2023-05-15T16:04:41-05:00 2022-06-30 911194016 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1400 BELLEVUE WA 98004 990 2021-07-01 911180810 COMPASS HEALTH COMP 4253496200 PO BOX 3810 EVERETT WA 982138810 TOM SEBASTIAN PRESIDENT/CEO 4253498414 2023-05-15 1 TOM SEBASTIAN XXX-XX-XXXX SARA ELIZABETH H JONES P00235495 4254544919 2023-05-15 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z TOM SEBASTIAN PO BOX 3810 EVERETT WA 982138810 84104248 0 X WWW.COMPASSHEALTH.ORG X 1984 WA COMPASS HEALTH CHAMPIONS THE QUEST FOR WELL-BEING THROUGHOUT OUR COMMUNITIES BY ADVANCING BEHAVIORAL HEALTH IN SNOHOMISH, SKAGIT, ISLAND, SAN JUAN AND WHATCOM COUNTIES. WE PROVIDE A FULL CONTINUUM OF OUTPATIENT, RESIDENTIAL, CRISIS AND INPATIENT SERVICES. 7 7 836 65 -13 0 13941304 11999468 59460753 62348828 28747 342335 700238 406905 74131042 75097536 597065 647251 0 0 51085530 55116616 0 0 1228585 14767728 16904315 66450323 72668182 7680719 2429354 49121108 47446323 21680990 17486304 27440118 29960019 X COMPASS HEALTH CHAMPIONS THE QUEST FOR WELL-BEING THROUGHOUT OUR COMMUNITIES BY ADVANCING BEHAVIORAL HEALTH IN SNOHOMISH, SKAGIT, ISLAND, SAN JUAN AND WHATCOM COUNTIES. 0 0 36786247 161045 37423864 MENTAL HEALTH OUTPATIENT PROGRAM: COMPASS HEALTH OFFERS A BROAD CONTINUUM OF COUNSELING SERVICES FOR ADULTS, OLDER ADULTS, CHILDREN, ADOLESCENTS AND FAMILIES. WE PROVIDE TREATMENT FOR BOTH BRIEF AND ONGOING BEHAVIORAL HEALTH ISSUES. WE UTILIZE AN ARRAY OF EVIDENCE-BASED PRACTICES TO PROMOTE THE BEST OUTCOMES FOR CLIENTS. SERVICES INCLUDE INDIVIDUAL, GROUP, FAMILY, CASE MANAGEMENT, PEER SUPPORT, AND PSYCHIATRIC EVALUATION WITH MEDICATION. SERVICES ARE TAILORED TO THE INDIVIDUAL, AND CAN INCLUDE A RANGE OF INTENSITIES BASED ON NEED. INTENSIVE, MULTI-DISCIPLINARY TEAM-BASED SERVICES ARE AVAILABLE, PROVIDING COMMUNITY-BASED SUPPORT AND AROUND THE CLOCK ACCESS TO THE CARE TEAM. 11,313 EPISODES OF CARE. 12933543 4539 13748726 CRISIS SERVICES: COMPASS HEALTH SERVES PEOPLE OF ALL AGES WHO ARE EXPERIENCING ACUTE MENTAL HEALTH ISSUES REQUIRING STABILIZATION. SERVICES AVAILABLE INCLUDE CRISIS EVALUATION AND INTERVENTION BY MENTAL HEALTH PROFESSIONALS, ON AN OUTPATIENT/OUTREACH BASIS. FOR ADULTS WE ALSO CAN PROVIDE A SHORT-TERM STAY IN A LICENSED TRIAGE FACILITY PROVIDING 24-HOUR SUPERVISION AND SUPPORT. 