SANTA YNEZ VALLEY COTTAGE HOSPITAL INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- SANTA YNEZ VALLEY COTTAGE HOSPITAL INC (EIN 95-2224265)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-14
- IRS object ID
- 201203209349303445
- Schema version
- 2011v1.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-14T14:51:04-07:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 952224265 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SANTA YNEZ VALLEY COTTAGE HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SANT | NameControl |
| Phone | 8056827111 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 689 | AddressLine1 |
| City | SANTA BARBARA | City |
| State | CA | State |
| ZIP Code | 931020689 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Joan Bricher | Name |
| Title | Senior Vice President and CFO | Title |
| Phone | 8055697294 | Phone |
| Date Signed | 2012-11-14 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Ronald Werft | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | Same As Above | AddressLine1 |
| City | Santa Barbara | City |
| State | CA | State |
| ZIP Code | 93102 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 14580001 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.COTTAGEHEALTHSYSTEM.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1962 | YearFormation |
| State Legal Domicile | CA | StateLegalDomicile |
| Activity Or Mission Description | It is the mission of Santa Ynez 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. SYVCH is a rural hospital and is designated a critical access hospital. The hospital provides critical emergency services which allow for local stabilization of the patient and transfer to an affiliated hospital that provides a higher level of care. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 19 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 94 | TotalNbrEmployees |
| Total Nbr Volunteers | 207 | TotalNbrVolunteers |
| Total Gross UBI | 15862 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -1411 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 3398339 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 935108 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 12428413 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 13274677 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 93293 | InvestmentIncomePriorYear |
| Investment Income Current Year | 63538 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 109411 | OtherRevenuePriorYear |
| Other Revenue Current Year | 114895 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 16029456 | TotalRevenuePriorYear |
| Total Revenue Current Year | 14388218 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 10175 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 10000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 7107826 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 7245862 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4775901 | OtherExpensePriorYear |
| Other Expenses Current Year | 5690263 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 11893902 | TotalExpensesPriorYear |
| Total Expenses Current Year | 12946125 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 4135554 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1442093 | RevenuesLessExpensesCY |
| Total Assets BOY | 18793565 | TotalAssetsBOY |
| Total Assets EOY | 20638573 | TotalAssetsEOY |
| Total Liabilities BOY | 2857177 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 3826488 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 15936388 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 16812085 | NetAssetsOrFundBalancesEOY |
| Mission Description | It is the mission of Santa Ynez 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 Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 10104110 | Expense |
| Grants | 10000 | Grants |
| Revenue | 13866892 | Revenue |
| Description | Santa Ynez Valley Cottage Hospital is a 10-bed acute-care hospital located in the rural area known as the Santa Ynez Valley. In 2011, the Hospital had 1,010 patient days, served 28,511 outpatients including emergency services to 6,757 patients. The Hospital provided essential emergency treatment, inpatient acute care, outpatient surgical services, laboratory, imaging diagnostic services and cardiac rehabilitation services to the residents of the Santa Ynez Valley, including the communities of Solvang, Buellton, Santa Ynez, Los Olivos, and Ballard. Santa Ynez Valley Cottage Hospital provides emergency services to anyone seeking care, regardless of their ability to pay. All patients who do not present with 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. To ensure that every member of the community has access to healthcare, Santa Ynez 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 542% of the FPL. In order to ensure that the Community has access to physician specialists, the Hospital also rents medical office space on a per clinic basis. In 2011 , Santa Ynez provided 79 patients with financial assistance. In 2011, the Hospital provided over 600 flu shots at a reduced cost to the community, low cost bike helmets and CPR classes. The hospital's cardiac rehabilitation service also provides a low cost exercise program for seniors. Santa Ynez Valley Cottage Hospital is also rebuilding and retrofitting its facilities in order to comply with the unfunded California mandate that requires hospitals to be able to withstand a major earthquake or close its doors. The Hospital is complying with the State mandate in order to ensure that hospital services remain accessible to the Community. | Description |
