FURP.ORG / PUBLIC DATA EXPLORER

GOLETA VALLEY COTTAGE HOSPITAL: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
GOLETA VALLEY COTTAGE HOSPITAL (EIN 95-2413596)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-14
IRS object ID
201113199349310851
Schema version
2010v3.4
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-11-14T21:23:48-07:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN952413596EIN

Name Name

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

US Address USAddress

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

Officer Officer

FieldValueIRS element (for citing)
NameJOAN BRICHERName
TitleSENIOR VICE PRESIDENT AND CFOTitle
Phone8055697294Phone
Date Signed2011-11-15DateSigned
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

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

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1Same as C aboveAddressLine1
CitySanta BarbaraCity
StateCAState
ZIP Code93105ZIPCode
FieldValueIRS element (for citing)
Gross Receipts68155233GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.COTTAGEHEALTHSYSTEM.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1965YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionIt is the mission of Goleta Valley Cottage Hospital to provide superior health care through a commitment to our Community and to our core values of excellence, integrity, and compassion. The volunteer Board of Directors uses these core values to make decisions that will improve health care access, affordability and quality.ActivityOrMissionDescription
Nbr Voting Members Governing Body17NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees356TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year157000ContributionsGrantsPriorYear
Contributions Grants Current Year264304ContributionsGrantsCurrentYear
Program Service Revenue Prior Year56563321ProgramServiceRevenuePriorYear
Program Service Revenue CY63123502ProgramServiceRevenueCY
Investment Income Prior Year-672253InvestmentIncomePriorYear
Investment Income Current Year705998InvestmentIncomeCurrentYear
Other Revenue Prior Year351940OtherRevenuePriorYear
Other Revenue Current Year333210OtherRevenueCurrentYear
Total Revenue Prior Year56400008TotalRevenuePriorYear
Total Revenue Current Year64427014TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY124000GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year26328505SalariesEtcPriorYear
Salaries Etc Current Year28174903SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year21170380OtherExpensePriorYear
Other Expenses Current Year24930977OtherExpensesCurrentYear
Total Expenses Prior Year47498885TotalExpensesPriorYear
Total Expenses Current Year53229880TotalExpensesCurrentYear
Revenues Less Expenses Prior Year8901123RevenuesLessExpensesPriorYear
Revenues Less Expenses CY11197134RevenuesLessExpensesCY
Total Assets BOY50630377TotalAssetsBOY
Total Assets EOY71525247TotalAssetsEOY
Total Liabilities BOY17956863TotalLiabilitiesBOY
Total Liabilities EOY26107066TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY32673514NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY45418181NetAssetsOrFundBalancesEOY
Mission DescriptionIt is the mission of Goleta Valley Cottage Hospital to provide superior health care through a commitment to our Community and to our core values of excellence, integrity, and compassion. The volunteer Board of Directors uses these core values to make decisions that will improve health care access, affordability and quality.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense42978204Expense
Grants124000Grants
Revenue63456712Revenue
DescriptionGoleta Valley Cottage Hospital is a 122-bed acute-care hospital located in the City of Goleta. In 2010, the Hospital had 16,151 patient days and served 41,074 outpatients, including emergency services to 17,261 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. Community outreach efforts for Cottage Health System in 2010 focused on five health areas: cancer, heart disease and stroke, children's health, seniors' health, along with prevention and wellness. Activities in these areas included screenings and health fairs; classes, clinics, lectures, and seminars; community services; community collaborations; and coalitions/committees. Cottage Health System, which includes Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital and Santa Ynez Valley Cottage Hospital, provides critical funding for community health, charity care, and external grants, while also realizing shortfalls in Medicare, Medi-Cal, and indigent care. In 2010, Cottage Health System spent nearly $105 million on these programs. 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 543% of the FPL. Due to the formalized expansion of the charity care program, patients who do not have access to a third-party insurer now have a process to apply for charity care for their outpatient procedure. In 2010, 285 patients qualified for financial assistance.Description
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense42978204TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached0FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109663NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees356NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members17NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs1ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonKaren JonesNamePerson
Telephone Number8056827111TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1Pueblo at Bath StreetAddressLine1
CitySanta BarbaraCity
StateCAState
ZIP Code93105ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
J Robert Andrews Esq
Board Member3X000
Margaret Baker
Board Member2X000
Jon Clark
Board Member2X000
Judith Hopkinson
Board Member2X000
Angel Iscovich MD
Board Member3X000
Charles A Jackson
Board Member3X000
Alex Koper MD
Board Member2X0150800
John Romo
Board Member2X000
Robert Nourse
Board Member2X000
Marshall Turner
Board Member2X000
Tom Watson MD
Board Member2X0172930
Fred Lukas
Board Member2X000
Jeffrey Kupperman MD
Secretary3X30000286780X
Robert Nakasone
Vice Chair3X000X
Ed Birch PhD
Vice Chair3X000X
Frederick Gluck
Treasurer3X000X
Gretchen Milligan
Chairman4X000X
Ronald C Werft
President & CEO60965143599725X
Steven A Fellows
COO60561677147378X
Joan Bricher
CFO40505806233530X
Julie Artoux
Assistant Secretary6010834813238X
Diane Wisby
Vice President40311243036590X
Lisa La Bouve
Clinical Manager40160771015859X
Rosemary Bray
Clinical Manager40152590015450X
Dennis Mc Daniel
Clinical Manager40156140015628X
Irene Mindo
Clinical Nurse II40146860015164X
Rosemarie Jones
Clinical Resource Nurse40151587015400X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1109191TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2202025TotalReportableCompFrmRltdOrgs
Total Other Compensation1107962TotalOtherCompensation
Number Individuals GT100 K51NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensationAddress Line2AddressOfContractor/AddressUS/AddressLine2
HOSPITAL BUILDING & EQUIP CO
11330 OLIVE BLVDST LOUISMO63141GENERAL CONTRACTOR/ARCHITECT1250454
ANESTHESIA ASSOC MED GROUP INC
5333 HOLLISTER AVE 130SANTA BARBARACA93111PHYSICIAN730000
COMFORCE
PO BOX 31001-0893PASADENACA911100893NURSING566170
DIVERSIFIED CLINICAL SERVICES
PO BOX 850001ORLANDOFL32885PHYSICIAN667890
MNS ENGINEERS INC
201 N CALLE CESAR CHAVEZSANTA BARBARACA93103ENGINEER514182SUITE 300
FieldValueIRS element (for citing)
Number Of Contractors GT100 K12NumberOfContractorsGT100K
Federated Campaigns0FederatedCampaigns
Membership Dues0MembershipDues
Fundraising Events0FundraisingEvents
Related Organizations0RelatedOrganizations
Government Grants0GovernmentGrants
All Other Contributions264304AllOtherContributions
Noncash Contributions0NoncashContributions
Total Contributions264304TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
NET PATIENT SERVICE REVENUE90009962188325621883250$0
HOSPITAL MEDI-CAL SUPPLEMENTAL FEE9000998801898801890$0
REFERENCE TESTING - PDL90009954988549880$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue63123502TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column326546TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$326,546ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

