FURP.ORG / PUBLIC DATA EXPLORER

INTERNATIONAL COMMUNITY HEALTH SERVICES: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
INTERNATIONAL COMMUNITY HEALTH SERVICES (EIN 91-0947084)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-09-26
IRS object ID
201842699349300944
Schema version
2017v2.3
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)
Return2018-09-26T19:27:40-05:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line110700 NORTHUP WAY SUITE 200AddressLine1Txt
CityBELLEVUECityNm
State AbbreviationWAStateAbbreviationCd
ZIP98004ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN910947084EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1INTERNATIONAL COMMUNITY HEALTH SERVICESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlINTEBusinessNameControlTxt
Phone2067883618PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1720 8TH AVENUE SOUTH NO 100AddressLine1Txt
CitySEATTLECityNm
State AbbreviationWAStateAbbreviationCd
ZIP98104ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTERESITA BATAYOLAPersonNm
Person TitlePRESIDENT/CEOPersonTitleTxt
Phone2067883618PhoneNum
Signature2018-09-24SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKURT BENNIONPreparerPersonNm
PTINP01469618PTIN
Phone4252506100PhoneNum
Preparation2018-09-24PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address67.137.57.251IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-09-24IPDt
IP Tm15:10:19IPTm
IP TimezonePDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdB1033B006BFCD7423EE2E3AB54E3E8445E45BF8BAtSubmissionCreationDeviceId
At Submission Filing Device IdF0F62AA6298128500262D125680EAF6D2D38659BAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2018-06-14 16:35:46ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTERESITA BATAYOLAPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1720 8TH AVENUE SOUTH NO 100AddressLine1Txt
CitySEATTLECityNm
State AbbreviationWAStateAbbreviationCd
ZIP98104ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$44,267,462GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.ICHS.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1973FormationYr
Legal Domicile StateWALegalDomicileStateCd
Activity Or MissionPROVIDE HEALTH SERVICES TO IMPROVE THE HEALTH OF ASIAN PACIFIC ISLANDER AND OTHER COMMUNITIES.ActivityOrMissionDesc
Voting Members Governing Body16VotingMembersGoverningBodyCnt
Voting Members Independent16VotingMembersIndependentCnt
Total Employee614TotalEmployeeCnt
Total Volunteers40TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$6,511,898PYContributionsGrantsAmt
CY Contributions Grants$6,616,050CYContributionsGrantsAmt
PY Program Service Revenue$34,678,290PYProgramServiceRevenueAmt
CY Program Service Revenue$37,152,888CYProgramServiceRevenueAmt
PY Investment Income$14,347PYInvestmentIncomeAmt
CY Investment Income$10,840CYInvestmentIncomeAmt
PY Other Revenue$398,897PYOtherRevenueAmt
CY Other Revenue$468,795CYOtherRevenueAmt
PY Total Revenue$41,603,432PYTotalRevenueAmt
CY Total Revenue$44,248,573CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$35,000CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$29,819,877PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$34,528,696CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$264,939CYTotalFundraisingExpenseAmt
PY Other Expenses$12,718,655PYOtherExpensesAmt
CY Other Expenses$14,385,320CYOtherExpensesAmt
PY Total Expenses$42,538,532PYTotalExpensesAmt
CY Total Expenses$48,949,016CYTotalExpensesAmt
PY Revenues Less Expenses-$935,100PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$4,700,443CYRevenuesLessExpensesAmt
Total Assets BOY$49,416,514TotalAssetsBOYAmt
Total Assets EOY$47,993,046TotalAssetsEOYAmt
Total Liabilities BOY$19,155,700TotalLiabilitiesBOYAmt
