GOLETA VALLEY COTTAGE HOSPITAL: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: GOLETA VALLEY COTTAGE HOSPITAL (EIN 95-2413596)
Tax period: 2016-01-01 to 2016-12-31
Filed: 2017-11-01
IRS object ID: 201713059349301126
Schema version: 2016v3.0
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-11-01T11:01:09-05:00	ReturnTs
Tax Period End	2016-12-31	TaxPeriodEndDt
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	952413596	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Goleta Valley Cottage Hospital	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	GOLE	BusinessNameControlTxt
Phone	8053249903	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 689	AddressLine1Txt
City	Santa Barbara	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	931020689	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Brett Tande	PersonNm
Person Title	Senior VP & CFO	PersonTitleTxt
Signature	2017-10-23	SignatureDt

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Ronald Werft	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 689	AddressLine1Txt
City	Santa Barbara	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	931020689	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$75,811,232	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	http://www.cottagehealth.org/locations/goleta-valley-cottage-hospital	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1965	FormationYr
Legal Domicile State	CA	LegalDomicileStateCd
Activity Or Mission	It is the mission of Goleta Valley Cottage Hospital (GVCH) 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 give our Community access to affordable, quality healthcare.	ActivityOrMissionDesc
Voting Members Governing Body	17	VotingMembersGoverningBodyCnt
Voting Members Independent	16	VotingMembersIndependentCnt
Total Employee	332	TotalEmployeeCnt
Total Volunteers	142	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$3,518,287	PYContributionsGrantsAmt
CY Contributions Grants	$1,170,517	CYContributionsGrantsAmt
PY Program Service Revenue	$75,937,153	PYProgramServiceRevenueAmt
CY Program Service Revenue	$74,144,697	CYProgramServiceRevenueAmt
PY Investment Income	$45,616	PYInvestmentIncomeAmt
CY Investment Income	-$35,867	CYInvestmentIncomeAmt
PY Other Revenue	$396,165	PYOtherRevenueAmt
CY Other Revenue	$434,772	CYOtherRevenueAmt
PY Total Revenue	$79,897,221	PYTotalRevenueAmt
CY Total Revenue	$75,714,119	CYTotalRevenueAmt
PY Grants And Similar Paid	$225,453	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$426,688	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$34,504,424	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$33,367,554	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$39,717,905	PYOtherExpensesAmt
CY Other Expenses	$40,437,671	CYOtherExpensesAmt
PY Total Expenses	$74,447,782	PYTotalExpensesAmt
CY Total Expenses	$74,231,913	CYTotalExpensesAmt
PY Revenues Less Expenses	$5,449,439	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$1,482,206	CYRevenuesLessExpensesAmt
Total Assets BOY	$134,551,440	TotalAssetsBOYAmt
Total Assets EOY	$131,386,512	TotalAssetsEOYAmt
Total Liabilities BOY	$37,163,630	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$29,068,851	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$97,387,810	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$102,317,661	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	It is the mission of Goleta Valley Cottage Hospital (GVCH) 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 give our Community access to affordable, quality healthcare.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	Yes (true)	SignificantChangeInd
Expense	$63,592,921	ExpenseAmt
Grant	$426,888	GrantAmt
Revenue	$74,298,978	RevenueAmt
Desc	Goleta Valley Cottage Hospital is a 52-bed acute-care hospital located in the City of Goleta. In 2016, the Hospital had 3,960 patient days and served 48,055 outpatients, including emergency services to 21,262 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. In addition, grants have been provided for the support of nursing education, various community wellness education programs, health fairs, and the provision of flu shots to the community. In 2016 the hospital spent over $16.1 million on these programs.	Desc
Total Program Service Expenses	$63,592,921	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	Yes (true)	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	79	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	332	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	17	GoverningBodyVotingMembersCnt
Independent Voting Member	16	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Lawrence Thomas	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	8053249933	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	400 West Pueblo	AddressLine1Txt
City	Santa Barbara	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	93105	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (32 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
Steven Ainsley
Board Chair	1.8	18.2	Yes (X)	Yes (X)	$0	$0	$0
Gregory Faulkner
Vice Chair	0.5	4.5	Yes (X)	Yes (X)	$0	$0	$0
Dorothy Largay PhD
Vice Chair	0.5	4.5	Yes (X)	Yes (X)	$0	$0	$0
Marshall (Chip) Turner
Vice Chair	0.5	4.5	Yes (X)	Yes (X)	$0	$0	$0
Edward Bentley MD
Secretary Feb-Dec	0.5	4.5	Yes (X)	Yes (X)	$0	$0	$0
Jon Clark
Committee Chair	0.5	4.5	Yes (X)		$0	$0	$0
Judith Hopkinson
Committee Chair	0.5	4.5	Yes (X)		$0	$0	$0
Fred Lukas
Committee Chair	0.5	4.5	Yes (X)		$0	$0	$0
Robert Nourse
Committee Chair	0.5	4.5	Yes (X)		$0	$0	$0
Margaret Baker
Board Member	0.4	3.6	Yes (X)		$0	$0	$0
Lori Gaskin PhD
Board Member	0.4	3.6	Yes (X)		$0	$0	$0
Harry McMahon
Board Member	0.4	3.6	Yes (X)		$0	$0	$0
Gamble Parks
Board Member	0.4	3.6	Yes (X)		$0	$0	$0
Richard Ponce MD
Board Member	0.4	3.6	Yes (X)		$0	$875	$0
Elliot Prager MD
Board Member	0.4	3.6	Yes (X)		$0	$0	$0
Anne Rodriguez MD
Board Member	0.4	3.6	Yes (X)		$0	$938	$0
Mark Scott MD
Board Member	0.4	3.6	Yes (X)		$0	$0	$0
Alex Koper MD
Secretary thru Jan 2016	0.4	3.6	Yes (X)		$0	$0	$0
Gretchen Milligan
Board Member thru Jan 2016	0.4	3.6	Yes (X)		$0	$0	$0
Robert Nakasone
Vice Chair thru Jan 2016	0.4	3.6	Yes (X)		$0	$0	$0
Tom Watson MD
Board Member thru Jan 2016	0.4	3.6	Yes (X)		$0	$0	$0
Ronald Werft
President & CEO	5.4	54.6		Yes (X)	$0	$1,297,085	$38,969
Steven Fellows
COO	9.0	41.0		Yes (X)	$0	$790,365	$38,969
Brett Tande
CFO	4.5	45.5		Yes (X)	$0	$475,737	$36,112
Joan Bricher
CFO- beginning of year	4.5	45.5		Yes (X)	$0	$321,797	$13,851
Cristina Kern
Asst. Secretary-Board	4.5	45.5		Yes (X)	$0	$93,214	$26,438
ARIE DEJONG
VP GVCH	40.0	0			$344,062	$0	$58,224	Yes (X)
LISA M LA BOUVE
CLINICAL MANAGER	40.0	0			$217,309	$0	$18,929		Yes (X)
SUSAN C SAN MARCO
DIRECTOR SRVC LINE	40.0	0			$216,754	$0	$18,910		Yes (X)
CAROLINE A ROSEN
DIR NURSING GVCH	40.0	0			$208,115	$0	$27,757		Yes (X)
ROSEMARY A BRAY
CLINICAL MANAGER	40.0	0			$203,857	$0	$18,676		Yes (X)
JASON A KORN
CLIN NURSE COORD	40.0	0			$200,018	$0	$18,861		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,390,115	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$2,980,011	TotReportableCompRltdOrgAmt
Total Other Compensation	$315,696	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
HOSPITAL BUILDING & EQUIP CO
11330 OLIVE BLVD	ST LOUIS	MO	63141	CONTRACTOR SERVICES	$2,751,207
SNYDER LANGSTON LP
17962 COWAN	IRVINE	CA	92614	CONSTRUCTION CONTRACTOR	$2,578,346
AMN HEALTHCARE INC
12400 HIGH BLUFF DRIVE	SAN DIEGO	CA	92130	CONTRACT LABOR	$796,966
ANESTHESIA ASSOC MED GROUP INC
ONE POST STREET	SAN FRANCISCO	CA	94104	PHYSICIAN SERVICES	$732,000
ARNDT DALE V
415 FLORA VISTA DRIVE	SANTA BARBARA	CA	93109	GV CONSTRUCTION CONTRACTOR	$709,582