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

Royalties Revenue RoyaltiesRevenue

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

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities4107671Securities
Other0Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities3728219Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities379452Securities
Other0Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column379452TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$379,452ExclusionAmount
FieldValueIRS element (for citing)
Cntrbtns Rprtd Fundraising Events0CntrbtnsRprtdFundraisingEvents

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
CAFETERIA REVENUE9000992157732157730$0
ED MALPRACTICE REIMBURSEMENT90009978469784690$0
REBATES AND REFUNDS90009926416264160$0

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column12552TotalRevenueColumn
Related Or Exempt Function Income12552RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue333210TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column64427014TotalRevenueColumn
Related Or Exempt Function Income63456712RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$705,998ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total124000Total
Program Services124000ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total347833Total
Program Services243483ProgramServices
Management And General104350ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

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

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total19705692Total
Program Services14608350ProgramServices
Management And General5097342ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1157789Total
Program Services858484ProgramServices
Management And General299305ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total5534418Total
Program Services3972656ProgramServices
Management And General1561762ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1429171Total
Program Services1194317ProgramServices
Management And General234854ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Management FeesForServicesManagement

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

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total3092Total
Program Services0ProgramServices
Management And General3092ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total79506Total
Program Services0ProgramServices
Management And General79506ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total10495Total
Program Services0ProgramServices
Management And General10495ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total56869Total
Program Services0ProgramServices
Management And General56869ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5676905Total
Program Services4442168ProgramServices
Management And General1234737ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total13415Total
Program Services1598ProgramServices
Management And General11817ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total11361106Total
Program Services10526763ProgramServices
Management And General834343ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total60404Total
Program Services44728ProgramServices
Management And General15676ManagementAndGeneral
Fundraising0Fundraising

