FURP.ORG / PUBLIC DATA EXPLORER

GOLETA VALLEY COTTAGE HOSPITAL: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
GOLETA VALLEY COTTAGE HOSPITAL (EIN 95-2413596)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-14
IRS object ID
201343199349305924
Schema version
2012v2.0
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)
Timestamp2013-11-14T12:39:09-07:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN952413596EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1GOLETA VALLEY COTTAGE HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlGOLENameControl
Phone8056827111Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 689AddressLine1
CitySANTA BARBARACity
StateCAState
ZIP Code931020689ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJoan BricherName
TitleCFOTitle
Phone8055697294Phone
Date Signed2013-11-14DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRonald C WerftNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1same as C aboveAddressLine1
CitySanta BarbaraCity
StateCAState
ZIP Code93102ZIPCode
FieldValueIRS element (for citing)
Gross Receipts75115494GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.COTTAGEHEALTHSYSTEM.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1965YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionIt is the mission of Goleta Valley Cottage Hospital to provide superior health care through a commitment to our Community and to our core values of excellence, integrity, and compassion. The volunteer Board of Directors uses these core values to make decisions that will improve health care access, affordability and quality.ActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees401TotalNbrEmployees
Total Nbr Volunteers79TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year243241ContributionsGrantsPriorYear
Contributions Grants Current Year2200000ContributionsGrantsCurrentYear
Program Service Revenue Prior Year65715579ProgramServiceRevenuePriorYear
Program Service Revenue CY69898820ProgramServiceRevenueCY
Investment Income Prior Year606773InvestmentIncomePriorYear
Investment Income Current Year351726InvestmentIncomeCurrentYear
Other Revenue Prior Year345016OtherRevenuePriorYear
Other Revenue Current Year377212OtherRevenueCurrentYear
Total Revenue Prior Year66910609TotalRevenuePriorYear
Total Revenue Current Year72827758TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year148000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY173000GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year29933346SalariesEtcPriorYear
Salaries Etc Current Year31691646SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year26719792OtherExpensePriorYear
Other Expenses Current Year27605998OtherExpensesCurrentYear
Total Expenses Prior Year56801138TotalExpensesPriorYear
Total Expenses Current Year59470644TotalExpensesCurrentYear
Revenues Less Expenses Prior Year10109471RevenuesLessExpensesPriorYear
Revenues Less Expenses CY13357114RevenuesLessExpensesCY
Total Assets BOY84849918TotalAssetsBOY
Total Assets EOY103831400TotalAssetsEOY
Total Liabilities BOY32802546TotalLiabilitiesBOY
Total Liabilities EOY38770001TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY52047372NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY65061399NetAssetsOrFundBalancesEOY
Mission DescriptionIt is the mission of Goleta Valley Cottage Hospital to provide superior health care through a commitment to our Community and to our core values of excellence, integrity, and compassion. The volunteer Board of Directors uses these core values to make decisions that will improve health care access, affordability and quality.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense51791359Expense
Grants173000Grants
Revenue70276032Revenue
DescriptionGoleta Valley Cottage Hospital is a 122-bed acute-care hospital located in the City of Goleta. In 2012, the Hospital had 14,643 patient days and served 40,427 outpatients, including emergency services to 18,680 patients. The Hospital provides a wide array of inpatient and outpatient services, including but not limited to cardiac, orthopedic, wound care, breast care, emergency and sub-acute services. Goleta Valley Cottage Hospital provides emergency services to anyone seeking care, regardless of their ability to pay. All patients who do not present third-party insurance are automatically screened for eligibility in government health programs and are assisted in applying for charity if the patient does not qualify for any other assistance. Cottage Health System, which includes Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital and Santa Ynez Valley Cottage Hospital, provides critical funding for community health, charity care, and external grants, while also realizing shortfalls in Medicare, Medi-Cal, and indigent care. Community outreach efforts for Cottage Health System in 2012 focused on five health areas: cancer, heart disease and stroke, children's health, seniors' health, along with prevention and wellness. Activities in these areas included screenings and health fairs; classes, clinics, lectures, and seminars; community services; community collaborations; and coalitions/committees. In 2012, Cottage Health System spent over $144 million on these programs. To ensure that every member of the community has access to healthcare Goleta Valley Cottage Hospital offers full charity care to all patients whose income level is at or below 350% of the Federal Poverty Level (FPL). Discounted care is also available for families who make up to 543% of the FPL. Due to the formalized expansion of the charity care program, patients who do not have access to a third-party insurer now have a process to apply for charity care for their outpatient procedure. In 2012, Goleta Valley Cottage Hospital provided 289 patients with financial assistance.Description