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	24	CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIII	Yes (X)	InfoInScheduleOPartVIIIInd
All Other Contributions	$1,170,517	AllOtherContributionsAmt
Total Contributions	$1,170,517	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE	900099	$71,731,623	$71,731,623
CA HOSPITAL FEE PROGRAM	900099	$1,887,221	$1,887,221
EHR MEDICARE GRANT	900099	$525,853	$525,853

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$74,144,697	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$56,925	TotalRevenueColumnAmt
Exclusion	$56,925	ExclusionAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$4,321	SecuritiesAmt
Other	$0	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$4,386	SecuritiesAmt
Other	$92,727	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	-$65	SecuritiesAmt
Other	-$92,727	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$92,792	TotalRevenueColumnAmt
Exclusion	-$92,792	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
CAFETERIA/GIFT SHOP	900099	$280,491	$280,491
ED INSURANCE PREMIUM REIMBURSEMENT	900099	$84,004		$84,004
Healthy Balance Weight Loss Classes	900099

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$70,277	TotalRevenueColumnAmt
Related Or Exempt Func Income	$70,277	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$434,772	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$75,714,119	TotalRevenueColumnAmt
Related Or Exempt Func Income	$74,298,978	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$244,624	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$426,688	TotalAmt
Program Services	$426,688	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$402,286	TotalAmt
Management And General	$402,286	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$22,165,356	TotalAmt
Program Services	$18,945,044	ProgramServicesAmt
Management And General	$3,220,312	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,966,274	TotalAmt
Program Services	$1,709,170	ProgramServicesAmt
Management And General	$257,104	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$7,383,834	TotalAmt
Program Services	$6,058,145	ProgramServicesAmt
Management And General	$1,325,689	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,449,804	TotalAmt
Program Services	$1,348,906	ProgramServicesAmt
Management And General	$100,898	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$14,479	TotalAmt
Management And General	$14,479	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$12,693	TotalAmt
Management And General	$12,693	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$14,033,035	TotalAmt
Program Services	$10,516,442	ProgramServicesAmt
Management And General	$3,516,593	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$22,818	TotalAmt
Management And General	$22,818	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,219,345	TotalAmt
Program Services	$990,050	ProgramServicesAmt
Management And General	$229,295	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$100,336	TotalAmt
Program Services	$73,330	ProgramServicesAmt
Management And General	$27,006	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,494,893	TotalAmt
Program Services	$1,289,238	ProgramServicesAmt
Management And General	$205,655	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$9,129	TotalAmt
Program Services	$6,196	ProgramServicesAmt
Management And General	$2,933	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$8,704	TotalAmt
Program Services	$7,783	ProgramServicesAmt
Management And General	$921	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$717,868	TotalAmt
Program Services	$613,777	ProgramServicesAmt
Management And General	$104,091	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$6,462,824	TotalAmt
Program Services	$5,526,512	ProgramServicesAmt
Management And General	$936,312	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$383,026	TotalAmt
Program Services	$283,897	ProgramServicesAmt
Management And General	$99,129	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$12,845,299	$12,844,748	$551
SYSTEM MANAGEMENT ALLOCATION
HOSPITAL FEE PROGRAM	$1,714,108	$1,714,108
EQUIPMENT MAINTENANCE	$930,298	$894,503	$35,795

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$468,816	TotalAmt
Program Services	$344,384	ProgramServicesAmt
Management And General	$124,432	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$74,231,913	TotalAmt
Program Services	$63,592,921	ProgramServicesAmt
Management And General	$10,638,992	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$979,353	BOYAmt
EOY	$1,318,719	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$5,268	BOYAmt
EOY	$5,460	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$13,964,183	BOYAmt
EOY	$11,602,129	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$300,000	BOYAmt
EOY	$300,000	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$518,623	BOYAmt
EOY	$643,027	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$562,596	BOYAmt
EOY	$605,430	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$150,788,932	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$34,521,725	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$117,870,410	BOYAmt
EOY	$116,267,207	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$5,699	BOYAmt
EOY	$5,673	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$1,570	BOYAmt
EOY	$1,838	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$343,738	BOYAmt
EOY	$637,029	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$134,551,440	BOYAmt
EOY	$131,386,512	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$8,702,194	BOYAmt
EOY	$5,008,417	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$28,461,436	BOYAmt
EOY	$24,060,434	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$37,163,630	BOYAmt
EOY	$29,068,851	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$97,387,810	BOYAmt
EOY	$102,317,661	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$97,387,810	BOYAmt
EOY	$102,317,661	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$134,551,440	BOYAmt
EOY	$131,386,512	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$1,482,206	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$383	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$3,447,262	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$10,330	OtherActivitiesAmt
Total Lobbying Expenditures	$10,330	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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.
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.

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$118,933,691	OtherCostOrOtherBasisAmt
Depreciation	$20,662,663	DepreciationAmt
Book Value	$98,271,028	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,830,610	OtherCostOrOtherBasisAmt
Depreciation	$2,881,684	DepreciationAmt
Book Value	$1,948,926	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$26,910,111	OtherCostOrOtherBasisAmt
Depreciation	$10,977,378	DepreciationAmt
Book Value	$15,932,733	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$114,520	OtherCostOrOtherBasisAmt
Book Value	$114,520	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$116,267,207	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
SELF INSURANCE LIABILITY	$2,211,121
ACCRUED PENSION & SERP	$5,145,773
GVCH ALLOCATION OF TAX EXEMPT DEBT	$16,082,754
ALL OTHER LIABILITIES	$620,786

Field	Value	IRS element (for citing)
Total Liability	$24,060,434	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote	FormAndLineReferenceDesc
Explanation	Cottage completed an analysis of its tax positions, in accordance with FASB ASC 740, Income Taxes, 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 2012.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	350	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Discounted Care Other	405	DiscountedCareOtherPct

Field	Value	IRS element (for citing)
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$443,029	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$443,029	NetCommunityBenefitExpnsAmt
Total Expense	0.0060	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$9,058,470	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,965,995	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,092,475	NetCommunityBenefitExpnsAmt
Total Expense	0.0821	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$9,501,499	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,965,995	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,535,504	NetCommunityBenefitExpnsAmt
Total Expense	0.0880	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$238,985	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$238,985	NetCommunityBenefitExpnsAmt
Total Expense	0.0032	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$226,688	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$226,688	NetCommunityBenefitExpnsAmt
Total Expense	0.0031	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$200,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$200,000	NetCommunityBenefitExpnsAmt
Total Expense	0.0027	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$665,673	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$665,673	NetCommunityBenefitExpnsAmt
Total Expense	0.0090	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$10,167,172	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,965,995	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,201,177	NetCommunityBenefitExpnsAmt
Total Expense	0.0970	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$4,028,165	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$16,414,482	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$25,414,758	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$9,000,276	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Goleta Valley Cottage Hospital	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	351 South Patterson	AddressLine1Txt
City	Goleta	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	93111	ZIPCd