| Total Of Other Program Service Exp | 0 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 0 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 0 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 10104110 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 35 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 94 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 19 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | CA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Karen Jones | NamePerson |
| Telephone Number | 8056827111 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 West Pueblo | AddressLine1 |
| City | Santa Barbara | City |
| State | CA | State |
| ZIP Code | 93105 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (30 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Steve Ainsley | ||||||||
| Board Member | 2 | X | 0 | 0 | 0 | |||
| J Robert Andrews Esq | ||||||||
| Board Member | 3 | X | 0 | 0 | 0 | |||
| Margaret Baker | ||||||||
| Board Member | 2 | X | 0 | 0 | 0 | |||
| Ed Birch PhD | ||||||||
| Vice Chair | 3 | X | 0 | 0 | 0 | X | ||
| Jon Clark | ||||||||
| Board Member | 2 | X | 0 | 0 | 0 | |||
| Greg Faulkner Esq | ||||||||
| Board Member | 2 | X | 0 | 0 | 0 | |||
| Frederick Gluck | ||||||||
| Board Member | 3 | X | 0 | 0 | 0 | |||
| Judith Hopkinson | ||||||||
| Board Member | 2 | X | 0 | 0 | 0 | |||
| Angel Iscovich MD | ||||||||
| Board Member | 3 | X | 0 | 0 | 0 | |||
| Charles A Jackson | ||||||||
| Board Member | 3 | X | 0 | 0 | 0 | |||
| Alex Koper MD | ||||||||
| Board Member | 2 | X | 0 | 25385 | 0 | |||
| Jeffrey Kupperman MD | ||||||||
| Secretary | 3 | X | 0 | 15013 | 0 | X | ||
| Fred Lukas | ||||||||
| Board Member | 2 | X | 0 | 0 | 0 | |||
| Gretchen Milligan | ||||||||
| Chair | 4 | X | 0 | 0 | 0 | X | ||
| Robert Nakasone | ||||||||
| Vice Chair | 3 | X | 0 | 0 | 0 | X | ||
| Robert Nourse | ||||||||
| Board Member | 2 | X | 0 | 0 | 0 | |||
| Elliot Prager MD | ||||||||
| Board Member | 2 | X | 0 | 240231 | 0 | |||
| John Romo | ||||||||
| Board Member | 2 | X | 0 | 0 | 0 | |||
| Marshall Turner | ||||||||
| Board Member | 2 | X | 0 | 0 | 0 | |||
| Tom Watson MD | ||||||||
| Board Member | 2 | X | 0 | 11725 | 0 | |||
| Ronald C Werft | ||||||||
| CEO | 40 | 0 | 985900 | 614404 | X | |||
| Steven A Fellows | ||||||||
| COO | 40 | 0 | 578747 | 156703 | X | |||
| Joan Bricher | ||||||||
| CFO | 40 | 0 | 514928 | 241780 | X | |||
| Julie Artoux | ||||||||
| Assistant Secretary | 40 | 0 | 119146 | 16212 | X | |||
| Wende Cappetta | ||||||||
| VP SYVCH | 40 | 200693 | 0 | 31754 | X | |||
| Madeline Lozano | ||||||||
| Clinical Lab Scientist III | 40 | 158409 | 0 | 18175 | X | |||
| Gayle Mercado | ||||||||
| Clinical Manager | 40 | 154965 | 0 | 18003 | X | |||
| Denise Holmes | ||||||||
| Clinical Manager | 40 | 137740 | 0 | 17142 | X | |||
| Mary Puryear | ||||||||
| Clinical Manager | 40 | 135892 | 0 | 17049 | X | |||
| Ricardo Gonzalez Menchaca | ||||||||
| Radiology Technician III | 40 | 135621 | 0 | 17036 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 923320 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2491075 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1148258 | TotalOtherCompensation |
| Number Individuals GT100 K | 12 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| CALIFORNIA EM-1 MEDICAL SERVICES | |||||
| 7032 COLLECTION CENTER DR | CHICAGO | IL | 60693 | PHYSICIAN | 263551 |
| COMFORCE | |||||
| PO BOX 31001-0893 | PASADENA | CA | 91110 | NURSING | 213131 |
| HAGEN MD KATHARYN | |||||
| 870 COYOTE ROAD | SANTA BARBARA | CA | 93108 | PHYSICIAN | 125255 |
| SMITH ROGER A | |||||
| PO BOX 634 | SANTA YNEZ | CA | 93460 | INSPECTION SERVICES | 104625 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Federated Campaigns | 0 | FederatedCampaigns |
| Membership Dues | 4090 | MembershipDues |
| Fundraising Events | 0 | FundraisingEvents |
| Related Organizations | 867000 | RelatedOrganizations |
| Government Grants | 9567 | GovernmentGrants |
| All Other Contributions | 54451 | AllOtherContributions |
| Noncash Contributions | 24740 | NoncashContributions |
| Total Contributions | 935108 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 900099 | 13217978 | 13217978 | 0 | $0 |
| HOSPITAL MEDI-CAL SUPPLEMENTAL FEE | 900099 | 31289 | 31289 | 0 | $0 |
| PHYSICIAN ROOM RENT | 900099 | 25410 | 25410 | 0 | $0 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 13274677 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 55984 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $55,984 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 174352 | Securities |
| Other | 0 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 166798 | Securities |
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 7554 | Securities |
