2021-08-16T13:49:11-05:00 2020-09-30 366055558 GRANT THORNTON LLP 75 STATE ST 13TH FLOOR BOSTON MA 02109 990 2019-10-01 571119337 CONWAY HOSPITAL COMMUNITY SERVICES CONW 8433478037 300 SINGLETON RIDGE ROAD CONWAY SC 29526 BRIAN ARGO TREASURER 8433478037 2021-08-16 1 ERIN COUTURE P01390592 6177237900 2019 2022-09-23 18:48:47Z BRET BARR 300 SINGLETON RIDGE ROAD CONWAY SC 29526 3134372 0 X WWW.CONWAYMEDICALCENTER.COM X 2001 SC SEE SCHEDULE O 2 0 298 0 0 0 13190 0 22471724 3134372 -13089 -328994 0 0 22471825 2805378 0 0 0 0 24651180 2337761 0 0 0 6454482 1502807 31105662 3840568 -8633837 -1035190 12462409 8189575 75601658 72364014 -63139249 -64174439 X PROVISION OF OUTPATIENT HEALTH CARE SERVICES TO HORRY COUNTY AND THE SURROUNDING COMMUNITY IN CONJUNCTION WITH CONWAY HOSPITAL, INC. 0 0 3844386 0 3134372 IT IS THE PURPOSE OF CONWAY HOSPITAL COMMUNITY SERVICES TO PROVIDE THE BEST OUTPATIENT CARE THROUGH HOSPITAL PHYSICIAN OFFICES LOCATED THROUGHOUT THE COMMUNITY. DURING THE FISCAL YEAR, 16,006 PATIENTS WERE TREATED BY EMPLOYED PROVIDERS OF THE CORPORATION. ALL BUT THE TWO AYNOR PRACTICES WERE TRANSFERRED UNDER CONWAY HOSPITAL'S FEIN AT THE END OF FISCAL YEAR 2019.IN MARCH 2020, THE WORLD HEALTH ORGANIZATION DECLARED COVID-19, THE DISEASE CAUSED BY THE NOVEL CORONAVIRUS, A PANDEMIC, WHICH STARTED TO AND CONTINUES TO SPREAD THROUGHOUT THE UNITED STATES OF AMERICA. AS A RESULT OF THE COVID-19 PANDEMIC, THE CONWAY HOSPITAL AND ITS AFFILITATES EXPERIENCED A DECLINE IN PATIENT VISITS, ADMISSIONS, AND MEDICAL PROCEDURES PERFORMED. ELECTIVE MEDICAL PROCEDURES WERE SUSPENDED BY STATE AND LOCAL GOVERNMENTS AT VARYING TIME PERIODS BEGINNING IN MID-MARCH THROUGH LATE JULY 2020, CONTRIBUTING TO A SIGNIFICANT DECLINE IN PATIENT SERVICE REVENUE DUE TO COVID-19 WHEN COMPARED TO HISTORIC AND FORECASTED RESULTS FOR THAT PERIOD. 3844386 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 31 0 1 298 1 0 0 0 0 0 0 0 0 0 0 0 0 X 2 0 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 SC X BRIAN ARGO 8433478037 300 SIGLETON RIDGE ROAD CONWAY SC 29526 BRET BARR PRESIDENT 1.00 43.00 X X 0 608195 47331 ANDREW GRESKO PHYSICIAN 40.00 0.00 X 590512 0 23493 SAMER CHARBEL PHYSICIAN 40.00 0.00 X 426224 0 17800 BRIAN ARGO TREASURER/SECRETARY 1.00 43.00 X X 0 385469 43668 MEGHAN MALONE PHYSICIAN 40.00 0.00 X 387099 0 14000 WARREN RATLEY VICE PRESIDENT 40.00 0.00 X 345921 0 23098 RAM PENMETSA PHYSICIAN 40.00 0.00 X 386250 0 2327 HAFEZ HAYEK PHYSICIAN 40.00 0.00 X 474277 0 3800 2610283 993664 175517 42 0 1 0 EARLY OUT SERVICES INC 5807 N 102ND ST OMAHA NE 68134 