Field	Value	IRS element (for citing)
Website Address	http://www.cottagehealth.org/locations/goleta-valley-cottage-hospital	WebsiteAddressTxt
State License	050000034	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Goleta Valley Cottage Hospital	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	16	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	http://www.cottagehealth.org/app/files/public/1991/Cottage_Population_Health_CHNA_Report_020217.pdf	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	16	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	https://www.cottagehealth.org/app/files/public/2102/Cottage_Population_Health_Community_Benefit_Impl	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	350.0	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	405.0	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	false	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	http://www.cottagehealth.org/billing/financial-assistance/	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	http://www.cottagehealth.org/billing/financial-assistance/	FAPAppAvailableOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit Report To Credit Agency	Yes (X)	PermitReportToCreditAgencyInd
Permit Legal Judicial Process	Yes (X)	PermitLegalJudicialProcessInd
Collection Activities	Yes (true)	CollectionActivitiesInd
Reporting To Credit Agency	Yes (X)	ReportingToCreditAgencyInd
Engaged Legal Judicial Process	Yes (X)	EngagedLegalJudicialProcessInd
None Made	Yes (X)	NoneMadeInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - GOLETA VALLEY COTTAGE HOSPITAL. As part of this Community Health Needs Assessment, a telephone survey was done with approximately 2500 community members and a listening tour with more than 230 individuals via 20 focus groups conducted from June through August 2016. The focus group participants included public health officials, health providers, nonprofit workers, Cottage Health employees, government leaders and business owners. In addition, existing health and demographic data already collected for the County and State of California was utilized as well as data collected from prior Community Health Needs Assessments. Potential focus group participants were chosen because of their ability to identify primary concerns of the populations that they represent or with whom they work, as well as of the community overall. Focus group candidates were first contacted by letter or email to request their participation. Follow-up phone calls were then made to ascertain whether or not they would be able to attend. Confirmation calls were placed or e-mails sent the day before the groups were scheduled to ensure a reasonable turnout. Through this process, input was gathered from representatives of local government officials, public health, as well as several individuals whose organizations work with low-income, minority (including Latino/Mixteco, Native American, Asian, and African American), or other medically underserved populations (specifically, persons who are young adults, elderly, veterans, disabled, lesbian/gay/bisexual/transgender [LGBT], homeless, mentally ill, undocumented, uninsured/underinsured, or receive Medi-Cal/Medicare). Final participation included representatives of the following organizations: the Santa Barbara County Education Office; Santa Barbara Unified School District; Goleta Union School District; Santa Barbara County Public Health Department; Santa Barbara County Emergency Medical Services Agency; Santa Barbara County Fire Department; Santa Barbara County and Metropolitan Transit District; Santa Ynez Valley Transit; the County Board of Supervisors; Santa Barbara Police Department; City of Solvang; Santa Barbara, Santa Ynez and Solvang Chambers of Commerce; CenCal Health; Community Action Commission; Foodbank of Santa Barbara County; Girls Inc.; Alzheimer's Association; Arthritis Foundation; CALM; Domestic Violence Solutions; Juvenile Diabetes Research Foundation; Mental Wellness Center; New Beginnings Counseling Center; Visiting Nurse and Hospice Care; Carpinteria's Children's Project; Central Coast Collaborative on Homelessness; Family Service Agency; Habitat for Humanity; First 5 of Santa Barbara County; Immigrant Hope; Just Communities; Pacific Pride Foundation; People's Self-Help Housing; Safe Parking Program; Meals on Wheels; Santa Barbara Rape Crisis Center; United Way; Alisal Ranch; and numerous local clergy. All required sources responded and participated. Secondary data sources included data from US Census Bureau, US Department of Education, US Department of Agriculture, US Department of Health and Human Services, Center for Disease Control, Dartmouth College Institute for Health Policy Clinical Practice, State Cancer Profiles, and Nielsen SiteReports.
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. Eight of the 13 leading health indicators identified in the 2016 CHNA fit into the five prioritized health areas: (1) access to care; (2) behavioral health - including injury and violence; (3) chronic conditions; (4) food insecurity; and (5) housing insecurity. The five indicators not prioritized and addressed are: (1) general health status; (2) smoking cigarettes; (3) binge drinking; (4) physical inactivity; and (5) access to dental care. 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 general health status, smoking cigarettes, binge drinking, physical inactivity, and access to dental care. 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 and health fairs. In addition, Goleta Valley Cottage Hospital provides grants to support Health Professional Education.

