2017-08-15T12:50:17-05:00 2016-09-30 Grant Thornton LLP 201 S COLLEGE ST STE 2500 CHARLOTTE NC 28244 990 2015-10-01 570314381 Conway Hospital Inc % BRET BARR CONW 8433478037 300 SINGLETON RIDGE ROAD CONWAY SC 29526 BRET BARR CFO 8433477111 2017-08-14 true MICHELE N MELCHIOR P00488037 7046323500 2017-08-14 2015 2021-01-29 14:40:06Z Conway Medical Center PHILIP CLAYTON 300 SINGLETON RIDGE ROAD CONWAY SC 29526 172339239 false X WWW.CONWAYMEDICALCENTER.COM X 1928 SC WE ARE AN ACUTE CARE HOSPITAL SERVING HORRY AND SURROUNDING COUNTIES. OUR MISSION IS TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY BY BEING A LEADER IN HEALTH CARE. 14 13 1298 226 40580 1221466 585331 153264910 156785649 5001862 8509680 285317 288056 159773555 166168716 63223 38137 0 0 65041429 67969649 0 0 0 70023868 75878590 135128520 143886376 24645035 22282340 424315697 442657878 93315242 89349303 331000455 353308575 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 118280654 38137 157073705 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, 2016, THE HOSPITAL FURNISHED CHARITY CARE IN THE AMOUNT OF $16,654,048 IN FOREGONE CHARGES. THE TOTAL DAYS OF PATIENT CARE WERE 32,836 AND CONWAY HOSPITAL INC. SAW A TOTAL OF 134,856 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. 118280654 true true false true false false false false true true false false true true true false true false false false false false false false false true true true true true true false false false false false false false false false false false false false false false true true true false false true 141 0 true 1298 true true true false false false false false false false false false X 14 13 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 CEO AND TRUSTEE 40.0 4.0 X X 836001 0 280778 LEROY RAINBOW JR CHAIRMAN 1.0 1.0 X X 0 0 0 M WAYNE STATON SECRETARY 1.0 1.0 X X 0 0 0 WILLIAM R BENSON TRUSTEE 1.0 1.0 X 0 0 0 DR REGINALD F DAVES TRUSTEE 1.0 1.0 X 0 0 0 Dr MICHAEL ELLIS TRUSTEE 1.0 1.0 X 0 0 0 GEORGE H GOLDFINCH JR TRUSTEE 1.0 1.0 X 0 0 0 JOHN P HENRY TRUSTEE 1.0 1.0 X 0 0 0 DR HAL B HOLMES TRUSTEE 1.0 1.0 X 0 0 0 CHRISTOPHER S HUGGINS TRUSTEE 1.0 1.0 X 0 0 0 CHARLES B JORDAN TRUSTEE 1.0 1.0 X 0 0 0 GEORGE N MAGRATH JR TRUSTEE 1.0 1.0 X 0 0 0 DIANNE W RAY TRUSTEE 1.0 1.0 X 0 0 0 DR DEIRDRE S WILLIAMS DDS TRUSTEE 1.0 1.0 X 0 0 0 BRET BARR CFO 40.0 4.0 X 362189 0 99225 PRESTON STROSNIDER VP OF MEDICAL STAFF 40.0 0.0 X 518399 0 81848 TONY MINSHEW VP OF NURSING 40.0 0.0 X 260079 0 53075 MATTHEW SECURRO VP OF HUMAN RESOURCES 40.0 0.0 X 209405 0 49686 PAUL RICHARDSON VP OF MEDICAL AFFAIRS 40.0 0.0 X 354619 0 36317 ANGELA WILLIFORD CHIEF RISK OFFICER 40.0 0.0 X 228912 0 52541 KEVIN LOVETT VP OF FACILITIES 40.0 0.0 X 208745 0 50093 BERNARD MASSEY VP OF FOUNDATION 40.0 0.0 X 197409 0 35202 ROBERT GAJEWSKI DIRECTOR OF PHARMACY 40.0 0.0 X 169035 0 34339 DENNIS FINLEY DIRECTOR OF PHYSICAL THERAPY 40.0 0.0 X 144731 0 32650 FRANK GRELLA DIRECTOR OF PATIENT ACCTING 40.0 0.0 X 141381 0 6992 GLENN SISK PHARMACIST 40.0 0.0 X 145575 0 7267 WENDELL BEVERLY CLINICAL PHARMACY COORDINATOR 40.0 0.0 X 150275 0 33495 3926755 0 853508 43 false true false CONWAY EMERGENCY GROUP 300 SINGLETON RIDGE ROAD CONWAY SC 29526 PHYSICIAN SERVICES 5060310 HOSPITAL MEDICINE ASSOCIATES LLC PO BOX 634850 CINCINNATI OH 45263 PHYSICIAN SERVICES 3077439 ARAMARK CTS INC 10510 TWIN LAKES PARKWAY CHARLOTTE NC 28269 TECHNICAL 869088 LITTLE DIVERSIFIED ARCHITECTURAL 5815 WESTPARK DRIVE CHARLOTTE NC 28217 CONSTRUCTION 782278 MORRISON MANAGEMENT SPECIALISTS 5801 PEACHTREE DUNWOODY ROAD ATLANTA GA 303421503 DIETARY 674809 32 125000 460331 585331 NET PATIENT REVENUE 621990 153649510 153649510 DIETARY REVENUE 624210 1175097 1138538 36559 PHARMACY 900099 236472 236472 PREMIER INCOME 900099 91465 87444 4021 COASTAL HOME CARE 900099 68903 68903 1564202 1564202 156785649 3162564 3162564 0 0 288056 288056 0 288056 288056 11043168 474471 5320032 850491 5723136 -376020 5347116 5347116 0 0 0 0 166168716 156964222 40580 8578583 25160 25160 12977 12977 0 0 3226089 645218 2580871 0 48976998 39181598 9795400 1942824 1554259 388565 10140027 8112022 2028005 3683711 2946969 736742 8163448 6530758 1632690 907306 725845 