5,289 EPISODES OF CARE. 5424071 3562 3812618 INPATIENT PROGRAM: COMPASS HEALTH OPERATES A 16-BED SECURE SHORT STAY INPATIENT TREATMENT FACILITY FOR PERSONS DETAINED UNDER THE INVOLUNTARY TREATMENT ACT. 202 EPISODES OF CARE. 2496557 2988 2095930 RESIDENTIAL TREATMENT - ELIGIBLE CLIENTS WHO ARE UNABLE TO LIVE INDEPENDENTLY DUE TO SERIOUS AND PERSISTENT MENTAL ILLNESS ARE SERVED IN TWO 16-BED FACILITIES. FACILITY IS STAFFED 24/7 AND PROVIDES COUNSELING, CASE MANAGEMENT, AND SUPPORT TO PREPARE FOR A TRANSITION TO INDEPENDENT LIVING. 56 EPISODES OF CARE. 3741922 472357 3451356 HOUSING - COMPASS HEALTH PROVIDES SAFE AND AFFORDABLE HOUSING TO HOMELESS INDIVIDUALS SO THEY CAN FOCUS ON SYMPTOM MANAGEMENT AND DAILY LIVING SKILLS, SERVED 283 HOUSEHOLDS. 1682350 2760 1810097 SUBSTANCE USE DISORDER - TREATMENT FOR SUBSTANCE USE DISORDER. 214 EPISODES OF CARE.PAYEE SERVICES - PROTECTIVE PAYEE SERVICES FOR INDIVIDUALS WHO NEED ASSISTANCE MANAGING THEIR MONEY. 396 CLIENTS SERVED.SPECIALTY PROGRAMS - WE PROVIDE SPECIALTY PROGRAMS TO THE COMMUNITY WHICH ARE FUNDED THROUGH PRIVATE FOUNDATION, SUCH AS DAY CAMP PROGRAMS FOR CHILDREN LIVING WITH SERIOUS MENTAL HEALTH ISSUES, WEEKEND CAMPS FOR CHILDREN WHO HAVE FAMILY MEMBERS LIVING WITH SUBSTANCE USE DISORDERS AND MOTEL VOUCHERS PROGRAMS FOR PEOPLE IN EMERGENCY HOUSING SITUATIONS. 2,191 EPISODES OF CARE. 7920829 478105 7357383 63064690 1 1 0 1 0 0 0 0 1 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 1 27 0 836 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 1 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 WA X X TAMERA LOESCH 4253498436 PO BOX 3810 EVERETT WA 98213 CAMIS MILAM CMO 40.00 0.00 X 393614 0 28255 TOM SEBASTIAN PRESIDENT/CEO 39.40 0.60 X 293282 0 25063 MICHAEL RAMSEY PSYCHIATRIST 40.00 0.00 X 290166 0 28617 MARY ELLEN LESLIE COTTER PSYCHIATRIST 32.00 0.00 X 222659 0 24865 BENJAMIN MARTE PSYCHIATRIST 32.00 0.00 X 222388 0 23341 MICHAEL SHEN PSYCHIATRIST 30.00 0.00 X 205673 0 26268 LAUREN BARBER ARNP 40.00 0.00 X 198397 0 12243 ANASTASIA ALLES COO 40.00 0.00 X 192752 0 21511 TAMERA LOESCH CFO 38.70 1.30 X 191541 0 23435 BECKY OLSON-HERNANDEZ CQIPO 40.00 0.00 X 154948 0 21443 TOM KOZACZYNSKI CD&CO 40.00 0.00 X 137306 0 20390 LAJOLLA PETERS FORMER CAO 40.00 0.00 X 133416 0 18207 MISSY JUDD CEA 40.00 0.00 X 83157 0 15373 CONNIE SUMMERS CHR&DO 20.00 0.00 X 0 0 0 JONALYN WOOLF-IVORY IMMEDIATE PAST CHAIR 0.20 0.40 X X 0 0 0 MACAULAY IVORY VICE CHAIR 0.20 0.40 X X 0 0 0 ERIC CARLSEN TREASURER 0.20 0.40 X X 0 0 0 ALEX DE SOTO CHAIR 0.20 0.40 X X 0 0 0 HILARY PRESTON SECRETARY 0.20 0.40 X X 0 0 0 ROXI CRONIN MEMBER 0.20 0.00 X 0 0 0 CYNTHIA WEAVER MEMBER 0.20 0.00 X 0 0 0 ERIC RUSSELL MEMBER 0.20 0.00 X 0 0 0 DAVE SCHNEIDER MEMBER 0.10 0.00 X 0 0 0 JOE MARRA MEMBER 0.10 0.00 X 0 0 0 SEAN GEORGE MEMBER 