2012-11-14T16:36:00-07:00 2011-12-31 990 2011-01-01 770431902 COTTAGE HEALTH SYSTEM COTT 8056827111 PO Box 689 Santa Barbara CA 93102 Joan Bricher 8056827111 2012-11-14 2011 2016-02-24 21:20:13Z Ronald C Werft Same as C above Santa Barbara CA 93102 52550291 0 X www.cottagehealthsystem.org X 1996 CA It is the mission of Cottage Health System to provide superior health care through a commitment to our Community and to our core values of excellence, integrity, and compassion. Cottage Health System is the sole corporate member for Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital and Santa Ynez Valley Cottage Hospital, Inc. 19 14 178 0 155208 5260 0 0 0 52110647 0 0 0 439644 0 52550291 0 0 0 0 0 25412783 0 0 0 0 27130115 0 52542898 0 7393 0 13165367 0 19005078 0 -5839711 X It is the mission of Cottage Health System to provide superior health care through a commitment to our Community and to our core values of excellence, integrity, and compassion. Cottage Health System is the sole corporate member for Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital and Santa Ynez Valley Cottage Hospital, Inc. 1 0 43366805 0 52395083 CHS provided management and administrative services to Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital, Santa Ynez Valley Cottage Hospital and Goleta Valley Professional Buildings, Inc. 0 0 0 43366805 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 96 0 0 178 1 1 1 0 0 0 0 0 0 0 0 0 X 19 14 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 1 0 CA X Karen L Jones 8056827111 PO Box 689 Santa Barbara CA 93102 X Steve Ainsley 2 X 0 0 0 J Robert Andrews Esq 3 X 0 0 0 Margaret Baker 2 X 0 0 0 Ed Birch PhD 3 X X 0 0 0 Jon Clark 2 X 0 0 0 Greg Faulkner Esq 2 X 0 0 0 Frederick Gluck 3 X 0 0 0 Judith Hopkinson 2 X 0 0 0 Angel Iscovich MD 3 X 0 0 0 Charles A Jackson 3 X 0 0 0 Alex Koper MD 2 X 450 24935 0 Jeffrey Kupperman MD 3 X 0 15013 0 Fred Lukas 2 X 0 0 0 Gretchen Milligan 4 X X 0 0 0 Robert Nakasone 3 X X 0 0 0 Robert Nourse 2 X 0 0 0 Elliot Prager MD 2 X 0 0 0 John Romo 2 X 0 0 0 Marshall Turner 2 X 0 0 0 Tom Watson MD 2 X 0 11725 0 Ronald C Werft 40 X 985900 0 0 Steven A Fellows 40 X 578747 0 0 Joan Bricher 40 X 514928 0 0 Julie Artoux 40 X 119146 0 0 Ed Wroblewski MD 40 X 458085 0 0 Patrice Ryan 40 X 302214 0 0 Ronald Biscaro 40 X 299180 0 0 Karen Jones Grandidier 40 X 335142 0 0 Suzanne Dalston 40 X 377874 0 0 Herbert Geary 40 X 331325 0 0 Lisa Moore 40 X 299850 0 0 Alberto Kywi 40 X 344244 0 0 Afshin Fatholahi 40 X 273462 0 0 Paul Erickson MD 40 X 253756 0 0 Sharon Lutz 40 X 227177 0 0 Kristin Tufvesson 40 X 211388 0 0 Armando Falcon 40 X 200544 0 0 David Dietrich 40 X 222242 0 0 6335654 51673 0 55 0 1 0 VITALIZE CONSULTING SOLUTIONS 248 MAIN STREET STE 101 READING MA 018673643 IT CONSULTING 3904445 ECLIPSYS SOLUTIONS CORPORATION PO BOX 8538133 PHILADELPHIA PA 191710133 IT CONSULTING 2904856 CIO SOLUTIONS LP 150 CASTILLIAN DRIVE GOLETA CA 93117 IT CONSULTING 1528548 SAGEWOOD SYSTEMS 2320 BATH STREET SUITE 305 SANTA BARBARA CA 93105 IT CONSULTING 1412238 TECHSTRATA