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense51791359TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109674NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees401NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonKaren JonesNamePerson
Telephone Number8055697294TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1400 West PuebloAddressLine1
CitySanta BarbaraCity
StateCAState
ZIP Code93105ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (31 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Judith Hopkinson
Director0.363.64X000
Jon Clark
Director0.363.64X000
P Steven Ainsley
Director0.363.64X000
Gregory Faulkner
Director0.363.64X000
Elliot Prager MD
Director0.363.64X000
J Robert Andrews
Director (Partial Year)0.363.64X000
Angel Iscovich MD
Director (Partial Year)0.363.64X000
Edward Bentley MD
Director0.363.64X000
John Romo
Committee Chair0.454.55X000
Marshall Turner Jr
Committee Chair0.454.55X000
Thomas Watson MD
Committee Chair0.454.55X0118050
Charles A Jackson
Committee Chair0.454.55X000
Fred Lukas
Committee Chair0.454.55X000
Margaret Baker
Committee Chair0.454.55X000
Jeffrey Kupperman MD
Secretary (Partial year)0.454.55X013420X
Alex Koper MD
Secretary (Partial year)0.454.55X2500100750X
Fred Gluck
Vice Chair (Partial Year)0.454.55X000X
Ed Birch PhD
Vice Chair (Partial Year)0.454.55X000X
Robert Nakasone
Vice Chair (Partial Year)0.454.55X000X
Robert Nourse
Vice Chair (Partial Year)0.454.55X000X
Gretchen Milligan
Board Chair1.818.2X000X
Ronald C Werft
CEO5.454.601010499635089X
Steven A Fellows
COO10400576456174787X
Joan Bricher
CFO4.545.50540682239362X
Julie Artoux
Assistant Secretary4.545.5011768018962X
Diane Wisby
VP GVCH400308864042881X
Susan San Marco
Director Srvc Line400188608022534X
Dennis McDaniel
Clinical Lab Coord400181743025738X
Lisa La Bouve
Clinical Manager400173976021826X
Ken Kettler
Radiology Mgr-Gvch400167889024005X
Rosemary Bray
Clinical Manager400160326022528X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1183906TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2268539TotalReportableCompFrmRltdOrgs
Total Other Compensation1227712TotalOtherCompensation
Number Individuals GT100 K66NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensationAddress Line2AddressOfContractor/AddressUS/AddressLine2
HOSPITAL BUILDING & EQUIP CO
11330 Olive BlvdSaint LouisMO63141Building contractor fees18123627
MICHAEL L DAVIS & ASSOCIATES INC
1835 NEWPORT BLVD A 109COSTA MESACA92627INSPECTION SERVICES769747SUITE 361
ANESTHESIA ASSOC MED GROUP INC
5333 HOLLISTER AVE 130SANTA BARBARACA93111PHYSICIAN SERVICES732000
PACIFIC MATERIALS LAB
PO BOX 96GOLETACA93116INSPECTION SERVICES519407
DIVERSIFIED CLINICAL SERVICES
5220 Belfort RoadJacksonvilleFL32256Clinic services410938Suite 200
FieldValueIRS element (for citing)
Number Of Contractors GT100 K16NumberOfContractorsGT100K
Federated Campaigns0FederatedCampaigns
Membership Dues0MembershipDues
Fundraising Events0FundraisingEvents
Related Organizations2000000RelatedOrganizations
Government Grants0GovernmentGrants
All Other Contributions200000AllOtherContributions
Noncash Contributions0NoncashContributions
Total Contributions2200000TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
NET PATIENT SERVICE REVENUE90009968183217681832170$0
CA HOSPITAL FEE PROGRAM9000997657817657810$0
EHR-Medicare Revenue9000999498229498220$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue69898820TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column304108TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$304,108ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities2335354Securities
Other0Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities2287736Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities47618Securities
Other0Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column47618TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$47,618ExclusionAmount
FieldValueIRS element (for citing)
Cntrbtns Rprtd Fundraising Events0CntrbtnsRprtdFundraisingEvents

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
CAFETERIA REVENUE7222102478182478180$0
ED MALPRACTICE REIMBURSEMENT90009983786837860$0
REBATES AND REFUNDS90009925588255880$0

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column20020TotalRevenueColumn
Related Or Exempt Function Income20020RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue377212TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column72827758TotalRevenueColumn
Related Or Exempt Function Income70276032RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$351,726ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total173000Total
Program Services173000ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total354245Total
Program Services315553ProgramServices
Management And General38692ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total20877088Total
Program Services18641322ProgramServices
Management And General2235766ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2624196Total
Program Services2319748ProgramServices
Management And General304448ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total6233194Total
Program Services5409198ProgramServices
Management And General823996ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1602923Total
Program Services1489102ProgramServices
Management And General113821ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total4721161Total
