2011-08-15T12:45:51-05:00 2010-09-30 Grant Thornton LLP 201 S COLLEGE ST STE 2500 CHARLOTTE NC 28244 990 2009-10-01 571119337 Conway Hospital Community Services CONW 8433478037 300 Singleton Ridge Road Conway SC 29526 BRET BARR 8433477111 2011-08-15 true 7046323500 2009 2016-02-24 21:20:13Z PHILIP CLAYTON 300 SINGLETON RIDGE RD CONWAY SC 29526 6066913 false X WWW.CONWAYHOSPITAL.COM X 2001 SC SEE SCHEDULE O 3 0 73 2 0 0 6894 4535621 6060019 -29450 0 0 0 4506171 6066913 641 0 0 0 5253489 6904994 0 0 0 1949414 2923349 7203544 9828343 -2697373 -3761430 5016562 7073307 11036080 16854255 -6019518 -9780948 SEE SCHEDULE O false false 9144336 6060019 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, 67,947 patients were treated by employed providers of the corporation. 9144336 true false false false false false false false false true 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 true 31 0 true 73 true false false false false false false false false false 3 0 false false false false true true true true true false false true true true true true true true true false X BRET BARR 8433477111 300 SINGLETON RIDGE ROAD CONWAY SC 29526 Philip Clayton 1.0 X X 0 643759 198582 Bret Barr 1.0 X X 0 304134 60197 Dwight Gentry 1.0 X X 0 198960 29291 Warren Ratley 40.0 X 184227 0 32726 Darin Sutton 40.0 X 672025 0 27775 Richard Eisenman 40.0 X 573263 0 27775 Joseph Edelson 40.0 X 512896 0 15525 Terry Levenson 40.0 X 363677 0 15525 James W Adamson 40.0 X 207908 0 25934 2513996 1146853 433330 12 false true false MB Kahn Construction Co Inc 101 Flint Lake Rd COLUMBIA SC 29223 Construction 1046634 Omega Medical Solutions 4728 Jenn Dr Ste 103 MYRTLE BEACH SC 29577 Billing Service 238317 Allscripts 8529 Six Forks Rd RALEIGH NC 27615 PHYS. CLINIC SOFTWAR 199879 Forms Supply P O Box 563953 CHARLOTTE NC 28256 Office Supplies 166539 Usery Wolfe Peterson Doyle 4610 Oleander Dr Suite 201 MYRTLE BEACH SC 29577 Architecture 103014 5 6894 6894 NET PATIENT REVENUE 621110 5722029 5722029 HOSPITAL PHYSICIAN FEES 900099 175134 175134 PROGRAM RENTAL INCOME 531120 162856 162856 6060019 0 0 0 0 0 0 0 0 6066913 5897163 0 162856 0 0 0 0 179552 179552 0 5609425 5421848 187577 120510 110395 10115 748727 693848 54879 246780 227595 19185 0 11899 11287 612 7525 7525 0 0 0 950781 887771 63010 0 844030 785075 58955 0 0 174147 168631 5516 0 0 0 0 0 412438 379685 32753 193901 193901 MINOR EQUIPMENT 266400 221565 44835 RECRUITMENT AND RETENTION 10293 5982 4311 EDUCATION 49551 35697 13854 OTHER EXPENSES 2384 1056 1328 9828343 9144336 684007 0 221045 825844 40688 70138 29575 44095 7574320 1441090 4725254 6133230 5016562 7073307 1131623 843899 9904457 16010356 11036080 16854255 X -6019518 -9780948 -6019518 -9780948 5016562 7073307 X false true true X false X 1117423 1117423 4865639 933101 3932538 210379 56349 154030 1186113 388866 797247 194766 62774 131992 6133230 0 DUE TO CONWAY HOSPITAL, INC. 16010356 16010356 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. X X X X X false true false false false false false false false Philip Clayton 0 425036 0 218723 0 0 0 183057 0 15525 0 842341 0 0 Bret Barr 0 227625 0 76509 0 0 0 44672 0 15525 0 364331 0 0 Dwight Gentry 0 159012 0 39948 0 0 0 3769 0 25522 0 228251 0 0 Warren Ratley 155476 0 28751 0 0 0 17201 0 15525 0 216953 0 0 0 Darin Sutton 547633 0 124392 0 0 0 12250 0 15525 0 699800 0 0 0 Richard Eisenman 391791 0 181472 0 0 0 12250 0 15525 0 601038 0 0 0 Joseph Edelson 433100 0 79796 0 0 0 0 0 15525 0 528421 0 0 0 Terry Levenson 264476 0 99201 0 0 0 0 0 15525 0 379202 0 0 0 James W Adamson 207908 0 0 0 0 0 10409 0 15525 0 233842 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 Organization's Mission Part I, Line 1 and Part III, Line 1: PROVISION OF OUTPATIENT HEALTH CARE SERVICES TO HORRY COUNTY AND THE SURROUNDING COMMUNITY IN CONJUNCTION WITH CONWAY HOSPITAL, INC. ORGANIZATION MEMBER PART VI, SECTION A, LINE 6: Conway Hospital, Inc. is the sole member of Conway Hospital Community Services, Inc. ELECTION OF GOVERNING BODY PART VI, SECTION A, LINE 7A: The Trustees of Conway Hospital Community Services, Inc. are appointed by Conway Hospital Inc.'s Board of Trustees. DECISIONS OF GOVERNING BODY SUBJECT TO APPROVAL BY MEMBERS PART VI, SECTION A, 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. ORGANIZATION'S FORM 990 REVIEW PROCESS PART VI, SECTION B, LINE 11: 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, department heads and executive level employees) 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: The Conway Hospital Inc 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 Community Services, Inc. makes its financial statements available to the public upon request. CONWAY HOSPITAL INC 300 SINGLETON RIDGE RD CONWAY SC 29526 570314381 HEALTHCARE SC 501(c)3 3 CONWAY HOSPITAL ANESTHESIA PROFESSIONAL 300 SINGLETON RIDGE RD CONWAY SC 29526 208817302 ANESTHESIA SC 501(c)3 11a-I CONWAY HOSPITAL EMERGENCY PROFESSIONAL 300 SINGLETON RIDGE RD CONWAY SC 29526 208817905 EMERGENCY SC 501(c)3 11a-I false false true false false false false false false true false true true true true false true false No disclosure required