CONWAY REGIONAL HEALTH FOUNDATION INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- CONWAY REGIONAL HEALTH FOUNDATION INC (EIN 71-0797723)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-11
- IRS object ID
- 201313169349300851
- Schema version
- 2012v2.1
- 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 D
- Schedule G
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-11T08:26:01-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 3667 | AddressLine1 |
| City | LITTLE ROCK | City |
| State | AR | State |
| ZIP Code | 722033667 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 710797723 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CONWAY REGIONAL HEALTH FOUNDATION INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % KAREN DAYER CONTROLLER | InCareOfName |
| Name Control | CONW | NameControl |
| Phone | 5013293831 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2302 COLLEGE AVE | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | CONWAY | City |
| State | AR | State |
| ZIP Code | 72034 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | STEVE ROSE | Name |
| Title | TREASURER | Title |
| Phone | 5013721040 | Phone |
| Date Signed | 2013-08-13 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | AMBER SHERRILL | Name |
| Phone | 5013721040 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JIM LAMBERT | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2302 COLLEGE AVENUE | AddressLine1 |
| City | CONWAY | City |
| State | AR | State |
| ZIP Code | 72034 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 2384048 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.CONWAYREGIONAL.ORG/ABOUT/FOUNDATION | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1994 | YearFormation |
| State Legal Domicile | AR | StateLegalDomicile |
| Activity Or Mission Description | THE PURPOSE OF CONWAY REGIONAL HEALTH FOUNDATION, INC. IS TO FOSTER SUPPORT, ENCOURAGE THE ACTIVITIES, AND TO ADVANCE THE OBJECTIVES OF CONWAY REGIONAL MEDICAL CENTER, INC. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 106 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1215141 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 404342 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 21550 | InvestmentIncomePriorYear |
| Investment Income Current Year | 38277 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1213359 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1332589 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 2450050 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1775208 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 108609 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 490576 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 67552 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 24000 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 24000 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1444109 | OtherExpensePriorYear |
| Other Expenses Current Year | 1721604 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1620270 | TotalExpensesPriorYear |
| Total Expenses Current Year | 2236180 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 829780 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -460972 | RevenuesLessExpensesCY |
| Total Assets BOY | 18069331 | TotalAssetsBOY |
| Total Assets EOY | 17465841 | TotalAssetsEOY |
| Total Liabilities BOY | 413747 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 195243 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 17655584 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 17270598 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE PURPOSE OF CONWAY REGIONAL HEALTH FOUNDATION, INC IS TO FOSTER SUPPORT, ENCOURAGE THE ACTIVITIES, AND TO ADVANCE THE OBJECTIVES OF CONWAY REGIONAL MEDICAL CENTER, INC. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 1764908 | Expense |
| Grants | 490576 | Grants |
| Description | TO PROVIDE FINANCIAL AID TO CONWAY REGIONAL MEDICAL CENTER, INC TO HELP SUPPORT PATIENT CARE, PROGRAMS AND SERVICES. | Description |
| Total Program Service Expense | 1764908 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | true | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | true | ProfessionalFundraising |
| Fundraising Activities | true | FundraisingActivities |
| Gaming | true | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | true | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | true | DeductibleNonCashContributions |
