHCARE
9520 WEST PALM LANEPhoenixAZ85037PCPOPULATION HEALTH MANAGEMENT GRANT$133,327
ASSOCIATION OF CLINICIANS FOR THE UNDERSERVED
1420 SPRING HILL ROAD SUITE 600TYSONS CORNERVA22102PCCONFERENCE SPONSORSHIP$5,000
BI-STATE PRIMARY CARE ASSOCIATION
525 CLINTON STREETbowNH03304PCCONFERENCE SPONSORSHIP$1,250
CALLEN-LORDE COMMUNITY HEALTH CENTER
356 WEST 18TH STREETNEW YORKNY10011PCSUPPORT OF CHARITABLE ORGANIZATION$1,000
CHARLES B WANG COMMUNITY HEALTH CENTER
268 CANAL STREETNew YorkNY10013PCPOPULATION HEALTH MANAGEMENT GRANT$125,000
CHINATOWN HEALTH CLINIC FOUNDATION
268 CANAL ST 6TH FLOORNEW YORKNY10013PCSUPPORT OF CHARITABLE ORGANIZATION$1,500
COLORADO COMMUNITY HEALTH NETWORK
600 GRANT STREET SUITE 800DenverCO80203PCPOPULATION HEALTH MANAGEMENT GRANT$133,333
COMMUNITY HEALTH CARE ASSOCIATION OF NEW YORK STATE
111 BROADWAY SUITE 1402New YorkNY10006PCSUPPORT OF CHARITABLE ORGANIZATION$1,000
COMMUNITY HEALTH CARE ASSOCIATION OF NEW YORK STATE
111 BROADWAY SUITE 1402NEW YORKNY10006PCCONFERENCE SPONSORSHIP$1,000
EAST BOSTON NEIGHBORHOOD HEALTH CENTER
20 MAVERICK SQUAREeast bostonMA02128PCSUPPORT OF CHARITABLE ORGANIZATION$200
ERIE COUNTY HEALTH DEPARTMENT
420 SUPERIOR STREETSanduskyOH44870PCPOPULATION HEALTH MANAGEMENT GRANT$35,000
FOOD BANK FOR NEW YORK CITY
39 BROADWAYnew YORKNY10006PCSUPPORT OF CHARITABLE ORGANIZATION$1,000
GEORGE WASHINGTON UNIVERSITY
2121 I STREET NW SUITE 601WASHINGTONDC20052PCGIFT TO SUPPORT GEIGER GIBSON PROGRAM IN DEPARTMENT OF HEALTH POLICY, MILKEN INSTITUTE SPH$350,000
HRHCARE FOUNDATION
55 SOUTH BROADWAYTARRYTOWNNY10591PCSUPPORT OF CHARITABLE ORGANIZATION$1,500
HUDSON HEADWATERS HEALTH FOUNDATION
9 CAREY ROADQUEENSBURYNY12804PCSUPPORT OF CHARITABLE ORGANIZATION$1,000
HUDSON HEADWATERS HEALTH NETWORK
9 CAREY ROADQueensburyNY12804PCPOPULATION HEALTH MANAGEMENT GRANT$133,333
MAINE PRIMARY CARE ASSOCIATION
73 WINTHOP STREETAUGUSTAME04330PCOUTREACH & ENROLLMENT GRANT$7,500
NEW YORK ASSOCIATION FOR AMBULATORY CARE
150 VETERANS MEMORIAL HIGHWAY 406CommackNY11725PCSUPPORT OF CHARITABLE ORGANIZATION$675
PRIMARY CARE DEVELOPMENT CORP
45 BROADWAY SUITE 530NEW YORKNY10006PCSUPPORT OF CHARITABLE ORGANIZATION$1,000
SANTA ROSA COMMUNITY HEALTH CENTERS
3569 ROUND BARN CIRCLESanta RosaCA95403PCPOPULATION HEALTH MANAGEMENT GRANT$100,000
URBAN HEALTH PLAN INC
960 SOUTHERN BOULEVARDBRONXNY10459PCSUPPORT OF CHARITABLE ORGANIZATION$1,000
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$1,167,951TotalGrantOrContriPdDurYrAmt