| Other | 0 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7554 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $7,554 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 12674 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 0 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 24985 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -12311 | TotalRevenueColumn |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | -$12,311 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| THRIFT SHOP REVENUE | 453310 | 100752 | 0 | 0 | $100,752 |
| LABORATORY MISC REVENUE | 621511 | 15862 | 0 | 15862 | $0 |
| REBATES AND REFUNDS | 900099 | 4673 | 4673 | 0 | $0 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5919 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5919 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 127206 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 14388218 | TotalRevenueColumn |
| Related Or Exempt Function Income | 13285269 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 15862 | UnrelatedBusinessRevenue |
| Exclusion | $151,979 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10000 | Total |
| Program Services | 10000 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 232447 | Total |
| Program Services | 197580 | ProgramServices |
| Management And General | 34867 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4835558 | Total |
| Program Services | 3934122 | ProgramServices |
| Management And General | 901436 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 484009 | Total |
| Program Services | 394589 | ProgramServices |
| Management And General | 89420 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1318141 | Total |
| Program Services | 1028724 | ProgramServices |
| Management And General | 289417 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 375707 | Total |
| Program Services | 316079 | ProgramServices |
| Management And General | 59628 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 876215 | Total |
| Program Services | 369885 | ProgramServices |
| Management And General | 506330 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1705 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 1705 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20280 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 20280 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5485 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 5485 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Fundraising | 0 | Fundraising |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25849 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 25849 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2608100 | Total |
| Program Services | 2128689 | ProgramServices |
| Management And General | 479411 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 211547 | Total |
| Program Services | 100807 | ProgramServices |
| Management And General | 110740 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49948 | Total |
| Program Services | 39051 | ProgramServices |
| Management And General | 10897 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 293700 | Total |
| Program Services | 225916 | ProgramServices |
| Management And General | 67784 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13816 | Total |
| Program Services | 6596 | ProgramServices |
| Management And General | 7220 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 661 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 661 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 574390 | Total |
| Program Services | 505475 | ProgramServices |
| Management And General | 68915 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 68472 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 68472 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| MEDICAL SUPPLIES | 603637 | 603637 | 0 | 0 |
| EQUIPMENT MAINTENANCE | 294869 | 239519 | 55350 | 0 |
| LICENSES | 25329 | 392 | 24937 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16260 | Total |
| Program Services | 3049 | ProgramServices |
| Management And General | 13211 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12946125 | Total |
| Program Services | 10104110 | ProgramServices |
| Management And General | 2842015 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2489710 | BOY |
| EOY | 3336405 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1723549 | BOY |
| EOY | 1848730 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1307447 | BOY |
| EOY | 2042025 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 78314 | BOY |
| EOY | 82967 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 125443 | BOY |
| EOY | 104428 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 16738035 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 4320681 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12063974 | BOY |
| EOY | 12417354 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1005128 | BOY |
| EOY | 806664 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18793565 | BOY |
| EOY | 20638573 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1353709 | BOY |
| EOY | 1395729 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1503468 | BOY |
| EOY | 2430759 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2857177 | BOY |
| EOY | 3826488 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15850382 | BOY |
| EOY | 16723448 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 86006 | BOY |
| EOY | 88637 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15936388 | BOY |