| Deductible Contributions Of Art | true | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 18 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 5 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | true | NonDeductibleContributions |
| Non Deductible Disclosure | true | NonDeductibleDisclosure |
| Quid Pro Quo Contributions | true | QuidProQuoContributions |
| Quid Pro Quo Disclosure | true | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | KAREN DAYER CONTROLLER | NamePerson |
| Telephone Number | 5013293831 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2302 COLLEGE AVE | AddressLine1 |
| City | CONWAY | City |
| State | AR | State |
| ZIP Code | 72034 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (14 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Average Hours Per Week RelatedAverageHoursPerWeekRelated |
|---|---|---|---|---|---|---|---|
| BOB GANT | |||||||
| CHAIRMAN | 1.0 | X | X | 0 | 0 | 1218 | |
| JACK ENGELKES | |||||||
| VICE CHAIRMAN | 1.0 | X | X | 0 | 0 | 1452 | |
| CORNELL MALTBIA | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 1452 | ||
| ROBERT MCCORMACK | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 1320 | ||
| BART THRONEBERRY MD | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 1452 | ||
| BARBARA WILLIAMS | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 660 | ||
| JIM LAMBERT | |||||||
| PRESIDENT/CEO | 1.0 | X | X | 0 | 416956 | 36421 | 40.0 |
| KEITH BELL MD | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 1260 | ||
| ANDREW COLE MD | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 711 | ||
| JIM RANKIN JR | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 63 | ||
| ANDREA WOODS JD | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 1071 | ||
| ALAN FINLEY | |||||||
| COO | 1.0 | X | 0 | 153190 | 22834 | 40.0 | |
| STEVEN ROSE | |||||||
| VP FINANCIAL SERVICES/ CFO | 1.0 | X | 0 | 186066 | 25473 | 40.0 | |
| JACQUELYN WILKERSON | |||||||
| VP NURSING SERVICES/ CNO | 1.0 | X | 0 | 150275 | 14788 | 40.0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 906487 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 110175 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Membership Dues | 3410 | MembershipDues |
| Fundraising Events | 108626 | FundraisingEvents |
| Related Organizations | 23000 | RelatedOrganizations |
| All Other Contributions | 269306 | AllOtherContributions |
| Noncash Contributions | 130869 | NoncashContributions |
| Total Contributions | 404342 | TotalContributions |
| Total Program Service Revenue | 0 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 38277 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $38,277 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 513 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $513 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1684256 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 324114 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1360142 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1360142 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,360,142 | ExclusionAmount |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 203653 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 108626 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 257064 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -53411 | TotalRevenueColumn |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | -$53,411 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Gaming | 52862 | GrossIncomeGaming |
| Gaming Direct Expenses | 27662 | GamingDirectExpenses |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 25200 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $25,200 | ExclusionAmount |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER INCOME | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 145 | TotalRevenueColumn |
| Exclusion | $145 | ExclusionAmount |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 145 | TotalRevenueColumn |
| Exclusion | $145 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 145 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1775208 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,370,866 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 457711 | Total |
| Program Services | 457711 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32865 | Total |
| Program Services | 32865 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 161904 | Total |
| Program Services | 119787 | ProgramServices |
| Management And General | 42117 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24000 | Total |