Total Liabilities EOY$22,432,679TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$30,260,814NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$25,560,367NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionDEEPLY ROOTED IN THE ASIAN PACIFIC ISLANDER COMMUNITY, ICHS PROVIDES CULTURALLY AND LINGUISTICALLY APPROPRIATE HEALTH AND WELLNESS SERVICES AND PROMOTES HEALTH EQUITY FOR ALL.MissionDesc
Significant New Program SrvcYes (1)SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$18,161,901ExpenseAmt
Grant$35,000GrantAmt
Revenue$18,032,314RevenueAmt
DescICHS PROVIDES MEDICAL SERVICES TO PEOPLE, REGARDLESS OF ABILITY TO PAY. THESE SERVICES INCLUDE PHYSICAL EXAMS, IMMUNIZATIONS, MINOR SURGERY, HOME VISITS, AND INFANT AND WELL-CHILD CHECK-UPS. DURING 2017, ICHS PROVIDED 75,042 PRIMARY HEALTH CARE VISITS TO PATIENTS AND $273,629 OF CHARITY CARE.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$11,208,817ExpenseAmt
Revenue$11,664,184RevenueAmt
DescICHS PROVIDES FULL DENTAL CARE FOR THE ENTIRE FAMILY. ICHS PROVIDES EXTENSIVE DENTURE WORK, FULL CLEANING FOR ADULTS AND CHILDREN, PREVENTIVE DENTISTRY, MINOR ORAL SURGERY, RESTORATIVE SERVICES, ORTHODONTIA, AND EMERGENCY CARE. THE STAFF ALSO PROVIDES ORAL HEALTH EDUCATION IN THE COMMUNITY. DURING 2017, ICHS PROVIDED 53,247 DENTAL CARE VISITS TO PATIENTS AND $862,616 OF CHARITY CARE.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$11,036,611ExpenseAmt
Revenue$7,456,390RevenueAmt
DescICHS PROVIDES A VARIETY OF OTHER HEALTH CARE SERVICES TO THE COMMUNITY. THESE SERVICES INCLUDE CHINESE TRADITIONAL MEDICINE TECHNIQUES, DISEASE PREVENTION, HEALTH EDUCATION, BEHAVIORAL HEALTH, NUTRITION SERVICES, AND FAMILY PLANNING FOR TEENS AND ADULTS. DURING 2017, ICHS PROVIDED 8,511 HEALTH CARE VISITS TO PATIENTS AND $129,190 OF CHARITY CARE.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$40,407,329TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document50IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee614EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members16GoverningBodyVotingMembersCnt
Independent Voting Member16IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local ChaptersYes (1)LocalChaptersInd
Policies Reference ChaptersYes (1)PoliciesReferenceChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HERMES SHAHBAZIANBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2067883618PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1720 8TH AVENUE SOUTH NO 100AddressLine1Txt
CitySEATTLECityNm
State AbbreviationWAStateAbbreviationCd
ZIP98104ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
GILDAS CHEUNG
CHAIR5.000.00Yes (X)Yes (X)$0$0$0
JOHN FOZ
1ST VICE PRESIDENT3.002.00Yes (X)Yes (X)$0$0$0
CRIS KRISOLOGO-ELLIOTT
2ND VICE PRESIDENT3.000.00Yes (X)Yes (X)$0$0$0
KELLI NOMURA
3RD VICE PRESIDENT3.000.00Yes (X)Yes (X)$0$0$0
CATHERINE JOHNSON
SECRETARY3.000.00Yes (X)Yes (X)$0$0$0
RICHARD MELLON
TREASURER3.000.00Yes (X)Yes (X)$0$0$0
MARIAM ABARIENTOS
DIRECTOR1.500.00Yes (X)$0$0$0
JOYCE CHIN
DIRECTOR1.502.00Yes (X)$0$0$0
JENNY FANG
DIRECTOR1.500.00Yes (X)$0$0$0
JANYCE KO FISHER
DIRECTOR1.502.00Yes (X)$0$0$0
TED LEW
DIRECTOR1.500.00Yes (X)$0$0$0
ANU MADAN
DIRECTOR1.500.00Yes (X)$0$0$0
LEE MARCHISIO
DIRECTOR1.500.00Yes (X)$0$0$0
HIROSHI NAKANO
DIRECTOR1.500.00Yes (X)$0$0$0
BARBARA OBENA
DIRECTOR1.500.00Yes (X)$0$0$0
CHARLES WU
DIRECTOR1.502.00Yes (X)$0$0$0
TERESITA BATAYOLA
CHIEF EXECUTIVE OFFICER50.003.00Yes (X)$255,911$0$20,348
HERMES SHAHBAZIAN
CHIEF FINANCIAL OFFICER40.002.00Yes (X)$194,472$0$15,529
RAYBURN LEWIS
CHIEF MEDICAL OFFICER20.000.00Yes (X)$28,958$0$3,109
SHERMAN LOHN
CHIEF OPERATING OFFICER40.000.00Yes (X)$158,352$0$16,888
KIMO HIRAYAMA
ASSISTANT MEDICAL DIRECTOR40.000.00$258,847$0$20,646Yes (X)
ALAN CHUN
