2013-11-14T12:46:52-07:00 2012-12-31 990 2012-01-01 770431902 COTTAGE HEALTH SYSTEM COTT 8056827111 PO Box 689 Santa Barbara CA 93102 Joan Bricher 8058798752 2013-11-14 2012 2016-02-25 16:41:14Z Ronald Werft same as C above Santa Barbara CA 93102 60006018 0 X www.cottagehealthsystem.org X 1996 CA It is the mission of Cottage Health System to provide superior health care through a commitment to our Community and to our core values of excellence, integrity, and compassion. Cottage Health System is the sole corporate member for Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital and Santa Ynez Valley Cottage Hospital, Inc. 16 12 181 0 167912 0 0 52110647 59550886 0 0 439644 455132 52550291 60006018 0 0 0 0 25412783 29636765 0 0 0 27130115 30361133 52542898 59997898 7393 8120 13165367 16816750 19005078 21701899 -5839711 -4885149 It is the mission of Cottage Health System to provide superior health care through a commitment to our Community and to our core values of excellence, integrity, and compassion. Cottage Health System is the sole corporate member for Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital and Santa Ynez Valley Cottage Hospital, Inc. 0 0 53934317 0 59838106 Cottage Health System provided management and administrative services to Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital, Santa Ynez Valley Cottage Hospital and Goleta Valley Professional Buildings, Inc. 0 0 0 53934317 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 79 0 1 181 1 1 1 0 0 0 0 0 0 0 0 0 X 16 12 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 1 0 CA X Karen L Jones 8055697294 PO Box 689 Santa Barbara CA 93102 Judith Hopkinson 2 2 X 0 0 0 Jon Clark 2 2 X 0 0 0 P Steven Ainsley 2 2 X 0 0 0 Gregory Faulkner 2 2 X 0 0 0 Elliot Prager MD 2 2 X 0 0 0 J Robert Andrews 2 2 X 0 0 0 Angel Iscovich MD 2 2 X 0 0 0 Edward Bentley MD 2 2 X 0 0 0 John Romo 2.5 2.5 X 0 0 0 Marshall Turner Jr 2.5 2.5 X 0 0 0 Thomas Watson MD 2.5 2.5 X 0 11805 0 Charles A Jackson 2.5 2.5 X 0 0 0 Fred Lukas 2.5 2.5 X 0 0 0 Margaret Baker 2.5 2.5 X 0 0 0 Jeffrey Kupperman MD 2.5 2.5 X X 0 1342 0 Alex Koper MD 2.5 2.5 X X 0 12575 0 Fred Gluck 2.5 2.5 X X 0 0 0 Ed Birch PhD 2.5 2.5 X X 0 0 0 Robert Nakasone 2.5 2.5 X X 0 0 0 Robert Nourse 2.5 2.5 X X 0 0 0 Gretchen Milligan 10 10 X X 0 0 0 Ronald C Werft 30 30 X 1010499 0 635089 Steven A Fellows 15 35 X 576456 0 174787 Joan Bricher 25 25 X 540682 0 239362 Julie Artoux 25 25 X 117680 0 18962 Edmund Wroblewski MD 40 0 X 526419 0 56952 Patrice Ryan 40 0 X 311948 0 45664 Ronald Biscaro 40 0 X 305850 0 46127 Suzanne Dalston 40 0 X 380808 0 32128 Karen Jones 40 0 X 358598 0 48838 Herbert Geary 40 0 X 333724 0 47378 Lisa Moore 40 0 X 320801 0 47250 Alberto Kywi 40 0 X 370037 0 48159 Afshin Fatholahi 40 0 X 264861 0 43211 Sharon Lutz 40 0 X 231955 0 41510 Paul Erickson MD 40 0 X 314829 48694 28875 Kristin Tufvesson 40 0 X 228552 0 27970 David Dietrich 40 0 X 229641 0 24483 Laura Davidson 40 0 X 198840 0 26547 6622180 74416 1633292 60 0 1 0 VITALIZE CONSULTING SOLUTIONS 248 MAIN STREET STE 101 READING MA 018673643 IT CONSULTING 2926316 CIO SOLUTIONS LP 150 CASTILLIAN DRIVE GOLETA CA 93117 IT CONSULTING 1619482 SAGEWOOD SYSTEMS 2320 BATH STREET SUITE 305 SANTA BARBARA CA 93105 IT CONSULTING 1482149 ALLSCRIPTS HEALTHCARE LLC LOCKBOX 077133 PO BOX 8538-0311 PHILADELPHIA PA 191710133 COMPUTER SERVICES 1383384 TECHSTRATA LLC 575 ANTON BLVD STE 300 COSTA MESA CA 92626 IT CONSULTING 1222873 19 0 ADMIN REVENUE FROM TAX-EXEMPT AFFILIATES 900099 59550886 59550886 0 0 0 0 0 0 59550886 0 0 0 0 VRE Administrative Fee Revenue 900099 167912 0 167912 0 HR Revenue 900099 157964 157964 0 0 Discounts and