| Fundraising | 24000 | Fundraising |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 65127 | Total |
| Program Services | 48185 | ProgramServices |
| Management And General | 16942 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4493 | Total |
| Program Services | 3324 | ProgramServices |
| Management And General | 1169 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 382013 | Total |
| Program Services | 282638 | ProgramServices |
| Management And General | 99375 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12 | Total |
| Program Services | 9 | ProgramServices |
| Management And General | 3 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 988851 | Total |
| Program Services | 731617 | ProgramServices |
| Management And General | 257234 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44168 | Total |
| Program Services | 32678 | ProgramServices |
| Management And General | 11490 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| BAD DEBT | 2216 | 2216 | 0 | 0 |
| . | ||||
| . | ||||
| . |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 72820 | Total |
| Program Services | 53878 | ProgramServices |
| Management And General | 18942 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2236180 | Total |
| Program Services | 1764908 | ProgramServices |
| Management And General | 447272 | ManagementAndGeneral |
| Fundraising | 24000 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 283444 | BOY |
| EOY | 300947 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2653226 | BOY |
| EOY | 3093285 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1002503 | BOY |
| EOY | 1053126 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 516121 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7500 | BOY |
| EOY | 7500 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32452 | BOY |
| EOY | 27093 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 21533023 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 10666862 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11908757 | BOY |
| EOY | 10866161 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1665328 | BOY |
| EOY | 2117729 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18069331 | BOY |
| EOY | 17465841 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 228784 | BOY |
| EOY | 195243 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 184963 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 413747 | BOY |
| EOY | 195243 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16154164 | BOY |
| EOY | 16000382 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1501420 | BOY |
| EOY | 1270216 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17655584 | BOY |
| EOY | 17270598 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18069331 | BOY |
| EOY | 17465841 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -460972 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 342 | ReconciliationUnrealizedInvest |
| Reconcilation Donated Services | 75644 | ReconcilationDonatedServices |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | true | ContribByControllingIndividual |
| Contribution By Related Party | true | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | false | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CONWAY REG MED CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 710249735 | EIN |
| Type Of Organization | 03 | TypeOfOrganization |
| Listed In Governing Doc | true | ListedInGoverningDoc |
| Supported Organization Notified | true | SupportedOrganizationNotified |
| Organized In US | true | OrganizedInUS |
| Amount | $457,711 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 457711 | SumOfAmounts |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Solicited Assets For Sale | true | SolicitedAssetsForSale |
| Current Year Minus3 Years | CurrentYearMinus3Years | |
| Current Year Minus4 Years | CurrentYearMinus4Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 4116708 | InvestmentCostOrOtherBasis |
| Book Value | 4116708 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 17347649 | InvestmentCostOrOtherBasis |
| Depreciation | 10616817 | Depreciation |
| Book Value | 6730832 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 50066 | InvestmentCostOrOtherBasis |
| Depreciation | 50045 | Depreciation |
| Book Value | 21 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 18600 | InvestmentCostOrOtherBasis |
| Book Value | 18600 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 10866161 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DEFERRED LEASE | 1227336 |
