2024-11-11T13:38:57+00:00 2023-12-31 990 2023-01-01 952413596 Goleta Valley Cottage Hospital GOLE 8052876903 PO BOX 689 Attn Finance Dept Santa Barbara CA 931020689 Kristin Tufvesson Sr VP Finance and CFO 2024-11-11 true 2023 2024-10-15 13:58:12Z Ronald Werft PO BOX 689 Attn Finance Dept Santa Barbara CA 931020689 291440237 false X http://www.cottagehealth.org/locations/goleta-valley-cottage-hospital X 1965 CA It is the mission of Goleta Valley Cottage Hospital to provide superior health care for and improve the health care of our communities through a commitment to our core values of excellence, integrity, and compassion. 15 15 347 260 0 0 164859 4007714 111932983 120772316 4489679 6921948 964107 567200 117551628 132269178 2192126 2591161 0 43164022 45114180 0 0 47436800 51244778 92792948 98950119 24758680 33319059 238193880 278250447 11560662 11658796 226633218 266591651 It is the mission of Goleta Valley Cottage Hospital to provide superior health care for and improve the health care of our communities through a commitment to our core values of excellence, integrity, and compassion. false false 86348267 2591161 121057159 Goleta Valley Cottage Hospital is a 52-bed acute-care hospital located in the City of Goleta. In 2023 the Hospital had 2,728 patient days and served 63,737 outpatients, including emergency services to 23,775 patients. The Hospital provides a wide array of inpatient and outpatient services, including but not limited to cardiac, orthopedic, wound care, breast care and emergency services. Goleta Valley Cottage Hospital is diligent to ensure that all patients have adequate access to healthcare. All patients who do not present with insurance are automatically screened for eligibility in government health programs and are assisted in applying for financial assistance if the patient does not qualify for any other assistance. Goleta Valley Cottage Hospital provides critical funding for community health, financial assistance programs, and external grants, while also realizing shortfalls in Medicare, Medi-Cal, and indigent care. External grants were provided which aimed at specific community needs for at risk populations (indigent health; substance abuse recovery; elderly; family counseling). In addition, the hospital provides support of nursing education, health fairs, and the provision of flu shots to the community. In 2023 the hospital spent over $16.6 million on all community benefit programs. 86348267 true true false true false false false false false true true false true true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false true true true false false true 59 0 true 347 true false false false false false false false false false false false X 15 15 false false false false true true true true true false false true true true true true true true true false CA X Kristin Tufvesson 8053249933 400 West Pueblo Santa Barbara CA 93105 Richard Ponce MD Secretary 0.5 5.5 X X 0 0 0 Steven Zola Board Chair 1.6 18.4 X X 0 0 0 Susan Christol-Deacon Vice Chair 0.5 5.5 X X 0 0 0 Thomas Cusack Vice Chair 0.5 5.5 X X 0 0 0 Bhupi Singh Board Member 0.3 3.7 X 0 0 0 Dorothy Largay PhD Board Member (Part Year through 1/2023) 0.3 3.7 X 0 0 0 Ernesto Paredes Board Member 0.3 3.7 X 0 0 0 Gamble Parks ATTY Board Member 0.3 3.7 X 0 0 0 Ginger Salazar Board Member 0.3 3.7 X 0 0 0 Gregory Faulkner Board Member (Part Year through 1/2023) 0.3 3.7 X 0 0 0 Mark Scott MD Board Member 0.3 3.7 X 0 0 0 Nancy Nielsen Board Member (Part Year through 9/2023) 0.3 3.7 X 0 0 0 Pamela Gann Board Member 0.3 3.7 X 0 0 0 Roberta Griffin Board Member 0.3 3.7 X 0 0 0 Robin Malone MD Board Member 0.3 3.7 X 0 0 0 Steve Ortiz Board Member 0.3 3.7 X 0 0 0 Wesley Schooler MD Board Member 0.3 3.7 X 0 0 0 Yulun Wang PhD Board Member 0.3 3.7 X 0 0 0 Kristin Tufvesson Senior VP and CFO 5.0 50.0 X 0 1006800 103185 Lisa Moore Executive VP and COO 5.0 50.0 X 0 1070894 234431 Ronald Werft President & CEO 5.0 60.0 X 0 1914019 88325 Stacy Bratcher Senior VP and General Counsel 5.0 50.0 X 0 885425 91065 ARIE DEJONG VP OF GVCH 40.0 0 X 660116 0 89444 DANIEL THOMAS Director Nursing 40.0 0 X 267026 0 65667 STEFFANIE CARTY Director, Surgery & Outpatient Services GVCH 40.0 0 X 264622 0 32306 IRENE MINDO Clinical Resource Nurse 40.0 0 X 223468 0 34176 JASON KORN Clinical Nurse Coordinator 40.0 0 X 258544 0 53219 LISA MARIE LABOUVE Clinical Manager 40.0 0 X 247475 0 52164 MARY FULCHER Clinical Manager 40.0 0 X 225319 0 61058 SUSAN SAN MARCO Director Service Line 40.0 0 X 242937 0 53601 2389507 4877138 958641 0 false true false ANESTHESIA ASSOCIATES MEDICAL GROUP INC ONE POST STREET SAN FRANCISCO CA 94104 Physician Services 990583 AMN HEALTHCARE INC PO Box 56157 Los Angeles CA 90074 Contract