Field	Value	IRS element (for citing)
Facility	3	FacilityNum

Supplemental Information Detail SupplementalInformationDetail (21 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 OSHPD website: https://www.oshpd.ca.gov/HID/CommunityBenefit/Plans.html
Schedule H, Part I, Line 3c Other Financial Assistance Factors	Goleta Valley Cottage Hospital used the following criteria during the tax year to determine eligibility for free or discounted care (in addition to FPG): asset level, medical indigency, insurance status, underinsurance status, and residency. Patients who were determined to be homeless qualified for free care, assuming they did not qualify for other insurance programs.
Schedule H, Part V Section D	There are no longer any facilities operated outside of the hospital. Upon the completion of the new hospital, both the Breast Care Center and the Wound Center are now operated within the hospital facility.
Schedule H, Part V, Section B Disclosure Pursuant to Rev. Proc. 2015-21	The following information is provided pursuant to Section 7 of Revenue Procedure 2015-21 to disclose certain noncompliance with the requirements of Internal Revenue Code section 501(r). The Revenue Procedure provides for such noncompliance to be reported on the Form 990 filed for the year such noncompliance was discovered (Form 990 for 2017, due May 15, 2018). However, in the interest of timeliness and transparency, Cottage Health is making this disclosure of noncompliance on its Form 990 for 2016 and will reference the disclosure on the 2017 return. SECTION 7.01(1) Internal Revenue Code (Code) sections 501(r)(4) and (r)(6) require a hospital facility to establish a financial assistance policy ("FAP") and to implement processes and procedures in connection with the FAP and with the hospital facility's collections activities. Cottage Health discovered certain errors with respect to its FAP and its collections activities during a review conducted in 2017 by new financial management personnel. The errors apply to years 2011 through 2016. The errors occurred at Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital, and Santa Ynez Valley Cottage Hospital and resulted from a lack of clarity of the 501(r) requirements at the time the policy was implemented in 2011 . Due to its generous financial assistance and discounting practices for patients with low incomes that far exceed the minimum requirements stipulated under section 501(r) and its implementing regulations, Cottage Health has not yet been able to identify any individuals who were affected by the noncompliance, though it will continue to take steps to do so (as further described below). Cottage Health's noncompliance pursuant to Code sections 501(r)(4) and 501(r)(6) included the following: 1. The FAP that Cottage Health established and implemented throughout the time period specified above did not satisfy the "widely publicized" requirement at 26 C.F.R. 1.501(r)-4(b)(1)(ii), did not include certain elements required by 26 C.F.R. 1.501(r)-4(b)(1)(iii), and did not include the methodology used to calculate amounts generally billed to individuals who have insurance covering emergency or other medically necessary care ("AGB") under 26 C.F.R. 1.501(r)-4(b)(2)(i)(C). As a result of not complying with all requirements under 26 C.F.R. 1.501(r)-4, certain individuals who may have otherwise qualified for financial assistance under Cottage Health's FAP may not have received proper notification regarding the availability of such assistance. 2. Cottage Health did not determine AGB pursuant to 26 C.F.R. 1.501(r)-5(b). 3. Cottage Health engaged in extraordinary collection actions ("ECA") to obtain payment for care prior to making reasonable efforts to determine FAP eligibility as required by 26 C.F.R. 1.501(r)-6(c). SECTION 7.01(2) Cottage Health's noncompliance with certain provisions of Code sections 501(r)(4), (r)(5) and (r)(6) was inadvertent and did not rise to the level of willful or egregious conduct. Promptly upon discovery of the noncompliance, Cottage Health exercised reasonable diligence to identify the full scope of noncompliance and promptly took corrective action from April through October 2017. Cottage Health's corrective actions throughout this period included: 1. For each Cottage Health hospital facility, Cottage Health substantially rewrote its FAP, Plain Language Summary, FAP signage and FAP Application; ensured compliance with the "widely publicized" requirement at 26 C.F.R. 1.501(r)-4(b)(1)(ii); verified that the FAP contained all of the elements required at 26 C.F.R. 1.501(r)-4(b)(1)(iii) and the methodology used to calculate AGB required under 26 C.F.R. 1.501(r)-4(b)(2)(i)(C); drafted new language for its Patient Billing Statement; and updated its website so that all are compliant with the documentation and operational requirements at 26 C.F.R. 1.501(r)-4, (r)-5, and (r)-6. In addition, Cottage Health is undertaking additional public outreach to inform affected individuals that the FAP is now available on Cottage Health's website at https://www.cottagehealth.org/billing/financial-assistance/ by sending an email to individuals whose email addresses were on record with one of Cottage Health's hospital facilities. 