2016-11-15T11:01:24-06:00 2015-12-31 346565596 Ernst & Young LLP 560 Mission St Suite 1600 San Francisco CA 94105 990 2015-01-01 952413596 Goleta Valley Cottage Hospital GOLE 8053249903 PO BOX 689 Santa Barbara CA 931020689 Brett Tande Sr. Vice President & CFO 2016-08-10 false Eva Nitta P01286320 4158948000 2015 2017-02-10 21:41:12Z Ronald Werft PO BOX 689 Santa Barbara CA 931020689 79900814 false X http://www.cottagehealth.org/locations/goleta-valley-cottage-hospital X 1965 CA 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. 18 16 400 113 0 0 2375000 3518287 76865860 75937153 282481 45616 424277 396165 79947618 79897221 258750 225453 0 31634563 34504424 0 0 33552002 39717905 65445315 74447782 14502303 5449439 133353188 134551440 43215589 37163630 90137599 97387810 X 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. false true 61926899 225453 76057363 Goleta Valley Cottage Hospital is a 52-bed acute-care hospital located in the City of Goleta. In 2015, the Hospital had 7,499 patient days and served 43,553 outpatients, including emergency services to 19,898 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. Those 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. Activities in these areas included screenings and health fairs; classes, clinics, lectures, and seminars; community services; community collaborations; and coalitions/committees. In 2015 the hospital spent over $16.1 million on these programs. 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. 61926899 true true false true false false false false false false true false false false true true false true false false false false false false false false true true true false true false false false true false false false false false false false false false true true true false false true 81 0 true 400 true false false false false false false false false false false X 18 16 false false false false true true true true true false false true true true true true true true true false CA X Karen Jones Grandidier 8055697294 400 West Pueblo Santa Barbara CA 93105 Robert E M Nourse Chair 1.8 18.2 X X 0 0 0 P Steven Ainsley Vice Chair 0.5 4.5 X X 0 0 0 Robert C Nakasone Vice Chair 0.5 4.5 X X 0 0 0 Marshall (Chip) Turner Jr Vice Chair 0.5 4.5 X X 0 0 0 Alex Koper MD Secretary 0.5 4.5 X X 0 0 0 Gregory F Faulkner Vice Chair 0.5 4.5 X 0 0 0 Edward S Bentley MD Committee Chair 0.5 4.5 X 0 0 0 Jon Clark Committee Chair 0.5 4.5 X 0 0 0 Judith Hopkinson Committee Chair 0.5 4.5 X 0 0 0 Fred Lukas Committee Chair 0.5 4.5 X 0 0 0 Margaret Baker Director 0.4 3.6 X 0 0 0 Lori Gaskin PhD Director 0.4 3.6 X 0 0 0 Dorothy Largay Director 0.4 3.6 X 0 0 0 Harry McMahon Director 0.4 3.6 X 0 0 0 Gretchen Milligan Director 0.4 3.6 X 0 0 0 Gamble Parks Director 0.4 3.6 X 0 0 0 Elliot Prager MD Director 0.4 3.6 X 0 0 0 Thomas Watson MD Director 0.4 3.6 X 0 7000 0 Ronald Werft President & CEO 5.4 54.6 X 0 1212091 37675 Joan Bricher CFO 4.5 45.5 X 0 686061 31045 Steven Fellows COO 10.0 40.0 X 0 753412 37675 Julie Artoux Asst Secretary 4.5 45.5 X 0 130529 14955 Arie Dejong VP GVCH 40.0 0 X 340047 0 56685 Susan San Marco Director Srvc Line 40.0 0 X 214361 0 19488 Lisa La Bouve Clinical Manager 40.0 0 X 195851 0 18591 Caroline Rosen Director Nursing-GVCH 40.0 0 X 192121 0 13498 Mary Fulcher Clinical Manager 40.0 0 X 190945 0 31225 Ken Kettler Radiology Mgr-Gvch 40.0 0 X 190173 0 26614 1323496 2789092 287451 82 false true false ANESTHESIA ASSOCIATES MEDICAL GROUP INC 5333 HOLLISTER AVE 130 SANTA BARBARA CA 93111 PHYSICIAN SERVICES 730000 SINDONI CONSULTING & MANAGEMENT SERVICES 1107 QUAIL STREET NEWPORT BEACH CA 92660 Construction management 427172 AMN Healthcare Inc PO Box 56157 Los Angeles CA 900746157 Contract Labor 395103 MICHAEL L DAVIS & ASSOCIATES INC 1835 NEWPORT BLVD SUITE A109 COSTA MESA CA 92627 INSPECTION SERVICES 355859 RIGHTSOURCING INC 999 STEWART AVE SUITE 100 BETHPAGE NY 11714 CONRACT LABOR 342594 27 X 3518287 3518287 NET PATIENT SERVICE REVENUE 900099 74862097 74862097 CA HOSPITAL FEE PROGRAM 900099 1044863 1044863 EHR MEDICARE GRANT 900099 30193 30193 0 0 0 0 75937153 45561 45561 0 0 3648 3593 55 0 55 55 CAFETERIA/GIFT SHOP 900099 275955 275955 ED INSURANCE PREMIUM REIMBURSEMENT 900099 79921 79921 Healthy Balance Weight Loss Classes 900099 17225 17225 23064 23064 0 0 396165 79897221 76057363 0 321571 X 225453 225453 396732 396732 22708160 19933478 2774682 2801045 2459318 341727 7041626 5769901 1271725 1556861 1471259 85602 4005 4005 42343 42343 11498602 7881544 3617058 0 1671881 1388656 283225 93900 78246 15654 1563092 1375636 187456 6421 5494 927 3819 2556 1263 389657 342119 47538 4983044 4410895 572149 772647 684375 88272 MEDICAL SUPPLIES 13472434 13472322 112 SYSTEM MANAGEMENT ALLOCATION 2113478 2113478 HOSPITAL FEE PROGRAM 1363600 1363600 EQUIPMENT MAINTENANCE 995912 968871 27041 743070 93176 649894 0 74447782 61926899 12520883 0 5150733 979353 5400 5268 10125397 13964183 300000 300000 0 0 463734 518623 457938 562596 148892286 31021876 115450222 117870410 5965 5699 1433 1570 0 1392366 343738 133353188 134551440 13284384 8702194 0 29931205 28461436 43215589 37163630 X 90137599 97387810 0 0 90137599 97387810 133353188 134551440 X 5449439 -430 1801202 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 44730 44730 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. 