2014-08-15T10:48:49-05:00 2013-09-30 Grant Thornton LLP 201 S COLLEGE ST STE 2500 CHARLOTTE NC 28244 990 2012-10-01 570314381 Conway Hospital Inc % BRET BARR CONW 8433478037 300 SINGLETON RIDGE ROAD Suite CONWAY SC 29526 Bret Barr 8433477111 2014-08-14 true MICHELE N MELCHIOR 7046323500 2012 2015-11-30 17:44:51Z Conway Medical Center PHILIP CLAYTON 300 SINGLETON RIDGE ROAD CONWAY SC 29526 140404616 false X www.CONWAYMEDICALCENTER.COM X 1928 SC WE ARE AN ACUTE CARE HOSPITAL SERVING RESIDENTS OF HORRY AND SURROUNDING COUNTIES. OUR MISSION IS TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY BY BEING A LEADER IN HEALTH CARE. 14 12 1225 238 42051 2623023 918025 132796778 135028388 1840453 3827701 0 271616 137260254 140045730 76612 163653 0 0 60384627 59642946 0 0 0 62270555 63851688 122731794 123658287 14528460 16387443 341352922 358229547 91310136 80109903 250042786 278119644 X CONWAY HOSPITAL INC., LOCATED IN CONWAY, SOUTH CAROLINA, IS A NOT-FOR-PROFIT ACUTE CARE HOSPITAL THAT PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES GENERALLY FOR RESIDENTS OF HORRY AND SURROUNDING COUNTIES. false false 105173140 163653 135300004 CONWAY HOSPITAL INC. IS A 210 BED ACUTE FACILITY LOCATED IN THE CITY OF CONWAY, SOUTH CAROLINA. THE HOSPITAL WAS ORGANIZED UNDER THE LAWS OF THE STATE OF SOUTH CAROLINA IN 1928 FOR THE PURPOSE OF OPERATING A COMMUNITY HOSPITAL IN HORRY COUNTY. THE HOSPITAL WAS CREATED FOR THE PURPOSE OF PROMOTING HEALTH FOR ALL RESIDENTS OF HORRY COUNTY AND ITS OUTLYING AREAS. THE PROMOTION OF HEALTH HAS BEEN ESTABLISHED AS A CHARITABLE PURPOSE UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)3 REVENUE RULE 69-545, 1969-2 C B 117, AS MODIFIED BY REV RUL 83-157, 1983-2 C B 94, WHICH SETS FORTH THE FACTORS THE INTERNAL REVENUE SERVICE WILL CONSIDER IN DETERMINING WHETHER A NONPROFIT HOSPITAL QUALIFIES FOR TAX EXEMPT STATUS. THE HOSPITAL HAS A BOARD OF TRUSTEES COMPOSED OF INDEPENDENT CIVIC LEADERS AND PHYSICIANS. AN OPEN MEDICAL STAFF IS MAINTAINED BY THE HOSPITAL, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS. ALSO, THE HOSPITAL PROVIDES EMERGENCY AND NON-EMERGENCY CARE TO ANYONE REGARDLESS OF THEIR ABILITY TO PAY, EITHER DIRECTLY OR THROUGH THIRD-PARTY REIMBURSEMENT, INCLUDING MEDICARE AND MEDICAID. DURING THE YEAR ENDED SEPTEMBER 30, 2013, THE HOSPITAL FURNISHED CHARITY CARE IN THE AMOUNT OF $16,188,800 IN FOREGONE CHARGES. THE TOTAL DAYS OF PATIENT CARE WERE 29,070 AND CONWAY HOSPITAL INC. SAW A TOTAL OF 118,174 PATIENTS DURING THE YEAR. IN ADDITION TO PROVIDING PATIENT CHARITY CARE, AND IN FURTHERANCE OF ITS EXEMPT PURPOSE TO BENEFIT THE COMMUNITY, THE HOSPITAL OFFERS A MOBILE OUTREACH PROGRAM. THIS PROGRAM OFFERS FREE SCREENING SERVICES TO MEDICALLY UNDERSERVED AREAS OF OUR COMMUNITY. THESE AREAS ARE DESIGNATED AS SUCH THROUGH CENSUS DATA AND HEALTH SERVICE AREA STATISTICS. EXAMPLES OF SCREENING SERVICES OFFERED ON A WEEKLY BASIS INCLUDE BLOOD PRESSURE, CHOLESTEROL AND BLOOD SUGAR. EXAMPLES OF SCREENING SERVICES OFFERED THROUGHOUT THE YEAR INCLUDE MEDICAL BREAST EXAMS, PROSTATE CANCER EXAMS, THYROID SCREENINGS, AND PAP EXAMS. IN ADDITION, HEALTH EDUCATION AND REFERRAL ASSISTANCE ARE PROVIDED. THE HOSPITAL ALSO OFFERS FREE HEALTH SCREENINGS AND HEALTH EDUCATION PROGRAMS TO THE COMMUNITY AT LARGE RELATED TO SMOKING CESSATION, BREAST CANCER AWARENESS, HEART DISEASE PREVENTION AND EARLY DETECTION, NUTRITION AND WEIGHT MANAGEMENT, DIABETES EDUCATION, BREASTFEEDING EDUCATION. SELF HELP AND SUPPORT GROUPS ARE ALSO PROVIDED AT NO COST TO THE COMMUNITY ON A VARIETY OF TOPICS. FAMILY SUPPORT SERVICES ARE ALSO OFFERED TO ASSIST COMMUNITY MEMBERS IN LOCATING OTHER FREE OR REDUCED SERVICES AVAILABLE IN THE COMMUNITY IN ORDER TO IMPROVE THEIR HEALTH OUTCOMES. 