Program Services2484000ProgramServices
Management And General2237161ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total6264Total
Program Services0ProgramServices
Management And General6264ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total85414Total
Program Services0ProgramServices
Management And General85414ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total10789Total
Program Services0ProgramServices
Management And General10789ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total87685Total
Program Services0ProgramServices
Management And General87685ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5328438Total
Program Services4192755ProgramServices
Management And General1135683ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total4263Total
Program Services2663ProgramServices
Management And General1600ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1301526Total
Program Services1129104ProgramServices
Management And General172422ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total68000Total
Program Services60520ProgramServices
Management And General7480ManagementAndGeneral
Fundraising0Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total952101Total
Program Services837151ProgramServices
Management And General114950ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total10198Total
Program Services10109ProgramServices
Management And General89ManagementAndGeneral
Fundraising0Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1498Total
Program Services1284ProgramServices
Management And General214ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total382Total
Program Services382ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1633173Total
Program Services1582477ProgramServices
Management And General50696ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total561443Total
Program Services472191ProgramServices
Management And General89252ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
MEDICAL SUPPLIES111334481113344530
HOSPITAL FEE PROGRAM85152485152400
EQUIPMENT MAINTENANCE702039670192318470
LICENSES9049214361761310

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total56160Total
Program Services1278ProgramServices
Management And General54882ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total59470644Total
Program Services51791359ProgramServices
Management And General7679285ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1549395BOY
EOY2288003EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY962117BOY
EOY804347EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY10454077BOY
EOY10623319EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY564500BOY
EOY543183EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY543843BOY
EOY863597EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis105000492LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec24224106LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY61562541BOY
EOY80776386EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY6193371BOY
EOY4562784EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY2734471BOY
EOY2248544EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY285603BOY
EOY1121237EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY84849918BOY
EOY103831400EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY8313913BOY
EOY7749852EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY24488633BOY
EOY31020149EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY32802546BOY
EOY38770001EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY51837372BOY
EOY64926577EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY210000BOY
EOY134822EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY52047372BOY
EOY65061399EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY84849918BOY
EOY103831400EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses13357114ReconcilationRevenueExpenses
Reconciliation Unrealized Invest514018ReconciliationUnrealizedInvest
Reconcilation Donated Services0ReconcilationDonatedServices
Reconcilation Invest Expenses0ReconcilationInvestExpenses
Reconcilation Prior Adjustment0ReconcilationPriorAdjustment
Reconcilation Other Changes-857105ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$10,789OtherActivitiesAmount
Total Lobbying Expenditures IIB10789TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierSchC_P2B_S00_L01Identifier
Return ReferenceSchedule C, Part II-B, Line 1ReturnReference
ExplanationLobbying activites are calculated as a percentage of dues paid to various organizations.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Book Value0BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis14563087OtherCostOrOtherBasis
Depreciation14527217Depreciation
Book Value35870BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis2270321OtherCostOrOtherBasis
Depreciation2233957Depreciation
Book Value36364BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis11878288OtherCostOrOtherBasis
Depreciation7099468Depreciation
Book Value4778820BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis76288796OtherCostOrOtherBasis
Depreciation363464Depreciation
Book Value75925332BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings80776386TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
SELF INSURANCE LIABILITY$2,641,155
MINIMUM PENSION LIABILITY$4,896,766
RETIREMENT PLAN SERP$73,796
DUE TO AFFILIATES$7,325,678
GVCH ALLOCATION OF TAX EXEMPT DEBT$16,082,754
FieldValueIRS element (for citing)
Total Of Amounts31020149TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierSchD_P10_S00_L02Identifier