Labor 937341 PROWEST PCM INC 22710 Palomar St Wildomar CA 92595 Construction Services 764113 ANDERSON SYSTEMS 75 B Robin Hill Road Goleta CA 93117 Construction Services 592308 TOWER AIR 650 Ward Drive Suite 105 Goleta CA 93117 Construction Services 414476 20 0 0 0 0 7714 4000000 0 4007714 NET PATIENT SERVICE REVENUE 622110 115937217 115937217 0 0 CA HOSPITAL FEE PROGRAM 622110 4835099 4835099 0 0 0 0 0 0 0 120772316 2635393 0 0 2635393 0 0 163453316 4298 159109812 61247 4343504 -56949 4286555 0 0 4286555 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 CAFETERIA/GIFT SHOP 900099 282357 282357 Corporate Allocation 900099 205391 205391 Other Revenues 900099 53024 53024 26428 26428 0 0 567200 132269178 121057159 0 7204305 X 2590534 2590534 627 627 0 0 0 0 1379181 629621 749560 0 0 0 0 0 30735238 28009599 2725639 0 378880 65053 313827 0 10640446 8145002 2495444 0 1980435 1899279 81156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 642720 0 642720 0 12390832 10793514 1597318 0 0 0 0 0 1815903 1570360 245543 0 2998535 1807424 1191111 0 0 0 0 0 2419731 2048969 370762 0 13625 6815 6810 0 0 0 0 0 4709 1574 3135 0 29950 17970 11980 0 0 0 0 0 7915635 6473801 1441834 0 620662 434726 185936 0 MEDICAL SUPPLIES 18835133 18811791 23342 0 HOSPITAL FEE PROGRAM 1604539 1604539 0 0 EQUIPMENT MAINTENANCE 1428506 1354550 73956 0 Settlement 190089 0 190089 0 334209 82519 251690 0 98950119 86348267 12601852 0 8109985 13723428 701494 3435693 0 0 12532363 13525804 0 0 0 0 0 786948 866837 819158 567638 179199433 74976539 101110220 104222894 55979217 87128741 36029678 31410022 0 0 0 22124817 23369390 238193880 278250447 9304409 10212220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2256253 1446576 11560662 11658796 226633218 266591651 0 0 0 0 0 0 0 0 226633218 266591651 238193880 278250447 X 33319059 5175512 0 0 0 1463862 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 21540 21540 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Lobbying activities are calculated as a percentage of dues paid to various hospital associations, including American Hospital Association, California Hospital Association and Hospital Association of Southern California. The percentage of dues used for lobbying purposes is provided by each association. 0 7230602 7230602 0 121861903 50867698 70994205 0 5325397 4636860 688537 0 29010127 19471981 9538146 0 15771404 0 15771404 104222894 Alternative Investments 31410022 F 31410022 Prepaid pension benefit 15148750 Due from Government payors 7868409 Other assets 352231 23369390 SELF INSURANCE LIABILITY 1052359 Deferred Physician guarantees 343792 Due to affiliates 50425 1446576 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote Cottage completed an analysis of its tax positions, in accordance with ASC 740, and determined that there are no uncertain tax positions taken. Cottage has recognized no interest or penalties related to uncertain tax positions. Cottage 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 2020. true true X true X 500 true X 699 true true true false true true 2390409 2390409 0.0242 13755861 7793875 5961986 0.0603 0 0 0 0.0 0 0 16146270 7793875 8352395 0.0844 712424 49315 663109 0.0067 531339 3270 528069 0.0053 22882 10825 12057 0.0001 0 0 0 0.0 2357534 0 2357534 0.0238 0 0 3624179 63410 3560769 0.0360 0 0 19770449 7857285 11913164 0.1204 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 true 0 0 28752985 33445322 -4692337 X true true 1 1 Goleta Valley Cottage Hospital 351 South Patterson Goleta CA 93111 http://www.cottagehealth.org/locations/goleta-valley-cottage-hospital 050000034 X X X Goleta Valley Cottage Hospital 1 false false true X X X X X X X X X 22 true true false true X https://www.cottagehealth.org/about/community-benefit/ X X true 23 true https://www.cottagehealth.org/about/community-benefit/ false true X 500.0 699.0 X X X X true true X X X X true X https://www.cottagehealth.org/billing/financial-assistance/ X https://www.cottagehealth.org/billing/financial-assistance/ X https://www.cottagehealth.org/billing/financial-assistance/ X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E In the most recent Community Health Needs Assessment (CHNA), six areas emerged as priority health areas in Santa Barbara County: Access to Care, Behavioral Health, Chronic Conditions, Maternal Care, Resiliency and Social Needs. In addition, we identified injury and violence as a health priority base on our emergency and trauma departments. These identified needs have guided Cottage Health's direct funding provided to local agencies. In addition, our population health department seeks to align with broader initiatives in the community which are addressing these identified needs. