2012-08-15T11:36:02-05:00 2011-09-30 Grant Thornton LLP 201 S COLLEGE ST STE 2500 CHARLOTTE NC 28244 990 2010-10-01 571119337 CONWAY HOSPITAL COMMUNITY SERVICES CONW 8433478037 300 SINGLETON RIDGE ROAD CONWAY SC 29526 BRET BARR 8433477111 2012-08-15 true MICHELE N MELCHIOR 7046323500 2010 2016-02-24 21:20:13Z PHILIP CLAYTON 300 SINGLETON RIDGE ROAD CONWAY SC 29526 7908345 false X WWW.CONWAYMEDICALCENTER.COM X 2001 SC PROVISION OF OUTPATIENT HEALTH CARE SERVICES TO HORRY COUNTY AND THE SURROUNDING COMMUNITY IN CONJUNCTION WITH CONWAY HOSPITAL, INC. 3 0 100 9 0 6894 0 6060019 7908186 0 -1529 0 0 6066913 7906657 0 0 0 0 6904994 9560829 0 0 0 2923349 2886342 9828343 12447171 -3761430 -4540514 7073307 6812212 16854255 21133674 -9780948 -14321462 PROVISION OF OUTPATIENT HEALTH CARE SERVICES TO HORRY COUNTY AND THE SURROUNDING COMMUNITY IN CONJUNCTION WITH CONWAY HOSPITAL, INC. false false 11524532 7908186 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, 86,085 PATIENTS WERE TREATED BY EMPLOYED PROVIDERS OF THE CORPORATION. 11524532 true false false false false false false false false true false false false true false false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false false true 31 0 true 100 true false false false false false false false false false false X 3 0 false false false false true true true true true false false true true true true true true true true false SC X BRET BARR 8433477111 300 SIGLETON RIDGE ROAD CONWAY SC 29526 X PHILIP CLAYTON 1.0 X X 0 616201 234361 BRET BARR 1.0 X X 0 291507 75838 DWIGHT GENTRY 1.0 X X 0 201490 16900 WARREN RATLEY 40.0 X 192179 0 46088 RICHARD EISENMAN MD 40.0 X 650574 0 31580 DARIN SUTTON MD 40.0 X 609741 0 31580 JOSEPH EDELSON MD 40.0 X 567756 0 31580 HAFEZ HAYEK MD 40.0 X 353466 0 19330 TERRY LEVENSON MD 40.0 X 302640 0 31580 2676356 1109198 518837 15 false true false ALLSCRIPTS 8529 SIX FORKS ROAD RALEIGH NC 27615 SOFTWARE SUPPORT 231472 1 0 NET PATIENT REVENUE 621110 7582297 7582297 HOSPITAL PHYSICIAN FEES 900099 165407 165407 PROGRAM RENTAL INCOME 531120 160482 160482 7908186 159 159 0 0 1688 -1688 -1688 -1688 0 0 0 0 7906657 7908186 0 -1529 0 0 0 0 200944 200944 0 7988192 7543251 444941 0 1371693 1215516 156177 0 0 0 9924 9924 0 0 0 488187 481960 6227 53448 53313 135 975008 956624 18384 0 0 433237 395873 37364 6359 3449 2910 0 0 0 0 497333 464341 32992 251424 251424 MINOR EQUIPMENT 149323 147792 1531 RECRUITMENT AND RETENTION 3905 3905 EDUCATION 64111 54417 9694 OTHER EXPENSES 9587 8171 1416 CHANGE IN BAD DEBT ACCRUAL -55504 -55504 12447171 11524532 922639 0 825844 542338 70138 192889 44095 60862 7875300 1859177 6133230 6016123 7073307 6812212 843899 630687 16010356 20502987 16854255 21133674 X -9780948 -14321462 -9780948 -14321462 7073307 6812212 -4540514 X false true true X false X 1117423 1117423 4869396 1153689 3715707 210379 100358 110021 1471829 528591 943238 206273 76539 