Grant Or Contri Apprv For Fut GrantOrContriApprvForFutGrp (5 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmt
ACCESS FAMILY CARE
47 NELSON AVENUENeoshoMO64850PCPOPULATION HEALTH MANAGEMENT GRANT$66,667
ADELANTE HEALTHCARE
9520 WEST PALM LANEPhoenixAZ85037PCPOPULATION HEALTH MANAGEMENT GRANT$66,667
COLORADO COMMUNITY HEALTH NETWORK
600 GRANT STREET SUITE 800DenverCO80203PCPOPULATION HEALTH MANAGEMENT GRANT$66,667
ERIE COUNTY HEALTH DEPARTMENT
420 SUPERIOR STREETSanduskyOH44870PCPOPULATION HEALTH MANAGEMENT GRANT$25,000
HUDSON HEADWATERS HEALTH NETWORK
9 CAREY ROADQueensburyNY12804PCPOPULATION HEALTH MANAGEMENT GRANT$66,667
FieldValueIRS element (for citing)
Total Grant Or Contri Apprv Fut$291,668TotalGrantOrContriApprvFutAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$1,336ExclusionAmt

Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$649,694ExclusionAmt

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Exclusion18ExclusionCd
Exclusion$1,177,945ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Unrelated Business Taxbl Incm$0UnrelatedBusinessTaxblIncmAmt
Exclusion$1,828,975ExclusionAmt
Related Or Exempt Function Incm$0RelatedOrExemptFunctionIncmAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$1,828,975TotalIncomeProducingActyAmt

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

FieldValueIRS element (for citing)
Trnsfr Of Cash To Nonchrtbl EO0TrnsfrOfCashToNonchrtblEOInd
Trnsfr Other Asset Nonchrtbl EO0TrnsfrOtherAssetNonchrtblEOInd
Sales Or Exchanges Of Assets0SalesOrExchangesOfAssetsInd
Purchase Of Assets Nonchrtbl EO0PurchaseOfAssetsNonchrtblEOInd
Rental Of Facilities Oth Assets0RentalOfFacilitiesOthAssetsInd
Reimbursement Arrangements0ReimbursementArrangementsInd
Loans Or Loan Guarantees0LoansOrLoanGuaranteesInd
Performance Of Services Etc0PerformanceOfServicesEtcInd
Sharing Of Facilities Etc0SharingOfFacilitiesEtcInd
Relationships Nonchrtbl EOYes (1)RelationshipsNonchrtblEOInd

Relationship Schedule Detail RelationshipScheduleDetail

Organization Business Name OrganizationBusinessName

FieldValueIRS element (for citing)
Business Name Line1RCHN COMMUNITY HEALTH FOUNDATION SUPPORT CORP incBusinessNameLine1Txt
FieldValueIRS element (for citing)
Organization Type501(c)(4)OrganizationTypeDesc
Relationship DescriptionTHE ORGANIZATION IS THE SOLE MEMBER OF RCHN COMMUNITY HEALTH FOUNDATION SUPPORT CORP, INC.RelationshipDescriptionTxt

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

FieldValueIRS element (for citing)
CategoryCOHNREZNICK LLPCategoryTxt
Amt$53,100Amt
Net Investment Income$39,825NetInvestmentIncomeAmt
Disbursements Charitable Prps$12,600DisbursementsCharitablePrpsAmt

General Explanation Attachment GeneralExplanationAttachment

General Explanation GeneralExplanationGrp

FieldValueIRS element (for citing)
Form And Line Referenceform 990-pf, part vii-B, line 1a(4):FormAndLineReferenceDesc
Medium ExplanationOFFICERS FEYGELE JACOBS AND IGOR GOLDENBERG RECEIVED COMPENSATION FOR THE YEAR ENDING DECEMBER 31, 2016. THIS AMOUNT REPRESENTS PAYMENT FOR THEIR SERVICES WITH REGARD TO THE FOUNDATION AND THE SERVICES IT PROVIDES. THIS MEETS THE EXCEPTION AND IS CONSIDERED REASONABLE, AND THEREFORE, FORM 4720 IS NOT PREPARED.MediumExplanationTxt

Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule

Investments Corporate Bonds InvestmentsCorporateBondsGrp

FieldValueIRS element (for citing)
BondFIXED INCOMEBondNm
EOY Book Value$1,644,248EOYBookValueAmt
EOYFMV$1,644,248EOYFMVAmt

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corporate Stock InvestmentsCorporateStockGrp

FieldValueIRS element (for citing)
StockEquitiesStockNm
EOY Book Value$4,489,255EOYBookValueAmt
EOYFMV$4,489,255EOYFMVAmt

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOtherGrp (3 entries)

Category Or ItemCategoryOrItemTxtListed At Cost Or FMVListedAtCostOrFMVCdBook ValueBookValueAmtEOYFMVEOYFMVAmt
ALTERNATIVE INVESTMENTSFMV$230,901$230,901
Investment in CHA/CHVFMV$523,323$523,645
Mutual FundsFMV$9,799,893$9,799,893

Legal Fees Schedule LegalFeesSchedule

Legal Fees LegalFeesGrp (4 entries)

CategoryCategoryTxtLegal FeesLegalFeesAmtNet Investment IncomeNetInvestmentIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
SMITH & DOWNEY$1,739$1,739$0
WHITEMAN OSTERMAN & HANNA LLP$2,692$0$2,989
Dechert$27,366$13,683$12,880
Feldesman tucker leifer$506$506$0

Other Decreases Schedule OtherDecreasesSchedule

Other Decreases Detail OtherDecreasesDetail (2 entries)

DescDescAmtAmt
Unrealized Loss$39,072
prior period adjustment$1,269

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp (12 entries)

DescDescRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAmtNet Investment IncomeNetInvestmentIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
INSURANCE$32,502$11,701$16,403
INFORMATION TECHNOLOGY EXPENSES$43,873$15,794$28,079
DUES AND MEMBERSHIPS$7,230$0$7,230
TELEPHONE$21,024$7,569$13,455
EQUIPMENT RENTAL/MAINTENANCE$9,141$3,291$5,850
food$7,523$2,708$4,815
payroll processing$4,687$1,687$3,000
bank charges$3,145$3,145$0
office supplies$2,644$952$1,692
offsite storage$2,568$924$1,644
postage/express delivery$670$241$429
miscellaneous$5,439$1,958$3,482

Other Liabilities Schedule OtherLiabilitiesSchedule

Other Liabilities Detail OtherLiabilitiesDetail

FieldValueIRS element (for citing)
Descdeferred RentDesc
BOY Book Value$69,883BOYBookValueAmt
EOY Book Value$65,392EOYBookValueAmt

Other Professional Fees Schedule OtherProfessionalFeesSchedule

Other Professional Fees Detail OtherProfessionalFeesDetail (9 entries)

CategoryCategoryTxtAmtAmtNet Investment IncomeNetInvestmentIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
PUBLIC INTEREST MEDIA GROUP$16,600$0$15,100
MIRRAM GROUP LLC$60,000$0$60,000
HEALTH TECH STRATEGIES$0$0$1,554
MERRILL LYNCH$111,483$111,483$0
VSHIFT$34,500$0$34,500
COMMUNITY COUNSELLING SERVICES$315,000$315,000$0
Merle Cunningham$11,700$0$11,700
Dr. David Stevens$36,805$0$34,638
Ian O'Brien$10,290$0$10,416

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail (2 entries)

CategoryCategoryTxtAmtAmtNet Investment IncomeNetInvestmentIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
Federal Excise Tax$7,000$0$0
Foreign Taxes$2,059$2,059$0