Rebates 900099 82471 82471 0 0 46785 46785 0 0 455132 60006018 59838106 167912 0 0 0 0 0 0 0 0 0 6765627 6089064 676563 0 0 11618621 10573338 1045283 1944080 1749671 194409 8330079 7522549 807530 978358 880523 97835 0 0 0 219590 219590 9943 9943 40115 40115 4514752 4063277 451475 723933 651603 72330 3233629 2972924 260705 17053713 15348342 1705371 89454 80509 8945 187094 168385 18709 0 0 0 85015 76513 8502 2844609 2534514 310095 527231 474508 52723 DUES & SUBSCRIPTIONS 509278 458350 50928 EDUCATION AND TRAINING 92098 82888 9210 EQUIPMENT MAINTENANCE 38255 34429 3826 192424 172930 19494 59997898 53934317 6063581 0 1110742 5256397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2786268 3722728 36743030 29723538 8009410 7019492 0 0 0 0 0 0 0 0 1258947 818133 13165367 16816750 4223296 5672609 0 0 0 0 0 0 0 14781782 16029290 19005078 21701899 X -5839711 -4885149 0 0 0 0 -5839711 -4885149 13165367 16816750 X 8120 0 0 0 0 946442 X 0 1 X 1 0 X X 0 0 0 Santa Barbara Cottage Hospital 951644629 3 1 1 1 0 Goleta Valley Cottage Hospital 952413596 3 1 1 1 0 Santa Ynez Valley Cottage Hospital Inc 952224265 3 1 1 1 0 3 0 0 0 0 0 0 0 0 0 1 40115 40115 0 SchC_P2B_S00_L01 Schedule C, Part II-B, Line 1 Membership fees paid to California Hospital Association used for lobbying issues. 0 0 0 0 0 0 0 0 284831 69993 214838 0 35843715 29653545 6190170 0 614484 0 614484 7019492 0 Group Health Reserve 107829 Minimum Pension Liability 4008298 SERP & Retirement Plan 11726935 Due to Affiliates 186228 16029290 X SchD_P10_S00_L02 Schedule D, Part X, Line 2 The System and its affiliates, except for Pacific Diagnostic Laboratories, are not-for-profit corporations and are tax-exempt pursuant to Section 501(c)(3) of the Internal Revenue Code and are exempt from income taxation under Section 501(a) of the Code and corresponding provisions of the California Revenue and Taxation Code, except to the extent of income derived from taxable unrelated business activities. Unrelated business income is not material to the financial statements. The System completed an analysis of its tax positions, in accordance with ASC 740, Income Taxes, and determined that there are no uncertain tax positions taken or expected to be taken. The System has recognized no interest or penalties related to uncertain tax positions. The System is subject to routine audits by the taxing jurisdictions; however, there are currently no audits for any tax periods in progress. The System believes it is no longer subject to income tax examinations for years prior to 2009. X 1 1 X X X X X 1 1 0 0 0 0 0 0 0 Ronald C Werft 747865 0 248541 0 14093 0 619353 0 15736 0 1645588 0 0 0 Steven A Fellows 439361 0 123935 0 13160 0 159051 0 15736 0 751243 0 0 0 Joan Bricher 424551 0 101024 0 15107 0 223576 0 15786 0 780044 0 0 0 Edmund Wroblewski MD 420106 0 70272 0 36041 0 41237 0 15714 0 583370 0 28517 0 Patrice Ryan 261018 0 47236 0 3694 0 30260 0 15403 0 357611 0 0 0 Ronald Biscaro 250025 0 42692 0 13133 0 29502 0 16625 0 351977 0 0 0 Karen Jones 289326 0 53782 0 15490 0 32213 0 16625 0 407436 0 0 0 Herbert Geary 281358 0 39661 0 12705 0 31664 0 15714 0 381102 0 0 0 Lisa Moore 279182 0 39374 0 2245 0 31514 0 15736 0 368051 0 0 0 Alberto Kywi 279483 0 45766 0 44788 0 31534 0 16625 0 418196 0 19005 0 Afshin Fatholahi 220964 0 39202 0 4695 0 27497 0 15714 0 308072 0 0 0 Suzanne Dalston 103063 0 0 0 277745 0 19361 0 12767 0 412936 0 0 0 Kristin Tufvesson 203445 0 13649 0 11458 0 11340 0 16625 0 256517 0 0 0 David Dietrich 210639 0 12094 0 6908 0 11340 0 13143 0 254124 0 0 0 Laura Davidson 183332 0 15099 0 409 0 9922 0 16625 0 225387 0 0 0 Sharon Lutz 196006 0 33098 0 2851 0 12250 0 15736 0 259941 