105173140 true true false true false false false false true true false false true false true false true false false false false false false false false true true true false true true false false false false false false false false false true false false false false false true true true false false true 144 0 1225 true true true false false false false false false false false false X 14 12 true false false false false false false true true false false true true true true true true true true true true NC SC X BRET BARR 8433477111 300 SINGLETON RIDGE ROAD CONWAY SC 29526 X PHILIP CLAYTON 40.0 4.0 X X 683662 0 57373 LEROY RAINBOW JR 1.0 1.0 X X 0 0 0 M WAYNE STATON 1.0 1.0 X X 0 0 0 WILLIAM R BENSON 1.0 1.0 X 0 0 0 DR REGINALD F DAVES 1.0 1.0 X 0 0 0 Dr MICHAEL ELLIS 1.0 1.0 X 0 0 0 DIANNE W RAY 1.0 1.0 X 0 0 0 GEORGE H GOLDFINCH JR 1.0 1.0 X 0 0 0 CHARLES B JORDAN 1.0 1.0 X 0 0 0 DR HAL B HOLMES 1.0 1.0 X 0 0 0 CHRISTOPHER S HUGGINS 1.0 1.0 X 0 0 0 DR DEIRDRE S WILLIAMS DDS 1.0 1.0 X 0 0 0 JOHN P HENRY 1.0 1.0 X 0 0 0 GEORGE N MAGRATH JR 1.0 1.0 X 0 0 0 BRET BARR 40.0 4.0 X 315186 0 41218 PRESTON STROSNIDER 40.0 X 381729 0 39066 TONY MINSHEW 40.0 X 202175 0 23257 CRAIG HYMAN 40.0 X 225622 0 22749 DWIGHT GENTRY JR 40.0 3.0 X 255665 0 26557 ANGELA WILLIFORD 40.0 X 196497 0 36599 KEVIN LOVETT 40.0 X 181988 0 34394 BERNARD MASSEY 40.0 X 172807 0 31092 ROBERT GAJEWSKI 40.0 X 145621 0 32036 DENNIS FINLEY 40.0 X 127955 0 30673 ANGELA PORTER 40.0 X 107353 0 17653 GLENN SISK 40.0 X 129321 0 6466 WENDELL BEVERLY 40.0 X 123256 0 27058 3248837 0 426191 39 false true false Hospital Medicine Associates LLC P O Box 634850 CINCINNATI OH 45263 Physician Services 2527223 Harrell Saltrick Associates LLC 8016 Tower Point Drive CHARLOTTE NC 28227 Collections/legal 1562185 MB KAHN INC 101 FLINT LAKE ROAD COLUMBIA SC 29223 CONSTRUCTION 912658 ARAMARK CTS INC 10510 TWIN LAKES PARKWAY CHARLOTTE NC 28269 DIETARY MANAGEMENT 803397 MERIDIAN HEALTHCARE GROUP INC 3500 FINANCIAL PLAZA SUITE 200 TALLAHASSEE FL 32312 THERAPY MANAGEMENT 684039 15 150000 768025 918025 NET PATIENT REVENUE 621110 131598039 131598039 WELLNESS CENTER 900099 951296 951296 DIETARY REVENUE 722210 1093151 1060098 33053 PREMIER INCOME 900099 235322 226324 8998 COASTAL HOME CARE 900099 255438 255438 895142 895142 135028388 4186360 4186360 0 0 271616 271616 0 271616 271616 227 296922 61964 -296922 -61737 -358659 -358659 0 0 0 0 140045730 135002515 42051 4083139 160388 160388 3265 3265 0 0 3248836 1217421 2031415 0 42063543 34354532 7709011 0 11073376 9855305 1218071 3257191 2898900 358291 5317307 4732403 584904 465573 465573 117116 117116 2549 2549 0 0 5491569 5491569 0 3155254 2808176 347078 1427722 1427722 0 4533985 4267258 266727 16713 16713 0 0 3181341 3181341 0 8123707 7230099 893608 721147 641821 79326 MEDICAL SUPPLIES 25161289 22393547 2767742 MEDICAL PROVIDER TAX 3451016 3451016 FOOD SUPPLIES 1007318 896513 110805 PATIENT INFORMATION 721634 721634 956448 851239 105209 123658287 105173140 18485147 0 15505584 11900214 0 0 0 0 12247003 14422479 0 0 0 0 2691242 833703 2766171 2663029 1240990 1443559 191790186 96740557 96373282 95049629 162294153 177279546 0 0 3913752 3824115 456049 770981 43864696 50042292 341352922 358229547 18007938 18314150 0 0 491730 491730 63221391 61304023 0 0 0 0 0 0 0 0 9589077 0 91310136 80109903 X 248711863 276640019 769571 664690 561352 814935 250042786 278119644 341352922 358229547 16387443 11689415 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 2549 2549 false Other Activities Schedule C, Part II-B, Line 1i CONWAY HOSPITAL, INC. PAYS ANNUAL MEMBERSHIP DUES AS PART OF THEIR MEMBERSHIP WITH THE SOUTH CAROLINA HOSPITAL ASSOCIATION AND A PERCENTAGE OF THESE DUES ARE USED FOR LOBBYING ACTIVITIES. 