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - GOLETA VALLEY COTTAGE HOSPITAL. As part of this Community Health Needs Assessment (CHNA), a web-based and telephone survey was conducted with approximately 1600 randomly selected Santa Barbara County residents, including oversampling of lower-income areas. In addition, a listening tour occurred consisting of focus groups and interviews with more than 200 individuals representing the broad interests of the community, including medically underserved, low-income, and vulnerable populations. Cottage Health contracted with the University of Pittsburgh who has extensive experience in survey methodology, analysis and reporting. The questionnaire was created from CDC's Behavioral Risk Factor Surveillance System (BRFSS) and other leading surveys and questionnaires carefully selected to provide count-level information. It was administered in both English and Spanish. In addition the CHNA utilized existing health and demographic data already collected for the county and California (such as U.S. Census data). Input was gathered from representatives of local government, public health, health systems and organizations working with low-income, minority (including Hispanic/Latinx/Mixtec, Native American, Asian, Africa American), or other medically underserved populations experiencing health disparities (including young adults, elderly, veterans, disabled, lesbian/gay/bisexual/transgender (LGBT), homeless, mentally ill, undocumented, uninsured/underinsured, and Medi-Cal/Medicare recipient populations. Final participation included representatives of approximately 90 local organizations, some of which are: Santa Barbara County Department of Behavioral Wellness, CALM, Family Service Agency, Housing Authority of the City of Santa Barbara, Pacific Pride Foundation, Santa Barbara County Education Office, Santa Barbara Neighborhood Clinics, YouthWell Coalition, Cottage Health Psychiatry and Addition Services, CenCal Health, Domestic Violence Solutions, University of California, Santa Ynez Tribal Health Clinic, People's Self Help Housing, Transition House, and Council on Alcohol and Drug Abuse. Secondary data sources included data from the US Census Bureau, US Department of Education, US Department of Agriculture, US Department of Health and Human Services, Centers for Disease Control and Prevention, State Cancer Profiles, and Nielsen Site Reports. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - GOLETA VALLEY COTTAGE HOSPITAL. The CHNA was completed jointly by Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital, and Santa Ynez Valley Cottage Hospital. Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - GOLETA VALLEY COTTAGE HOSPITAL. A press release was issued announcing the completion and availability of the CHNA. This information was also shared and presented to the community on an as requested basis. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - GOLETA VALLEY COTTAGE HOSPITAL. As a member of Cottage Health (CH), the needs identified in the Hospital's CHNA are incorporated into the Community Benefit Program of CH. Seventeen leading health indicators identified in the 2022 CHNA were grouped into six priority areas: (1) access to care; (2) behavioral health (3) chronic conditions; (4) maternal health; (5) resiliency; and (6) social needs (including food and housing insecurity). In addition, Cottage Health has identified injury and violence as a priority based on Emergency Department and trauma registry reporting. The four indicators not prioritized and addressed are: (1) smoking cigarettes (2) binge drinking (3) physical inactivity and (4) obesity. These health indicators were not ranked as highly (in terms of need, urgency, collaboration among community organizations, health disparities, and community resources available). In addition, there are currently leading community partners/stakeholders who are addressing smoking cigarettes, binge drinking, physical activity and obesity. Though not selected as priority areas, some of the non-prioritized needs will be indirectly addressed through enhancing access to health care and by partnering with lead organizations addressing these areas. The implementation strategy to address the priority needs includes Goleta Valley Cottage Hospital's grants, its hospital programs, population health initiatives and health fairs. In addition, Goleta Valley Cottage Hospital provides grants to support Health Professional Education. Schedule H, Part V, Section B, Line 15 Facility , 1 Facility , 1 - Goleta Valley Cottage Hospital. The FAP also describes the physical locations where patients can obtain a copy of the FAP Application, as well as the Cottage Health website address. 