2012-11-14T15:16:58-07:00 2011-12-31 990 2011-01-01 952413596 GOLETA VALLEY COTTAGE HOSPITAL GOLE 8056827111 PO BOX 689 SANTA BARBARA CA 931020689 JOAN BRICHER 8055697294 2012-11-14 2011 2016-02-24 21:20:13Z Ronald C Werft Same as above Santa Barbara CA 93102 73667332 0 X WWW.COTTAGEHEALTHSYSTEM.ORG X 1965 CA It is the mission of Goleta Valley Cottage Hospital to provide superior health care through a commitment to our Community and to our core values of excellence, integrity, and compassion. The volunteer Board of Directors uses these core values to make decisions that will improve health care access, affordability and quality. 19 14 384 80 0 0 264304 243241 63123502 65715579 705998 606773 333210 345016 64427014 66910609 124000 148000 0 0 28174903 29933346 0 0 0 24930977 26719792 53229880 56801138 11197134 10109471 71525247 84849918 26107066 32802546 45418181 52047372 It is the mission of Goleta Valley Cottage Hospital to provide superior health care through a commitment to our Community and to our core values of excellence, integrity, and compassion. The volunteer Board of Directors uses these core values to make decisions that will improve health care access, affordability and quality. 0 0 44621959 148000 67809751 Goleta Valley Cottage Hospital is a 122-bed acute-care hospital located in the City of Goleta. In 2011, the Hospital had 15,049 patient days and served 39,803 outpatients, including emergency services to 18,373 patients. The Hospital provides a wide array of inpatient and outpatient services, including but not limited to cardiac, orthopedic, wound care, breast care, emergency and subacute services. Goleta Valley Cottage Hospital provides emergency services to anyone seeking care, regardless of their ability to pay. All patients who do not present third-party insurance are automatically screened for eligibility in government health programs and are assisted in applying for charity if the patient does not qualify for any other assistance. To ensure that every member of the community has access to healthcare Goleta Valley Cottage Hospital offers full charity care to all patients whose income level is at or below 350% of the Federal Poverty Level (FPL). Discounted care is also available for families who make up to 542% of the FPL. Due to the formalized expansion of the charity care program, patients who do not have access to a third-party insurer now have a process to apply for charity care for their outpatient procedure. In 2011 , Goleta Valley Cottage Hospital provided 289 patients with financial assistance. 0 0 0 44621959 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 76 0 1 384 1 0 0 0 0 0 0 0 0 0 0 X 19 14 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 1 1 0 CA X Karen Jones 8056827111 400 West Pueblo Santa Barbara CA 93105 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 3000 22385 0 Jeffrey Kupperman MD 3 X 2500 12513 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 240231 0 John Romo 2 X 0 0 0 Marshall Turner 2 X 0 0 0 Tom Watson MD 2 X 11525 200 0 Ronald C Werft 40 X 0 985900 614404 Steven A Fellows 40 X 0 578747 156703 Joan Bricher 40 X 0 514928 241780 Julie Artoux 40 X 0 119146 16212 Diane Wisby 40 X 285604 0 39561 Susan San Marco 40 X 180027 0 19256 Dennis Mc Daniel 40 X 172620 0 18886 Lisa La Bouve 40 X 172497 0 18880 Rosemary Bray 40 X 155162 0 18013 Rosemarie Jones 40 X 153838 0 17947 1136773 2474050 1161642 62 0 1 0 HOSPITAL BUILDING & EQUIP CO 11330 OLIVE BLVD ST LOUIS MO 63141 GENERAL CONTRACTOR/ARCHITECT 1133119 PACIFIC MATERIALS LAB PO BOX 96 GOLETA CA 93116 INSPECTION SERVICES 1037637 ANESTHESIA ASSOC MED GROUP INC 5333 HOLLISTER AVE 130 SANTA BARBARA CA 93111 PHYSICIAN SERVICES 730000 COMFORCE PO BOX 31001-0893 PASADENA CA 911100893 CONTRACT LABOR 663791 MICHAEL L DAVIS & ASSOCIATES INC 1835 NEWPORT BLVD A 109 SUITE 361 COSTA MESA CA 92627 INSPECTION SERVICES 503868 10 0 0 0 0 0 243241 0 243241 NET PATIENT SERVICE REVENUE 900099 65380032 