0.10 0.00 X 0 0 0 2719299 0 289011 56 1 1 0 COMMERCIAL CONSTRUCTION & MAINTENANCE CO PO BOX 1128 SNOHOMISH WA 98291 PROPERTY MANAGEMENT 1777738 ANKROM MOISAN ARCHITECTS INC PO BOX 5273 PORTLAND OR 97208 CONSTRUCTION 1226998 FASPSYCH LLC 8687 E VIA DE VENTURA STE 310 SCOTTSDALE AZ 85258 TEMP STAFF 1128102 HERMANSON COMPANY LLP 1221 2ND AVENUE N KENT WA 98032 BUILDING REPAIRS 518624 MAXIM HEALTHCARE SERVICES 12558 COLLECTIONS CENTER DR CHICAGO IL 60693 TEMP STAFF 512862 18 40367 10423088 1536013 372122 11999468 PATIENT SERVICES 621400 59456209 59449959 6250 CONSULTATION REVENUE 541900 2030874 2030874 RENTAL INCOME 531110 861745 861758 -13 62348828 95674 95674 30321 14363 15958 15958 15958 8471221 767789 8564849 427500 -93628 340289 246661 246661 INSURANCE SETTLEMENTS 900099 334434 334434 REFUNDS 900099 56513 56513 390947 75097536 62342591 -13 755490 647251 647251 1719221 605266 946932 167023 156021 156021 40866768 37158611 3365976 342181 1641324 1490015 136919 14390 7124725 6448045 619057 57623 3608557 3223605 345081 39871 242192 19847 222345 357239 215794 139536 1909 58500 58500 3664045 2729206 628981 305858 16335 4568 11767 2274064 1748933 510016 15115 55179 54111 523 545 4950431 4587093 343772 19566 357445 328895 27456 1094 161786 121982 36540 3264 403242 118746 284391 105 1564998 1382273 176076 6649 1623407 1469812 153329 266 BAD DEBT 442644 442644 DUES 140917 26561 112853 1503 TAX & LICENSES 115372 102549 12779 44 476519 84951 151756 239812 72668182 63064690 8374907 1228585 15009765 4107958 36342 34719 2414034 6871972 8731163 9786039 943406 943406 2377322 2549907 33349186 15311477 15290989 18037709 1063854 989368 734840 806429 2519393 3318816 49121108 47446323 7801246 6163308 2272513 1010467 107984 0 1564515 1346883 8937044 8479576 997688 486070 21680990 17486304 X 20792909 23016460 6647209 6943559 27440118 29960019 49121108 47446323 X 2429354 101547 -11000 X 0 1 X 1 1 1 X 4437956 4622560 15695426 13941304 11990612 50687858 60662830 68130662 60744007 59448473 62342591 311328563 65100786 72753222 76439433 73389777 74333203 362016421 17583 24439 562070 90312 134294 828698 0 17583 24439 562070 90312 134294 828698 361187723 51762 63374 54369 43753 125995 339253 51762 63374 54369 43753 125995 339253 35993 63002 6237 105232 96238 93331 115634 710003 390947 1406153 65284779 72972929 76609436 74143533 74856382 363867059 0.99260 0.99370 0.00090 0.00080 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: REBATES/REFUNDS - 2017 AMOUNT: $ 14,725. 2018 AMOUNT: $ 7,283. 2019 AMOUNT: $ 104,685. 2020 AMOUNT: $ 33,954. 