2824600 334226 318538 308821 3168543 2533913 334052 361512 6158 398719 2824600 2464486 421801 -11208 341166 2533913 2299137 360688 106530 301869 2464486 2186079 423964 353 311259 2299137 0.23000 0.51000 0.26000 false true true 3279136 3279136 83249124 30064303 53184821 85785396 58445583 27339813 19476530 8230671 11245859 95049629 DUE FROM AFFILIATES 46932292 BOND REFUNDING 3110000 50042292 0 0 X Intended Uses of Endowment Funds Schedule D, Part V, Line 4 ENDOWMENT FUNDS ARE HELD AND ADMINISTERED BY CONWAY HOSPITAL FOUNDATION. THE ENDOWMENT FUNDS BENEFIT A VARIETY OF PROGRAMS, INCLUDING: QUALITY PATIENT CARE AND SAFETY, PEDIATRIC AND CHILDREN'S MEDICINE, EQUIPMENT AND TECHNOLOGY IMPROVEMENTS, NURSING SCHOLARSHIPS AND OTHER PROGRAMS AND FUNDING AS IS CONSISTENT WITH THE WISHES AND DESIGNATIONS OF DONORS. Liability for Uncertain Tax Position (ASC 740) Schedule D, Part X, Line 2 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, 2013, the tax years ended September 30, 2012, 2011 and 2010 for federal jurisdiction remain open to examination. true true true X true X true true false true true 6632275 5655968 976307 0.00790 21546794 19999249 1547545 0.01250 28179069 25655217 2523852 0.02040 610 41748 224583 224583 0.00180 5 205 25605 25605 0.00020 60 1200 153000 153000 0.00120 675 43153 403188 403188 0.00320 675 43153 28582257 25655217 2927040 0.02360 3 1700 1700 3 1700 1700 false 33604296 46699452 41874734 4824718 X true true 1 1 Conway Hospital Inc

300 Singleton Ridge Road Conway SC 29526

X X X Conway Hospital Inc true X X X X X X X X 13 true false true X X X X X X X X X X false false true true 100 true 200. true X X X X X X X true true X X X X X true false X X X X X true X true false 1 Conway Hosp Outpatient Diagnostic CTR

801 Farrar Dr Conway SC 29526

Imaging Mammography Costing Methodology Schedule H, Part I, Line 7 The IRS Worksheets with input from our medicare cost report were used to compute the amounts in the table utilizing a cost to charge ratio. Community Building Activities SCHEDULE H, PART II, LINE 9 The hospital participated with local chamber of commerce, Conway City and Horry County Schools in various projects including recycling and clean water programs. Bad Debt Expense Schedule H, Part III, Line 4 Information about Conway Hospital's allowance for bad debt can be found on pages 10 and 11 of the attached financial statement footnotes. Contractual adjustments and discounts are applied to patient accounts before determining bad debt. Bad debt and adjustments to accounts receivable are determined using a look-back method and aging categories based on historical collection percentages. The cost of bad-debt reported on Line 2 of part III was computed with the cost to charge ratio developed from the IRS worksheets and our Medicare cost report. Collection Practices Schedule H, Part III, Line 9b When individuals are latently identified as potentially qualifying for financial assistance, the normal collection process is halted and the patient is referred to a financial counselor to determine their need and what assistance can be provided. We use a third party to assist patients in completing the