| EXTERNALLY RESTRICTED CASH | 890393 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 2117729 | TotalBookValueOtherAssets |
| Tot Revenue Etc Audited Fincl Stmt | 2499962 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 342 | NetUnrealizedGainsInvestments |
| Donated Srvc And Use Of Facilities | 75644 | DonatedSrvcAndUseOfFacilities |
| Other Revenues | 648768 | OtherRevenues |
| Revenue Not Rptd F990 | 724754 | RevenueNotRptdF990 |
| Revenue Subtotal | 1775208 | RevenueSubtotal |
| Total Revenue Per Form990 | 1775208 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 2845020 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 608840 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 608840 | ExpensesNotRptdF990 |
| Expenses Subtotal | 2236180 | ExpensesSubtotal |
| Total Expenses Per Form990 | 2236180 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| RECONCILIATION OF REVENUES | FORM 990, SCHEDULE D, PART XII, LINE 2D | RENTAL EXPENSES $324,114 FUNDRAISING EXPENSES $257,064 GAMING EXPENSES $27,662 NET ASSETS RELEASED $39,928 ========= $648,768 |
| RECONCILIATION OF EXPENSES | FORM 990, SCHEDULE D, PART XIII, LINE 2D | RENTAL EXPENSES $324,114 FUNDRAISING EXPENSES $257,064 GAMING EXPENSES $27,662 ========= $608,840 |
| FIN 48 DISCLOSURE | FORM 990, SCHEDULE D, PART X, LINE 2 | MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | X | MailSolicitations |
| Email Solicitations | X | EmailSolicitations |
| Phone Solicitations | X | PhoneSolicitations |
| In Person Solicitations | X | InPersonSolicitations |
| Solicitation Of Non Govt Grants | X | SolicitationOfNonGovtGrants |
| Special Fundraising Events | X | SpecialFundraisingEvents |
| Agreement Ref Fundraising | true | AgreementRefFundraising |
Fundraiser Activity Information FundraiserActivityInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Individual | HUESTON CONSULTING GROUP LLC | NameOfIndividual |
| Activity | FUNDRAISING CONSULTANT | Activity |
| Fundraiser Control Of Funds | false | FundraiserControlOfFunds |
| Gross Receipts | 0 | GrossReceipts |
| Amount Retained By Contractor | 24000 | AmountRetainedByContractor |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Gross Receipts | 0 | TotalGrossReceipts |
| Total Retained By Contractors | 24000 | TotalRetainedByContractors |
| Licensed States | AR | LicensedStates |
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | DAZZLE DAZE | NameOfEvent1 |
| Gross Receipts Event1 | 235204 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 96971 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 138233 | GrossRevenueEvent1 |
| Cash Prizes Event1 | 0 | CashPrizesEvent1 |
| Non Cash Prizes Event1 | 0 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 17656 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 6484 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 550 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 185580 | OtherDirectExpensesEvent1 |
| Name Of Event2 | GOLF CLASSIC | NameOfEvent2 |
| Gross Receipts Event2 | 71905 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 11655 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 60250 | GrossRevenueEvent2 |
| Cash Prizes Event2 | 5450 | CashPrizesEvent2 |
| Non Cash Prizes Event2 | 11833 | NonCashPrizesEvent2 |
| Rent Facility Costs Event2 | 7776 | RentFacilityCostsEvent2 |
| Food And Beverage Event2 | 7400 | FoodAndBeverageEvent2 |
| Entertainment Event2 | 0 | EntertainmentEvent2 |
| Other Direct Expenses Event2 | 12688 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 2 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 5170 | GrossReceiptsOtherEvents |
| Charitable Contrib Other Events | 0 | CharitableContribOtherEvents |
| Gross Revenue Other Events | 5170 | GrossRevenueOtherEvents |
| Cash Prizes Other Events | 0 | CashPrizesOtherEvents |
| Non Cash Prizes Other Events | 0 | NonCashPrizesOtherEvents |
| Rent Facility Costs Other Events | 0 | RentFacilityCostsOtherEvents |
| Food And Beverage Other Events | 0 | FoodAndBeverageOtherEvents |
| Entertainment Other Events | 0 | EntertainmentOtherEvents |
| Other Direct Expenses Other Events | 1647 | OtherDirectExpensesOtherEvents |
| Gross Receipts Total | 312279 | GrossReceiptsTotal |
| Charitable Contributions Total | 108626 | CharitableContributionsTotal |
| Gross Revenue Total Events | 203653 | GrossRevenueTotalEvents |
| Cash Prizes Total Events | 5450 | CashPrizesTotalEvents |