LLC 575 ANTON BLVD STE 300 COSTA MESA CA 92626 IT CONSULTING 1095395 23 0 ADMIN REVENUE FROM TAX-EXEMPT AFFILIATES 900099 52110647 52110647 0 0 0 0 0 0 52110647 0 0 0 0 VRE ADMINISTRATIVE FEE REVENUE 900099 155208 0 155208 0 HR REVENUE 900099 253009 253009 0 0 COMMUNITY HEALTH REVENUE 900099 22073 22073 0 0 9354 9354 0 0 439644 52550291 52395083 155208 0 0 0 0 0 0 0 0 0 6620506 5627430 993076 0 0 0 0 0 9121673 6628883 2492790 0 1340760 1043680 297080 0 7416770 5756432 1660338 0 913074 729659 183415 0 0 0 0 0 197171 0 197171 0 1125 0 1125 0 0 0 0 0 0 0 0 0 0 0 3091408 2467338 624070 0 719315 575452 143863 0 1441422 1205487 235935 0 17030051 15327046 1703005 0 0 0 0 0 61452 55307 6145 0 187337 131749 55588 0 0 0 0 0 32221 25907 6314 0 0 0 0 0 0 0 0 0 3431582 3060172 371410 0 0 0 0 0 DUES AND SUBSCRIPTIONS 613923 498653 115270 EQUIPMENT MAINTENANCE 43710 35397 8313 0 279398 198213 81185 0 52542898 43366805 9176093 0 0 1110742 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2786268 34918110 26908700 0 8009410 0 0 0 0 0 0 0 0 0 1258947 0 13165367 0 4223296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14781782 0 19005078 X 0 -5839711 0 0 0 0 0 -5839711 0 13165367 X 7393 -5847104 X 0 1 1 X 0 X X 0 0 0 Santa Barbara Cottage Hospital 951644629 3 1 1 1 0 Goleta Valley Cottage Hospital 952413596 3 1 1 1 0 Santa Ynez Valley Cottage Hospital Inc 952224265 3 1 1 1 0 3 0 0 0 0 0 0 0 0 0 284831 41510 243321 0 34633279 26867190 7766089 0 0 0 0 8009410 DUE FROM AFFILIATES 781723 OTHER RECEIVABLES 118522 SERP RETIREMENT PLAN 358702 1258947 0 SELF INSURANCE LIABILITY 143000 MIMIMUM PENSION LIABILITY 3458156 RETIEREMENT PLAN - SERP AND HEALTH INSURANCE 10803682 DUE TO AFFILIATES 376944 14781782 SchD_P10_S00_L02 Schedule D, Part X, Line 2 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. X 1 1 X X X X 0 1 0 0 0 0 0 0 0 Ronald C Werft 725498 0 249255 0 11147 0 604149 0 10255 0 1600304 0 0 0 Steven A Fellows 423622 0 125335 0 29789 0 146448 0 10255 0 735449 0 0 0 Joan Bricher 409331 0 98073 0 7524 0 231525 0 10255 0 756708 0 0 0 Ed Wroblewski MD 406624 0 43937 0 7524 0 40174 0 10255 0 508514 0 0 0 Patrice Ryan 252376 0 46279 0 3559 0 29501 0 10255 0 341970 0 0 0 Ronald Biscaro 244323 0 42216 0 12641 0 28900 0 10255 0 338335 0 0 0 Karen Jones Grandidier 282391 0 50618 0 2133 0 31448 0 10255 0 376845 0 0 0 Suzanne Dalston 305019 0 45749 0 27106 0 31458 0 10255 0 419587 0 0 0 Herbert Geary 274955 0 44478 0 11893 0 31091 0 10255 0 372672 0 0 0 Lisa Moore 246737 0 41898 0 11215 0 29059 0 10255 0 339164 0 0 0 Alberto Kywi 283312 0 45866 0 15066 0 30905 0 10255 0 385404 0 0 0 Afshin Fatholahi 215990 0 38736 0 18736 0 26479 0 10255 0 310196 0 0 0 Paul Erickson MD 251566 0 0 0 2190 0 12250 0 10255 0 276261 0 0 0 Sharon Lutz 191208 0 33468 0 2501 0 24511 0 10255 0 261943 0 0 0 Kristin Tufvesson 183449 0 16171 0 11769 0 10569 0 10255 0 232213 0 0 0 Armando Falcon 200444 0 0 0 100 0 10027 0 10255 0 220826 0 0 0 David Dietrich 187745 0 8052 0 6096 0 10095 0 10255 0 222243 0 0 0 Elliot Prager MD 0 236762 0 0 0 3469 0 0 0 4273 0 244504 0 0 SchJ_P01_S00_L01a Schedule J, Part I, Line 1a Health club dues are paid for the CEO and COO. 