2. Cottage Health calculated its AGB for medical care provided at each hospital facility, in accordance with 26 C.F.R. 1.501(r)-5(b), and instituted policies and procedures to assure that such information is readily obtainable . During the timeframe at issue, Cottage Health had a generous charity care and financial assistance policy. Patients eligible for assistance were those with family incomes at or below 405% of the federal poverty level ("FPL"), with the lowest discount being 45% off the amount for which the patient was personally responsible, and the highest discount being 100% (for all patients at or below 350% of FPL). To the extent any individual submitted a complete FAP Application during the period at issue, Cottage Health processed the Application and provided financial assistance commensurate with the patient's qualifications under the FAP. Cottage Health will continue to comply with the safe harbor requirements at 26 C.F.R. 1.501(r)-5(d) by accepting completed FAP applications and refunding any amount the individual paid for the care that exceeds the amount s/he is determined to be personally responsible for paying, unless such excess amount is less than $5.00. Additionally, to the extent feasible, Cottage Health is assessing how many, if any, individuals were affected by Cottage Health's noncompliance with the requirements at 26 C.F.R. 1.501(r)-5, and will take corrective action as appropriate to restore affected individuals to the position they would have been in had the noncompliance not occurred. Cottage Health will provide additional information regarding these actions, including, if appropriate, an explanation as to why restoration of one or more individuals was not reasonably feasible, on its Form 990 for tax year 2017, as appropriate. 3. Cottage Health revised its policies and procedures to ensure that it makes reasonable efforts to determine FAP eligibility in accordance with the requirements at 26 C.F.R. 1.501(r)-6(c). Furthermore, Cottage Health has discontinued the use of any ECAs. Additionally, Cottage Health currently is assessing how many individuals were affected by Cottage Health's noncompliance with the requirements at 26 C.F.R. 1.501(r)-6 not to engage in ECAs prior to making reasonable efforts to determine FAP eligibility, and will take corrective action, as appropriate and to the extent reasonably feasible, to restore affected individuals to the position they would have been in had the noncompliance not occurred. Cottage Health will provide additional information regarding these actions, including, if appropriate, an explanation as to why restoration of one or more individuals was not reasonably feasible, on its Form 990 for tax year 2017, as appropriate. SECTION 7.01(3) Cottage Health has revised or newly established practices and procedures for all facilities to minimize the likelihood of recurring noncompliance and to facilitate the prompt identification and correction of any failures that do occur. Cottage Health discontinued the use of any ECAs as of April 2017 . Cottage Health revised its FAP notification on Patient Billing Statements in August 2017 to include additional information regarding the availability of financial assistance. In October 2017, Cottage Health increased the population of patients who qualify for financial assistance from 405% FPL to 445% FPL, which further expands the number of patients who will be FAP-eligible.
Schedule H, Part V, Section B, Line 22 Determining max amt that could be charged for emergency care	Goleta Valley Cottage Hospital did not determine maximum amounts that could be charged to FAP-eligible individuals for emergency or other medically necessary care using the methods specified in Question 22. A more detailed description of the Hospital's noncompliance with this requirement is provided in Part VI.
Schedule H, Part V, Section B, Line 16 FAP Languages	The FAP is available in English and Spanish at the website notated in 16 a and b
Schedule H, Part V, Section B, Line 23 AGB	By meeting the requirements of the safe harbor at 26 C.F.R. 1-501(r)-5(d), Goleta Valley Cottage Hospital is deemed to meet the requirements of 1-501(r)-5(a), which prohibits charging more than AGB for FAP Eligible individuals. Goleta Valley Cottage Hospital has no knowledge of charging more than AGB for any FAP Eligible individuals. After calculating AGB for the years in question, Goleta Valley Cottage Hospital will confirm whether FAP Eligible individuals who applied for FAP and were determined to be eligible for assistance paid more than AGB. A more detailed description is provided in Part VI reference V-B.
Schedule H, Part I, Line 6a Community benefit report prepared by related organization	COTTAGE HEALTH