129734 6016123 0 DUE TO CONWAY HOSPITAL INC. 20502987 20502987 LIABILITY FOR UNCERTAIN TAX POSITION (ASC 740) SCHEDULE D, PART X, LINE 2 THE ORGANIZATION ADOPTED FIN48 (NOW KNOWN AS ASC740) IN AN EARLIER YEAR, HOWEVER AS THE ORGANIZATION DID NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT REQUIRED DISCLOSURE, NO FOOTNOTE IS INCLUDED IN THE CURRENT YEAR FINANCIAL STATEMENTS. X X X X X false true false false false false false false false PHILIP CLAYTON 0 431954 0 184247 0 0 0 215031 0 19330 0 850562 0 0 BRET BARR 0 227385 0 64122 0 0 0 56508 0 19330 0 367345 0 0 DWIGHT GENTRY 0 160068 0 41422 0 0 0 7319 0 9581 0 218390 0 0 WARREN RATLEY 147893 0 44286 0 0 0 26758 0 19330 0 238267 0 0 0 RICHARD EISENMAN MD 444691 0 203981 0 1902 0 12250 0 19330 0 682154 0 0 0 DARIN SUTTON MD 577748 0 27493 0 4500 0 12250 0 19330 0 641321 0 0 0 JOSEPH EDELSON MD 565164 0 2592 0 0 0 12250 0 19330 0 599336 0 0 0 HAFEZ HAYEK MD 348941 0 4525 0 0 0 0 0 19330 0 372796 0 0 0 TERRY LEVENSON MD 294464 0 8176 0 0 0 12250 0 19330 0 334220 0 0 0 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B CONWAY HOSPITAL (A RELATED ORGANIZATION) 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, DWIGHT GENTRY, WARREN RATLEY. THERE WERE NO PAYOUTS FROM THE PLANS DURING THE YEAR. MEMBERS OR STOCKHOLDERS FORM 990, PART VI, LINE 6 CONWAY HOSPITAL, INC. IS THE SOLE MEMBER OF CONWAY HOSPITAL COMMUNITY SERVICES. MEMBERS OR STOCKHOLDERS WHO MAY ELECT FORM 990, PART VI, LINE 7A THE TRUSTEES OF CONWAY HOSPITAL COMMUNITY SERVICES, INC. ARE APPOINTED BY CONWAY HOSPITAL INC.'S BOARD OF TRUSTEES. DECISIONS SUBJECT TO APPROVAL FORM 990, PART VI, LINE 7B 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 REVIEW PROCESS FORM 990, PART VI, LINE 11B 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. ORGANIZATION'S MONITORING CONFLICT OF INTEREST POLICY PART VI, SECTION B, LINE 12C 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. OFFICER/KEY EMPLOYEE COMPENSATION DECISIONS PART VI, SECTION B, LINE 15A AND 15B CONPENSATION 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. DOCUMENTS AVAILABLE TO THE PUBLIC PART VI, SECTION C, LINE 19 CONWAY HOSPITAL COMMUNITY SERVICES, INC. MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:PHILIP CLAYTON TITLE:PRESIDENT HOURS:43 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:BRET BARR TITLE:TREASURER HOURS:43 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DWIGHT GENTRY TITLE:SECRETARY HOURS:42 CONWAY HOSPITAL INC 300 SINGLETON RIDGE ROAD CONWAY SC 29526 570314381 HEALTHCARE SC 501(C)3 03 NA CONWAY HOSPITAL ANESTHESIA SERVICES 300 SINGLETON RIDGE ROAD CONWAY SC 29526 208817302 ANESTHESIA SC 501(C)3 11 A-I NA CONWAY HOSPITAL EMERGENCY SERVICES 300 SINGLETON RIDGE ROAD CONWAY SC 29526 208817905 EMERGENCY SC 501(C)3 11 A-1 NA false false true false false false false false false true false true true true true false true false