Medicaid application and the hospital assistance application. We use the Federal Poverty Guidelines to determine eligibility for free or discounted care. If a patient is found to qualify we apply a discount to their account in accordance with our policy. For the portion of the bill that the patient is responsible for, the hospital works out a payment plan with the patient and then any further action is handled through normal collection practices. Conway Hospital, Inc. Schedule H, Part V, Section B, Question 3 The Community Needs Assessment Team entered into dialogue with key hospital administrators, physicians, those with knowledge and expertise in public health, and those serving underserved and chronic disease populations. During this phase, the team conducted face to face interviews, phone interviews, and written questionnaires in which respondents were able to comment and discuss general community health issues of their specific service area. Through these numerous interviews and surveys, a summary of community input was created. This summary would eventually be used to help focus in on priorities and ultimately, implementation strategies. The respondents who participated in this phase include experts in the field of public health, hospital administration members, community outreach groups, and other local organizations. Public health, hospital administration members, community outreach groups, and other local organizations were included in the process. All input was collected and summarized during April 2013. Respondents included: The CEO of Conway Medical Center; the Director of Case Management of Conway Medical Center; the VP of Nursing Services of Conway Medical Center; HEALTHREACH Coordinator (Community Outreach); HEALTHREACH Educator; Director of Friendship Medical Clinic; Director of School Nurses of Horry County Schools; Director of AccessHealth - Horry; Community Systems Director of Pee Dee Region - SCDHEC (Public Health Department). Respondents were asked what they viewed as the top health issues facing Horry County and its residents. They were then asked to elaborate on certain barriers and strategies for addressing these needs. After combining input from these individuals, a summary table was created to illustrate the frequency in which certain issues were mentioned. Conway Hospital, Inc. Schedule H, Part V, Section B, Question 7 The Community Health Needs Assessment Team used the data and input that had been collected to prioritize the needs of the hospital's defined community. After discussing the priorities in depth and discussing Conway's expertise, the expertise of other community organizations and outreach, and the hospital's wide range of services currently available, the following issues were chosen for implementation: access to care for the uninsured, prevention/screenings, diabetes, smoking, and infant mortality. The priorities not addressed by the hospital are as follows: Oral Health - Due to resource constraints along with the presence of other local organizations championing this area of need, Conway Medical Center will not address oral health at this time. Horry Georgetown Technical College is one organization in the area that has plans for improvement in this area. Obesity/Nutrition - Conway Medical Center offers programs to give children healthy food options to take home on the weekends. Conway Medical Center will also continue to participate in health fairs on educating the community on the importance of nutrition and exercise. There are also numerous local