Royalties Royalties

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

Occupancy Occupancy

FieldValueIRS element (for citing)
Total965982Total
Program Services715156ProgramServices
Management And General250826ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total7898Total
Program Services3883ProgramServices
Management And General4015ManagementAndGeneral
Fundraising0Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

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

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total809Total
Program Services0ProgramServices
Management And General809ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total55Total
Program Services0ProgramServices
Management And General55ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

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

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2604607Total
Program Services2297048ProgramServices
Management And General307559ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total-79265Total
Program Services0ProgramServices
Management And General-79265ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
PROVISIONS FOR BAD DEBT1724383172438300
HOSPITAL FEE PROGRAM1709592170959200
EQUIPMENT MAINTENANCE600157503510966470
LICENSES617086970547380
DUES AND SUBSCRIPTIONS545491115534340

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total18710Total
Program Services0ProgramServices
Management And General18710ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total53229880Total
Program Services42978204ProgramServices
Management And General10251676ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY-47793BOY
EOY2227399EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY10292668BOY
EOY7807270EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY6759670BOY
EOY9380757EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY453566BOY
EOY460375EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY467007BOY
EOY559308EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis60955109LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec22937817LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY24536167BOY
EOY38017292EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY5724461BOY
EOY8406472EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY2166192BOY
EOY3779155EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY278439BOY
EOY887219EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY50630377BOY
EOY71525247EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY5310443BOY
EOY6877229EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY12646420BOY
EOY19229837EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY17956863BOY
EOY26107066EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY32673514BOY
EOY45418181EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY32673514BOY
EOY45418181EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY50630377BOY
EOY71525247EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses11197134ReconcilationRevenueExpenses
Reconcilation Other Changes1547533ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations1RalliesDemonstrations
Rallies Demonstrations$10,495RalliesDemonstrationsAmount
Other Activities0OtherActivities
Total Lobbying Expenditures IIB10495TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierSchC_P2B_S00_L01Identifier
Return ReferenceSchedule C, Part II-B, Line 1ReturnReference
ExplanationLOBBYING ACTIVITIES ARE CALCULATED AS A PERCENTAGE OF DUES PAID TO VARIOUS ORGANIZATIONS.Explanation

Schedule D IRS990ScheduleD

Land Land

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

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis14499493OtherCostOrOtherBasis
Depreciation13930766Depreciation
Book Value568727BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis2229108OtherCostOrOtherBasis
Depreciation1438958Depreciation
Book Value790150BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis13593610OtherCostOrOtherBasis
Depreciation7204796Depreciation
Book Value6388814BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis30632898OtherCostOrOtherBasis
Depreciation363297Depreciation
Book Value30269601BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings38017292TotalOfBookValueLandBuildings

Financial Derivatives FinancialDerivatives

FieldValueIRS element (for citing)
Book Value0BookValue

Closely Held Equity Interests CloselyHeldEquityInterests

FieldValueIRS element (for citing)
Book Value3779155BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities3779155TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
SELF INSURANCE LIABILITY$1,897,941
MINIMUM PENSION LIABILITY-$1,441,744
RETIREMENT PLAN - SERP$34,888
DUE TO AFFILIATES$2,611,029
DUE TO THIRD PARTIES$44,969
GVCH ALLOCATION OF TAX EXEMPT DEBT$16,082,754
FieldValueIRS element (for citing)
Total Of Amounts19229837TotalOfAmounts