0 0 0 Paul Erickson MD 302778 48694 0 0 12051 0 12250 0 16625 0 343704 48694 0 0 SchJ_P01_S00_L01a Schedule J, Part I, Line 1a Health club dues are paid on behalf of CEO and COO. The COO dues are all considered taxable. The CEO portion of the dues that are related to personal use are considered taxable. SchJ_P01_S00_L03 Schedule J, Part I, Line 3 On an annual basis the Executive Compensation Committee (ECC) of the Board of Directors meets to determine appropriate compensation for executives, including the CEO, COO, CFO, and vice presidents. All members of the ECC are independent members of the Board of Directors. The ECC engages an independent consultant to prepare comparative compensation reports for each position. The executive's individual performance will also be considered when determining compensation. The ECC recommends compensation for the executives to the full Board for approval. This process takes place annually for all executives. SchJ_P01_S00_L04 Schedule J, Part I, Line 4 Severance: Suzanne Dalston 276,373 paid at lump sum at time employment was terminated. The amounts reported in the current year's deferred compensation includes recognition of past service. The amounts are subject to a substantial risk of forfeiture. Any amounts paid under this plan in the future will be reported again as reportable compensation in the year paid. Recipients of 457(f) plan payouts include Dr. Ed Wroblewski ($28,517) and Alberto Kywi ($19,005). Mullen and Henzel Board member is partner 172587 Legal Fees 0 Santa Barbara Cardio Med Group Board member is partner 94159 Medical Professional Fees 0 F990_P06_S0A_L02 Form 990, Part VI, Section A, Line 2 J. Robert Andrews and Greg Faulkner are law partners. F990_P06_S0B_L11b Form 990, Part VI, Section B, Line 11b Form 990 is prepared under the direction of the Vice President of Finance and CFO. Form 990 is reviewed by VP Finance, CFO and independent tax consultants prior to submitting to the Audit and Compliance Committee. All members of the Board receive a copy of the organization's form 990 for review prior to filing. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c The purpose of the Conflict of Interest policy is to protect the interest of the organization when it contemplates entering into a transaction or arrangement that could benefit the private interest of a Director or Officer of Cottage Health System, Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital, Santa Ynez Valley Cottage Hospital, Santa Barbara Cottage Hospital Foundation and Goleta Valley Professional Buildings, Inc., collectively known as Cottage Health System. The Cottage Health System Directors have a duty to: 1.) discharge their duties to benefit the Cottage Health System and not the Directors personally 2.) disclose situations with the potential for conflict of interest with the vision and mission of Cottage Health System 3.) refrain from discussing confidential Cottage Health System business with others. Each Board member will annually complete the Cottage Health System Directors Annual Conflict Disclosure Form. The Disclosure information will be reviewed annually by the Board Chair and the results reported to the full Board. Each Director or Officer will disclose to the Board Chair for items to be discussed at a Board meeting. If there are any material financial or personal interests a Board member/family member may have in a Board decision, the Director or Officer will disclose this to the Committee Chair for items to be discussed at Board Committees, before the Board reviews the transaction and takes action. In general, an Officer who had disclosed a potential conflict should