organizations that continue to address this need through weight loss classes, healthy food outlets and local recreational facilities. Transportation - Through prioritization, the team found a lack of effective interventions to address this need. Conway Medical Center will, however, continue to use available resources to offer the HEALTHREACH mobile van when possible. Mental Health - Due to other local facilities specifically addressing mental health issues, along with certain resource constraints and lack of expertise in the mental health area, Conway Medical Center has chosen not to address this need in this year's strategies. Conway Hospital, Inc. Schedule H, Part V, Section B, Question 14(G) The financial assistance policy was also provided to patients upon discharge by case managers. Conway Hospital, Inc. Schedule H, Part V, Section B, Question 18(e) The hospital did not perform any of the actions indicated on Line 17 before making reasonable efforts to qualify patients for eligibility under our financial assistance policy. The hospital made all efforts checked in Line 18. Conway Hospital, Inc. Schedule H, Part V, Section B, Question 20 The hospital provided discounted care to individuals qualifying for financial assistance based on the federal poverty guidelines. In addition to those patients who did not qualify according to the financial assistance policy, we take into consideration the patient's current social and economic circumstances and provide additional reductions depending on their specific situation. Conway Hospital, Inc. Schedule H, Part V, Section B, Question 21 During the filing year, the hospital was in process of evaluating the methodology options provided in the proposed IRS Regulations but had not yet determined the best approach in order to update its financial assitance policy. Community Health Care Needs Assessment SCHEDULE H, PART VI, LINE 2 The South Carolina Department of Health and Environmental Control issued a report in 2012 related to the impact of chronic health conditions for those in Horry County. The full report can be found at http://www.scdhec.gov/Health/docs/Epi/chronic/Horry.pdf. Horry County ranks higher than the state average for the following risk factors which contribute to chronic health conditions: sedentary lifestyle and high cholesterol. The age-adjusted death rate for lung cancer in Horry County (per 100,000) is 55.9% compared to the state average of 51.4%. The hospital offers a free program for the community two times a year related to smoking cessation. Additionally, all patients are assessed for their use of tobacco and provided with appropriate education should they report they do use tobacco. The hospital's mobile outreach program also conducts a similar assessment and education for those individuals seen in the community by the outreach van. The county's age-adjusted death rate for heart disease (per 100,000) is 193.6 which is also higher than the state average of 178.5. The mobile health outreach van offers free blood pressure and cholesterol testing as well as nutritional education on a routine basis throughout the western part of Horry County. Additional statistics are noted below under 'promotion of community health.' The hospital produced a Community Health Needs Assessment (CHNA) during 2013 and created an Implementation Strategy to address many of those needs. The full CHNA report can be found at http://www.conwaymedicalcenter.com/aboutcmc.aspx. Eligibility Education Schedule H, Part VI, Line 3 Signs are posted throughout