COLLECTIONS 164623 CONWAY COMMERICAL CLEANING 5786 ADRIAN HWY CONWAY SC 29526 HOUSEKEEPING 147865 SSI GROUP INC 4721 MORRISON DR MOBILE AL 36609 COLLECTIONS 126527 OMEGA MEDICAL SOLUTIONS LLC PO BOX 50431 MYRTLE BEACH SC 29579 COLLECTIONS 115651 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 ACCOUNTING 110119 5 NET PATIENT REVENUE 621110 2820214 2820214 ALL OTHER PROGRAM REVENUE 900099 276591 276591 HOSPITAL PHYSICIAN FEES 900099 37567 37567 3134372 328994 -328994 -328994 -328994 2805378 3134372 0 -328994 2059324 2056479 2845 37976 37311 665 142839 142785 54 97622 142327 -44705 110878 110468 410 14139 14139 340045 322432 17613 147 147 232343 230671 1672 110138 110138 791 791 308809 308809 55466 55466 MINOR EQUIPMENT 151604 151604 MEDICAL SUPPLIES 97729 97729 LICENSES 50704 50704 TRAINING/EDUCATION 10982 9882 1100 19032 16643 2389 3840568 3844386 -3818 0 1158021 140597 1532267 490728 166702 9404 9487148 1938302 9605419 7548846 12462409 8189575 1861525 236603 73740133 72127411 75601658 72364014 X -63139249 -64174439 -63139249 -64174439 12462409 8189575 -1035190 0 X 0 1 X 1 0 X 2562443 2562443 6083809 1480137 4603672 240345 204052 36293 600551 254113 346438 7548846 DUE TO CONWAY HOSPITAL INC. 72127411 72127411 X PART X, LINE 2: LIABILITY FOR UNCERTAIN TAX POSITION (ASC 740) THE HOSPITAL CONTINUES TO EVALUATE TAX POSITIONS RELATED TO ASC 740, "INCOME TAXES," WHICH PRESCRIBES FINANCIAL STATEMENT RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTES FOR TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN TAX RETURNS. AS OF SEPTEMBER 30, 2020, THE TAX YEARS ENDED SEPTEMBER 30, 2020, 2019 AND 2018 FOR FEDERAL JURISDICTION REMAIN OPEN TO EXAMINATION. 1 1 0 0 0 0 0 0 0 BRET BARR PRESIDENT 0 417418 0 166853 0 23924 0 18317 0 29014 0 655526 0 0 ANDREW GRESKO PHYSICIAN 457179 0 0 0 133333 0 0 0 23493 0 614005 0 0 0 SAMER CHARBEL PHYSICIAN 426224 0 0 0 0 0 14000 0 3800 0 444024 0 0 0 BRIAN ARGO TREASURER/SECRETARY 0 302442 0 79520 0 3507 0 16157 0 27511 0 429137 0 0 MEGHAN MALONE PHYSICIAN 387099 0 0 0 0 0 14000 0 0 0 401099 0 0 0 WARREN RATLEY VICE PRESIDENT 66381 0 0 0 279540 0 0 0 23098 0 369019 0 0 0 RAM PENMETSA PHYSICIAN 386250 0 0 0 0 0 0 0 2327 0 388577 0 0 0 HAFEZ HAYEK PHYSICIAN 474277 0 0 0 0 0 0 0 3800 0 478077 0 0 0 PART I, LINES 4A-B SUPPLEMENTAL SERVERANCE PAYMENTS CONWAY HOSPITAL PROVIDED SERVERANCE PAYMENTS OF $160,493 TO WILLIAM RATLEY AND $133,333 TO ANDREW GRESKO. THESE AMOUNTS ARE INCLUDED IN THE WAGES REPORTED ON THIS FORM 990. SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN COMPENSATION FOR KEY