ASSISTANT MEDICAL DIRECTOR36.000.00$209,729$0$16,302Yes (X)
UYENVY PHAM
ASSISTANT MEDICAL DIRECTOR40.000.00$206,680$0$16,044Yes (X)
DAVID CHEN
ASSISTANT DENTAL DIRECTOR40.000.00$193,455$0$18,035Yes (X)
HARVEY WU
ASSISTANT DENTAL DIRECTOR40.000.00$194,894$0$18,129Yes (X)
GRANDY AU
ASSISTANT DENTAL DIRECTOR40.000.00$188,188$0$17,953Yes (X)
HAMED SAHARI-RASHTI
ASSISTANT DENTAL DIRECTOR40.000.00$180,148$0$17,119Yes (X)
STEPANIE KANG
ASSISTANT DENTAL DIRECTOR40.000.00$172,717$0$14,812Yes (X)
YUN HEE JO
ASSISTANT DENTAL DIRECTOR40.000.00$162,306$0$7,190Yes (X)
NANCY SNAPP
MD/PROVIDER32.000.00$186,367$0$15,484Yes (X)
TIMOTHY LAM
DDS/PROVIDER40.000.00$168,588$0$16,941Yes (X)
JON SONODA
PHARMACY MANAGER40.000.00$165,965$0$14,323Yes (X)
CHINDA ROACH
MD/PROVIDER36.000.00$165,563$0$17,130Yes (X)
CHRISTOPHER YEE
MD/PROVIDER & MED RESIDENCY DIRECTOR40.000.00$162,026$0$13,673Yes (X)
GRACE WANG
FORMER CMO36.000.00$153,408$0$14,087Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,406,574TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$293,742TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K54IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
INDEMAND INTERPRETING
555 ANDOVER PARK WEST SUITE 201TUKWILAWA98188INTERPRETING SERVICES$338,200
COLVOS CONSTRUCTION
711 COURT CTACOMAWA98042VISION CLINIC CONSTRUCTION$309,665
QUALITY SYSTEMS INC
PO BOX 511449LOS ANGELESCA90051NEXTGEN MAINTENANCE & BILLING$307,002
DENTAL PROFESSIONALS
4200 42ND AVE SWSEATTLEWA98116DENTAL TEMP SERVICES$183,665
KELLER ROHRBACK LLP
1201 THIRD AVE SUITE 3200SEATTLEWA98101LEGAL SERVICES$128,578
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K7CntrctRcvdGreaterThan100KCnt
Related Organizations$204,419RelatedOrganizationsAmt
Government Grants$5,649,469GovernmentGrantsAmt
All Other Contributions$762,162AllOtherContributionsAmt
Noncash Contributions$826,503NoncashContributionsAmt
Total Contributions$6,616,050TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE FEES624100$35,789,948$35,789,948
POOL SAVINGS REVENUE900099$1,342,688$1,342,688
OTHER MEDICAL REVENUE900099$20,252$20,252
FieldValueIRS element (for citing)
Total Program Service Revenue$37,152,888TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$18,132TotalRevenueColumnAmt
Exclusion$18,132ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$21,470RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$11,597RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$9,873RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$9,873TotalRevenueColumnAmt
Exclusion$9,873ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$7,292OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$7,292OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$7,292TotalRevenueColumnAmt
Exclusion-$7,292ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
MANAGEMENT FEES900099$273,894$273,894
MISCELLANEOUS REVENUE900099$185,028$185,028
FieldValueIRS element (for citing)
Other Revenue Total$458,922OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$44,248,573TotalRevenueColumnAmt
Related Or Exempt Func Income$37,152,888RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$479,635ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$35,000TotalAmt
Program Services$35,000ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$2,606,763TotalAmt
Program Services$1,532,653ProgramServicesAmt
Management And General$1,074,110ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$24,899,910TotalAmt
Program Services$21,316,545ProgramServicesAmt
Management And General$3,368,591ManagementAndGeneralAmt
Fundraising$214,774FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$973,343TotalAmt
Program Services$833,790ProgramServicesAmt
Management And General$131,351ManagementAndGeneralAmt