| Non Cash Prizes Total Events | 11833 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 25432 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 13884 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 550 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 199915 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 257064 | DirectExpenseSummaryEvents |
| Net Income Summary | -53411 | NetIncomeSummary |
Gaming Information GamingInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Revenue Other Gaming | 52862 | GrossRevenueOtherGaming |
| Non Cash Prizes Other Gaming | 26714 | NonCashPrizesOtherGaming |
| Other Direct Expenses Other Gaming | 948 | OtherDirectExpensesOtherGaming |
| Volunteer Labor Other Gaming | true | VolunteerLaborOtherGaming |
| Volunteer Labor Prcnt Other Gaming | 0.20000 | VolunteerLaborPrcntOtherGaming |
| Gross Revenue Total Gaming | 52862 | GrossRevenueTotalGaming |
| Non Cash Prizes Total Gaming | 26714 | NonCashPrizesTotalGaming |
| Other Direct Expenses Total Gaming | 948 | OtherDirectExpensesTotalGaming |
| Direct Expense Summary Gaming | 27662 | DirectExpenseSummaryGaming |
| Net Gaming Income Summary | 25200 | NetGamingIncomeSummary |
| Field | Value | IRS element (for citing) |
|---|---|---|
| States Where Gaming Conducted | AR | StatesWhereGamingConducted |
| Licensed | true | Licensed |
| License Suspended Etc | false | LicenseSuspendedEtc |
| Gaming With Nonmembers | true | GamingWithNonmembers |
| Member Of Other Entity | false | MemberOfOtherEntity |
| Percentage Of Gaming Own Facility | 0.50000 | PercentageOfGamingOwnFacility |
| Percentage Of Gaming Othr Facility | 0.50000 | PercentageOfGamingOthrFacility |
| Name Of Gaming Rec Keeper Person | DOT WELCH | NameOfGamingRecKeeperPerson |
Address Of Gaming Rec Keeper US AddressOfGamingRecKeeperUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2302 COLLEGE AVENUE | AddressLine1 |
| City | CONWAY | City |
| State | AR | State |
| ZIP Code | 72034 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contract With3rd Party For Gam Rev | false | ContractWith3rdPartyForGamRev |
| Gaming Manager Name Person | DOT WELCH | GamingManagerNamePerson |
| Gaming Manager Compensation | 0 | GamingManagerCompensation |
| Gaming Manager Services Provided | RECORDKEEPING, MONEY COUNTING | GamingManagerServicesProvided |
| Gaming Manager Is Employee | X | GamingManagerIsEmployee |
| Charitable Distrib Required | true | CharitableDistribRequired |
| Amount Distributed | 25200 | AmountDistributed |
Form990 Schedule G Part IV Form990ScheduleGPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | GAMING MANAGER | Identifier |
| Return Reference | FORM 990, SCHEDULE G, PART III, LINE 16 | ReturnReference |
| Explanation | DOT WELCH, GAMING MANAGER, IS AN EMPLOYEE OF CONWAY REGIONAL MEDICAL CENTER, A RELATED ENTITY. | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CONWAY REGIONAL MEDICAL CENTER | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2302 COLLEGE AVENUE | AddressLine1 |
| City | CONWAY | City |
| State | AR | State |
| ZIP Code | 72034 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 710249735 | EINOfRecipient |
| IRC Section | 501(C)(3) | IRCSection |
| Amount Of Cash Grant | 457711 | AmountOfCashGrant |
| Method Of Valuation | FMV | MethodOfValuation |
| Description Of Non Cash Assistance | N/A | DescriptionOfNonCashAssistance |
| Purpose Of Grant | GENERAL SUPPORT | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part III Form990ScheduleIPartIII (2 entries)
| Type Of GrantTypeOfGrant | Number Of RecipientsNumberOfRecipients | Amount Of Cash GrantAmountOfCashGrant | Method Of ValuationMethodOfValuation | Description Of Non Cash AssistanceDescriptionOfNonCashAssistance |
|---|---|---|---|---|
| SCHOLARSHIPS | 15 | 24000 | FMV | N/A |
| BENEVOLENCE ASSISTANCE | 89 | 8865 | FMV | N/A |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANT FUNDS | Identifier |
| Return Reference | FORM 990, SCHEDULE I, PART I, LINE 2 | ReturnReference |
| Explanation | THE FOUNDATION AWARDS COLLEGE SCHOLARSHIPS TO RECIPIENTS WHO ARE SELECTED BY A DIVERSE SCHOLARSHIP COMMITTEE COMPRISED OF HOSPITAL EMPLOYEES. WINNERS ARE SELECTED BASED ON ACADEMIC SUCCESS, FINANCIAL NEED, ESSAY SCORES, AND INTERVIEW SCORES. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JIM LAMBERT | ||||||||||||||
| PRESIDENT/CEO | 0 | 296420 | 0 | 90058 | 0 | 30478 | 0 | 10001 | 0 | 26420 | 0 | 453377 | 0 | 0 |
| ALAN FINLEY | ||||||||||||||
| COO | 0 | 124757 | 0 | 24362 | 0 | 4071 | 0 | 5411 | 0 | 17423 | 0 | 176024 | 0 | 0 |
| STEVEN ROSE | ||||||||||||||
| VP FINANCIAL SERVICES/ CFO | 0 | 144167 | 0 | 27766 | 0 | 14133 | 0 | 7730 | 0 | 17743 | 0 | 211539 | 0 | 0 |
| JACQUELYN WILKERSON | ||||||||||||||