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	The costing methodology includes inpatient, outpatient, and emergency department and is broken down by Payer categories. Both direct and overhead costs have been allocated, by services rendered. Each Payer's net revenue is offset by the total cost and the results by Payer are calculated. In addition to a hospital wide cost to charge ratio, we have calculated cost to charge ratios for each Payer, based on the cost of the type of services rendered to their specific patients. Therefore, the community benefit amounts attributable to Medicaid and other government programs are calculated based on their specific cost to charge ratio.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	Patient service revenue, net of contractual allowances and discounts, is reduced by the provision for bad debts, and accounts receivable is reduced by an allowance for uncollectible accounts. The hospital establishes an allowance for uncollectible accounts based on many factors, including payer mix, age of receivables, historical cash collection experience, and other relevant information. A portion of the hospital's uninsured patients will be unable or unwilling to pay for their health services a portion of the hospital's insured patients will be unable or unwilling to pay for co-payments and deductibles. If these individuals do not qualify for financial assistance, the hospital records a provision for bad debts related to these insured and uninsured patients in the period the services are provided. The hospital writes down the expected reimbursement after reasonable collection efforts have been exhausted.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	The hospital establishes an allowance for doubtful accounts based on many factors, including payer mix, age of receivables, historical cash collection experience and other relevant information. A significant portion of the hospital's uninsured patients will be unable or unwilling to pay for services provided and a significant portion of Cottage's insured patients will be unable or unwilling to pay for co-payments and deductibles. Thus, hospital records a provision for doubtful accounts related to these insured and uninsured patients in the period the services are provided. The hospital writes down the expected reimbursement after reasonable collection efforts have been exhausted.
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 2016 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 during the relevant time period, which applied to the largest number of patients, stated that collection activities would not be pursued during the 120-day Notification Period, unless FAP Eligibility had been determined, and that any collection activity would cease if the patient submitted a financial assistance application during the requisite time period.
Schedule H, Part V, Section B, Line 16a FAP website	- Goleta Valley Cottage Hospital: Line 16a URL: http://www.cottagehealth.org/billing/financial-assistance/;
Schedule H, Part V, Section B, Line 16b FAP Application website	- Goleta Valley Cottage Hospital: Line 16b URL: http://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 2016, Cottage Health spent over $170 million on these programs.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	COTTAGE HEALTH HAS A MULTIFACETED FINANCIAL ASSISTANCE PROGRAM TO ENSURE THAT ALL PATIENTS RECEIVE INFORMATION ABOUT FINANCIAL ASSISTANCE PROGRAMS AND PATIENTS WHO DO NOT HAVE INSURANCE ARE SCREENED FOR ELIGIBILITY IN A GOVERNMENT SPONSORED HEALTHCARE PLAN. THE HOSPITAL POSTS INFORMATION ABOUT THE FINANCIAL ASSISTANCE PROGRAM IN ALL REGISTRATION AREAS. SIGNS IN ENGLISH AND SPANISH ARE LOCATED IN ALL AREAS WHERE PATIENTS ARE REGISTERED FOR INPATIENT AND OUTPATIENT SERVICES. SIGNS ARE ALSO LOCATED IN THE PATIENT BILLING OFFICE AND CASHIER OFFICE. PATIENTS WILL ALSO BE CONTACTED BY AN ADMITTING REPRESENTATIVE OR ELIGIBILITY COUNSELOR TO ASSIST THE PATIENT IN DETERMINING ELIGIBILITY FOR GOVERNMENT SPONSORED INSURANCE PROGRAMS AND ASSIST WITH THE APPLICATION PROCESS AT NO COST TO THE PATIENT. PATIENT FINANCIAL COUNSELORS WHO ANSWER CUSTOMER SERVICE CALLS ARE INSTRUCTED TO OFFER FINANCIAL ASSISTANCE APPLICATIONS TO ALL PATIENTS WHO INDICATE THEY HAVE FINANCIAL NEED. 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 440,000 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 33.6 years. The population age breakdown is: 27.4% under 20 years old; 59.2% are 20 to 64 years old and 13.4% are 65 and older. For people reporting one race, 46.8% are White; 43.7% are Hispanic; 1.6% are Black or African American; 4.8% are Asian; and 3.1% are Other/Multi-Racial. 16.65% 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 prominent community members who volunteer their time to ensure that the Goleta Community has access to high-quality, affordable healthcare. The Board of Directors is actively involved in the Hospital's strategic decisions and takes its commitment to the Community very seriously. The Board approves of an annual financial budget and reviews a long-term 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 were being used to rebuild the facility. Because of Board foresight, construction was complete and in 2016 Goleta Valley Cottage Hospital moved into its new hospital which complies with the unfunded mandate of the State of California's Senate Bill 1953 (SB1953), requiring 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 met the current and future healthcare needs of the Community. Goleta Valley Cottage Hospital works cooperatively with the open medical staff to improve healthcare in the community. The Hospital is exploring how to better align with physicians in order to provide the highest quality of care.
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