0 Schedule H, Part I, Line 6b Community Benefit Report Availability Cottage Health prepares a Community Benefit Report on behalf of Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital and Santa Ynez Valley Cottage Hospital. It is filed with the State of California, in compliance with California Senate Bill 697. The Community Benefit Report is available to the public upon request. In addition it can be found on the Cottage web site: https://www.cottagehealth.org/about/community-benefit/ and the California CHHS web site: https://data.chhs.ca.gov/dataset/community-benefit-plans Schedule H, Part I, Line 3c Other Financial Assistance Factors Goleta Valley Cottage Hospital Cottage Hospital uses FPG based on Household Income to determine eligibility for both discount and charity care on the patient responsibility whether or not covered by insurance. A presumptive FPG is also utilized to write off balances for patients who have a presumptive score of 500% of FPG or lower. A presumptive FPG up to 699% will receive a sliding scale discount. Assets are considered for certain patients who exceed FPG levels but who have high medical debt. Patients who were determined to be homeless also qualify for free care, assuming they did not qualify for other insurance programs. Schedule H, Part V, Section B, Line 16 FAP LANGUAGES THE FAP IS AVAILABLE IN ENGLISH, TAGALOG, MANDARIN AND SPANISH AT THE WEBSITE NOTATED IN 16A AND B. Schedule H, Part I, Line 6a Community benefit report prepared by related organization Cottage Health Schedule H, Part I, Line 7g Subsidized Health Services THE HOSPITAL PROVIDES SUBSIDIZED HEALTH CARE VIA A CARDIAC REHABILITATION PROGRAM. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance DIRECT COSTS ARE CALCULATED AT THE PROVIDING DEPARTMENT LEVEL AND OVERHEAD COSTS ARE ALLOCATED ACCORDING TO THE MEDICARE STEP-DOWN METHOD, BASED UPON APPLICABLE STATISTICS. EACH PAYER'S COST IS DETERMINED BY THE SERVICES PROVIDED TO THEIR MEMBERS. THE COMMUNITY BENEFITS AMOUNTS ATTRIBUTABLE TO MEDICAID AND OTHER GOVERNMENT PROGRAMS ARE BASED UPON THE SERVICES PROVIDED AND RESULTING COSTS INCURRED FOR THEIR INPATIENTS, OUTPATIENTS AND EMERGENCY DEPARTMENT VISITS. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE HOSPITAL ADOPTED THE FINANCIAL ACCOUNTING STANDARDS BOARD'S ACCOUNTING STANDARDS UPDATE 2014-09 TOPIC 606 (ASU 606) EFFECTIVE JANUARY 1, 2018. ASU 606 AND THE HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA) DIFFERENTIATE BAD DEBT FROM IMPLICIT PRICE CONSESSIONS. THE HOSPITAL MAKES A DETERMINATION REGARDING A PRICE CONCESSION TO STANDARD PRICING ON A PORTFOLIO BASIS PRIOR TO ASSESSING THE CREDIT RISK OF INDIVIDUALS WITHIN THE PORTFOLIO. PATIENT SERVICE REVENUE IS RECORDED NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS, INCLUDING AN ESTIMATE FOR IMPLICIT PRICE CONCESSIONS. BAD DEBT IS RECORDED AS AN OPERATING EXPENSE AND RESULTS WHEN A PATIENT, DETERMINED TO HAVE THE FINANCIAL CAPACITY TO PAY FOR HEALTHCARE SERVICES, IS UNWILLING TO DO SO. FOR THE TAX YEAR ENDED DECEMBER 31, 2023, THE HOSPITAL MADE NO SUCH DETERMINATION, AND THEREFORE RECORDED NO BAD DEBT EXPENSE. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE HOSPITAL DID NOT RECORD ANY BAD DEBT EXPENSE IN 2023, THEREFORE THERE IS NO REFERENCE TO BAD DEBT EXPENSE IN THE FOOTNOTES TO THE FINANCIAL STATEMENTS. SEE SUPPLEMENTAL INFORMATION FOR H PART III LINE 2 FOR ADDITIONAL INFORMATION. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs The shortfall from total costs for Medicare patients is a significant loss to the hospital. The Hospital is providing care to patients whose insurance (Medicare) does not cover the entire cost of their care. This provides significant aid to the elderly in the community. Some of these elderly people would qualify under FAP guidelines for financial assistance under any other Payer program. The dollars reported are taken from the 2023 Medicare Cost Report and are derived following their guidelines of allowable and non-allowable costs. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance Cottage Health's Financial Assistance Policy (FAP), which includes actions Cottage Health may take in the event of non-payment and applies to the largest number of Cottage Health's patients, states that Cottage Health will not engage in Extraordinary Collection Activities (ECAs) (defined in the policy) for a period of at least 180 days following the date of the first post-discharge billing statement, nor will Cottage Health engage in ECAs before making a reasonable effort to determine whether a patient is eligible for financial assistance pursuant to Cottage Health's FAP. The FAP further states that, at least 30 days prior to engaging in any ECAs, Cottage