Schedule H IRS990ScheduleH

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

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage3.50FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage5.43DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense355466TotalCommunityBenefitExpense
Net Community Benefit Expense355466NetCommunityBenefitExpense
Percent Of Total Expense0.0069PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense14497866TotalCommunityBenefitExpense
Direct Offsetting Revenue11221387DirectOffsettingRevenue
Net Community Benefit Expense3276480NetCommunityBenefitExpense
Percent Of Total Expense0.0636PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense295165TotalCommunityBenefitExpense
Net Community Benefit Expense295165NetCommunityBenefitExpense
Percent Of Total Expense0.0057PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense15148497TotalCommunityBenefitExpense
Direct Offsetting Revenue11221387DirectOffsettingRevenue
Net Community Benefit Expense3927111NetCommunityBenefitExpense
Percent Of Total Expense0.0762PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense24000TotalCommunityBenefitExpense
Net Community Benefit Expense24000NetCommunityBenefitExpense
Percent Of Total Expense0.0005PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense100000TotalCommunityBenefitExpense
Net Community Benefit Expense100000NetCommunityBenefitExpense
Percent Of Total Expense0.0019PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense124000TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense124000NetCommunityBenefitExpense
Percent Of Total Expense0.0024PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense15272497TotalCommunityBenefitExpense
Direct Offsetting Revenue11221387DirectOffsettingRevenue
Net Community Benefit Expense4051111NetCommunityBenefitExpense
Percent Of Total Expense0.0786PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$617,408BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare8774710AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare11604751CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-2830041MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

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

Address Address

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

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Goleta Valley Cottage HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchH_P01_S00_L06aSchedule H, Part I, Line 6aCottage Health System
SchH_P01_S00_L07Schedule H, Part I, Line 7The cost-to-charge ratio was used determine unreimbursed services provided to patients. The amounts reported represent all hospital segments including inpatient, outpatient, and emergency department. All health plans including Medicare, Medicaid and private insurance are also accounted for. The cost-to-charge ratio, specific to the services rendered, is also used to determine the cost of charity care provided to patients.
SchH_P01_S00_L072fSchedule H, Part I, Line 7, Column f$1,724,383 in bad debt expense was deducted from net expenses for purposes of calculating community benefit percentages.
SchH_P01_S00_L07gSchedule H, Part I, Line 7gThe Hospital provides subacute and outpatient wound care services to the Community, despite a financial loss of negligible profit margin. These losses are not broken out, but are included in the Medi-Cal and Medicare shortfalls. The Subacute Unit at the Hospital has the capacity for up to 35 residents needing subacute level of care, including patients who have tracheostomies and may be on ventilators, patients with feeding tubes, and patients who are compromised in two or more activities of daily living as a result of illness or trauma. Subacute services are offered to the Community at a financial loss to the Hospital. Wound care services are specifically designed to combine wound care with ongoing health care as most problem wounds are often associated with other underlying medical conditions such as diabetes or heart disease. At the request of referring physicians, patients enter an appropriate outpatient program for evaluation and individualized care and treatment. Patients who meet the income guidelines are eligible for financial assistance. Wound care services are provided to the Community though there is almost no financial benefit to the hospital.
SchH_P03_S0A_L04Schedule H, Part III, Section A, Line 4No note in audited financial statements regarding bad debt. Bad debt is not included in the community benefit report. Bad debt expense is dervied from the cost to charge ratios.
SchH_P03_S0B_L08Schedule H, Part III, Section B, Line 8These are significant losses for our organization and they provide a tremendoues benefit to our community as do the other government programs that do not cover the cost of care for the patients served. The cost to charge ratio was used to determine unreimbursed services to patients with a third-party payer. The amounts reported represent all hospital segments.Medicare allowable costs are derived from the hospital's cost report, as summarized on W/S D-1 Part II (Inpatient) and W/S D Part V (Outpatient). Total expenses from the general ledger are separated into reimbursable and non-reimbursable cost centers. Adjustments are applied to eliminate additional non-reimbursable costs and to offset revenue recoveries against certain costs. Overhead costs (capital, administrative and general, etc) are allocated to each revenue-generating reimbursable cost center on a statistical basis. Total costs (direct and allocated) for all revenue-generating departments are compared to total charges (gross revenues) for each department to determine a departmental cost-to-charge ratio. These cost-to-charge ratios are used to derive Medicare allowable costs for each department, by multiplying these ratios by total Medicare charges as summarized on provider statistical and reimbursement system (PS&R) reports provided by the Medicare fiscal intermediary.
SchH_P03_S0C_L09bSchedule H, Part III, Section C, Line 9bThe community service policy is followed for all patient types. If a patient is known to qualify for charity care, their account is written down to zero and they do not proceed through the formal collection process
SchH_P06_S00_L02Schedule H, Part VI, Line 2In 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 our own focus areas and then next reviewed our 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 included questions regarding community needs. Cottage Health System also held a brainstorming session with 20 different hospital departments, and the Community Health Coordinating Committee provided input. After reviewing all of the information, Cottage Health System determined the greatest needs to be children's health, seniors' health, cancer, heart disease and stroke and prevention and wellness.
SchH_P06_S00_L03Schedule H, Part VI, Line 3Goleta Valley Cottage Hospital (GVCH) has a mulit-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 to assist patient in determining eligibility for government-sponsored insurance programs and assist with the application process at no cost to the patient. Patient Financial Counselors who answer customer service calls are instructed to offer charity care applications to all patients who indicate they have financial need.
SchH_P06_S00_L04Schedule H, Part VI, Line 4Santa Barbara County 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_L05Schedule H, Part VI, Line 5The Board of Directors is made up of prominent community members who volunteer their time to ensure that the Santa Barbara 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.
SchH_P06_S00_L06Schedule H, Part VI, Line 6Cottage Health System (CHS) is the parent organization of Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital and Santa Ynez Valley Cottage Hospital. These organizations have a common Board of Directors. Cottage Health System Hospitals are the sole hospital providers in the Community and strategic plans are created with all the Hospitals and their Communities in mind. Goleta Valley Cottage Hospital is the second largest of the CHS Hospitals and primarily provides services to the City of Goleta (adjacent to Santa Barbara) and the University of California, Santa Barbara.
SchH_P06_S00_L07Schedule H, Part VI, Line 7California