be excused from the decision making portion of the discussion and is prohibited from voting on a matter involving a potential conflict of interest. If the Board has reasonable cause to believe that a Director or Officer failed to disclose a material financial interest or other potential material conflict of interest, the Board Chair shall inform the member of the basis for the belief and afford the member an opportunity to explain the alleged failure to disclose. After hearing the Director or Officer's response and conducting any further necessary investigation, the Board determines if the Director or Officer failed to disclose a material financial or other potential material conflict of interest. The Board Chair shall take appropriate corrective action. Committee Chairs who address conflict of interest situations with a Board Committee member are responsible for reporting such situations to the Board Chair. Key employees are treated as other employees of Cottage Health System and sign an annual conflict of interest form. These forms are reviewed by Compliance and any issues are brought to the Chief Compliance Officer. F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 On an annual basis the Executive Compensation Committee (ECC) of the Board of Directors meets to determine appropriate compensation for executives, including the CEO, COO, CFO, and vice presidents. All members of the ECC are independent members of the Board of Directors. The ECC engages an independent consultant to prepare comparative compensation reports for each position. The executive's individual performance will also be considered when determining compensation. The ECC recommends compensation for the executives to the full Board for approval. This process takes place annually for all executives. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 Audited Financial Statements and tax filings can be obtained upon request from the CFO. F990_P11_S00_L09 Form 990, Part XI, Line 9 Form 990 XI - OTHER CHANGES IN NET ASSETS includes Change in Pension Liability $946,442 Santa Barbara Cottage Hospital PO Box 689 Santa Barbara CA 93102 951644629 Hospital CA 501(c)(3) 3 Cottage Health System 1 Goleta Valley Cottage Hospital PO Box 689 Santa Barbara CA 93102 952413596 Hospital CA 501(c)(3) 3 Cottage Health System 1 Santa Ynez Valley Cottage Hospital Inc PO Box 689 Santa Barbara CA 93102 952224265 Hospital CA 501(c)(3) 3 Cottage Health System 1 Santa Barbara Cottage Hospital Foundation PO Box 689 Santa Barbara CA 93102 953802238 Fundraising CA 501(c)(3) 7 Santa Barbara Cottage Hospital 1 Goleta Valley Professional Buildings Inc PO Box 689 Santa Barbara CA 93102 770004202 Medical Professional Building CA 501(c)(3) 11b-II Cottage Health System 1 Villa Riviera Real Estate Company PO Box 689 Santa Barbara CA 93102 272996284 Workforce housing developer CA SBCHFndtn C 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 1 Santa Barbara Cottage Hospital l 50496063 accrual Santa Barbara Cottage Hospital o 379521 accrual Santa Barbara Cottage Hospital p 14141666 accrual Santa Barbara Cottage Hospital q 2949060 accrual Santa Barbara Cottage Hospital s 10000000 accrual Goleta Valley Cottage Hospital l 4768899 accrual Goleta Valley Cottage Hospital p 63083 accrual Goleta Valley Cottage Hospital q 116200 accrual Santa Ynez Valley Cottage Hospital Inc l 1213163 accrual Santa Ynez Valley Cottage Hospital Inc q 69744 accrual Santa Barbara Cottage Hospital Foundation l 2107103 accrual Santa Barbara Cottage Hospital Foundation m 1142104 accrual Santa Barbara Cottage Hospital Foundation o 235807 accrual Santa Barbara Cottage Hospital Foundation q 87260 accrual