Health will: (a) provide written notice to patients regarding the availability of financial assistance, the specific ECAs Cottage Health intends to take in the event of non-payment, and a deadline after which Cottage Health may initiate ECAs; (b) provide to patients a written plain language summary of Cottage Health's FAP; and (c) make reasonable efforts to orally notify patients about Cottage Health's FAP and how the patient can obtain assistance with the financial assistance application. The FAP further states that, if Cottage Health receives a complete financial assistance application during the Application Period (as defined in the FAP), Cottage Health will suspend ECAs and process the patient's application, and if Cottage Health receives an incomplete financial assistance application during the Application Period, Cottage Health will suspend ECAs and provide a reasonable opportunity for the patient to submit a complete financial assistance application. ECAs are defined as (a) actions requiring a legal or judicial process; and (b) reporting adverse information to credit reporting agencies or credit bureaus. Cottage Health's FAP further states that Cottage Health may employ reasonable collection efforts to obtain payment from patients, other than ECAs, including issuing statements, making telephone calls, sending text messages, and sending e-mail messages. If a patient qualifies for FAP, we will not do any collection activities. Schedule H, Part V, Section B, Line 16a FAP website - Goleta Valley Cottage Hospital: Line 16a URL: https://www.cottagehealth.org/billing/financial-assistance/; Schedule H, Part V, Section B, Line 16b FAP Application website - Goleta Valley Cottage Hospital: Line 16b URL: https://www.cottagehealth.org/billing/financial-assistance/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - Goleta Valley Cottage Hospital: Line 16c URL: https://www.cottagehealth.org/billing/financial-assistance/; Schedule H, Part VI, Line 2 Needs assessment Cottage Health, through its hospitals Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital, and Santa Ynez Valley Cottage Hospital, researched the needs of the county through the Community Health Needs Assessment (CHNA). As discussed in detail in H-V-line5, the assessment included a broad group of participants from the public and private sector plus existing health data in the government sector and past needs assessment information. Needs prioritized in the CHNA include: Access to Care, Behavioral Health, Chronic conditions, food insecurity and housing insecurity. In addition, Cottage Health has prioritized injury and violence within the Behavioral Health area. The Hospitals provide critical funding for community health, financial assistance, and external grants, while also realizing shortfalls in Medicare, Medi-Cal, and indigent care. Activities in these areas included screenings and health fairs; classes, clinics, lectures, and seminars; community services; community collaborations; and coalitions/committees. In 2023, Cottage Health spent over $250 million on these programs. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance COTTAGE HEALTH HAS A MULTIFACETED FINANCIAL ASSISTANCE PROGRAM (FAP) TO ENSURE THAT ALL PATIENTS RECEIVE INFORMATION ABOUT OUR FAP, AND PATIENTS WHO DO NOT HAVE INSURANCE ARE SCREENED FOR ELIGIBILITY IN A GOVERNMENT SPONSORED HEALTHCARE PLAN. THE HOSPITAL POSTS INFORMATION ABOUT THE FAP IN ALL REGISTRATION AREAS. SIGNS ARE IN ENGLISH, AND SPANISH AND 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. PAPER COPIES ARE PROVIDED TO PATIENTS WHO SPEAK TAGALOG or MANDARIN. 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 a plain language summary (PLS) of the FAP APPLICATIONS TO ALL PATIENTS. Additionally, each patient is provided with information regarding the FAP on their billing statement, and each billing statement is accompanied by the PLS. SANTA BARBARA COTTAGE HOSPITAL ALSO WORKS CO-OPERATIVELY WITH THE COUNTY OF SANTA BARBARA TO PROVIDE NON-EMERGENCY FINANCIAL ASSISTANCE SERVICES. THIS PROGRAM IS KNOWN AS THE COMMUNITY SERVICE PROGRAM. ALL MEMBERS OF THE COMMUNITY WHO MEET THE FINANCIAL CRITERIA ARE ELIGIBLE FOR THE COMMUNITY SERVICE PROGRAM, BUT MUST BE REFERRED BY A PHYSICIAN. WHEN PATIENTS WHO VISIT THE SANTA BARBARA PUBLIC HEALTH DEPARTMENT CLINIC HAVE A NEED FOR A MEDICALLY-NECESSARY BUT NON-EMERGENT SERVICE, THE PHYSICIANS AND CLINIC STAFF INFORM THE PATIENT OF THE COMMUNITY SERVICE PROGRAM AND HELP THE PATIENT TO APPLY. INDEPENDENT PHYSICIANS IN THE COMMUNITY WERE MADE AWARE OF THE PROGRAM AND HOW TO ACCESS SERVICES ON BEHALF OF THEIR PATIENTS. Schedule H, Part VI, Line 4 Community information Santa Barbara County consists of 2,750 square miles of land and inland water area. Approximately rectangular in shape, Santa Barbara County is bordered on the north by San Luis Obispo County, on the east by Ventura County, and on the south and west by 107 miles of Pacific coastline. 