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. Mullen & Henzel Partners in Law firm 120625 Legal Fees 0 F990_P03_S00_L02 Form 990, Part III, Line 2 In 2011, employees of Santa Barbara Cottage Hospital were transferred to Cottage Health System CHS so that most administrative/management functions were performed by CHS on behalf of Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital, Santa Ynez Valley Cottage Hospital and Goleta Valley Professional Buildings, Inc. F990_P06_S0A_L02 Form 990, Part VI, Section A, Line 2 J. Robert Andrews and Greg Faulkner, business relationship. F990_P06_S0B_L11b Form 990, Part VI, Section B, Line 11b Form 990 is prepared under the direction of the Vice President of Finance and CFO. Form 990 is reviewed by VP Finance, CFO and independent tax consultants prior to submitting to the Audit and Compliance Committee. All members of the Board receive a copy of the organization's form 990 for review prior to filing. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c The purpose of the Conflict of Interest policy is to protect the interest of the 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. Conflict of interest policy is availabe upon request. 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 CHANGE IN PENSION LIABILITY - ($4,077,906); SERP - ($1,006,114); RHI LIABILITY - ($763,084) Santa Barbara Cottage Hospital PO Box 689 Santa Barbara CA 93102 951644629 Hospital CA 501(c)(3) 3 Cottage Health System 1 Goleta Valley Cottage Hospital PO Box 689 Santa Barbara CA 93102 952413596 Hospital CA 501(c)(3) 3 Cottage Health System 1 Santa Ynez Valley Cottage Hospital Inc PO Box 689 Santa Barbara CA 93102 952224265 Hospital CA 501(c)(3) 3 Cottage Health System 1 Santa Barbara Cottage Hospital Foundation PO Box 689 Santa Barbara CA 93102 953802238 Fundraising CA 501(c)(3) 7 Santa Barbara Cottage Hospital 1 Goleta Valley Professional Buildings Inc PO Box 689 Santa Barbara CA 93102 770004202 Medical Professional Buidling CA 501(c)(3) 11b-II Cottage Health System 1 Villa Riviera Real Estate Company Inc PO Box 689 Santa Barbara CA 93102 272996284 Workforce housing developer CA Santa Barbara Cottage Hospital Foundation C 0 39324510 1 0 0 0 1 1 0 0 0 0 0 1 1 0 1 1 1 1 1 Santa Barbara Cottage Hospital d 7500000 accrual Santa Barbara Cottage Hospital e 9000000 accrual Santa Barbara Cottage Hospital k 45452134 accrual Santa Barbara Cottage Hospital l 310874 accrual Santa Barbara Cottage Hospital n 394474 accrual Santa Barbara Cottage Hospital o 10600709 accrual Santa Barbara Cottage Hospital p 102698 accrual Santa Barbara Cottage Hospital q 22527273 accrual Santa Barbara Cottage Hospital r 14033986 accrual Santa Barbara Cottage Hospital Foundation k 1016215 accrual Santa Barbara Cottage Hospital Foundation r 2369513 accrual Goleta Valley Cottage Hospital k 4360749 accrual Goleta Valley Cottage Hospital o 63833 accrual Santa Ynez Valley Cottage Hospital Inc k 882659 accrual