EXECUTIVES IS PROVIDED BY RELATED ENTITY CONWAY HOSPITAL, INC. DURING THE YEAR ENDED SEPTEMBER 30, 2020, CONWAY HOSPITAL, INC. AND KEY EXECUTIVES HELD JOINTLY OWNED SPLIT-DOLLAR AGREEMENTS THROUGH AN INSURANCE COMPANY. THE FOLLOWING EXECUTIVES PARTICIPATED IN THE PLAN DURING THE YEAR: BRET BARR. CERTAIN EXECUTIVES PARTICIPATED IN A CAPITAL ACCUMULATION PLAN PROVIDED BY THE COMPANY. THE FOLLOWING EMPLOYEES RECEIVED DISTRIBUTIONS FROM THE PLAN. ALL AMOUNTS ARE INCLUDED IN THE EMPLOYEE'S W-2. BRET BARR - $7,144 WARREN RATLEY - $119,047 FORM 990 PART I, ORGANIZATION MISSION PROVISION OF OUTPATIENT HEALTH CARE SERVICES TO HORRY COUNTY AND THE SURROUNDING COMMUNITY IN CONJUNCTION WITH CONWAY HOSPITAL, INC. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIPS BRET BARR AND BRIAN ARGO HAVE A BUSINESS RELATIONSHIP. BOTH ARE OFFICERS OF CONWAY HOSPITAL, INC., THE ORGANIZATION RELATED TO THIS ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS CONWAY HOSPITAL, INC. IS THE SOLE MEMBER OF CONWAY HOSPITAL COMMUNITY SERVICES. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OR STOCKHOLDERS WHO MAY ELECT THE TRUSTEES OF CONWAY HOSPITAL COMMUNITY SERVICES, INC. ARE APPOINTED BY CONWAY HOSPITAL INC.'S BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS SUBJECT TO APPROVAL CONWAY HOSPITAL COMMUNITY SERVICES, INC. BOARD OF TRUSTEES SHALL MAKE OR OVERSEE MANAGEMENT AND OPERATIONAL MATTERS OF THE CORPORATION. CONWAY HOSPITAL, INC. RESERVES TO ITS OWN BOARD OF TRUSTEES THE AUTHORITY TO DIRECT ALL FINANCIAL MATTERS AND MATTERS AFFECTING THE PURPOSE OF THE CORPORATION. APPROVAL BY THE CONWAY HOSPITAL BOARD OF TRUSTEES IS REQUIRED FOR ALL AMENDMENTS TO THE BY LAWS OF THIS ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS THE CONWAY HOSPITAL, INC. ACCOUNTING DEPARTMENT PREPARES THE 990 INFORMATION IN CONSULTATION WITH THE VP OF FISCAL SERVICES. AN OUTSIDE ACCOUNTING FIRM PREPARES THE IRS FORM 990 AND SENDS IT TO THE ACCOUNTING DEPARTMENT AND VP OF FISCAL SERVICES WHO REVIEW THE FORM IN DETAIL. THE FORM 990 IS PROVIDED TO ALL BOARD OF TRUSTEE MEMBERS BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY MONITORING & ENFORCEMENT THE POLICY IS DISTRIBUTED TO ALL COVERED PERSONS AFFILIATED WITH THIS ENTITY AND CONWAY HOSPITAL, INC. (BOARD OF TRUSTEES AND KEY MANAGEMENT PERSONNEL) AND EACH COVERED PERSON MUST SIGN AN ANNUAL STATEMENT THAT HE OR SHE: RECEIVED A COPY OF THE POLICY, READ AND UNDERSTANDS THE POLICY, AGREES TO COMPLY WITH THE POLICY, AND UNDERSTANDS THE POLICY APPLIES TO THE BOARD AND ALL BOARD COMMITTEES. DISCLOSURE OF POTENTIAL