65380032 0 0 HOSPITAL MEDI-CAL SUPPLEMENTAL FEE 900099 335547 335547 0 0 0 0 0 0 65715579 393768 0 0 393768 0 0 0 0 0 0 0 0 0 0 6969728 0 6756723 0 213005 0 213005 0 0 213005 0 CAFETERIA REVENUE 722210 231454 231454 0 0 ED MALPRACTICE REIMBURSEMENT 900099 82074 82074 0 0 REBATES AND REFUNDS 900099 12840 12840 0 0 18648 18648 0 0 345016 66910609 66060595 0 606773 148000 148000 0 0 0 0 0 0 330665 281065 49600 0 0 0 0 0 20066955 16098418 3968537 0 1511338 1213473 297865 0 6491790 5049826 1441964 0 1532598 1289675 242923 0 4320025 1999368 2320657 0 4153 0 4153 0 114890 0 114890 0 14575 0 14575 0 0 0 105073 0 105073 0 5503335 4069561 1433774 0 7797 4772 3025 0 1279413 507031 772382 0 70342 55647 14695 0 0 0 0 0 1072054 849332 222722 0 9548 8130 1418 0 0 0 0 0 2734 1640 1094 0 7 0 7 0 0 0 0 0 2373058 2049107 323951 0 513259 0 513259 0 MEDICAL SUPPLIES 9969148 9969148 0 0 HOSPITAL FEE PROGRAM 575226 575226 0 0 EQUIPMENT MAINTENANCE 558612 439115 119497 0 LICENSES 84031 12875 71156 0 142512 550 141962 0 56801138 44621959 12179179 0 2227399 1549395 7807270 962117 0 0 9380757 10454077 0 0 0 0 0 0 460375 564500 559308 543843 84693094 23130553 38017292 61562541 8406472 6193371 3779155 2734471 0 0 0 0 887219 285603 71525247 84849918 6877229 8313913 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19229837 24488633 26107066 32802546 X 45418181 51837372 0 210000 0 0 45418181 52047372 71525247 84849918 X 10109471 -3480280 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 14575 14575 0 SchC_P2B_S00_L01 Schedule C, Part II-B, Line 1 Lobbying Activities are calculated as a percentage of dues paid to various organizations. 0 0 0 0 14555087 14464191 90896 0 2301834 1983658 318176 0 11647017 6319323 5327694 0 56189156 363381 55825775 61562541 0 SELF INSURANCE LIABILITY 2693594 MINIMUM PENSION LIABILITY 2891976 RETIREMENT PLAN - SERP 51325 DUE TO AFFILIATES 2589958 DUE TO THIRD PARTIES 179026 GVCH ALLOCATION OF TAX EXEMPT DEBT 16082754 24488633 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. 1 1 X 1 X 3.5 1 X 5.42 1 1 1 0 1 1 563802 0 563802 0.00993 14764780 10606373 4158407 0.07321 336517 102238 234279 0.00412 0 0 15665099 10708611 4956488 0.08726 10005 10005 0.00017 48000 48000 0.00085 100000 100000 0.00176 0 0 158005 0 158005 0.00278 0 0 15823104 10708611 5114493 0.09004 1 725187 0 10175717 13510628 -3334911 X 1 1 1 1 Goleta Valley Cottage Hospital

351 South Patterson Goleta CA 93111

X X X Goleta Valley Cottage Hospital 1 0 1 1 350 1 542 1 X X X 1 1 X X 1 0 1 X 0 0 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_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 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. 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 Goleta Community has access to high-quality, affordable healthcare. The Board of Directors is actively involved in the Hospital's strategic decisions and takes its commitment to the Community very seriously. The Board approves of an annual financial budget and ten-year financial plan to guarantee the Hospital will continue to offer hospital services to the Community for years to come. The Board also approves of annual top goals that are consistent with the mission, vision and values of the Hospital. The financial forethought of the Board of Directors resulted in surplus funds that are being used to rebuild the facility. Goleta Valley Cottage Hospital is building a new hospital in order to comply with the unfunded mandate of the State of California's Senate Bill 1953 (SB1953), which requires all hospitals to retrofit or rebuild in order to withstand a major earthquake. The Hospital used this opportunity to live the core value of excellence by ensuring that the new facility will meet the current and future healthcare needs of the Community. Goleta Valley Cottage Hospital works cooperatively with the open medical staff to improve healthcare in the community. The Hospital is exploring how to better align with physicians in order to