the hospital in both English and Spanish (and on our website under patient and family responsibility) that inform patients of our assistance policy. All patients that do not have insurance are referred to financial counselors who assist with helping to inform patients of various financial assistance options either through government programs or through the hospital's assistance policy. Invoices sent to patients also include a notice that the hospital has an assistance program and how to they can apply for assistance. Example of language posted on our website and throughout the hospital: 'if a patient or family member cannot afford to pay their bill, we encourage them to ask us about the hospital assistance program.' and: 'si usted no tiene los recursos para pagar su cuenta, por favor pregntenos sobre el programa de asistencia del hospital.' Description of Community Served Schedule H, Part VI, Line 4 Conway Medical Center serves those persons living in Horry County as well as the bordering counties of Marion and Georgetown. Two other hospitals, McLeod Loris/Seacoast and Grand Strand Regional Medical Center are located in Horry County. The population of Horry County, according to the latest census figures, is as follows: population in 2012 was 282,290; the population grew by 7.6% from 2010 to 2013; in 2012, 20% of the population under 18 years, 33.4% if the population was 18-44 years of age, 27.9% of the population was aged 45-64, 17.1% of the population was 65-84 years of age, and 1.6% was over the age of 85%. Median household income for Horry County for 2008-2012 was $42,183 as compared to the state average of $44,263 with 18.1% of persons living below poverty level, compared to the state average of 17.6%. The Conway area's median household income for 2012 was $33,247 and there were 37.4% of persons living below poverty level. The metropolitan statistical area is considered to be Myrtle Beach-North Myrtle Beach-Conway, SC Metro area. The primary service area of the hospital includes those zip codes within a 15 mile radius of the hospital with approximately 40% of that area being in a rural location. Promoting the Health of the Community Schedule H, Part VI, Line 5 The mission of the hospital is to improve the overall health of the community. Major efforts have taken place to provide free screening within the community through our mobile health outreach program to detect illness and disease at an early stage. The 2012/2013 report shows that the outreach program delivered free health screenings to 92 various locations predominately in medically underserved areas of Horry County. There were 1,358 participants who were screened with results as follows: elevated blood pressure - 31%; elevated blood glucose - 20%; elevated blood cholesterol - 29%. By providing counseling, physician referral and follow-up, the outreach staff provided education to those individuals that are screened. In addition to the HEALTHREACH van screenings, during September through June, the staff obtains and delivers smart snacks to 4 schools and 605 children every Thursday. HEALTHREACH provided 605 flu shots at two events and provided diabetes screenings for 1200 persons at 65 events. Safesitter babysitting training classes were provided in June and July with a total of 17 children participating and receiving certification. Mammogram referrals are also initiated through the HEALTHREACH office and additional tracking and follow up communication is provided. As part of the program, over 614 patients, meeting financial