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationPurpose Of GrantPurposeOfGrant
SANTA BARBARA NEIGHBORHOOD CLINICS
1900 STATE ST SUITE GSANTA BARBARACA93101770496382501(c)(3)1000000CASHSupports Dental Clinic, an identified community need.
CALIFORNIA STATE UNIVERSITY CHANNEL ISLANDS FOUNDATION
ONE UNIVERSITY DRIVECAMARILLOCA93012770433230501(c)(3)240000CASHPLEDGE FOR THE ESTABLISHMENT OF A BACHELOR OF SCIENCE NURSING PROGRAM IN SANTA BARBARA.
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierSchI_P01_S00_L02Identifier
Return ReferenceSchedule I, Part I, Line 2ReturnReference
ExplanationThe Community Health Coordinating Committee (CHCC) serves as a resource and driving force for the health system's community outreach. The Committee is comprised of representation from the following Cottage departments: Administration, Compliance, Education, Finance, Nutrition, Parish Nursing, Psychiatric Services, Public Affairs, Reeves Library, Rehabilitation Hospital, Trauma Services, Volunteer Services, and Wound Care. During 2009, the committee began writing of a first-time Community Benefit Plan, which received Board approval in early 2010. The committee recommends grants and reviews six month progress reports. Funding is dispersed in quarterly increments and is contingent upon the six month review.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Ronald C Werft
070093902507180134870591904078210156486900
Steven A Fellows
04099330120408031336013955707821070905500
Joan Bricher
040223509617107400022570907821073933600
Diane Wisby
242662043047025534028769078210347833000
Lisa La Bouve
148133012458018008039078210176631000
Rosemary Bray
1385460127340131107630078210168042000
Dennis Mc Daniel
15123101580475107807078210171768000
Irene Mindo
1462020158049907343078210162023000
Rosemarie Jones
1508620158056807579078210166988000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchJ_P01_S00_L03Schedule J, Part I, Line 3On an annual basis the Executive Compensation Committee (ECC) of the Board of Directors meets to determine appropriate compensation for executives, including the CEO, COO, CFO, and vice presidents. All members of the ECC are independent members of the Board of Directors. The ECC engages an independent consultant to prepare comparative compensation reports for each position. The executive's individual performance will also be considered when determining compensation. The ECC recommends compensation for the executives to the full Board for approval. This process takes place annually for all executives.
SchJ_P01_S00_L04Schedule J, Part I, Line 4The amounts reported in the current year's deferred compensation includes recognition of past service expense. 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. No payouts were made in 2010.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P06_S0A_L02Form 990, Part VI, Section A, Line 2Robert Nourse and Robert Nakasone business relationship
F990_P06_S0A_L04Form 990, Part VI, Section A, Line 4Amended articles of incorporation to be consistent with California code on dissolution clause.
F990_P06_S0A_L06Form 990, Part VI, Section A, Line 6Cottage Health System is the sole corporate member of Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital, Santa Ynez Valley Cottage Hospital and Goleta Valley Professional Buildings, Inc.
F990_P06_S0A_L07aForm 990, Part VI, Section A, Line 7aCottage Health System is the sole corporate member of Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital and Goleta Valley Professional Buildings, Inc and can appoint Directors to the Board.
F990_P06_S0A_L07bForm 990, Part VI, Section A, Line 7bThe Board of Directors for Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital 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_L11aForm 990, Part VI, Section B, Line 11aForm 990 is prepared under the direction of the Vice President of Finance and CFO. Form 990 is reviewed by VP Finance, CFO and independent tax consultants prior to submitting to the Audit and Compliance Committee. All members of the Board receive a copy of the organization's form 990 for review prior to filing.
F990_P06_S0B_L12cForm 990, Part VI, Section B, Line 12cThe purpose of the Conflict of Interest policy is to protect the interest of the Hospital when it contemplates entering into a transaction or arrangement that could benefit the private interest of a Director or Officer of Cottage Health System, Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital, Santa Ynez Valley Cottage Hospital, Santa Barbara Cottage Hospital Foundation and Goleta Valley Professional Buildings, Inc., collectively known as Cottage Health System. The Cottage Health System Directors have a duty to 1.) discharge their duties to benefit the Cottage Health System and not the Directors personally 2.) disclose situations with the potential for conflict of interest with the vision and mission of Cottage Health System 3.) refrain from discussing confidential Cottage Health System business with others. Each Board member will annually complete the Cottage Health System Directors Annual Conflict Disclosure Form. The Disclosure information will be reviewed annually by the Board Chair and the results reported to the full Board. Each Director or Officer will disclose to the Board Chair for items to be discussed at a Board meeting Director or Officer will disclose to Committee Chair for items to be discussed at Board Committees, any material financial or personal interest he/she/family member may have in a Board decision before the Board reviews the transaction and takes action. In general, a director or Officer who had disclosed a potential conflict should be excused from the decision making portion of the discussion and are 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. If after hearing the Director or Officer's response and conducting a further investigation if warranted, the Board determines the Director of Officer failed to disclose a material financial or other potential material conflict of interest, the Board Chair shall take appropriate corrective action. Committee Chairs who address conflict of interest situations with a Board Committee member are responsible for reporting such situations to the Board Chair. Key employees are treated as other employees of Cottage Health System and sign an annual conflict of interest form. These forms are reviewed by Compliance and any issues are brought to the Chief Compliance Officer.
F990_P06_S0B_L15Form 990, Part VI, Section B, Line 15On 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 and is documented in the minutes.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19Governing documents can be obtained upon request from the Assistant Secretary of the Board. Tax filings can be obtained upon request from the CFO.
F990_P07_S0A_L01aForm 990, Part VII, Section A, Line 1aAs 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_L05Form 990, Part XI, Line 5UNREALIZED GAINS AND CHANGE IN MINIMUM PENSION LIABILITY

