2011-08-16T10:08:28-04:00 2010-09-30 Grant Thornton LLP 201 S COLLEGE ST STE 2500 CHARLOTTE NC 28244 990 2009-10-01 570314381 CONWAY HOSPITAL INC CONW 8433478037 300 SINGLETON RIDGE ROAD CONWAY SC 295820829 BRET BARR 8433477111 2011-08-15 true MICHELE N MELCHIOR 7046323500 2009 2016-02-24 21:20:13Z PHILIP CLAYTON 300 SINGLETON RIDGE RD CONWAY SC 29526 157273365 false X WWW.CONWAYHOSPITAL.COM X 1928 SC ACUTE CARE HOSPITAL SERVING RESIDENTS OF HORRY AND SURROUNDING COUNTIES. 15 13 1177 254 65252 649893 221132 144614683 154602155 3685864 2145656 56715 178847 149007155 157147790 160287 249558 0 0 54143248 55758286 0 0 0 79783907 88610712 134087442 144618556 14919713 12529234 292339083 309034146 93417659 95115862 198921424 213918284 SEE SCHEDULE O false false 126996600 225226 154602155 SEE SCHEDULE O 126996600 true true false true false false false false false true false true false false false false false false false false true true true true true false false false false false false false false false true false false false false false true true false false true 140 0 true 1177 true true true false false false false false false false false 15 13 false false false false false false false true true false false true true true true true true true true true true NC X BRET BARR 8433477111 300 SINGLETON RIDGE ROAD CONWAY SC 29526 Leroy Rainbow Jr 1.0 X X 0 0 0 George Hearn 1.0 X X 0 0 0 M Wayne Staton 1.0 X 0 0 0 William R Benson 1.0 X 0 0 0 Reginald F Daves 1.0 X 0 0 0 Michael Ellis 1.0 X 0 0 0 Henry V Saunders 1.0 X 0 0 0 Dianne W Ray 1.0 X 0 0 0 William L Huggins 1.0 X 0 0 0 George H Goldfinch Jr 1.0 X 0 0 0 Charles B Jordan 1.0 X 0 0 0 Hal B Holmes 1.0 X 0 0 0 Christopher S Huggins 1.0 X 0 0 0 Deirdre S Williams 1.0 X 0 0 0 Philip Clayton 40.0 X X 643759 0 198582 Bret Barr 40.0 X 304134 0 60197 Dwight Gentry 40.0 X X 198960 0 29291 Preston Strosnider 40.0 X 319985 0 18434 Ann Sheffield 40.0 X 216338 0 92269 Craig Hyman 40.0 X 219518 0 55682 Angela Williford 40.0 X 168973 0 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true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 3051 3051 Lobbying Activities Schedule C, Part II-B, Line I: 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. 3262667 3262667 80805434 24272195 56533239 74995840 46937995 28057845 16638509 5639573 10998936 98852687 DUE FROM AFFILIATES 27393609 BOND REFUNDING 3110000 30503609 0 INTEREST RATE SWAP LIABILITY 6974181 6974181 FIN 48 FOOTNOTE 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. true true true X true X true true true false true true 6042030 6042030 0.05300 23321292 23321292 29363322 23321292 6042030 0.05300 237778 237778 0.00200 80511 80511 0.00100 318289 318289 0.00300 29681611 23321292 6360319 0.05600 false 9404796 34269912 52183564 -17913652 X true true CONWAY HOSPITAL INC

300 SINGLETON RIDGE ROAD CONWAY SC 29526

X X X Costing methodology followed in computing the amounts in the table: The IRS worksheets were used to compute the amounts in the table with input from our Medicare Cost report. Bad-debt of $30,338,053 has been removed from total expenses in the calculation of the table on line 7. The cost of bad-debts reported on line 2 was computed using the cost to charge ratio computed using IRS worksheet 2. Medicare shortfall: The entire amount of Medicare Shortfall should be considered a community benefit. By accepting Medicare patients, the hospital promotes access to healthcare services, thus providing a community benefit. Collection policy for those qualifying for assistance: When these individuals are 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. The hospital works out a payment plan with the patient and then any further action is handled through normal collection practices. The hospital, along with our local university Coastal Carolina University, developed a community health needs assessment in 2007. This needs assessment is evaluated every 4 years for significant changes within our population served. Additionally, through research conducted by other local, state and federal sources, the community health needs are evaluated every year. Signs are posted throughout the hospital to 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 apply. Conway Medical Center serves those persons living in Horry County as well as the bordering counties of Marion and Georgetown. The population of Horry County, according to the latest Census figures, is as follows: Population in 2010 was 269,291; The population grew by 37% from 2000 to 2010; In 2009, the population consisted of 6.3% of people under the age of 5, 20.6% of the population as under 18 years of age and 18% of the population was aged 65 and older. The primary service area of the hospital includes those zip codes within a 15 mile radius of the hospital. 