eligibility status, were referred for either screening or diagnostic mammography at Conway Medical Center at no charge to the patient. In some cases, ultrasounds were required and also provided by the hospital at no charge. The hospital has also committed $15,000 per year to support a faculty position for the nursing program at Horry-Georgetown Technical College. A variety of community health education programs and health screenings were offered throughout the year such as blood pressure and cholesterol screenings for 1054 persons at 64 events. Community Benefit Report State Filings Schedule H, Part VI, Line 7 SC true UNITED WAY P O BOX 673 CONWAY SC 29526 570558692 501 (c)(3) 10434 GENERAL PURPOSE GENERAL PURPOSE NURSING SCHOLARSHIPS, BOOKS, TUITION GENERAL PURPOSE GENERAL PURPOSE GENERAL PURPOSE CONWAY MED CTR FOUNDATION P O BOX 829 CONWAY SC 29526 570870199 501 (c)(3) 23271 GENERAL PURPOSE ACCESSHEALTH HORRY P O Box 1732 CONWAY SC 29526 542075560 501 (c)(3) 125000 Community Health Access 3 Procedure for Monitoring Use of Grant Funds Inside U.S. Schedule I, Part I, Line 2 GRANTS TO ORGANIZATIONS - CONWAY HOSPITAL PAYS GRANTS TO VARIOUS LOCAL 501(C)3 ENTITIES WHICH ARE QUALIFIED EXEMPT ORGANIZATIONS. THE BOARD APPROVES EACH GRANT BEFORE IT IS PAID. X X X X X false true false false false false false false false PHILIP CLAYTON 464664 0 209988 0 9010 0 33097 0 24276 0 741035 0 0 0 BRET BARR 251183 0 64003 0 0 0 16942 0 24276 0 356404 0 0 0 PRESTON STROSNIDER 258089 0 95660 0 27980 0 14790 0 24276 0 420795 0 26402 TONY MINSHEW 165049 0 37126 0 0 0 11667 0 11590 0 225432 0 0 0 CRAIG HYMAN 173096 0 45646 0 6880 0 11281 0 11468 0 248371 0 0 0 DWIGHT GENTRY JR 175014 0 80651 0 0 0 15568 0 10989 0 282222 0 0 0 ANGELA WILLIFORD 158099 0 38398 0 0 0 12114 0 24485 0 233096 0 0 0 KEVIN LOVETT 140482 0 41506 0 0 0 9861 0 24533 0 216382 0 0 0 BERNARD MASSEY 139685 0 33122 0 0 0 19818 0 11274 0 203899 0 0 0 ROBERT GAJEWSKI 142771 0 2850 0 0 0 7281 0 24755 0 177657 0 0 0 DENNIS FINLEY 117955 0 10000 0 0 0 6397 0 24276 0 158628 0 0 0 WENDELL BEVERLY 123256 0 0 0 0 0 6162 0 20896 0 150314 0 0 0 Supplemental nonqualified retirement plan Schedule J, Part I, Line 4b CONWAY HOSPITAL PROVIDES A NON-QUALIFIED SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN, A CAPITAL ACCUMULATION PLAN AND AN ENVISION PLUS PLAN TO SENIOR EXECUTIVES SUBJECT TO CERTAIN VESTING REQUIREMENTS AND/OR SUBSTANTIAL RISKS OF FORFEITURE. THE FOLLOWING EXECUTIVES PARTICIPATED IN ONE OR MORE OF THE PLANS DURING THE YEAR: PHILIP CLAYTON, BRET BARR, PRESTON STROSNIDER, CRAIG HYMAN, DWIGHT GENTRY, JR., KEVIN LOVETT, BERNARD MASSEY, AND TONY MINSHEW. DURING THE CALENDAR YEAR REPORTED WITHIN THIS YEAR, THE FOLLOWING INDIVIDUAL RECEIVED PAYOUTS FROM THE PLAN: PRESTON STROSNIDER - $27,980. THESE AMOUNTS ARE INCLUDED IN THE WAGES REPORTED ON THIS FORM 990. A SC JOBS - ECONOMIC DEVELOPMENT 570960018 83703FFY3 2012-11-01 46017931 REFUND OF 2011 BONDS false false false B SC JOBS - ECONOMIC DEVELOPMENT 570960018 2011-09-30 19510000 REFUND 1998 SERIES BOND false false false A 0 0 46017931 0 0 0 607931 0 0 0 45410000 0 2009 true false true true B 1750275 0 19510000 0 0 0 146084 0 0 0 19363916 0 1998 true false true true A false false true true false 0 false false false true B false false true true false 0 false false false true A false true false false 0 false 0 false true B false true false false 0 false 0 false true A true B true Description of Purpose Part I - Line A, Column (f) The 2012 series bond was issued to refund the 2011 series bond