Return ReferenceSchedule D, Part X, Line 2ReturnReference
ExplanationThe 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.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage3.5FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage5.42DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense584959TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense584959NetCommunityBenefitExpense
Percent Of Total Expense0.0098PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense16188502TotalCommunityBenefitExpense
Direct Offsetting Revenue10965857DirectOffsettingRevenue
Net Community Benefit Expense5222645NetCommunityBenefitExpense
Percent Of Total Expense0.0878PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense518658TotalCommunityBenefitExpense
Direct Offsetting Revenue158035DirectOffsettingRevenue
Net Community Benefit Expense360623NetCommunityBenefitExpense
Percent Of Total Expense0.0061PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense17292119TotalCommunityBenefitExpense
Direct Offsetting Revenue11123892DirectOffsettingRevenue
Net Community Benefit Expense6168227NetCommunityBenefitExpense
Percent Of Total Expense0.1037PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense23129TotalCommunityBenefitExpense
Net Community Benefit Expense23129NetCommunityBenefitExpense
Percent Of Total Expense0.0004PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense48000TotalCommunityBenefitExpense
Net Community Benefit Expense48000NetCommunityBenefitExpense
Percent Of Total Expense0.0008PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense125000TotalCommunityBenefitExpense
Net Community Benefit Expense125000NetCommunityBenefitExpense
Percent Of Total Expense0.0021PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense196129TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense196129NetCommunityBenefitExpense
Percent Of Total Expense0.0033PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense17488248TotalCommunityBenefitExpense
Direct Offsetting Revenue11123892DirectOffsettingRevenue
Net Community Benefit Expense6364356NetCommunityBenefitExpense
Percent Of Total Expense0.1070PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$938,364BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare10576920AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare14778827CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-4201907MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Goleta Valley Cottage HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1351 South PattersonAddressLine1
CityGoletaCity
StateCAState
ZIP Code93111ZIPCode
FieldValueIRS element (for citing)
Website Addresswww.cottagehealthsystem.orgWebsiteAddress
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Goleta Valley Cottage HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent350FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent542FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchH_P01_S00_L06aSchedule H, Part I, Line 6aCottage Health System prepares a Community Benefit Report on behalf of Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital. It is filed with the State of California, in compliance with California Senate Bill 697. The Community Benefit Report is available to the public upon request.
SchH_P01_S00_L07Schedule H, Part I, Line 7Our costing methodology includes inpatient, outpatient, and emergency department and is broken down by payer categories. Both direct and overhead costs have been allocated, by services rendered. Each Payer's net revenue is offset by the total cost and the results by Payer are calculated. In addition to a hospital-wide cost/charge ratio, we have calculated cost/charge ratios for each Payer, based on the cost of the type of services rendered to their specific patients. Therefore, the community benefit amounts attributable to Medicaid and other government programs are calculated based on their specific cost/charge ratio.
SchH_P03_S0A_L04Schedule H, Part III, Section A, Line 4Bad debt is not included in the Community Benefit report. Bad debt expense is derived from cost to charge ratios. Footnote in the Audited Financial Statements says: In July 2011, the FASB issued Accounting Standards Update (ASU) No. 2011-07, Presentation and Disclosure of Patient Service Revenue, Provision for Bad Debts, and the Allowance for Doubtful Accounts for Certain Health Care Entities (ASU 2011-07). The provisions of ASU 2011-07 require certain health care entities to present the provision for bad debts related to patient service revenue as a deduction from patient service revenue in the statement of income rather than an operating expense. Additional disclosures related to sources of patient service revenue and allowance for uncollectible accounts is also be required. This new guidance is effective for fiscal years beginning after December 15, 2011, with early adoption permitted. The System adopted the provisions of ASU 2011-07 as of and for the year ended December 31, 2012, and retrospectively applied the presentation requirements to all periods presented.
SchH_P03_S0B_L08Schedule H, Part III, Section B, Line 8The shortfall for Medicare patients is a significant loss to the hospital. We are providing care to patients whose insurance (Medicare) does not cover the entire cost of their care. This provides significant aid to the elderly in the community. Some of these elderly people would qualify under FAP guidelines for charity care under any other Payer program. The dollars reported are taken from the 2012 Medicare Cost Report and are derived following their guidelines of allowable and non-allowable costs.