| VP NURSING SERVICES/ CNO | 0 | 119547 | 0 | 25021 | 0 | 5707 | 0 | 0 | 0 | 14788 | 0 | 165063 | 0 | 0 |
Schedule M IRS990ScheduleM
| Field | Value | IRS element (for citing) |
|---|---|---|
| Works Of Art | WorksOfArt | |
| Art Historical Treasures | ArtHistoricalTreasures | |
| Art Fractional Interest | ArtFractionalInterest | |
| Books And Publications | BooksAndPublications |
Clothing And Household Goods ClothingAndHouseholdGoods
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Noncash Contribs Rptd F990 | 35927 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | RETAIL ESTIMATE | MethodOfDeterminingRevenues |
Cars And Other Vehicles CarsAndOtherVehicles
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 5000 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | RETAIL ESTIMATE | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Boats And Planes | BoatsAndPlanes | |
| Intellectual Property | IntellectualProperty | |
| Securities Publicly Traded | SecuritiesPubliclyTraded | |
| Securities Closely Held Stock | SecuritiesCloselyHeldStock | |
| Securities Prtnrshp Trust Intrsts | SecuritiesPrtnrshpTrustIntrsts | |
| Securities Miscellaneous | SecuritiesMiscellaneous | |
| Qualified Contrib Hist Struct | QualifiedContribHistStruct | |
| Qualified Contrib Other | QualifiedContribOther | |
| Real Estate Residential | RealEstateResidential | |
| Real Estate Commercial | RealEstateCommercial | |
| Real Estate Other | RealEstateOther | |
| Collectibles | Collectibles | |
| Food Inventory | FoodInventory |
Drugs And Medical Supplies DrugsAndMedicalSupplies
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 2 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 1249 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Taxidermy | Taxidermy | |
| Historical Artifacts | HistoricalArtifacts | |
| Scientific Specimens | ScientificSpecimens | |
| Archaeological Artifacts | ArchaeologicalArtifacts |
Other Non Cash Contributions Table OtherNonCashContributionsTable (4 entries)
| Non Cash CheckboxNonCashCheckbox | DescriptionDescription | Number Of ContributionsNumberOfContributions | Noncash Contribs Rptd F990NoncashContribsRptdF990 | Method Of Determining RevenuesMethodOfDeterminingRevenues |
|---|---|---|---|---|
| X | DONATED FOOD | 21 | 12014 | RETAIL ESTIMATE |
| X | TECHNOLOGY/ EQUIPMENT | 2 | 49902 | RETAIL ESTIMATE |
| X | NONCASH PRIZES FOR EVENTS | 118 | 25527 | RETAIL ESTIMATE |
| X | INSURANCE | 1 | 1250 | RETAIL ESTIMATE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGifts |
| Third Parties Used | false | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| MEMBERSHIP | FORM 990, PART VI, SECTION A, LINE 6 | THE CORPORATION SHALL HAVE ONE CLASS OF MEMBER ONLY, WHICH CLASS SHALL CONSIST OF ONE MEMBER, WHICH SHALL BE CONWAY REGIONAL MEDICAL CENTER, INC., AN ARKANSAS NONPROFIT CORPORATION. ALL OF THE BUSINESS AND AFFAIRS OF THE CORPORATION SHALL BE MANAGED AND CONTROLLED BY THE MEMBER. |
| FORM 990 REVIEW PROCESS | FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS REVIEWED BY THE TREASURER AND THE PRESIDENT OF THE ORGANIZATION. THE FORM 990 IS THEN PRESENTED TO ALL MEMBERS OF THE GOVERNING BODY OF THE ORGANIZATION FOR REVIEW. |
| CONFLICT OF INTEREST MONITORING POLICY | FORM 990, PART VI, SECTION B, LINE 12C | EACH BOARD MEMBER IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT ANNUALLY. THESE STATEMENTS ARE REVIEWED BY THE CHAIRMAN OF THE BOARD, THE PRESIDENT OF THE ORGANIZATION, AND THE TREASURER OF THE ORGANIZATION. |
| COMPENSATION DETERMINATION POLICY | FORM 990, PART VI, SECTION B, LINE 15A & 15B | CONWAY REGIONAL HEALTH FOUNDATION DOES NOT COMPENSATE ANY OFFICERS OR KEY EMPLOYEES. THEREFORE, REVIEW AND APPROVAL BY INDEPENDENT PERSONS USING COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION IS NOT NECESSARY. |
| AVAILABILITY OF GOVERNING DOCUMENTS | FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CONWAY REGIONAL MEDICAL CENTER INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2302 COLLEGE AVENUE | AddressLine1 |
| City | CONWAY | City |
| State | AR | State |
| ZIP Code | 72034 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 710249735 | EIN |
| Primary Activities | HOSPITAL | PrimaryActivities |
| Legal Domicile State | AR | LegalDomicileState |
| Exempt Code Section | 501 (c) (3) | ExemptCodeSection |
| Public Charity Status | 3 | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | false | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | true | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
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