Fundraising$8,202FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,641,733TotalAmt
Program Services$3,073,622ProgramServicesAmt
Management And General$544,108ManagementAndGeneralAmt
Fundraising$24,003FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,406,947TotalAmt
Program Services$2,029,008ProgramServicesAmt
Management And General$359,979ManagementAndGeneralAmt
Fundraising$17,960FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$160,187TotalAmt
Program Services$10,563ProgramServicesAmt
Management And General$149,624ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$65,614TotalAmt
Management And General$65,614ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,361,910TotalAmt
Program Services$2,085,754ProgramServicesAmt
Management And General$1,276,156ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$51,356TotalAmt
Program Services$8,879ProgramServicesAmt
Management And General$42,477ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$313,226TotalAmt
Program Services$249,462ProgramServicesAmt
Management And General$63,764ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$212,738TotalAmt
Program Services$170,798ProgramServicesAmt
Management And General$41,940ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,460,647TotalAmt
Program Services$1,226,032ProgramServicesAmt
Management And General$234,615ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$98,862TotalAmt
Program Services$59,237ProgramServicesAmt
Management And General$39,625ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$124,464TotalAmt
Program Services$73,180ProgramServicesAmt
Management And General$51,284ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$400,917TotalAmt
Program Services$385,444ProgramServicesAmt
Management And General$15,473ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,415,117TotalAmt
Program Services$2,021,365ProgramServicesAmt
Management And General$393,752ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$119,588TotalAmt
Program Services$78,202ProgramServicesAmt
Management And General$41,386ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$3,341,932$3,276,735$65,197
PATIENT EXPENSE$1,094,263$1,092,526$1,737
EQUIPMENT$279,638$254,062$25,576
BAD DEBT EXPENSE$278,496$278,496

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$606,365TotalAmt
Program Services$315,976ProgramServicesAmt
Management And General$290,389ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$48,949,016TotalAmt
Program Services$40,407,329ProgramServicesAmt
Management And General$8,276,748ManagementAndGeneralAmt
Fundraising$264,939FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$7,774,289BOYAmt
EOY$7,652,621EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,264,905BOYAmt
EOY$2,255,124EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,334,194BOYAmt
EOY$3,017,155EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$210,878BOYAmt
EOY$212,449EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$712,955BOYAmt
EOY$942,994EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$44,122,174LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$13,115,932LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$32,280,175BOYAmt
EOY$31,006,242EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$5,000BOYAmt
EOY$2,053EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$1,200,000BOYAmt
EOY$1,200,000EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,634,118BOYAmt
EOY$1,704,408EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$49,416,514BOYAmt
EOY$47,993,046EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$6,179,785BOYAmt
EOY$10,078,196EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$789,168BOYAmt
EOY$668,840EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,483,028BOYAmt