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
Cottage Health System
PO Box 689Santa BarbaraCA931020689770431902Parent organization for 3 hospitals and medical professional buildingCA501 (C) (3)11b-IIN/A0
Santa Barbara Cottage Hospital
PO Box 689Santa BarbaraCA931020689951644629HospitalCA501 (C) (3)3N/A1
Santa Ynez Valley Cottage Hospital
PO Box 689Santa BarbaraCA931020689952224265HospitalCA501 (C) (3)3N/A1
Santa Barbara Cottage Hospital Foundation
PO Box 689Santa BarbaraCA931020689953802238Foundation to support Santa Barbara Cottage HospitalCA501 (C) (3)7N/A1
Goleta Valley Cottage Hospital Foundation
351 South PattersonGoletaCA93111770003554Foundation to support Santa Ynez Valley Cottage HospitalCA501 (C) (3)7N/A0
Goleta Valley Professional Buildings Inc
PO Box 689Santa BarbaraCA931020689770004202Medical prof bldgCA501 (C) (3)11b-IIN/A1
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (9 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Santa Barbara Cottage Hospital Foundation
j159084accrual
Santa Barbara Cottage Hospital
l71370accraul
Santa Barbara Cottage Hospital
m98170accrual
Santa Barbara Cottage Hospital
n4140338accrual
Santa Barbara Cottage Hospital
o28367881accrual
Santa Barbara Cottage Hospital
p362323accrual
Santa Barbara Cottage Hospital
q2743082accrual
Goleta Valley Professional Buildings Inc
j118134accrual
Santa Ynez Valley Cottage Hospital
n82708accrual