| EOY | 16812085 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18793565 | BOY |
| EOY | 20638573 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1442093 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -566396 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $5,485 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 5485 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SchC_P2B_S00_L01 | Identifier |
| Return Reference | Schedule C, Part II-B, Line 1 | ReturnReference |
| Explanation | LOBBYING ACTIVITIES ARE CALCULATED AS A PERCENTAGE OF DUES PAID TO VARIOUS ORGANIZATIONS. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 22582 | OtherCostOrOtherBasis |
| Book Value | 22582 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 8877057 | OtherCostOrOtherBasis |
| Depreciation | 1751749 | Depreciation |
| Book Value | 7125308 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 0 | Depreciation |
| Book Value | 0 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 4598041 | OtherCostOrOtherBasis |
| Depreciation | 2508328 | Depreciation |
| Book Value | 2089713 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 3240355 | OtherCostOrOtherBasis |
| Depreciation | 60604 | Depreciation |
| Book Value | 3179751 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 12417354 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (5 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| MINIMUM PENSION LIABILITY | $1,197,601 |
| SELF INSURANCE LIABILITY | $585,388 |
| DUE TO AFFILIATES | $476,366 |
| PHYSICIAN GUARANTEE | $136,819 |
| RETIREMENT PLAN - SERP | $34,585 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2430759 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SchD_P10_S00_L01 | Schedule D, Part X, Line 1 | The System and its affiliates 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 2008. |
| SchD_P10_S00_L02 | Schedule D, Part X, Line 2 | 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 2008. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 3.50 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 5.42 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 68436 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 68436 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0053 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 605310 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 270818 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 334492 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0258 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 18382 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4515 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 13867 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0011 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 692128 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 275333 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 416795 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0322 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 16455 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 16455 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0013 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 68096 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 22071 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 46025 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0035 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 84551 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 22071 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 62480 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0048 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 776679 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 297404 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 479275 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0370 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $331,825 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 5850090 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 5692645 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 157445 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Santa Ynez Valley Cottage Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 689 | AddressLine1 |
| City | Santa Barbara | City |
| State | CA | State |
| ZIP Code | 93102 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Santa Ynez Valley Cottage Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 0 | CHNAConducted |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 350 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 542 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SchH_P01_S00_L06a | Schedule H, Part I, Line 6a | Cottage Health System prepares a Community Benefit Report and files it 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_L07 | Schedule H, Part I, Line 7 | Our 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_P01_S00_L07g | Schedule H, Part I, Line 7g | Cardiac Rehab services are provided at a loss to the hospital. |
| SchH_P03_S0A_L04 | Schedule H, Part III, Section A, Line 4 | No Note in Audited Financial Statements regarding bad debt. Bad debt is not included in the Community Benefit report. Bad debt expense is derived from cost to charge ratios. |