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. 115526897 16950341 98576556 2270321 2270321 0 28035805 11357644 16678161 3059263 443570 2615693 117870410 SELF INSURANCE LIABILITY 2497745 DUE TO AFFILIATES 1676310 ACCRUED PENSION & SERP 8204627 GVCH ALLOCATION OF TAX EXEMPT DEBT 16082754 ALL OTHER LIABILITIES 0 28461436 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote Goleta Valley Cottage Hospital 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. Goleta Valley Cottage Hospital has recognized no interest or penalties related to uncertain tax positions. Goleta Valley Cottage Hospital 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 2011. true true X true X 350 true X 405 true true false true true 418192 418192 0.0056 12508761 3855103 8653658 0.1162 0 0.0 0 0 12926953 3855103 9071850 0.1219 24087 24087 0.0003 125455 125455 0.0017 4972 4972 0.0001 0 0.0 100000 100000 0.0013 0 0 254514 0 254514 0.0034 0 0 13181467 3855103 9326364 0.1253 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 3003825 0 14847668 21675149 -6827481 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 13 true true false true X http://santabarbaragoleta.healthforecast.net/2013%20PRC%20CHNA%20Report%20-%20Cottage%20Health%20Sys X X true 13 true https://www.cottagehealth.org/app/files/public/1303/CHNA_Implementation_Strategy_GVCH_2014.pdf false false true X 350.0 405.0 X X X X X true true X X X true X www.cottagehealth.org/patients-visitors/billing-insurance-financial-assistance/financial-assistance/ X www.cottagehealth.org/app/files/public/1408/Financial-Assistance-Application-English-2016.pdf X www.cottagehealth.org/patients-visitors/billing-insurance-financial-assistance/financial-assistance/ X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - GOLETA VALLEY COTTAGE HOSPITAL. As part of this Community Health Needs Assessment, five focus groups were held on October 9-10, 2013. The focus group participants included 52 local key informants: representatives from public health; physicians; other health professionals; social service providers; employers; and other community leaders. A list of recommended participants for the focus groups was provided by Cottage Health. Potential participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall. Focus group candidates were first contacted by letter 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 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, Santa Barbara Neighborhood Clinics, Planned Parenthood of Santa Barbara, Ventura, & San Luis Obispo Counties, American Indian Health & Services, Mental Wellness Center, Santa Barbara Rescue Mission, Council on Alcoholism & Drug Abuse, County of Santa Barbara Department of Social Services, Foodbank of Santa Barbara County, Pacific Pride, Domestic Violence Solutions, Sarah House, Arthritis Foundation, Pacific Region, Central Coast Office, Hospice of Santa Barbara, Alliance for Living & Dying Well, CenCal Health, Community Action Commission, Central Coast Commission for Senior Citizens-Area Agency on Aging, Visiting Nurse & Hospice Care, DASH (Doctors Assisting Seniors at Home), Carpinteria Children's Project at Main, United Way of Santa Barbara County, American Red Cross, Santa Barbara County Chapter Alzheimer's Association, California Central Chapter, Alpha Resource Center of Santa Barbara, American Heart Association, Central Coast Division , PathPoint, Friendship Center , Independent Living Resource Center, Isla Vista Youth Projects, County of Santa Barbara Public Health Department, Santa Barbara Neighborhood Clinics, Sansum Clinic, Cottage Health, Santa Barbara Street Medicine - Doctors Without Walls, Santa Barbara City College and the Orfalea Foundation. All required sources responded and participated. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - GOLETA VALLEY COTTAGE HOSPITAL. The CHNA was completed in conjunction with Santa Barbara 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 will be incorporated into the Community Benefit Program of CH. The implementation strategy of the CH Community Benefit Program is to address all the needs identified in the Hospital CHNA through various hospital programs, health fairs and grant programs. Santa Barbara Cottage Hospital supports the following identified health needs through its hospital programs and health fairs: Access to Care, Immunization & Infectious Diseases, Infant Health & Family Planning, Substance Abuse, Nutrition, Physical Activity & Weight, Dementias, Diabetes, and Mental Health & Mental Disorders. The hospital doesn't support Oral Health through direct programs but does provide grants to support this focus area. Schedule H, Part V, Section B, Line 22 Facility , 1 Facility , 1 - GOLETA VALLEY COTTAGE HOSPITAL. The maximum that can be charged is a percentage discount on gross charges which is lower than what is charged to commercially-insured patients. 