SchH_P03_S0C_L09bSchedule H, Part III, Section C, Line 9bAll patients receive 6 statements over 135 days, which include a statement about how to inquire about financial assistance. Patients who are known to qualify for charity care or are in the process of applying for charity care are not sent to collection until a final charity care determination is made. If they qualify, their account is written down to zero.
SchH_P05_S0B_L14Schedule H, Part V, Section B, Line 14A summary of the policy is posted in admitting offices. The full policy is reported to and available from the OSHPD website (www.oshpd.ca.gov). The policy can also be obtained upon request from a Patient Financial Counselor, whose contact information is provided on all billing statements along with a message regarding financial assistance. Patients that do not present any third party insurance information receive a brochure and eligibility counseling for the Patient Business Office.
SchH_P05_S0B_L20Schedule H, Part V, Section B, Line 20The maximum that could be charged is based on % of charges that is lower than commercial rates.
SchH_P06_S00_L02Schedule H, Part VI, Line 2Cottage Health System, on behalf of Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital and Santa Ynez Valley Cottage Hospital, is currently in the process of updating its review of community health needs. In 2011, the System relied upon the community health assessment performed by the County of Santa Barbara. The last full assessment completed by Cottage was in 2009, when Cottage Health System began an overhaul of its community benefit process and programs. First, Cottage reviewed focus areas of local, state, and national organizations to determine its own focus areas and then next reviewed its internal community outreach programs to ensure they aligned. Cottage Health System reviewed its external community grants process. Funds were shifted from the Foundation to Operations and grant guidelines were developed around the identified focus areas. Both the focus areas and grant program were part of an overall Community Benefit Plan that was approved by the Board of Directors in early 2010. As part of the community benefit review in 2009, Cottage Health System reviewed focus areas of multiple organizations. The Centers for Disease Control and Prevention and The National Health Foundation were reviewed at the national level, and the California Department of Public Health was reviewed at a state level. Locally, four organizations' focus areas and reports were reviewed: Santa Barbara County Public Health Department Status Report 2009, Santa Barbara KIDS Network, United Way of Santa Barbara, and Santa Barbara Neighborhood Clinics. Cottage Health System conducts a regular community perception survey, which includes questions regarding community needs. Cottage Health System also held a brainstorming session with 20 different hospital departments, and the Community Health Coordinating Committee provided input. After reviewing all of the information, Cottage Health System determined the greatest needs to be children's health, seniors' health, cancer, heart disease and stroke, and prevention and wellness.
SchH_P06_S00_L03Schedule H, Part VI, Line 3Cottage Health System has a multi-faceted Financial Assistance Program to ensure that patients who do not have insurance are screened for eligibility in a government-sponsored healthcare plan and receive information about charity care programs. Every patient who does not present the hospital with proof of insurance or existing government support will be given a handout (in English or Spanish) upon registration that is compliant with California Assembly Bill 774 (AB774). The handout contains information about the Hospital's charity care programs. This includes where to obtain applications, income guidelines, other qualification information and contact information for Customer Service and the Admitting department. The Hospital posts information about the charity care program in all registration areas required by AB774. Signs in English and Spanish are located in all areas where patients are registered for inpatient and outpatient services. Signs are also located in the patient billing office and cashier office. Patients will also be contacted by an admitting representative or eligibility counselor to assist the patient in determining eligibility for government-sponsored insurance programs and assist with the application process at no cost to the patient. Patient Financial Counselors who answer customer service calls are instructed to offer charity care applications to all patients who indicate they have financial need.