provide the highest quality of care. SchH_P06_S00_L06 Schedule H, Part VI, Line 6 Cottage Health System (CHS) is the parent organization of Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital, Santa Ynez Valley Cottage Hospital and Goleta Valley Professional Buildings, Inc. These organizations have a common Board of Directors. Cottage Health System Hospitals are the sole hospital providers in the Community and strategic plans are created with all the Hospitals and their Communities in mind. Goleta Valley Cottage Hospital is the second largest of the CHS Hospitals and primarily provides services to the City of Goleta (adjacent to Santa Barbara) and the University of California, Santa Barbara. SchH_P06_S00_L07 Schedule H, Part VI, Line 7 California 1 CALIFORNIA STATE UNIVERSITY CHANNEL ISLANDS FOUNDATION ONE UNIVERSITY DRIVE CAMARILLO CA 93012 770433230 government 48000 0 CASH PLEDGE FOR THE ESTABLISHMENT OF A BACHELOR OF SCIENCE NURSING PROGRAM IN SANTA BARBARA SANTA BARBARA NEIGHBORHOOD CLINICS 1900 STATE ST SUITE G SANTA BARBARA CA 93101 770496382 501(c)(3) 100000 0 CASH SUPPORTS DENTAL CLINIC, AN IDENTIFIED COMMUNITY NEED, AS WELL AS THE "CARE FOR EVERY CHILD" PROGRAM WHICH PROVIDES EDUCATION IN HEALTHY LIFE STYLE AND PREVENTATIVE CARE. 2 0 SchI_P01_S00_L02 Schedule I, Part I, Line 2 Grant funds are monitored through the Community Health Coordinating Committee of CHS. Grantees are required to submit a report in June of each year that is reviewed by the committee prior to entire amount of funds being disbursed. X X X X 0 1 0 0 0 0 0 0 0 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 Diane Wisby 238641 0 41571 0 5392 0 29306 0 10255 0 325165 0 0 0 Susan San Marco 165873 0 13661 0 492 0 9001 0 10255 0 199282 0 0 0 Dennis Mc Daniel 171617 0 0 0 1003 0 8631 0 10255 0 191506 0 0 0 Lisa La Bouve 157392 0 11797 0 3307 0 8625 0 10255 0 191376 0 0 0 Rosemary Bray 145075 0 8785 0 1303 0 7758 0 10255 0 173176 0 0 0 Rosemarie Jones 153335 0 0 0 504 0 7692 0 10255 0 171786 0 0 0 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. 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 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. Conflict of Interest policy is available 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. 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 UNREALIZED GAINS - ($556,769); CHANGE IN EQUITY INTEREST IN ALTERNATIVE INVESTMENTS -($111,277); CHANGE IN MINIMUM PENSION LIABILITY - ($2,812,297); AUDIT ADJUSTMENT TO FUND BALANCE - $63 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 Cottage Health System 1 Santa Ynez Valley Cottage Hospital PO Box 689 Santa Barbara CA 931020689 952224265 Hospital CA 501 (C) (3) 3 Cottage Health System 1 Santa Barbara Cottage Hospital Foundation PO Box 689 Santa Barbara CA 931020689 953802238 Foundation to support Santa Barbara Cottage Hospital CA 501 (C) (3) 7 Santa Barbara Cottage Hospital 1 Goleta Valley Professional Buildings Inc PO Box 689 Santa Barbara CA 931020689 770004202 Medical prof bldg CA 501 (C) (3) 11b-II Cottage Health System 1 Goleta Valley Cottage Hospital Foundation 350 South Patterson Santa Barbara CA 93111 770004202 Fundraising CA 501(c)(3) 7 N/A 0 Villa Riviera Real Estate Company Inc PO Box 689 Santa Barbara CA 93102 272996284 Workforce Housing Developer CA SBCHF C 0 39324510 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 1 1 1 Santa Barbara Cottage Hospital m 123720 accrual Santa Barbara Cottage Hospital n 2852230 accrual Santa Barbara Cottage Hospital o 32127676 accrual Santa Barbara Cottage Hospital p 2744872 accrual Santa Barbara Cottage Hospital q 1364117 accrual Santa Barbara Cottage Hospital r 741901 accrual Santa Barbara Cottage Hospital Foundation i 159084 accrual Goleta Valley Professional Buildings Inc i 148253 accrual Santa Barbara Cottage Hospital Foundation p 100423 accrual Santa Ynez Valley Cottage Hospital n 74726 accrual Goleta Valley Cottage Hospital Foundation o 100423 Accrual