3 Breast Care Center 351 SO PATTERSON Goleta CA 93117 Outpatient services Wound Care Center Goleta 351 SO PATTERSON Goleta CA 93117 Outpatient Wound Care Wound Care Center Solvang 2028 Village Lane Suite 202 Solvang CA 93463 Outpatient Wound Care 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 PATIENTS THAT ARE DETERMINED TO BE HOMELESS QUALIFY FOR PRESUMPTIVE FINANCIAL ASSISTANCE, ONCE IT IS DETERMINED THAT THEY DO NOT QUALIFY FOR OTHER INSURANCE PROGRAMS. 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 Payers 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 services provided and 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 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 2015 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 All patients receive 6 statements over 135 days, which include a statement about how to inquire about financial assistance. Patients who are known to qualify for financial assistance or are in the process of applying for financial assistance are not sent to collection until a final financial assistance determination is made. If they qualify, their account is written down to zero. Schedule H, Part V, Section B, Line 16a FAP website - Goleta Valley Cottage Hospital: Line 16a URL: www.cottagehealth.org/patients-visitors/billing-insurance-financial-assistance/financial-assistance/; Schedule H, Part V, Section B, Line 16b FAP Application website - Goleta Valley Cottage Hospital: Line 16b URL: www.cottagehealth.org/app/files/public/1408/Financial-Assistance-Application-English-2016.pdf; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - Goleta Valley Cottage Hospital: Line 16c URL: www.cottagehealth.org/patients-visitors/billing-insurance-financial-assistance/financial-assistance/; Schedule H, Part VI, Line 2 Needs assessment Cottage Health, through its hospitals Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital, researched the needs of the county through the Community Health Needs Assessment (CHNA). In addition, Santa Ynez Valley Cottage Hospital performed their own CHNA. For each hospital, an outside consultant was engaged to review the relevant health and population statistics, conduct a telephone survey and hold focus groups with area leaders who represented a broad group of community members. Along with the CHNA conducted by the Hospitals, CH also utilized the health assessment prepared by the County of Santa Barbara to assess the health of the community. Needs identified in the CHNA include: Access to Care, Immunization & Infectious Diseases, Infant Health & Family Planning, Oral Health, Substance Abuse, Nutrition, Physical Activity & Weight, Dementia, Diabetes, and Mental Health & Mental Disorders. Hospitals are using the information to further support the robust community benefit program that was already in place. 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 2015, Cottage Health spent over $155 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 patients who do not have insurance are screened for eligibility in a government sponsored healthcare plan and receive information about financial assistance programs. Every patient who does not present the hospital with proof of insurance or existing government support will be given a handout (in English or Spanish) upon registration that is compliant with California Assembly Bill 774 (AB774). The handout contains information about the Hospital financial assistance programs. This includes where to obtain applications, income guidelines, other qualification information and contact information for Customer Service and the Admitting department. The Hospital posts information about the financial assistance program in all registration areas required by AB774. Signs in English and Spanish are located in all areas where patients are registered for inpatient and outpatient services. Signs are also located in the patient billing office and cashier office. Patients will also be contacted by an admitting representative or eligibility counselor to assist the patient in determining eligibility for government sponsored insurance programs and assist with the application process at no cost to the patient. Patient Financial Counselors who answer customer service calls are instructed to offer financial assistance applications to all patients who indicate they have financial need. 