CONFLICT OF INTEREST: EVERY COVERED PERSON MUST SUBMIT IN WRITING TO THE CHIEF EXECUTIVE OFFICER A CONFLICT OF INTEREST DISCLOSURE STATEMENT LISTING ALL FINANCIAL AND/OR POTENTIAL CONFLICTING INTERESTS. INDIVIDUALS RESUBMIT UPDATED STATEMENTS EACH YEAR WITH ANY NECESSARY CHANGES OR AS ANY ADDITIONAL CONFLICTING OR FINANCIAL INTEREST ARISES. ALL BOARD MEMBERS WILL RECEIVE AN ANNUAL SUMMARY OF THE DISCLOSURES. IN ADDITION, THE BOARD CHAIR AND CHIEF EXECUTIVE OFFICER SHALL HAVE DISCLOSURE STATEMENTS AVAILABLE AT THE TIME OF ALL BOARD MEETINGS IN CASE A POTENTIAL CONFLICT ARISES. EVERY BOARD MEMBER HAS THE OBLIGATION TO INFORM THE BOARD CHAIR OR THE CHIEF EXECUTIVE OFFICER IF HE/SHE IS AWARE OF AN UNDISCLOSED POTENTIAL FINANCIAL AND/OR CONFLICTING INTEREST OF ANOTHER PERSON COVERED BY THE POLICY. IN THE EVENT OF SUCH NOTIFICATION, THE BOARD CHAIR OR CHIEF EXECUTIVE OFFICER SHALL INVESTIGATE THE POSSIBLE UNDISCLOSED INTEREST. FORM 990, PART VI, SECTION B, LINE 15B PROCESS FOR DETERMINING COMPENSATION COMPENSATION IS PROVIDED BY CONWAY HOSPITAL, INC. THE CONWAY HOSPITAL, INC. BOARD EXECUTIVE COMPENSATION COMMITTEE IS RESPONSIBLE FOR REVIEWING AND APPROVING COMPENSATION FOR THE CEO, CFO, AND ALL VICE PRESIDENTS. AT A MINIMUM OF EVERY THREE YEARS (AND MORE FREQUENTLY WHEN THERE IS TURNOVER IN A POSITION), AN INDEPENDENT CONSULTING COMPANY IS UTILIZED TO PROVIDE APPROPRIATE BENCHMARKED DATA FOR COMPARATIVE POSITIONS TO ASSIST IN DETERMINING COMPENSATION. THE CEO AND CFO ARE RESPONSIBLE FOR APPROVING COMPENSATION FOR ALL OTHER POSITIONS. THEY UTILIZE INDEPENDENT BENCHMARK DATA GATHERED BY THE SOUTH CAROLINA HOSPITAL ASSOCIATION IN SETTING APPROPRIATE COMPENSATION FOR THOSE POSITIONS. FORM 990, PART VI, SECTION C, LINE 19 HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC CONWAY HOSPITAL COMMUNITY SERVICES, INC. MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CONWAY HOSPITAL INC 300 SINGLETON RIDGE ROAD CONWAY SC 29526 570314381 HEALTHCARE SC 501(C)(3) LINE 3 N/A 0 CONWAY HOSPITAL ANESTHESIA PROF SERVICES 300 SINGLETON RIDGE ROAD CONWAY SC 29526 208817302 ANESTHESIA SC 501(C)(3) LINE 12A, I CONWAY HOSP 0 CONWAY HOSPITAL EMERGENCY PROF SERVICES 300 SINGLETON RIDGE ROAD CONWAY SC 29526 208817905 EMERGENCY SC 501(C)(3) LINE 12A, I CONWAY HOSP 0 CONWAY LONG-TERM CARE SERVICES INC 300 SINGLETON RIDGE ROAD CONWAY SC 29526 570875232 HEALTHCARE SC 501(C)(3) LINE 3 CONWAY HOSP 0 MEDICAL PROPERTIES INC 300 SINGLETON RIDGE RD CONWAY SC 29526 570751357 RENTALS SC CONWAY HOSP C 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 NOT REQUIRED