| SchH_P03_S0B_L08 | Schedule H, Part III, Section B, Line 8 | The hospital provides care to patients whose insurance (Medicare) does not cover the entire cost of their care. The loss on services provided to Medicare recipients represents a significant shortfall for Medicare patients.to the hospital. This provides significant aid to the elderly in the community. The dollars reported are taken from the 2011 Medicare Cost Report and are derived following their guidelines of allowable and non-allowable costs. Santa Ynez's status as a critical access hospital provides for additional reimbursement that covers the "Medicare allowable" costs but still does not cover the total cost of care. With total costs applied, SYVCH experienced a loss of approximately $1 million. |
| SchH_P03_S0C_L09b | Schedule H, Part III, Section C, Line 9b | All 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_L13 | Schedule H, Part V, Section B, Line 13 | A summary of the policy is posted in admitting offices. The full policy is reported to and available from the OSHPD website. 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. |
| SchH_P05_S0B_L19 | Schedule H, Part V, Section B, Line 19 | The maximum that could be charged is based on % of charges that is lower than commercial rates. |
| SchH_P06_S00_L02 | Schedule H, Part VI, Line 2 | Cottage Health System is currently in the process of updating its review of community needs. In its last assessment in 2009, 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_L03 | Schedule H, Part VI, Line 3 | Cottage 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_L04 | Schedule H, Part VI, Line 4 | Santa Barbara County is situated on the southern coast of California, with Ventura County bordering on the east, San Luis Obispo County on the north, and Kern County on the northeastern corner. Roughly rectangular in shape, the county contains 2,750 square miles of varied terrain. 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. The Los Padres National Forest, in the eastern part of the county, covers approximately 44 percent of the total county area. The county's 430,200 population is divided into five sub regions: South Coast (205,800); Lompoc Valley (61,200), Santa Maria Valley (137,600); Santa Ynez Valley (24,000); Cuyama (1,500). 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. Twenty-one percent of the county's population are foreign-born, and 32.8% of persons over the age of five reported speaking a language other than English at home. 12.7% of county residents live below the poverty level. |
| SchH_P06_S00_L05 | Schedule H, Part VI, Line 5 | The Board of Directors is made up of prominent community members who volunteer their time to ensure that the Santa Ynez Valley 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. SYVCH 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. SYVCH 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_L06 | Schedule H, Part VI, Line 6 | Cottage Health System is the parent organization of Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital and Santa Ynez Valley Cottage Hospital. 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. SYVCH is the smallest of the three hospitals and the only federally-designated critical access hospital. |
| SchH_P06_S00_L07 | Schedule H, Part VI, Line 7 | Cottage Health System files an annual community benefit report in the State of California. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | Scholarships | TypeOfGrant |
| Number Of Recipients | 3 | NumberOfRecipients |
| Amount Of Cash Grant | 10000 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SchI_P01_S00_L02 | Identifier |
| Return Reference | Schedule I, Part I, Line 2 | ReturnReference |
| Explanation | Scholarship applications are reviewed before funds are disbursed and verification that the student has enrolled and paid for the semester is required before funds are disbursed. For auxiliary patient-account payments, a bill is received from the Business Office to verify amount. The payment is made directly to the hospital. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Elliot Prager MD | |||||||||||||
| 0 | 236762 | 0 | 0 | 0 | 3469 | 0 | 0 | 0 | 4273 | 0 | 244504 | 0 | 0 |
| Ronald C Werft | |||||||||||||
| 0 | 725498 | 0 | 249255 | 0 | 11147 | 0 | 604149 | 0 | 10255 | 0 | 1600304 | 0 | 0 |
| Steven A Fellows | |||||||||||||
| 0 | 423622 | 0 | 125335 | 0 | 29789 | 0 | 146448 | 0 | 10255 | 0 | 735449 | 0 | 0 |
| Joan Bricher | |||||||||||||
| 0 | 409331 | 0 | 98073 | 0 | 7524 | 0 | 231525 | 0 | 10255 | 0 | 756708 | 0 | 0 |
| Wende Cappetta | |||||||||||||
| 167324 | 0 | 29068 | 0 | 4301 | 0 | 21499 | 0 | 10255 | 0 | 232447 | 0 | 0 | 0 |
| Madeline Lozano | |||||||||||||
| 148538 | 0 | 0 | 0 | 9872 | 0 | 7920 | 0 | 10255 | 0 | 176585 | 0 | 0 | 0 |
| Gayle Mercado | |||||||||||||
| 142664 | 0 | 8733 | 0 | 3567 | 0 | 7748 | 0 | 10255 | 0 | 172967 | 0 | 0 | 0 |
| Denise Holmes | |||||||||||||
| 128532 | 0 | 8794 | 0 | 414 | 0 | 6887 | 0 | 10255 | 0 | 154882 | 0 | 0 | 0 |
| Mary Puryear | |||||||||||||
| 121455 | 0 | 10277 | 0 | 4159 | 0 | 6795 | 0 | 10255 | 0 | 152941 | 0 | 0 | 0 |
| Ricardo Gonzalez Menchaca | |||||||||||||
