2011-11-14T21:23:48-07:00 2010-12-31 990 2010-01-01 952413596 GOLETA VALLEY COTTAGE HOSPITAL GOLE 8056827111 PO BOX 689 SANTA BARBARA CA 931020689 JOAN BRICHER 8055697294 2011-11-15 2010 2016-02-24 21:20:13Z Ronald C Werft Same as C above Santa Barbara CA 93105 68155233 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. 17 12 356 0 0 0 157000 264304 56563321 63123502 -672253 705998 351940 333210 56400008 64427014 0 124000 0 0 26328505 28174903 0 0 0 21170380 24930977 47498885 53229880 8901123 11197134 50630377 71525247 17956863 26107066 32673514 45418181 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 42978204 124000 63456712 Goleta 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. 0 0 0 42978204 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 63 0 1 356 1 0 0 0 0 0 0 0 0 0 0 X 17 12 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 0 1 1 0 CA X Karen Jones 8056827111 Pueblo at Bath Street Santa Barbara CA 93105 X J Robert Andrews Esq 3 X 0 0 0 Margaret Baker 2 X 0 0 0 Jon Clark 2 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 0 15080 0 John Romo 2 X 0 0 0 Robert Nourse 2 X 0 0 0 Marshall Turner 2 X 0 0 0 Tom Watson MD 2 X 0 17293 0 Fred Lukas 2 X 0 0 0 Jeffrey Kupperman MD 3 X X 30000 28678 0 Robert Nakasone 3 X X 0 0 0 Ed Birch PhD 3 X X 0 0 0 Frederick Gluck 3 X X 0 0 0 Gretchen Milligan 4 X X 0 0 0 Ronald C Werft 6 X 0 965143 599725 Steven A Fellows 6 X 0 561677 147378 Joan Bricher 4 X 0 505806 233530 Julie Artoux 6 X 0 108348 13238 Diane Wisby 40 X 311243 0 36590 Lisa La Bouve 40 X 160771 0 15859 Rosemary Bray 40 X 152590 0 15450 Dennis Mc Daniel 40 X 156140 0 15628 Irene Mindo 40 X 146860 0 15164 Rosemarie Jones 40 X 151587 0 15400 1109191 2202025 1107962 51 0 1 0 HOSPITAL BUILDING & EQUIP CO 11330 OLIVE BLVD ST LOUIS MO 63141 GENERAL CONTRACTOR/ARCHITECT 1250454 ANESTHESIA ASSOC MED GROUP INC 5333 HOLLISTER AVE 130 SANTA BARBARA CA 93111 PHYSICIAN 730000 COMFORCE PO BOX 31001-0893 PASADENA CA 911100893 NURSING 566170 DIVERSIFIED CLINICAL SERVICES PO BOX 850001 ORLANDO FL 32885 PHYSICIAN 667890 MNS ENGINEERS INC 201 N CALLE CESAR CHAVEZ SUITE 300 SANTA BARBARA CA 93103 ENGINEER 514182 12 0 0 0 0 0 264304 0 264304 NET PATIENT SERVICE REVENUE 900099 62188325 62188325 0 0 HOSPITAL MEDI-CAL SUPPLEMENTAL FEE 900099 880189 880189 0 0 REFERENCE TESTING - PDL 900099 54988 54988 0 0 0 0 0 0 63123502 326546 0 0 326546 0 0 0 0 0 0 0 0 0 0 4107671 0 3728219 0 379452 0 379452 0 0 379452 0 CAFETERIA REVENUE 900099 215773 215773 0 0 ED MALPRACTICE REIMBURSEMENT 900099 78469 78469 0 0 REBATES AND REFUNDS 900099 26416 26416 0 0 12552 12552 0 0 333210 64427014 63456712 0 705998 124000 124000 0 0 0 0 0 0 347833 243483 104350 0 0 0 0 0 19705692 14608350 5097342 0 1157789 858484 299305 0 5534418 3972656 1561762 0 1429171 1194317 234854 0 0 0 0 0 3092 0 3092 0 79506 0 79506 0 10495 0 10495 0 0 0 56869 0 56869 0 5676905 4442168 1234737 0 13415 1598 11817 0 11361106 10526763 834343 0 60404 44728 15676 0 0 0 0 0 965982 715156 250826 0 7898 3883 4015 0 0 0 0 0 809 0 809 0 55 0 55 0 0 0 0 0 2604607 2297048 307559 0 -79265 0 -79265 0 PROVISIONS FOR BAD DEBT 1724383 1724383 0 0 HOSPITAL FEE PROGRAM 1709592 1709592 0 0 EQUIPMENT MAINTENANCE 600157 503510 96647 0 LICENSES 61708 6970 54738 0 DUES AND SUBSCRIPTIONS 54549 1115 53434 0 18710 0 18710 0 53229880 42978204 10251676 0 -47793 2227399 10292668 7807270 0 0 6759670 9380757 0 0 0 0 0 0 453566 460375 467007 559308 60955109 22937817 24536167 38017292 5724461 8406472 2166192 3779155 0 0 0 0 278439 887219 50630377 