SchH_P06_S00_L04Schedule H, Part VI, Line 4Santa Barbara County consists of 2,750 square miles of land and inland water area. Approximately rectangular in shape, Santa Barbara County is bordered on the north by San Luis Obispo County, on the east by Ventura County, and on the south and west by 107 miles of Pacific coastline. Much of the county is mountainous. The Santa Ynez, San Rafael and Sierra Madre mountains extend in a predominately east-west direction. Within the county, there are numerous fertile agricultural areas, including the Santa Maria, Cuyama, Lompoc, and Santa Ynez Valleys, and the southeast coastal plain. These areas, which include most of the developed land, also accommodate the majority of the population. Los Padres National Forest, in the eastern part of the county, covers approximately 44 percent of the total county area. Vandenberg Air Force Base is in the Lompoc region, while UCSB is on the South Coast. "North County" refers to the area west and north of Gaviota and includes the Lompoc, Santa Maria, Santa Ynez and Cuyama valleys. "South Coast" refers to the Goleta, Santa Barbara, and Carpinteria coastal plain. Santa Barbara County's 423,895 population is divided into six sub regions: Carpinteria Valley (4.2%); Santa Barbara/Goleta Region (43.5%); Santa Ynez Valley (5.3%); Lompoc Valley (14%), Santa Maria Valley (31%); Guadalupe Valley (1.7%); and the Cuyama Valley (.3%). Of the total population, 50% are females. The median age is 33.6 years. Twenty-nine percent of the population is 0-17 years old; 58 % are 20-54 years old and 13% are 65 and older. For people reporting one race, 88.6% are White; 2.4% are Black or African American; 1.7% are American Indian or Alaska Native; 4.5% are Asian; less than 0.3% are Native Hawaiian or Other Pacific Islander, and 2.5% reported 2 or more races. 40.4% are persons of Hispanic or Latino origin. Of the County's population, 21%are foreign-born, 32.8% of persons over the age of five reported speaking a language other than English at home, and 12.7% of county residents live below the poverty level.
SchH_P06_S00_L05Schedule H, Part VI, Line 5The Board of Directors is made up of prominent community members who volunteer their time to ensure that the Goleta Community has access to high-quality, affordable healthcare. The Board of Directors is actively involved in the Hospital's strategic decisions and takes its commitment to the Community very seriously. The Board approves of an annual financial budget and ten-year financial plan to guarantee the Hospital will continue to offer hospital services to the Community for years to come. The Board also approves of annual top goals that are consistent with the mission, vision and values of the Hospital. The financial forethought of the Board of Directors resulted in surplus funds that are being used to rebuild the facility. Goleta Valley Cottage Hospital is building a new hospital in order to comply with the unfunded mandate of the State of California's Senate Bill 1953 (SB1953), which requires all hospitals to retrofit or rebuild in order to withstand a major earthquake. The Hospital used this opportunity to live the core value of excellence by ensuring that the new facility will meet the current and future healthcare needs of the Community. Goleta Valley Cottage Hospital works cooperatively with the open medical staff to improve healthcare in the community. The Hospital is exploring how to better align with physicians in order to provide the highest quality of care.
SchH_P06_S00_L06Schedule H, Part VI, Line 6Cottage Health System (CHS) is the parent organization of Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital and Santa Ynez Valley Cottage Hospital and Goleta Valley Professional Buildings, Inc. These organizations have a common Board of Directors. Cottage Health System Hospitals are the sole hospital providers in the Community and strategic plans are created with all the Hospitals and their Communities in mind. Goleta Valley Cottage Hospital is the second largest of the CHS Hospitals and primarily provides services to the City of Goleta (adjacent to Santa Barbara) and the University of California, Santa Barbara.
SchH_P06_S00_L07Schedule H, Part VI, Line 7Cottage Health System files an annual community benefit report in the State of California on behalf of Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital and Santa Ynez Valley Cottage Hospital.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationPurpose Of GrantPurposeOfGrant
SANTA BARBARA NEIGHBORHOOD CLINICS
1900 STATE ST SUITE GSANTA BARBARACA93101770496382501(c)(3)1250000CASHSUPPORTS DENTAL CLINIC, AN IDENTIFIED COMMUNITY NEED, AS WELL AS THE "CARE FOR EVERY CHILD" PROGRAM WHICH PROVIDES EDUCATION IN HEALTHY LIFE STYLES AND PREVENTATIVE CARE.
CALIFORNIA STATE UNIVERSITY CHANNEL ISLANDS FOUNDATION
ONE UNIVERSITY DRIVECAMARILLOCA93012770433230government48000CASHBACHELOR OF SCIENCE NURSING PROGRAM IN SANTA BARBARA.
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierSchI_P01_S00_L02Identifier
Return ReferenceSchedule I, Part I, Line 2ReturnReference
ExplanationGrant funds are monitored through the Community Health Coordinating Committee of CHS. Grantees are required to submit a report in June of each year that is reviewed by the committee prior to entire amount of funds being disbursed.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Ronald C Werft
CEO0747865024854101409306193530157360164558800
Steven A Fellows
COO043936101239350131600159051015736075124300
Joan Bricher
CFO042455101010240151070223576015786078004400
Diane Wisby
VP GVCH2578800404930104910300440128370351745000
Susan San Marco
Director Srvc Line1726680151550785093910131430211142000
Dennis McDaniel
Clinical Lab Coord17162400010119090250167130207481000
Lisa La Bouve
Clinical Manager15603501447103470086830131430195802000
Ken Kettler
Radiology Mgr-Gvch15478101103102077082910157140191894000
Rosemary Bray
Clinical Manager1490920978601448079440145840182854000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchJ_P01_S00_L03Schedule J, Part I, Line 3On 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_L04Schedule J, Part I, Line 4The 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.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P06_S0A_L02Form 990, Part VI, Section A, Line 2J. Robert Andrews and Greg Faulkner are law partners.