2021 AMOUNT: $ 56,513. MISCELLANEOUS - 2017 AMOUNT: $ 2,844. 2018 AMOUNT: $ 68,059. 2020 AMOUNT: $ 25. HONORARIA - 2017 AMOUNT: $ 5,127. 2019 AMOUNT: $ 2,442. INSURANCE SETTLEMENTS - 2017 AMOUNT: $ 73,542. 2018 AMOUNT: $ 17,989. 2020 AMOUNT: $ 676,024. 2021 AMOUNT: $ 334,434. UNUSED FSA - 2019 AMOUNT: $ 8,507. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 58500 0 0 58500 0 PART II-B, LINE 1: ONE VENDOR ADVOCATES ON BEHALF OF COMPASS HEALTH ON A STATE LEVEL FOR HOUSING AND MENTAL HEALTH ISSUES. THIS AMOUNT REPRESENTS VENDOR EXPENSE. 0 1 X 1100196 -76109 1024087 878171 222025 1100196 891629 -13458 878171 886431 5198 891629 828927 57504 886431 0.00000 0.72025 0.27975 0 0 2407410 2407410 15768146 8798033 6970113 5140296 1592266 3548030 6368235 4716863 1651372 3665099 204315 3460784 18037709 BENEFICIAL INTEREST IN TRUST 16258 FACILITY RECEIVABLES 193178 RESERVES 3027220 ACCRUED INTEREST 82160 3318816 CAPITAL LEASE LIABILITY 486070 486070 78422331 101547 196832 3012053 3310432 75111899 -14363 -14363 75097536 75624104 196832 2759090 2955922 72668182 0 72668182 PART IV, LINE 2B: THE COMPASS HEALTH PAYEE PROGRAM (CHPP) PROVIDES SERVICES TO INDIVIDUALS THE SOCIAL SECURITY ADMINISTRATION (SSA) OR COURTS HAVE DETERMINED TO BE UNABLE TO MANAGE THEIR OWN FINANCES. THE GOAL OF CHPP IS TO HELP CREATE A STABLE LIVING ENVIRONMENT FOR THE BENEFICIARY AND ENSURE THEIR BASIC CURRENT NEEDS OF FOOD, SHELTER, CLOTHING AND MEDICAL CARE ARE MET. PART V, LINE 4: THE ENDOWMENT FUND CONSISTS OF ONE FUND, A PORTION OF WHICH IS RESTRICTED FOR THE ORGANIZATION'S OPERATIONAL NEEDS WHILE THE REMAINING IS APPROPRIATED FOR EXPENDITURE BY THE ORGANIZATION TO CARE FOR CHILDREN AND YOUTH. PART XI, LINE 2D - OTHER ADJUSTMENTS: RELATED ORGANIZATION REVENUE 3,012,053. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -14,363. PART XII, LINE 2D - OTHER ADJUSTMENTS: RELATED ORGANIZATION EXPENSE 2,733,727. RENTAL EXPENSES 14,363. LOSS ON UNCOLLECTIBLE PLEDGES 11,000. 1 ASSISTANCE TO INDIVIDUALS FOR BASIC NEEDS SUCH AS FOOD, SHELTER, TRANSPORTATION AND CLOTHING 2612 543521 OTHER PAYMENTS TO VENDORS FOR BASIC NEEDS SUCH AS SHELTER, TRANSPORTATION AND CLOTHING FOR CLIENT NEEDS. FOSTER PARENT REIMBURSEMENT FOR BASIC NEEDS SUCH AS FOOD, SHELTER, TRANSPORTATION AND CLOTHING FOR OUR FOSTER CHILDREN 12 103730 PART I, LINE 2: IT IS THE POLICY OF COMPASS HEALTH TO DISTRIBUTE A GRANT ONLY AFTER CONDUCTING AN ANALYSIS OF THE RECEIVING INDIVIDUALS' NEEDS. COMPASS HEALTH HAS SEVERAL CONTRACTS WHICH ARE MONITORED ON AN INDIVIDUAL BASIS USING SPREADSHEETS