71525247 5310443 6877229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12646420 19229837 17956863 26107066 X 32673514 45418181 0 0 0 0 32673514 45418181 50630377 71525247 X 11197134 1547533 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 1 10495 0 10495 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 14499493 13930766 568727 0 2229108 1438958 790150 0 13593610 7204796 6388814 0 30632898 363297 30269601 38017292 0 3779155 F 3779155 SELF INSURANCE LIABILITY 1897941 MINIMUM PENSION LIABILITY -1441744 RETIREMENT PLAN - SERP 34888 DUE TO AFFILIATES 2611029 DUE TO THIRD PARTIES 44969 GVCH ALLOCATION OF TAX EXEMPT DEBT 16082754 19229837 1 1 X 1 X 3.50 1 X 5.43 1 1 1 0 1 1 355466 355466 0.0069 14497866 11221387 3276480 0.0636 295165 295165 0.0057 0 0 15148497 11221387 3927111 0.0762 24000 24000 0.0005 100000 100000 0.0019 0 0 124000 0 124000 0.0024 0 0 15272497 11221387 4051111 0.0786 1 617408 0 8774710 11604751 -2830041 X 1 1 1 1 Goleta Valley Cottage Hospital

351 South Patterson Goleta CA 93111

X X X Goleta Valley Cottage Hospital 1 SchH_P01_S00_L06a Schedule H, Part I, Line 6a Cottage Health System SchH_P01_S00_L07 Schedule H, Part I, Line 7 The 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_L072f Schedule 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_L07g Schedule H, Part I, Line 7g The 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_L04 Schedule H, Part III, Section A, Line 4 No note in audited financial statements regarding bad debt. Bad debt is not included in the community benefit report. Bad debt expense is dervied from the cost to charge ratios. SchH_P03_S0B_L08 Schedule H, Part III, Section B, Line 8 These 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_L09b Schedule H, Part III, Section C, Line 9b The 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_L02 Schedule H, Part VI, Line 2 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 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_L03 Schedule H, Part VI, Line 3 Goleta 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_L04 Schedule H, Part VI, Line 4 Santa Barbara County is situated on the southern coast of California, with Ventura County bordering on the east, San Luis Obispo County on the north, and Kern County on the northeastern corner. Roughly rectangular in shape, the county contains 2,750 square miles of varied terrain. Much of the county is mountainous. The Santa Ynez, San Rafael and Sierra Madre mountains extend in a predominately east-west direction. Within the county, there are numerous fertile agricultural areas, including the Santa Maria, Cuyama, Lompoc, and Santa Ynez Valleys, and the southeast coastal plain. These areas, which include most of the developed land, also accommodate the majority of the population. The Los Padres National Forest, in the eastern part of the county, covers approximately 44 percent of the total county area. The county's 430,200 population is divided into five sub regions: South Coast (205,800); Lompoc Valley (61,200), Santa Maria Valley (137,600); Santa Ynez Valley (24,000); Cuyama (1,500). For people reporting one race, 88.6% are White; 2.4% are Black or African American; 1.7% are American Indian or Alaska Native; 4.5% are Asian; less than 0.3% are Native Hawaiian or Other Pacific Islander, and 2.5% reported 2 or more races. 