EOY$9,254,801EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$2,703,719BOYAmt
EOY$2,430,842EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$19,155,700BOYAmt
EOY$22,432,679EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$29,246,132BOYAmt
EOY$24,893,566EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,014,682BOYAmt
EOY$666,801EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$30,260,814BOYAmt
EOY$25,560,367EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$49,416,514BOYAmt
EOY$47,993,046EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$4,700,443ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$4NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersYes (1)VolunteersInd
Paid Staff Or ManagementYes (1)PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (1)DirectContactLegislatorsInd
Direct Contact Legislators$4,628DirectContactLegislatorsAmt
Rallies DemonstrationsYes (1)RalliesDemonstrationsInd
Rallies Demonstrations$810RalliesDemonstrationsAmt
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$550OtherActivitiesAmt
Total Lobbying Expenditures$5,988TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationINTERNATIONAL COMMUNITY HEALTH SERVICES ("ICHS") STAFF ATTENDED THE CHC/API LEGISLATIVE DAY AND ICHS PAID MEMBERSHIP DUES TO ASSOCIATIONS THAT LOBBIED ON BEHALF OF ALL MEMBERS, INCLUDING ICHS. WENT TO WASHINGTON D.C. TO LOBBY FOR HEPATITIS B. CEO WENT TO WASHINGTON D.C. TO MEET WITH LEGISLATORS.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,528,037OtherCostOrOtherBasisAmt
Book Value$3,528,037BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$26,609,901OtherCostOrOtherBasisAmt
Depreciation$4,907,060DepreciationAmt
Book Value$21,702,841BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,223,810OtherCostOrOtherBasisAmt
Depreciation$2,664,004DepreciationAmt
Book Value$2,559,806BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,760,426OtherCostOrOtherBasisAmt
Depreciation$5,544,868DepreciationAmt
Book Value$3,215,558BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$31,006,242TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$44,160,322TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$4NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$293,219DonatedServicesAndUseFcltsAmt
Other Revenue$42,300OtherRevenueAmt
Revenue Not Reported$335,515RevenueNotReportedAmt
Revenue Subtotal$43,824,807RevenueSubtotalAmt
Other Revenues Not Included$423,766OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$423,766RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$44,248,573TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$48,975,336TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$293,219DonatedServicesUseFcltsAmt
Other Expenses Included$11,597OtherExpensesIncludedAmt
Expenses Not Reported$304,816ExpensesNotReportedAmt
Expenses Subtotal$48,670,520ExpensesSubtotalAmt
Other Expenses Not Included$278,496OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$278,496ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$48,949,016TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:THE ORGANIZATION HAS RECEIVED A DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE (IRS) THAT STATES IT IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS SHOWN IN THE FINANCIAL STATEMENTS. MANAGEMENT EVALUATED ICHS'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF TOPIC 740 OF THE ACCOUNTING STANDARDS CODIFICATION.
PART XI, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSE 11,597. LOSS ON DISPOSAL OF EQUIPMENT 7,292. CAPITAL GRANT 23,411.
PART XI, LINE 4B - OTHER ADJUSTMENTS:RENTAL INCOME 21,470. CAPITAL CONTRIBUTIONS 123,800. BAD DEBT 278,496.
PART XII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSE 11,597.