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
CAL STATE UNIV CHANNEL ISLAND FNDTN
ONE UNIVERSITY DRIVE	CAMARILLO	CA	93012	770433230	501(C)(3)	$48,000	(SEE STATEMENT)
SANTA BARBARA CITY COLLEGE
721 CLIFF DRIVE	SANTA BARBARA	CA	93109	770070782	GOVERNMENT	$178,688	(SEE STATEMENT)
SB COUNTY EDUCATION OFFICE
4400 CATHEDRAL OAKS ROAD	SANTA BARBARA	CA	93160	956000940	GOVERNMENT	$200,000	(SEE STATEMENT)

Field	Value	IRS element (for citing)
Total501c3 Org	3	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule I, Part II, Line 1(h) CAL STATE UNIV CHANNEL ISLANDS FNDTN	SUPPORT OF THE BSN PROGRAM IN SANTA BARBARA
Schedule I, Part II, Line 1(h) SANTA BARBARA CITY COLLEGE	SUPPORT OF THE NURSING DEPARTMENT AT SANTA BARBARA CITY COLLEGE
Schedule I, Part II, Line 1(h) SB COUNTY EDUCATION OFFICE	SUPPORT OF CHILDREN'S ORAL HEALTH PROGRAM
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.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Ronald Werft
President & CEO	$0	$900,643	$0	$303,753	$0	$92,689	$0	$13,500	$0	$25,469	$0	$1,336,054	$0	$0
Steven Fellows
COO	$0	$550,031	$0	$160,574	$0	$79,760	$0	$13,500	$0	$25,469	$0	$829,334	$0	$0
Brett Tande
CFO	$0	$450,865	$0	$0	$0	$24,872	$0	$13,500	$0	$22,612	$0	$511,849	$0	$0
Joan Bricher
CFO- beginning of year	$0	$80,833	$0	$140,641	$0	$100,323	$0	$11,074	$0	$2,777	$0	$335,648	$0	$0
ARIE DEJONG
VP GVCH	$288,225	$0	$45,952	$0	$9,885	$0	$32,755	$0	$25,469	$0	$402,286	$0	$0	$0
LISA M LA BOUVE
CLINICAL MANAGER	$179,176	$0	$21,979	$0	$16,154	$0	$10,058	$0	$8,871	$0	$236,238	$0	$0	$0
SUSAN C SAN MARCO
DIRECTOR SRVC LINE	$196,458	$0	$16,487	$0	$3,809	$0	$10,647	$0	$8,263	$0	$235,664	$0	$0	$0
CAROLINE A ROSEN
DIR NURSING GVCH	$187,237	$0	$15,073	$0	$5,805	$0	$10,116	$0	$17,641	$0	$235,872	$0	$0	$0
ROSEMARY A BRAY
CLINICAL MANAGER	$126,924	$0	$10,509	$0	$66,424	$0	$6,872	$0	$11,804	$0	$222,533	$0	$0	$0
JASON A KORN
CLIN NURSE COORD	$199,798	$0	$0	$0	$220	$0	$9,990	$0	$8,871	$0	$218,879	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