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. Los Padres National Forest, in the eastern part of the county, covers approximately 44 percent of the total county area. Vandenberg Air Force Base is in the Lompoc region, while UCSB is on the South Coast. North County refers to the area west and north of Gaviota and includes the Lompoc, Santa Maria, Santa Ynez and Cuyama valleys. South Coast refers to the Goleta, Santa Barbara, and Carpinteria coastal plain. Santa Barbara County's approximate 446,000 population is divided into six sub regions: Santa Barbara/Goleta Region; Santa Ynez Valley; Carpinteria Valley; Lompoc Valley; Santa Maria Valley; Guadalupe Valley; and the Cuyama Valley. Of the total population, approximately 50% are females. The median age is 34.6 years. The population age breakdown is: 27.5% under 20 years old; 56.4% are 20 to 64 years old and 16.1% are 65 and older. For people reporting one race, 42.7% are White; 47.2% are Hispanic; 2.4% are Black or African American; 5.9% are Asian; and 4.2% are Other/Multi-Racial. 9% of county residents live below the poverty level. The residents of the County are served by 5 hospitals throughout the county. Schedule H, Part VI, Line 5 Promotion of community health The Board of Directors is made up of community members who volunteer their time to ensure the Goleta community has access to high-quality, affordable healthcare. The Board of Directors is actively involved in the hospital's strategic decisions. The Board approves an annual budget and reviews a long-term financial plan to guarantee the hospital continues to offer healthcare services to the community for years to come. The Board also approves annual strategic goals that are consistent with the mission, vision and values of Cottage Health. The financial forethought of the Board of Directors resulted in surplus funds that were used to rebuild the facility to meet updated seismic safety standards while providing uninterrupted care for the community. In 2016 Goleta Valley Cottage Hospital (GVCH) moved into its new building, which complies with the unfunded mandate of the State of California's Senate Bill 1953 (SB1953), requiring all hospitals to retrofit or rebuild to withstand a major earthquake. In 2020, the Board approved plans to renovate a portion of Goleta Valley Cottage Hospital to accommodate the relocation of Cottage Rehabilitation Hospital, currently in an older building that would be financially infeasible to retrofit for acute-care seismic compliance. Plans are now underway for this relocation, with an anticipated move date of 2025. GVCH works collaboratively with its medical staff to improve health in the community and has expanded the Community Health Needs Assessment Survey in the community to respond to current and future health needs in our area . Schedule H, Part VI, Line 6 Affiliated health care system Cottage Health (CH) is the parent organization of Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital and Santa Ynez Valley Cottage Hospital and Goleta Valley Professional Buildings, Inc. These organizations have a common Board of Directors. Cottage Health 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 CH Hospitals and primarily provides services to the City of Goleta (adjacent to Santa Barbara) and the University of California, Santa Barbara. Schedule H, Part VI, Line 7 State filing of community benefit report CA true Cottage Clinical Network 400 WEST PUEBLO STREET Santa Barbara CA 93105 843321175 1503000 Support of clinics throughout the County which provide access to care for individuals with no PCP SANTA BARBARA NEIGHBORHOOD CLINICS 1900 State St Suite G Santa Barbara CA 93101 770496382 501(c)(3) 300000 Support of neighborhood health clinics for low income patients COMMUNITY PARTNERS 1000 N ALAMEDA ST SUITE 240 LOS ANGELES CA 90012 954302067 501(c)(3) 250000 Provide mental health support to children and youth, including those with Adverse Childhood Experiences. Santa Barbara City College Foundation 721 Cliff Drive Santa Barbara CA 93109 770070782 government 170000 Support of Nursing Program at Santa Barbara City College CHILD ABUSE LISTENING MEDIATION 1236 Chapala St Santa Barbara CA 93101 237097910 501(c)(3) 99785 Provide mental health support to children and youth, including those with Adverse Childhood Experiences. The OpenMinds Foundation 1919 State St Suite 303 Santa Barbara CA 93101 884179016 501(c)(3) 80215 Provide mental health support to children and youth, including those with Adverse Childhood Experiences. CSUCI FOUNDATION One University Drive Camarillo CA 93012 770433230 501(c)(3) 63000 Support of the Bachelor's in Science, Nursing program in Santa Barbara COUNCIL ON ALCOHOLISM & DRUG PO BOX 28 Santa Barbara CA 93101 951878858 501(c)(3) 60000 Provide parenting education programs that will support parents of children and adolescents with culturally relevant parenting skills training. Pacific Pride Foundation 608 Anacapa St Santa Barbara CA 93101 953133613 501(c)(3) 60000 Provide parenting education programs that will support parents of children and adolescents with culturally relevant parenting skills training. 