PART XII, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT 278,496.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1AGING IN PACE WASHINGTONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 3007AddressLine1Txt
CitySEATTLECityNm
State AbbreviationWAStateAbbreviationCd
ZIP981143007ZIPCd
FieldValueIRS element (for citing)
Recipient EIN810856014RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$35,000CashGrantAmt
Purpose Of GrantINITIAL FUNDING TO SUPPORT OPERATIONSPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTHE ONLY TRANSFER WAS TO AN ORGANIZATION ON WHICH INTERNATIONAL COMMUNITY HEALTH SERVICES' PRESIDENT/CEO SERVES AS BOARD PRESIDENT. SHE ENSURES THAT TRANSFERRED FUNDS ARE USED FOR APPROPRIATE PURPOSES THROUGH HER POSITION ON THE BOARD OF DIRECTORS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgYes (1)CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
TERESITA BATAYOLA
CHIEF EXECUTIVE OFFICER$204,302$0$33,516$0$18,093$0$10,051$0$10,297$0$276,259$0$0$0
HERMES SHAHBAZIAN
CHIEF FINANCIAL OFFICER$190,800$0$0$0$3,672$0$7,632$0$7,897$0$210,001$0$0$0
SHERMAN LOHN
CHIEF OPERATING OFFICER$158,352$0$0$0$0$0$6,591$0$10,297$0$175,240$0$0$0
KIMO HIRAYAMA
ASSISTANT MEDICAL DIRECTOR$236,027$0$10,250$0$12,570$0$10,349$0$10,297$0$279,493$0$0$0
ALAN CHUN
ASSISTANT MEDICAL DIRECTOR$205,004$0$4,725$0$0$0$8,405$0$7,897$0$226,031$0$0$0
UYENVY PHAM
ASSISTANT MEDICAL DIRECTOR$192,088$0$11,250$0$3,342$0$8,147$0$7,897$0$222,724$0$0$0
DAVID CHEN
ASSISTANT DENTAL DIRECTOR$163,005$0$18,000$0$12,450$0$7,738$0$10,297$0$211,490$0$0$0
HARVEY WU
ASSISTANT DENTAL DIRECTOR$172,726$0$15,750$0$6,418$0$7,832$0$10,297$0$213,023$0$0$0
GRANDY AU
ASSISTANT DENTAL DIRECTOR$153,428$0$16,750$0$18,010$0$7,656$0$10,297$0$206,141$0$0$0
HAMED SAHARI-RASHTI
ASSISTANT DENTAL DIRECTOR$158,380$0$5,750$0$16,018$0$6,822$0$10,297$0$197,267$0$0$0
STEPANIE KANG
ASSISTANT DENTAL DIRECTOR$158,092$0$14,625$0$0$0$6,915$0$7,897$0$187,529$0$0$0
YUN HEE JO
ASSISTANT DENTAL DIRECTOR$145,806$0$16,500$0$0$0$6,493$0$697$0$169,496$0$0$0
NANCY SNAPP
MD/PROVIDER$177,367$0$9,000$0$0$0$7,587$0$7,897$0$201,851$0$0$0
TIMOTHY LAM
DDS/PROVIDER$133,330$0$15,000$0$20,258$0$6,644$0$10,297$0$185,529$0$0$0
JON SONODA
PHARMACY MANAGER$160,641$0$0$0$5,324$0$6,426$0$7,897$0$180,288$0$0$0
CHINDA ROACH
MD/PROVIDER$154,591$0$4,350$0$6,622$0$6,833$0$10,297$0$182,693$0$0$0
CHRISTOPHER YEE
MD/PROVIDER & MED RESIDENCY DIRECTOR$127,895$0$7,250$0$26,881$0$5,950$0$7,723$0$175,699$0$0$0
GRACE WANG
FORMER CMO$150,408$0$3,000$0$0$0$6,190$0$7,897$0$167,495$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 5FormAndLineReferenceDesc
ExplanationTHE PRESIDENT/CEO RECEIVES A BONUS BASED ON FIVE STRATEGIC GOALS, ONE OF WHICH IS DIVERSIFYING REVENUE.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1WASHINGTON HEALTH CARE FACILITIES AUTHORITYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN911108929BondIssuerEIN
Bond Issued2013-10-18BondIssuedDt
Issue Price$10,160,000IssuePriceAmt
PurposeCONSTRUCTIONPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$905,195RetiredAmt
Total Proceeds$10,160,000TotalProceedsAmt
In Reserve Fund$1,316,561InReserveFundAmt
Capitalized Interest$185,641CapitalizedInterestAmt
Issuance Costs From Proceeds$131,346IssuanceCostsFromProceedsAmt
Capital Expenditures$10,160,000CapitalExpendituresAmt
Current Refunding0CurrentRefundingInd
Advance Refunding0AdvanceRefundingInd
Final Allocation Made0FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due YetYes (1)RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate IssueYes (1)VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Schedule M IRS990ScheduleM

Clothing And Household Goods ClothingAndHouseholdGoodsGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Noncash Contributions Rpt F990$6,163NoncashContributionsRptF990Amt
Method Of Determining RevenuesDONOR VALUEDMethodOfDeterminingRevenuesTxt

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution3ContributionCnt
Noncash Contributions Rpt F990$696,440NoncashContributionsRptF990Amt
Method Of Determining RevenuesCOSTMethodOfDeterminingRevenuesTxt

Other Non Cash Contri Table OtherNonCashContriTableGrp (2 entries)

Non Cash CheckboxNonCashCheckboxIndDescDescContributionContributionCntNoncash Contributions Rpt F990NoncashContributionsRptF990AmtMethod Of Determining RevenuesMethodOfDeterminingRevenuesTxt
Yes (X)EQUIPMENT1$123,800DONOR VALUED
Yes (X)GIFT CARDS1$100FMV
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (1)ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 2VISION CLINIC AND SCHOOL-BASED HEALTH CENTER-BELLEVUE OPENED IN 2018.