40.4% are persons of Hispanic or Latino origin. Twenty-one percent of the county's population are foreign-born, and 32.8% of persons over the age of five reported speaking a language other than English at home. 12.7% of county residents live below the poverty level. SchH_P06_S00_L05 Schedule H, Part VI, Line 5 The Board of Directors is made up of prominent community members who volunteer their time to ensure that the Santa 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_L06 Schedule H, Part VI, Line 6 Cottage 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_L07 Schedule H, Part VI, Line 7 California 1 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. CALIFORNIA STATE UNIVERSITY CHANNEL ISLANDS FOUNDATION ONE UNIVERSITY DRIVE CAMARILLO CA 93012 770433230 501(c)(3) 24000 0 CASH PLEDGE FOR THE ESTABLISHMENT OF A BACHELOR OF SCIENCE NURSING PROGRAM IN SANTA BARBARA. 2 0 SchI_P01_S00_L02 Schedule I, Part I, Line 2 The 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. X X X X X 0 1 0 0 0 0 0 0 0 Ronald C Werft 0 700939 0 250718 0 13487 0 591904 0 7821 0 1564869 0 0 Steven A Fellows 0 409933 0 120408 0 31336 0 139557 0 7821 0 709055 0 0 Joan Bricher 0 402235 0 96171 0 7400 0 225709 0 7821 0 739336 0 0 Diane Wisby 242662 0 43047 0 25534 0 28769 0 7821 0 347833 0 0 0 Lisa La Bouve 148133 0 12458 0 180 0 8039 0 7821 0 176631 0 0 0 Rosemary Bray 138546 0 12734 0 1311 0 7630 0 7821 0 168042 0 0 0 Dennis Mc Daniel 151231 0 158 0 4751 0 7807 0 7821 0 171768 0 0 0 Irene Mindo 146202 0 158 0 499 0 7343 0 7821 0 162023 0 0 0 Rosemarie Jones 150862 0 158 0 568 0 7579 0 7821 0 166988 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 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. F990_P06_S0A_L02 Form 990, Part VI, Section A, Line 2 Robert Nourse and Robert Nakasone business relationship F990_P06_S0A_L04 Form 990, Part VI, Section A, Line 4 Amended articles of incorporation to be consistent with California code on dissolution clause. 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 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 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_L11a Form 990, Part VI, Section B, Line 11a 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 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_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 and is documented in the minutes. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 Governing documents can be obtained upon request from the Assistant Secretary of the Board. Tax filings can be obtained upon request from the CFO. 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 AND CHANGE IN MINIMUM PENSION LIABILITY 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 N/A 1 Santa Ynez Valley Cottage Hospital PO Box 689 Santa Barbara CA 931020689 952224265 Hospital CA 501 (C) (3) 3 N/A 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 N/A 1 Goleta Valley Cottage Hospital Foundation 351 South Patterson Goleta CA 93111 770003554 Foundation to support Santa Ynez Valley Cottage Hospital CA 501 (C) (3) 7 N/A 0 Goleta Valley Professional Buildings Inc PO Box 689 Santa Barbara CA 931020689 770004202 Medical prof bldg CA 501 (C) (3) 11b-II N/A 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 1 1 1 Santa Barbara Cottage Hospital Foundation j 159084 accrual Santa Barbara Cottage Hospital l 71370 accraul Santa Barbara Cottage Hospital m 98170 accrual Santa Barbara Cottage Hospital n 4140338 accrual Santa Barbara Cottage Hospital o 28367881 accrual Santa Barbara Cottage Hospital p 362323 accrual Santa Barbara Cottage Hospital q 2743082 accrual Goleta Valley Professional Buildings Inc j 118134 accrual Santa Ynez Valley Cottage Hospital n 82708 accrual