181461 128073 102458 25615 3129 3129 0 0 5512596 4410077 1102519 0 1568029 1254423 313606 2896951 2896951 0 6371744 5097395 1274349 25452 25452 0 0 2375305 2375305 0 8912255 7129804 1782451 671297 537038 134259 MEDICAL SUPPLIES 30695762 30695762 MEDICAID PROVIDER TAX 3309017 3309017 MINOR EQUIPMENT 1242303 993842 248461 FOOD SUPPLIES 1162992 930394 232598 1932931 1710333 222598 143886376 118280654 25605722 0 14644239 7457068 0 0 0 0 15320840 14214261 0 0 0 0 14393260 2554875 3294863 3548887 1531778 1466833 223648075 117154305 89137879 106493770 212437961 221314109 0 0 4650412 5465961 877864 816900 68026601 79325214 424315697 442657878 18996088 20356832 0 0 491730 491730 59017629 56456422 0 0 0 0 14809795 12018670 0 0 0 25649 93315242 89349303 X 329380687 351696191 723395 697342 896373 915042 331000455 353308575 424315697 442657878 X 22282340 33165 -7385 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 3129 3129 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. 3486048 245249 187247 205001 3713543 3465824 266360 -46641 199495 3486048 3168543 277647 221714 202080 3465824 2824600 334226 318538 308821 3168543 2533913 334052 361512 6158 398719 2824600 0.26000 0.49000 0.25000 false true true 2799142 2799142 104467154 43670974 60796180 90090 11162 78928 106654080 70279530 36374550 9637609 3192639 6444970 106493770 DUE FROM AFFILIATES 74602830 BOND REFUNDING 3110000 BENEFICIAL INTEREST IN FDN. 1612384 79325214 0 DUE TO AFFILIATE 25649 25649 X ENDOENMENT 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, 2016, the tax years ended September 30, 2015, 2014 and 2013 for federal jurisdiction remain open to examination. true true true X true X true true true false true true 4546142 2368498 2177644 0.01510 22920757 20400248 2520509 0.01750 27466899 22768746 4698153 0.03260 776 59446 393621 393621 0.00270 53 721 46397 46397 0.00030 75 52892 55006 55006 0.00040 904 113059 495024 495024 0.00340 904 113059 27961923 22768746 5193177 0.03600 19 2565 13338 13338 0.00010 19 2565 13338 13338 0.00010 false 38936487 54770091 50122542 4647549 X true true 1 1 Conway Hospital Inc 300 Singleton Ridge Road Conway SC 29526 www.conwaymedicalcenter.com HTL-0083 X X X CONWAY HOSPITAL INC false false true X X X X X X X X 15 true false false true X conwaymedical center.com/aboutcmc.aspx X true 16 true conwaymedical center.com/aboutcmc.aspx false false true X 100 200. X X X X X true true X X X X true X See section C. X See section C. X See section C. X X X X X X true X false X X X X true X false false Conway Hospital, Inc. Schedule H, Part V, Section B, Question 5: In conducting our Community Health Needs Assessment (CHNA), our team used several sources of quantitative health measures and social and demographic data specific to Conway Medical Centers (CMCs) home county (Horry) provided by local public health agencies, health care associations and various other data outlets. CMC took advantage of this opportunity to collaborate with its administrators, physicians, outreach programs, and local organizations as well. Conway Medical Center sought outside assistance from the Dixon Hughes Goodman CHNA team in this process. DHG provided data, organized community input, facilitated priority sessions, and supported the report drafting process. The assessment process consists of five steps: Data Assessment of our Community, Community Input, Prioritization & Implementation Strategy, Reporting, and Monitoring. In the initial step, service areas were defined, external data research was completed and key findings were summarized. As the data assessment was completed, the community input phase was started. During the community input phase, phone and written interviews were conducted with persons with special knowledge of public health. This included Hospital Administrators, Local and Community Organizations, Other Local Groups, and Public Health Officials Florence Health Department. In addition, hospital personnel, local organizations, and community outreach advocates were interviewed. A summary of this dialog was created and is included in the CHNA report. A prioritization session was then held to summarize and overlay data elements with