FORM 990, PART VI, SECTION A, LINE 1THE EXECUTIVE COMMITTEE IS CHAIRED BY THE CHAIR OF THE BOARD AND ONLY CONSISTS OF THE ELECTED OFFICERS OF THE BOARD AND THE PRESIDENT/CEO OF ICHS AS AN EX OFFICIO MEMBER. THE EXECUTIVE COMMITTEE IS EXCLUSIVELY AUTHORIZED TO ACT FOR THE BOARD IN URGENT SITUATIONS DURING THE INTERIM PERIOD BETWEEN MEETINGS OF THE BOARD IN A MANNER CONSISTENT WITH ESTABISHED BOARD POLICIES AND/OR DIRECTION, AND SHALL REPORT ALL ACTIVITIES AND ACTIONS AT THE NEXT MEETING OF THE BOARD.
FORM 990, PART VI, SECTION B, LINE 11BA DRAFT COPY OF THE FORM 990 WAS REVIEWED BY THE CFO AND DESIGNATED STAFF, INCLUDING THE ACCOUNTING MANAGER. THE ORGANIZATION'S FINANCE DEPARTMENT THEN REVIEWED AND SUBMITTED A DRAFT COPY OF THE FORM 990 TO THE FINANCE, AUDIT AND EXECUTIVE COMMITTEES OF THE THE BOARD OF DIRECTORS, WHO RECOMMENDED APPROVAL OF THE FORM TO THE FULL BOARD. THE FORM 990 WAS SUBSEQUENTLY PRESENTED TO THE FULL BOARD AT THE FOLLOWING BOARD MEETING FOR REVIEW AND APPROVAL.
FORM 990, PART VI, SECTION B, LINE 12CICHS REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICIES. ICHS HAS TWO CONFLICT OF INTEREST POLICIES. THE FIRST POLICY IS AN OVERARCHING POLICY FOR THE ENTIRE AGENCY, WHICH WORKS TO ENSURE EFFECTIVE MANAGEMENT OF CONFLICTS OF INTEREST AT ICHS. THE SECOND POLICY IS SET TO ENSURE ALL BOARD-RELATED ACTIVITIES ARE CONDUCTED IN A WAY THAT ENSURES COMPLIANCE WITH APPLICABLE LAWS, PRESERVES THE PUBLIC'S TRUST, ENSURES GOOD STEWARDSHIP OF ICHS RESOURCES, AND UPHOLDS HIGH STANDARDS OF CONDUCT AND PERSONAL INTEGRITY AMONG ALL BOARD DIRECTORS AND BOARD ASSOCIATES. THE CONFLICT OF INTEREST POLICY REQUIRES ALL EMPLOYEES AND NON-EMPLOYEE REPRESENTATIVES TO DISCLOSE ANY CONFLICTS OF INTEREST THAT MAY COMPROMISE THEIR JUDGMENT OR IF PERSONAL INTERESTS ARE IN SUBSTANTIAL CONFLICT WITH THE BEST INTERESTS OF ICHS. SIMILARLY, INDIVIDUALS ARE EXPECTED TO REMOVE THEMSELVES FROM A POSITION OF DECISION-MAKING AUTHORITY OR SIGNIFICANT INFLUENCE WITH RESPECT TO ANY CONFLICT SITUATION THAT ARISES. A SITUATION IS CONSIDERED A CONFLICT OF INTEREST IF AN INTEREST OR ACTIVITY INFLUENCES OR APPEARS TO INFLUENCE THE ABILITY OF AN INDIVIDUAL TO EXERCISE OBJECTIVITY OR IMPAIRS THE INDIVIDUAL'S ABILITY