F990_P06_S0A_L06Form 990, Part VI, Section A, Line 6Cottage Health System is the sole corporate member of Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital, Santa Ynez Valley Cottage Hospital and Goleta Valley Professional Buildings, Inc.
F990_P06_S0A_L07aForm 990, Part VI, Section A, Line 7aCottage Health System is the sole corporate member of Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital, Santa Ynez Valley Cottage Hospital, and Goleta Valley Professional Buildings, Inc and can appoint Directors to the Board.
F990_P06_S0A_L07bForm 990, Part VI, Section A, Line 7bThe Board of Directors for Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital, Santa Ynez Valley Cottage Hospital, and Goleta Valley Professional Buildings, Inc must obtain prior approval of the Board of Directors for Cottage Health System, in order to: a) amend or restate the Articles of Incorporation or Bylaws; b) implement the annual budget and long-term capital and operational budget; c) sell, lease, mortgage, pledge, merge, consolidate or make any other disposition of any material part of the property and assets of this corporation; or d) voluntarily dissolve the corporation.
F990_P06_S0B_L11bForm 990, Part VI, Section B, Line 11bForm 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_L12cForm 990, Part VI, Section B, Line 12cThe purpose of the Conflict of Interest policy is to protect the interest of the Hospital 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_S0C_L19Form 990, Part VI, Section C, Line 19Tax filings can be obtained upon request from the CFO. Audited Financial Statements are attached to the Form 990 in accordance with IRS instructions.
F990_P07_S0A_L01aForm 990, Part VII, Section A, Line 1aHours listed may not reflect total hours spent.
F990_P11_S00_L09Form 990, Part XI, Line 9CHANGE IN PENSION LIABILITY: (853,088); SPECIFIC PURPOSE FUNDS ACCOUNT ADJUSTMENT: (4,017)

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Cottage Health System
PO Box 689Santa BarbaraCA931020689770431902Parent organization for 3 hospitals and medical professional buildingCA501 (C) (3)11b-IIN/A0
Santa Barbara Cottage Hospital
PO Box 689Santa BarbaraCA931020689951644629HospitalCA501 (C) (3)31Cottage Health System
Santa Ynez Valley Cottage Hospital
PO Box 689Santa BarbaraCA931020689952224265HospitalCA501 (C) (3)31Cottage Health System
Santa Barbara Cottage Hospital Foundation
PO Box 689Santa BarbaraCA931020689953802238Foundation to support Santa Barbara Cottage HospitalCA501 (C) (3)71Santa Barbara Cottage Hospital
Goleta Valley Professional Buildings Inc
PO Box 689Santa BarbaraCA931020689770004202Medical prof bldgCA501 (C) (3)11b-II1Cottage Health System
Goleta Valley Cottage Hospital Foundation
350 South PattersonSanta BarbaraCA93111770003554FundraisingCA501(c)(3)7N/A0

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Villa Riviera Real Estate CompanyBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO Box 689AddressLine1
CitySanta BarbaraCity
StateCAState
ZIP Code93102ZIPCode
FieldValueIRS element (for citing)
EIN272996284EIN
Primary ActivityWorkforce Housing DeveloperPrimaryActivity
Legal Domicile StateCALegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SBCHFBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityCTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (8 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Santa Ynez Valley Cottage Hospital
o75275ACCRUAL
Santa Barbara Cottage Hospital Foundation
k184927ACCRUAL
Santa Barbara Cottage Hospital
m3290587accrual
Santa Barbara Cottage Hospital
o826606accrual
Santa Barbara Cottage Hospital
p39749749accrual
Santa Barbara Cottage Hospital
q1861549accrual
Santa Barbara Cottage Hospital
r247876accrual
Santa Barbara Cottage Hospital
s407049accrual