AND/OR ACCOUNTING SOFTWARE. X X X 0 0 0 0 0 0 0 1 0 CAMIS MILAM CMO 342398 0 51216 0 0 0 14500 0 13755 0 421869 0 0 0 TOM SEBASTIAN PRESIDENT/CEO 243350 0 49932 0 0 0 13116 0 11947 0 318345 0 0 0 MICHAEL RAMSEY PSYCHIATRIST 290166 0 0 0 0 0 14500 0 14117 0 318783 0 0 0 MARY ELLEN LESLIE COTTER PSYCHIATRIST 222659 0 0 0 0 0 11002 0 13863 0 247524 0 0 0 BENJAMIN MARTE PSYCHIATRIST 222388 0 0 0 0 0 9492 0 13849 0 245729 0 0 0 MICHAEL SHEN PSYCHIATRIST 205673 0 0 0 0 0 10284 0 15984 0 231941 0 0 0 LAUREN BARBER ARNP 198397 0 0 0 0 0 9920 0 2323 0 210640 0 0 0 ANASTASIA ALLES COO 166696 0 26056 0 0 0 9638 0 11873 0 214263 0 0 0 TAMERA LOESCH CFO 166433 0 25108 0 0 0 9560 0 13875 0 214976 0 0 0 BECKY OLSON-HERNANDEZ CQIPO 135047 0 19901 0 0 0 7747 0 13696 0 176391 0 0 0 TOM KOZACZYNSKI CD&CO 119205 0 18101 0 0 0 6858 0 13532 0 157696 0 0 0 LAJOLLA PETERS FORMER CAO 113515 0 19901 0 0 0 6671 0 11536 0 151623 0 0 0 PART I, LINE 7 OFFICERS OF COMPASS HEALTH RECEIVED A DISCRETIONARY BONUS DURING FY2022, WHICH WAS DETERMINED BY THE EXECUTIVE COMMITTEE, CAPPED BASED ON PERCENTAGE OF SALARY, AND IS BASED ON GOALS AND STRATEGIES BEING MET DURING THE COURSE OF THE YEAR. X 10165 FAIR MARKET VALUE X 2 87304 FAIR MARKET VALUE X 58805 100158 FAIR MARKET VALUE X SOFTWARE 1 168495 FAIR MARKET VALUE X CARE KITS 1 6000 FAIR MARKET VALUE 0 0 1 0 PART I, COLUMN (B): THE AMOUNTS REPORTED ON SCHEDULE M, PART I, COLUMN (B) REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED (SECURITIES AND SOFTWARE) OR POUNDS RECEIVED (FOOD INVENTORY). FORM 990, PART I, LINE 6: DURING FISCAL YEAR 2022, THERE WERE 11 VOLUNTEER BOARD MEMBERS AND FINANCE COMMITTEE MEMBERS AND 54 OTHER VOLUNTEERS WITH 6,566.28 HOURS SERVED. FORM 990, PART VI, SECTION A, LINE 2 JONALYN WOOLF-IVORY AND MACAULAY IVORY HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE EXECUTIVE COMMITTEE EITHER PRIOR TO OR AT THE NEXT SCHEDULED EXECUTIVE COMMITTEE MEETING. THE ACCOUNTING STAFF WILL ALSO REVIEW THE FORM 990 PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO REVIEW THE CONFLICT OF INTEREST POLICY AND DISCLOSE ANY INTERESTS THAT COULD POSSIBLY GIVE RISE TO A CONFLICT OF INTEREST AND/OR A RELATED PARTY TRANSACTION. SHOULD A POTENTIAL CONFLICT BE IDENTIFIED, THE FULL BOARD DETERMINES WHETHER A CONFLICT OF INTEREST EXISTS. THE FULL BOARD THEN REVIEWS THE CONFLICT AND TAKES ANY ACTION DEEMED NECESSARY TO ADDRESS THE CONFLICT. ANY INDIVIDUAL WHO HAS A CONFLICT RECUSES HIM OR HERSELF FROM VOTING ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR ALL POSITIONS ARE REVIEWED AND COMPARED TO WAGE SURVEYS EVERY TWO YEARS BY THE HUMAN RESOURCES DEPARTMENT. THE LAST COMPENSATION REVIEW WAS COMPLETED IN JUNE OF 2021. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: LOSS ON UNCOLLECTIBLE PLEDGES -11,000. COMPASS HEALTH HOLDINGS LLC 4526 FEDERAL AVENUE BUILDING 3 EVERETT WA 98203 911180810 HOLDING CO; MANAGING MEMBER OF MILWAUKEE PARK APTS WA 0 0 COMPASS HEALTH COMPASS HEALTH BROADWAY GP LLC 4526 FEDERAL AVENUE BUILDING 3 EVERETT WA 98203 911180810 LOW INCOME HOUSING WA 0 0 COMPASS HEALTH COMPASS HEALTH HOUSING SERVICES 4526 FEDERAL AVENUE BUILDING 3 EVERETT WA 98203 874805089 HOUSING AND SOCIAL ASSISTANCE WA 0 0 COMPASS HEALTH COLLEGE HILL CONSOCIATION 4526 FEDERAL AVENUE BUILDING 3 EVERETT WA 98203 911380645 REAL PROPERTY MANAGEMENT WA 501(C)(2) COMPASS HEALTH 1 COUNTERPOINT COMMONS 4526 FEDERAL AVENUE BUILDING 3 EVERETT WA 98203 911629821 LOW INCOME HOUSING WA 501(C)(3) LINE 7 COMPASS HEALTH 1 MENTAL HEALTH SERVICES OF SNOHOMISH COUNTY II 4526 FEDERAL AVENUE BUILDING 3 EVERETT WA 98203 911442572 LOW INCOME HOUSING WA 501(C)(3) LINE 7 COMPASS HEALTH 1 CHILD ADVOCACY CENTER OF SNOHOMISH COUNTY 1509 CALIFORNIA STREET EVERETT WA 98203 270627714 COORDINATION OF SERVICES TO CHILD PHYSICAL & SEXUAL ABUSE VICTIMS WA 501(C)(3) LINE 7 COMPASS HEALTH 1 HARMONY HOUSE NORTH ASSOCIATION 1299 CEDAR AVENUE MARYSVILLE WA 98270 911494758 LOW INCOME HOUSING WA 501(C)(3) LINE 10 COMPASS HEALTH 1 AMERICAN LUTHERAN CHURCH DBA LUTHER CHILD CENTER 4526 FEDERAL AVENUE BUILDING 3 EVERETT WA 98203 910564979 INACTIVE WA 501(C)(3) LINE 1 COMPASS HEALTH 1 MILWAUKEE PARK APTS LP 4526 FEDERAL AVENUE BUILDING 3 EVERETT WA 98203 208221787 LOW INCOME HOUSING WA COMPASS HEALTH HOLDINGS LLC RELATED -18 437133 0 -13 1 0.00010 COMPASS HEALTH BROADWAY PSH LLLP 4526 FEDERAL AVENUE BUILDING 3 EVERETT WA 98203 824028757 LOW INCOME HOUSING WA COMPASS HEALTH BROADWAY GP LLC RELATED -189 2002228 0 1 0.00010 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 CHILD ADVOCACY CENTER OF SNOHOMISH COUNTY O 832643 COST COUNTERPOINT COMMONS Q 64547 COST HARMONY HOUSE NORTH ASSOCIATION Q 57286 COST MILWAUKEE PARK APTS LP Q 84539 COST COMPASS HEALTH BROADWAY PSH LLLP B 71607 COST COMPASS HEALTH BROADWAY PSH LLLP O 661125 COST COMPASS HEALTH BROADWAY PSH LLLP Q 223671 COST MILWAUKEE PARK APTS LP A 31 COST COMPASS HEALTH BROADWAY PSH LLLP A 81768 COST COUNTERPOINT COMMONS D 181534 COST MENTAL HEALTH SERVICES OF SNOHOMISH COUNTY II D 71875 COST MILWAUKEE PARK APTS LP D 75000 COST COMPASS HEALTH BROADWAY PSH LLLP D 614997 COST