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 FY 2010 report shows that the outreach program delivered free health screenings to 125 various locations predominately in medically underserved areas of Horry County. There were 2100 participants who were screened with results as follows: Elevated blood pressure - 17%; Elevated Blood Glucose - 14%; Elevated Blood Cholesterol - 39%. By providing counseling, physician referral and follow-up, the outreach staff work to lower the elevations for each individual screened. The hospital also has an open medical staff and its board members are comprised of individuals who serve on a voluntary basis. Surplus funds of the hospital are returned to the community through expanded services and continued access for all individuals regardless of their ability to pay. SC true Horry Georgetown Technical College 743 Hemlock Ave Myrtle Beach SC 29577 570681224 501(c)(3) 30000 Funding for Nursing Instructors United Way P O Box 673 Conway SC 29526 570558692 501(c)(3) 9504 General Purpose Conway Hospital Foundation P O Box 829 Conway SC 29528 570870199 501(c)(3) 32186 General Purpose 3 0 NURSING SCHOLARSHIPS, BOOKS, AND TUITION 14 24332 PROCEDURES FOR MONITORING GRANT FUNDS 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. Scholarships to Individuals - Nursing Scholarships are given out to employees of the hospital and other members of the community based on financial need and nursing shortages. Tuition reimbursement is also granted to individuals for certain educational assistance. Conway pays for books and tuition only, and students are required to maintain certain minimum grades in order to qualify for assistance. X X X X X false true false false false false false false false Philip Clayton 425036 0 218723 0 0 0 183057 0 15525 0 842341 0 0 0 Bret Barr 227625 0 76509 0 0 0 44672 0 15525 0 364331 0 0 0 Dwight Gentry 159012 0 39948 0 0 0 13766 0 15525 0 228251 0 0 0 Preston Strosnider 270926 0 49059 0 0 0 15159 0 3275 0 338419 0 0 0 Ann Sheffield 181550 0 34788 0 0 0 83550 0 8719 0 308607 0 0 0 Craig Hyman 165452 0 54066 0 0 0 46936 0 8719 0 275173 0 0 0 Angela Williford 138953 0 30020 0 0 0 9338 0 15525 0 193836 0 0 0 Robert Gajewski 138357 0 2250 0 0 0 7153 0 15525 0 163285 0 0 0 Bernard Massey 122188 0 33617 0 0 0 79707 0 8719 0 244231 0 0 0 Kevin Lovett 122104 0 25263 0 0 0 10580 0 15525 0 173472 0 0 0 Part I, Question 4b Persons who participate in supplemental retirement plan Conway provides a supplemental retirement benefit to senior executives that is contingent on them remaining at Conway until retirement. The accrual amounts reflect the change in actuarial value during the year and are impacted by various factors, including age of the participant and changes in interest rates. Philip Clayton 170,807 Bret Barr 32,422 Ann Sheffield 72,810 Craig Hyman 36,009 Bernard Massey 1,927 Kevin Lovett 3,066 SC Jobs -Economic Development 570960018 83703FBB7 2007-11-08 50000000 See schedule O false false 50325379 3782704 1629648 44913027 2009 false false true true false false false false true true true true true WACHOVIA 30. false false false CHARLES JORDAN See Schedule O 2818871 INDEPENDENT CONTRACTOR false ORGANIZATION'S MISSION Part III, Line 1: 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. EXEMPT PURPOSE ACHIEVEMENT PART III, LINE 4a: Conway Hospital Inc. Is a 168 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, 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, 2010, the hospital furnished charity care in the amount of $19,590,065. The total days of patient care were 34,334 and Conway Hospital Inc. saw a total of 140,779 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. ORGANIZATION'S FORM 990 REVIEW PROCESS PART VI, SECTION B, LINE 11: 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. ORGANIZATION'S MONITORING CONFLICT OF INTEREST POLICY PART VI, SECTION B, 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. OFFICER/KEY EMPLOYEE COMPENSATION DECISIONS PART VI, SECTION B, LINE 15A and 15B: The Board Executive Compensation Committee is responsible for reviewing and approving compensation for the CEO, CFO and all Vice Presidents. 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 makes its financial statements available to the public upon request. TAX-EXEMPT BONDS SCHEDULE K, PART I AND II Part I, A, (f) - Construct and equip hospital bed tower Part II, A, line 5 - Includes $440,000 issuance costs plus $1,189,648 credit enhancement. 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 discussions and voting regarding this activity. TRANSACTIONS WITH RELATED ORGANIZATIONS Schedule R, Part V, Question 2 All reported transactions between related organization are the actual amounts transferred or contributed. Reimbursements are provided at cost which represents the fair value of the expenses incurred by the applicable organization. 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