| 135222 | 0 | 0 | 0 | 400 | 0 | 6781 | 0 | 10255 | 0 | 152658 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| 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 | 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. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | California EM-1 Care | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | Board Member is presdident | Relationship |
| Amount Of Transaction | 263551 | AmountOfTransaction |
| Description Of Transaction | medical professional fees | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| F990_P06_S0A_L02 | Form 990, Part VI, Section A, Line 2 | J. Robert Andrews and Greg Faulkner; business relationship. |
| F990_P06_S0A_L06 | Form 990, Part VI, Section A, Line 6 | Cottage 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_L07a | Form 990, Part VI, Section A, Line 7a | Cottage 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_L07b | Form 990, Part VI, Section A, Line 7b | The 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_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 CEO prior to submitting to the Audit and Compliance Committee. Audit and Compliance Committee reviews and approves Form 990. All members of the Board receive a copy of the organization's form 990 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 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 and officer 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 all 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 | Governing documents can be obtained upon request from the Assistant Secretary of the Board. Tax filings can be obtained upon request from the CFO. Audited Financial Statements are attached to the Form 990 in accordance with IRS instructions. Conflict of Interest policy is available upon request from the Assistant Secretary of the Board. |
| F990_P07_S0A_L01a | Form 990, Part VII, Section A, Line 1a | As required by the instructions of Form 990, the compensation amounts for Ronald C. Werft, CEO, Steven A. Fellows, COO, Joan Bricher, CFO and Julie Artoux, Assistant Secretary are repeated on the Form 990 for all organizations for which they serve as officers. The following list provides the amount of time each employed officer listed in Part VII performed services for related organizations. Ronald C. Werft: Santa Barbara Cottage Hospital 24 hours, Goleta Valley Cottage Hospital 6 hours, Santa Ynez Valley Cottage Hospital 1 hour, Santa Barbara Cottage Hospital Foundation 9 hours; Steven A. Fellows: Santa Barbara Cottage Hospital 33 hours, Goleta Valley Cottage Hospital 6 hours, Santa Ynez Valley Cottage Hospital 1 hour, Santa Barbara Cottage Hospital Foundation 0 hours; Joan Bricher: Santa Barbara Cottage Hospital 30 hours, Goleta Valley Cottage Hospital 4 hours, Santa Ynez Valley Cottage Hospital 1 hour, Santa Barbara Cottage Hospital Foundation 5 hours; Julie Artoux: Santa Barbara Cottage Hospital 24 hours, Goleta Valley Cottage Hospital 6 hours, Santa Ynez Valley Cottage Hospital 1 hour, Santa Barbara Cottage Hospital Foundation 9 hours. |
| F990_P11_S00_L05 | Form 990, Part XI, Line 5 | OTHER CHANGES IN NET ASSETS INCLUDE: UNREALIZED LOSSES - ($17,598); CHANGE IN PENSION LIABILITY - ($542,561); CHANGE IN CRT - ($6,263); AUDIT ADJUSTMENT - $26 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Cottage Health System | |||||||||||
| PO Box 689 | Santa Barbara | CA | 931020689 | 770431902 | Parent organization for 3 hospitals and medical professional building | CA | 501 (C) (3) | 11b-II | N/A | 0 | |
| Santa Barbara Cottage Hospital | |||||||||||
| PO Box 689 | Santa Barbara | CA | 931020689 | 951644629 | Hospital | CA | 501 (C) (3) | 3 | 1 | Cottage Health System | |
| Goleta Valley Cottage Hospital | |||||||||||
| PO Box 689 | Santa Barbara | CA | 931020689 | 952413596 | Hospital | CA | 501 (C) (3) | 3 | 1 | Cottage Health System | |
| Santa Barbara Cottage Hospital Foundation | |||||||||||
| PO Box 689 | Santa Barbara | CA | 93102 | 953802238 | Fundraising | CA | 501 (C) (3) | 7 | 1 | Santa Barbara Cottage Hospital | |
| Goleta Valley Professional Buildings Inc | |||||||||||
| PO Box 689 | Santa Barbara | CA | 931020689 | 770004202 | Medical prof bldg | CA | 501 (C) (3) | 11b-II | 1 | Cottage Health System | |
| Santa Ynez Valley Cottage Hospital Foundation | |||||||||||
| 2050 Viborg Rd | Santa Barbara | CA | 934632220 | 953308522 | Fundraising | CA | 501(c)(3) | 7 | N/A | 0 | |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Villa Riviera Real Estate Company Inc | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 689 | AddressLine1 |
| City | Santa Barbara | City |
| State | CA | State |
| ZIP Code | 93102 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 272996284 | EIN |
| Primary Activity | Workforce Housing Developer | PrimaryActivity |
| Legal Domicile State | CA | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SBCHF | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | 0 | ShareOfTotalIncome |
| Share Of EOY Assets | 39324510 | ShareOfEOYAssets |
| Percentage Ownership | 1 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Santa Barbara Cottage Hospital | ||
| n | 809777 | accrual |
| Goleta Valley Cottage Hospital | ||
| n | 74726 | accrual |
| Santa Barbara Cottage Hospital | ||
| o | 2099391 | accrual |
| Santa Barbara Cottage Hospital | ||
| p | 60438 | accrual |
| Santa Barbara Cottage Hospital | ||
| q | 256493 | accrual |
| Santa Ynez Valley Cottage Hospital Foundation | ||
| c | 867000 | accrual |