TO PERFORM HIS OR HER EMPLOYMENT OR REPRESENTATIVE WORK RESPONSIBILITIES IN THE BEST INTEREST OF ICHS. ANY UNETHICAL ABUSE OF EMPLOYEES OR NON-EMPLOYEE REPRESENTATIVES CAN RESULT IN DISCIPLINARY ACTION (INCLUDING TERMINATION OF EMPLOYMENT). THE CONFLICT OF INTEREST POLICY FOR BOARD DIRECTORS AND BOARD ASSOCIATES REQUIRES BOARD DIRECTORS AND ASSOCIATES TO DISCLOSE ANY REAL OR APPARENT CONFLICT OF INTEREST TO THE BOARD AND EXCUSE HIMSELF OR HERSELF FROM VOTING, AS APPROPRIATE. ADDITIONALLY, NO BOARD MEMBER CAN ALSO BE AN EMPLOYEE OR RELATED TO AN EMPLOYEE OF ICHS. IF A CONFLICT OF INTEREST IS PERCEIVED TO EXIST BUT IS NOT DISCLOSED, THE BOARD MAY VOTE WHETHER THERE IS A REAL CONFLICT OF INTEREST. IF THE VOTE IS AFFIRMATIVE, THE BOARD MEMBER IN QUESTION IS NOT ENTITLED TO VOTE ON THAT ISSUE.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD OF DIRECTORS PERFORM AN ANNUAL PERFORMANCE EVALUATION OF THE PRESIDENT/CEO WITH ASSISTANCE FROM A THIRD PARTY CONSULTANT. THE EXECUTIVE COMMITTEE OF THE BOARD (CHAIRS OF ALL THE COMMITTEES) MEETS WITH THE PRESIDENT/CEO TO NEGOTIATE COMPENSATION THAT IS CONSISTENT WITH MARKET PAY. THIS PROCESS IS UNDERTAKEN ANNUALLY. THE CHIEF FINANCIAL OFFICER AND OTHER KEY EMPLOYEES' COMPENSATION IS DETERMINED BY PERFOMANCE EVALUATIONS AND A COMPENSATION STUDY THAT IS UNDERTAKEN EVERY TWO YEARS.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1INTERNATIONAL COMMUNITY HEALTH SERVICES FOUNDATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1720 8TH AVENUE S SUITE 100AddressLine1Txt
CitySEATTLECityNm
State AbbreviationWAStateAbbreviationCd
ZIP98104ZIPCd
FieldValueIRS element (for citing)
EIN260493856EIN
Primary ActivitiesFUNDRAISINGPrimaryActivitiesTxt
Legal Domicile StateWALegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 12A, IPublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1INTERNATIONAL COMMUNITY HEALTH SERVICESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
INTERNATIONAL COMMUNITY HEALTH SERVICES FOUNDATION
C$204,419CASH
INTERNATIONAL COMMUNITY HEALTH SERVICES FOUNDATION
L$273,894FAIR MARKET VALUE
INTERNATIONAL COMMUNITY HEALTH SERVICES FOUNDATION
M$204,419CASH
INTERNATIONAL COMMUNITY HEALTH SERVICES FOUNDATION
O$273,894FAIR MARKET VALUE