which refunded the 2007 series bond which was used to construct and renovate a patient tower, administrative annex, and central energy plant at Conway Hospital. Hospital. Description of Purpose Part I - Line B, Column (f) Bonds issued to refund the outstanding maturities of Horry County, South Carolina Hospital Revenue Bonds (Conway Hospital, Inc) Series 1998. Charles Jordan See Part V 912658 Independent Contractor false BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS SCHEDULE L, PART IV, COLUMN B CHARLES JORDAN, TRUSTEE OF CONWAY HOSPITAL, HAS A BUSINESS RELATIONSHIP WITH CONWAY HOSPITAL. HE WAS CHAIRMAN OF MB KAHN, A CONSTRUCTION COMPANY HIRED TO ASSIST WITH HOSPITAL EXPANSION. MR. JORDAN DID NOT PARTICIPATE IN BOARD DISCUSSION AND VOTING REGARDING THIS ACTIVITY. Business Relationships Form 990, Part VI, Line 2 PHILIP CLAYTON, BRETT BARR, AND DWIGHT GENTRY HAVE A BUSINESS RELATIONSHIP. ALL THREE ARE BOARD MEMBERS AND OFFICERS OF TAX EXEMPT ORGANIZATIONS RELATED TO THIS ORGANIZATION. JOHN PAT HENRY, BOARD MEMBER, AND CHARLES JORDAN, BOARD MEMBER, HAVE A BUSINESS RELATIONSHIP. Form 990 Review Process Form 990, Part VI, Line 11b THE ORGANIZATION'S 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. Conflict of Interest Policy Monitoring & Enforcement Form 990, Part VI, Line 12c CONWAY HOSPITAL HAS A CONFLICT OF INTEREST POLICY THAT APPLIES TO THE BOARD OF DIRECTORS, DEPARTMENT HEADS AND EXECUTIVE LEVEL EMPLOYEES. ALL OF THESE COVERED PERSONS ARE REQUIRED TO ATTEST IN WRITING ANNUALLY THEIR UNDERSTANDING OF AND COMPLIANCE WITH THIS POLICY, AND TO PROVIDE INFORMATION CONCERNING ANY POSSIBLE CONFLICTS OF INTEREST. BOARD MEMBERS DO NOT PARTICIPATE IN VOTING ON MATTERS WHERE A CONFLICT OF INTEREST MAY EXIST. 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. Process for Determining Compensation Form 990, Part VI, Lines 15a & 15b THE 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. How Documents are Made Available to the Public Form 990, Part VI, Line 19 CONWAY HOSPITAL MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AS WELL AS ATTACHING THEM TO THIS RETURN. CONWAY LONG-TERM CARE SERVICES INC 300 SINGLETON RIDGE RD CONWAY SC 29526 570875232 HEALTHCARE SC 501(c)(3) 03 CONWAY HOSP true CONWAY HOSPITAL COMMUNITY SERVICES 300 SINGLETON RIDGE RD CONWAY SC 29526 571119337 HEALTHCARE SC 501(c)(3) 03 CONWAY HOSP true CONWAY HOSPITAL EMERGENCY PROF SERVICES 300 SINGLETON RIDGE RD CONWAY SC 29526 208817905 EMERGENCY SC 501(c)(3) 11 A-I CONWAY HOSP true CONWAY HOSPITAL ANESTHESIA PROF SERVICES 300 SINGLETON RIDGE RD CONWAY SC 29526 208817302 ANESTHESIA SC 501(c)(3) 11 A-I CONWAY HOSP true CONWAY HOSPITAL FOUNDATION 300 SINGLETON RIDGE RD CONWAY SC 29526 570870199 FUNDRAISING SC 501(c)(3) 11C-III-FI CONWAY HOSP false MEDICAL PROPERTIES INC 300 SINGLETON RIDGE RD CONWAY SC 29526 570751357 RENTALS SC CONWAY HOSPITAL C Corp 1412789 6730352 1.00000 true false true true false false false false false false true false true false true true false true false true CONWAY LONG-TERM CARE SERVICES INC B 4813959 CASH (FMV) CONWAY HOSPITAL COMMUNITY SERVICES INC B 11670751 CASH (FMV) CONWAY HOSPITAL EMERGENCY PROF SERVICES B 27667 CASH (FMV) CONWAY HOSPITAL ANESTHESIA PROF SERVICES B 4039537 CASH (FMV) MEDICAL PROPERTIES INC B 98953 CASH (FMV) CONWAY HOSPITAL ANESTHESIA PROF SERVICES Q 3295862 COST CONWAY HOSPITAL ANESTHESIA PROF SERVICES S 1875128 COST CONWAY LONG-TERM CARE SERVICES INC S 4751639 COST CONWAY HOSPITAL COMMUNITY SERVICES INC S 7144007 COST MEDICAL PROPERTIES INC S 820755 COST