8 1 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. Grant funds are monitored through the Community Health Coordinating Committee of Cottage Health. 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 false true false false false false false true false Ronald Werft President & CEO 0 1337016 0 521907 0 55096 0 65192 0 23133 0 2002344 0 0 Lisa Moore Executive VP and COO 0 736077 0 243742 0 91075 0 215597 0 18834 0 1305325 0 47038 Kristin Tufvesson Senior VP and CFO 0 642693 0 194998 0 169109 0 69000 0 34185 0 1109985 0 0 Stacy Bratcher Senior VP and General Counsel 0 642881 0 121810 0 120734 0 61500 0 29565 0 976490 0 0 ARIE DEJONG VP OF GVCH 437276 0 91132 0 131708 0 59250 0 30194 0 749560 0 45385 0 DANIEL THOMAS Director Nursing 222848 0 18326 0 25852 0 41535 0 24132 0 332693 0 0 0 STEFFANIE CARTY Director, Surgery & Outpatient Services GVCH 234023 0 15524 0 15075 0 12477 0 19829 0 296928 0 0 0 JASON KORN Clinical Nurse Coordinator 256214 0 1653 0 677 0 42893 0 10326 0 311763 0 0 0 LISA MARIE LABOUVE Clinical Manager 209265 0 19502 0 18708 0 41438 0 10726 0 299639 0 0 0 SUSAN SAN MARCO Director Service Line 212961 0 22533 0 7443 0 41775 0 11826 0 296538 0 0 0 MARY FULCHER Clinical Manager 193216 0 17280 0 14823 0 40525 0 20533 0 286377 0 0 0 IRENE MINDO Clinical Resource Nurse 219219 0 1653 0 2596 0 11044 0 23132 0 257644 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation 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 executives 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. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan COTTAGE HEALTH PROVIDES CERTAIN EXECUTIVES A SUPPLEMENTAL RETIREMENT PROGRAM. THE PROGRAM IS DEFINED AS DEFERRED COMPENSATION UNDER THE IRC SECTION 457(F). THE ANNUAL CONTRIBUTION IS 9.8% OF BASE YEARS SALARY WITH THE CONTRIBUTIONS VESTING FIVE YEARS FROM CREDITING DATE, OR AT AGE 62, OR IMMEDIATELY IN THE EVENT OF DEATH, DISABILITY, OR INVOLUNTARY TERMINATION WITHOUT CAUSE. THE UNVESTED ACCOUNT BALANCES ARE ASSETS OF THE ORGANIZATION AND ARE INCLUDED IN OTHER ASSETS AND THE ACCRUED EXPENSE IS INCLUDED IN ACCRUED EXPENSES IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS. THE AMOUNTS ARE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. DEFERRED CONTRIBUTIONS TO THIS PLAN WILL BE REPORTED AGAIN AS REPORTABLE COMPENSATION IN THE YEAR PAID. IN 2022, RECIPIENT PAYOUTS FROM THE 457(F) PLAN WERE Lisa Moore ($47,038) and Arie DeJong ($45,385). Schedule J, Part I, Line 7 Non-fixed payments Each year the Board of Directors determines if a bonus can be paid based on the financial operating results of the completed year. The Board determines the total amount of the bonus pool. This pool of money is distributed to employees in the management team based on the individual's achievement of personal goals and the overall team's accomplishment of system-wide goals pertaining to quality, service excellence, employee engagement, financial or other. The payout for individuals is calculated based on percentages of their base salary and their position. Form 990, Part VI, Line 6 Classes of members or stockholders Cottage Health is the sole corporate member. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body Cottage Health is the sole corporate member and can appoint Directors to the Board. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders The Board of Directors must obtain prior approval from the Board of Directors of Cottage Health, 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. Form 990, Part VI, Line 11b Review of form 990 by governing body Form 990 is prepared under the direction of the Senior Vice President and CFO. Form 990 is compiled and reviewed by the Senior Vice President & CFO, the Vice President Finance & Controller, the Director Corporate Finance, and the Accounting Manager. Form 990 is reviewed separately by Ernst & Young as an independent tax consultant to Cottage during the development of the response. Each party reviews Form 990 prior to submission to the Compliance & Audit Committee and to