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 435,697 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: 29% percent is 0 to 17 years old; 57 % are 20 to 64 years old and 14% are 65 and older. For people reporting one race, 85.8% are White; 2.4% are Black or African American; 2.2% are American Indian or Alaska Native; 5.8% are Asian; less than 0.2% are Native Hawaiian or Other Pacific Islander, and 3.6% reported 2 or more races. Persons reporting Hispanic or Latino origin are 44.8%. 17.4% 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. In 2016 Goleta Valley Cottage Hospital will move 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 will meet the current and future healthcare needs of the Community. Goleta Valley Cottage Hospital works cooperatively with the open medical staff to improve healthcare in the community. The Hospital is exploring how to better align with physicians in order to provide the highest quality of care. 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 Cal State Univ Channel Islands Fndtn One University Drive Camarillo CA 93012 770433230 501(c)(3) 48000 Support of the BSN program in Santa Barbara The Foundation for SB City College 721 Cliff Drive Santa Barbara CA 93109 953234551 501(c)(3) 46125 Support of the nursing department at Santa Barbara City College SANTA BARBARA CITY COLLEGE 721 Cliff Drive Santa Barbara CA 93109 770070782 government 31328 Support of the nursing department at Santa Barbara City College SB County Education Office 4400 Cathedral Oaks Road Santa Barbara CA 93160 956000940 GOVERNMENT 100000 Support of Children's Oral Health Program 4 0 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 X false true false false false false false false false Ronald Werft President & CEO 0 892108 0 284164 0 35819 0 13250 0 24425 0 1249766 0 0 Joan Bricher CFO 0 499644 0 134130 0 52287 0 13250 0 17795 0 717106 0 0 Steven Fellows COO 0 544854 0 153828 0 54730 0 13250 0 24425 0 791087 0 0 Arie Dejong VP GVCH 289946 0 46681 0 3420 0 31356 0 25329 0 396732 0 0 0 Susan San Marco Director Srvc Line 198881 0 14538 0 942 0 10671 0 8817 0 233849 0 0 0 Lisa La Bouve Clinical Manager 185290 0 10193 0 368 0 9774 0 8817 0 214442 0 0 0 Caroline Rosen Director Nursing-GVCH 181740 0 9056 0 1325 0 9540 0 3958 0 205619 0 0 0 Mary Fulcher Clinical Manager 190056 0 158 0 731 0 9511 0 21714 0 222170 0 0 0 Ken Kettler Radiology Mgr-Gvch 175458 0 9658 0 5057 0 9256 0 17358 0 216787 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 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 2015, no employee received a 457(f) payout. Arie DeJong Vice President Home Purchase X 300000 300000 false true true 300000 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 Vice President of Finance and CFO. Form 990 is reviewed by independent tax consultants prior to submitting to the Audit and Compliance Committee. All members of the Board receive a copy of the organization's form 990 for review prior to filing via the Board Portal. 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 6, 2015. 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 ALL OTHER INCOME - Total Revenue: 23064, Related or Exempt Function Revenue: 23064, 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: 2001993, Program Service Expense: 2001993, Management and General Expenses: 0, Fundraising Expenses: ; Medical Professional Fees - Total Expense: 1994473, Program Service Expense: 1731671, Management and General Expenses: 262802, Fundraising Expenses: ; Contract Labor - Total Expense: 751304, Program Service Expense: 599001, Management and General Expenses: 152303, Fundraising Expenses: ; Other Purchased Services - Total Expense: 6750832, Program Service Expense: 3548879, Management and General Expenses: 3201953, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances CHANGE IN PENSION LIABILITY - 1801202; COTTAGE HEALTH PO BOX 689 SANTA BARBARA CA 931020689 770431902 PARENT ORGANIZATION FOR 3 HOSPITALS & MEDICAL PROF BLDG CA 501(c)(3 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 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 FOUNDATION TO SUPPORT SANTA BARBARA COTTAGE HOSPITAL CA 501(c)(3 7 N/A false GOLETA VALLEY PROFESSIONAL BUILDINGS INC PO BOX 689 SANTA BARBARA CA 931020689 770004202 MEDICAL PROF BLDG CA 501(c)(3 Type I COTTAGE HEALTH true false false false false false false false false false false true false true true true true true true true Cottage Health M 2268478 accrual Cottage Health O 169045 accrual Cottage Health P 10385489 accrual Cottage Health Q 2259353 accrual Cottage Health S 106711 accrual Santa Barbara Cottage Hospital M 2027653 accrual Santa Barbara Cottage Hospital O 1612178 accrual Santa Barbara Cottage Hospital P 31159383 accrual Santa Barbara Cottage Hospital Q 946326 accrual Santa Barbara Cottage Hospital R 776258 accrual Santa Barbara Cottage Hospital S 2631157 accrual Santa Ynez Valley Cottage Hospital O 77555 accrual Goleta Valley Professional Building Q 61403 accrual Goleta Valley Professional Building R 113872 accrual SB Cottage Hosp Foundation K 205068 accrual