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 6.95% 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 HOSPITAL AND ARE INCLUDED IN OTHER ASSETS AND THE ACCRUED EXPENSE IS INCLUDED IN PENSION LIABILITY AND OTHER IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS. THE AMOUNTS REPORTED IN THE CURRENT YEAR'S DEFERRED COMPENSATION INCLUDES RECOGNITION OF PAST SERVICE. THE AMOUNTS ARE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. ANY DEFERRED CONTRIBUTIONS TO THIS PLAN WILL BE REPORTED AGAIN AS REPORTABLE COMPENSATION IN THE YEAR PAID. In 2016, no employee received a 457(f) payout.

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Arie DeJong	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Relationship With Org	Vice President	RelationshipWithOrgTxt
Loan Purpose	Home Purchase	LoanPurposeTxt
Loan From Organization	Yes (X)	LoanFromOrganizationInd
Original Principal	$300,000	OriginalPrincipalAmt
Balance Due	$300,000	BalanceDueAmt
Default	false	DefaultInd
Board Or Committee Approval	Yes (true)	BoardOrCommitteeApprovalInd
Written Agreement	Yes (true)	WrittenAgreementInd

Field	Value	IRS element (for citing)
Total Balance Due	$300,000	TotalBalanceDueAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part III, Line 3 Significant changes in program services	Goleta Valley Cottage Hospital moved into its new facility in 2015. The new hospital building did not accommodate subacute care patients. In anticipation of the move, accommodations at a nearby facility were arranged for all subacute patients remaining in Goleta Valley Cottage Hospital. In June 2015 the subacute contract with the State of California was terminated. This reduced Goleta Valley Cottage Hospital's licensed beds from 122 to 52 during 2015.
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. 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.
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 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 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 April 29, 2016.
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	OTHER - Total Revenue: 70277, Related or Exempt Function Revenue: 70277, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part IX, Line 11g Other Fees	Laboratory Purchased Services - Total Expense: 2302150, Program Service Expense: 2302150, Management and General Expenses: , Fundraising Expenses: ; Medical Professional Fees - Total Expense: 3172814, Program Service Expense: 2523615, Management and General Expenses: 649199, Fundraising Expenses: ; Contract Labor - Total Expense: 886637, Program Service Expense: 786815, Management and General Expenses: 99822, Fundraising Expenses: ; Other Purchased Services - Total Expense: 7671434, Program Service Expense: 4903862, Management and General Expenses: 2767572, Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	CHANGE IN PENSION LIABILITY - 3447262;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
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	Yes (true)
SANTA YNEZ VALLEY COTTAGE HOSPITAL
PO BOX 689	SANTA BARBARA	CA	931020689	952224265	HOSPITAL	CA	501(c)(3)	3	COTTAGE HEALTH	Yes (true)
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		false	N/A
GOLETA VALLEY PROFESSIONAL BUILDINGS INC
PO BOX 689	SANTA BARBARA	CA	931020689	770004202	MEDICAL PROF BLDG	CA	501(c)(3)	Type II	COTTAGE HEALTH	Yes (true)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	Abraaj Global Growth Markets Fund (B) LP	BusinessNameLine1Txt

Foreign Address ForeignAddress

Field	Value	IRS element (for citing)
Address Line1	PO Box 309	AddressLine1Txt
City	Ugland House	CityNm
Province Or State	Grand Cayman	ProvinceOrStateNm
Country	CJ	CountryCd
Foreign Postal	KY11104	ForeignPostalCd

Field	Value	IRS element (for citing)
EIN	981207058	EIN
Primary Activities	Investment Funds	PrimaryActivitiesTxt
Legal Domicile Foreign Country	CJ	LegalDomicileForeignCountryCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Entity Type	S Corporation	EntityTypeTxt
Share Of Total Income	$0	ShareOfTotalIncomeAmt
Share Of EOY Assets	$0	ShareOfEOYAssetsAmt
Ownership	0	OwnershipPct
Controlled Organization	false	ControlledOrganizationInd

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (true)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Santa Barbara Cottage Hospital
M	$2,302,150	accrual
Santa Barbara Cottage Hospital
O	$2,725,290	accrual