the Board of Directors, whose reviews are conducted prior to filing. A complete copy of the final Form 990 is provided to all members of the governing board before it is filed. Form 990, Part VI, Line 12c Conflict of interest policy 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, 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. The Directors have a duty to: 1.) discharge their duties to benefit Cottage Health and not the Directors personally 2.) disclose situations with the potential for conflict of interest with the vision and mission of Cottage Health 3.) refrain from discussing confidential Cottage Health business with others. Each Board member will annually complete the Cottage Health 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 items to be discussed at a Board meeting. If there are any material financial or personal interests a Board member or family member may have in a Board decision, the Director or Officer will disclose this to the Committee Chair before the Board reviews the items and takes action. In general, an Officer who has 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 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 other employees of Cottage Health and sign an annual conflict of interest form. These forms are reviewed by Compliance and any issues are brought to the Chief Compliance Officer. Form 990, Part VI, Line 15a Process to establish compensation of top management official On an annual basis the Compensation Committee (CC) of the Board of Directors meets to determine appropriate compensation for executives, including the CEO, COO, CFO, and vice presidents. All members of the CC are independent members of the Board of Directors. The CC 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 CC recommends compensation for the executives to the full Board for approval. This process takes place annually for all employed officers and key employees. Form 990, Part VI, Line 15b Process to establish compensation of other employees The process described in line 15a, above, takes place annually for all employed officers and key employees. For this fiscal year, the review occurred on March 31, 2023. Form 990, Part VI, Line 19 Required documents available to the public Tax filings can be obtained upon request from the CFO. Audited Financial Statements are attached to the Form 990 in accordance with IRS instructions. The bylaws, articles of incorporation and conflict of interest policies are not available to the public. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Settlements - Total Revenue: 26428, Related or Exempt Function Revenue: 26428, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees Medical Professional Fees - Total Expense: 4010100, Program Service Expense: 3509197, Management and General Expenses: 500903, Fundraising Expenses: 0; Laboratory Purchased Services - Total Expense: 3072875, Program Service Expense: 3072875, Management and General Expenses: 0, Fundraising Expenses: 0; Supplies & Services - Corporate Alloc - Total Expense: 2762003, Program Service Expense: 1708814, Management and General Expenses: 1053189, Fundraising Expenses: 0; Other Purchased Services - Total Expense: 1279443, Program Service Expense: 1240550, Management and General Expenses: 38893, Fundraising Expenses: 0; Other - Contract Labor - Total Expense: 1262078, Program Service Expense: 1262078, Management and General Expenses: 0, Fundraising Expenses: 0; Consulting Fees - Total Expense: 4333, Program Service Expense: 0, Management and General Expenses: 4333, Fundraising Expenses: 0; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Change in pension liabillity - 1463862; COTTAGE HEALTH PO BOX 689 SANTA BARBARA CA 931020689 770431902 PARENT ORGANIZATION FOR 3 HOSPITALS & MEDICAL PROF BLDG CA 501(c)(3) Type II NA false SANTA BARBARA COTTAGE HOSPITAL PO BOX 689 SANTA BARBARA CA 931020689 951644629 HOSPITAL CA 501(c)(3) 3 COTTAGE HEALTH true SANTA YNEZ VALLEY COTTAGE HOSPITAL INC PO BOX 689 SANTA BARBARA CA 931020689 952224265 Hospital CA 501(c)(3) 3 COTTAGE HEALTH true SANTA BARBARA COTTAGE HOSPITAL FOUNDATION PO BOX 689 SANTA BARBARA CA 931020689 953802238 fundraising CA 501(c)(3) 7 COTTAGE HEALTH true GOLETA VALLEY PROFESSIONAL BUILDINGS INC PO BOX 689 SANTA BARBARA CA 931020689 770004202 MEDICAL PROF BLDG CA 501(c)(3) Type II COTTAGE HEALTH true Villa Riviera Real Estate Company PO Box 689 Santa Barbara CA 93102 272996284 Workforce Housing Development CA SB Cottage Hosp Fndtn C Corporation 0 0 0 true false false false false false false false false false false false true true true true true true false false Santa Barbara Cottage Hospital M 3071175 accrual Santa Barbara Cottage Hospital O 1942841 accrual