key community input findings. From this session, priorities emerged based upon the significance of the need to the service area, and CMCs ability to impact the need. Based on these priorities, CMC decided on which priorities would be included in their implementation strategy and which priorities would not be addressed. These can be found in the Implementation Strategy document. This report and strategy were then approved by the board and made "widely available" on the Conway Medical Center website. Data Assessment Highlights and Findings: The data assessment piece of the CHNA process included data tables, graphs, and maps from various sources widely available. These data elements were used to identify at-risk populations, underserved populations, health need areas, and professional shortage areas. A summary of findings was then created to highlight areas of need within the service area. To gather input from various sources, the team used a combination of interviews of local community persons and groups, and sought other data such as recent county health rankings and national health statistics. Local Community Input: Hospital Administrators, Local and Community Organizations, Other Local Groups, and Public Health Officials Florence Health Department. 2016 County Health Rankings: This source is a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. It gives a general snapshot of how healthy each county is in relation to others in the same state. It measures and ranks both health outcomes and health factors that lead to those outcomes. Each indicator is weighed, standardized, and ranked in order to come up with an overall ranking of health for each county in South Carolina. Ranking areas included: Health Outcomes (length of life, quality of life), Health Factors (health behaviors, clinical care, social and economic factors, physical environment). Health Indicators Warehouse: The HIW is a collaboration of many Agencies and Offices within the Department of Health and Human Services. The HIW is maintained by the CDCs National Center for Health Statistics. HIW has many county level statistics that allow for comparison to state and national benchmarks. In addition, other government sites were used: CMS Standard Analytical Inpatient File, State Cancer Profiles, Small Area Health Insurance Estimates, Data.CMS.gov, South Carolina Department of Health and Environmental Control, South Carolina Department of Social Services. Conway Hospital, Inc. Schedule H, Part V, Section B, Question 11: 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 primary care providers, discharge follow up, motor vehicle fatality, diabetes, and percentage of mammography screenings. Access to primary care providers (PCPs) CMC will partner with local clinics to continue assisting in providing care at reduced costs through support in areas of rent, utility bills, and hospital services as well as evaluate the opportunities to expand access points for care. Discharge follow up In order to reduce several health concerns, CMC has identified patients no following discharge instructions as a significant community need. It is CMC's intent to establish best practices and education around discharge instructions. Motor vehicle fatality According to the Association of State and Territorial Health Officials, Crash-related deaths and injuries are largely preventable. States can utilize systems, policy, and programmatic interventions to target and prevent this serious public health problem. CMC will focus its efforts on the trauma side in partnership with local EMS providers. Diabetes Diabetes is a major health needs across the US and in Horry County. CMC will continue to support and educate medically underserved diabetics in the community. Percentage of mammography screenings Provide preventative screenings while finding innovative ways to address financial and transportation barriers of receiving these screenings. One of the priorities identified will not be addressed by the hospital: percentage of adults smoking. As part of CMCs 2013 CHNA, CMC included this need in its prioritization planning and actively implemented actions. At this time, however, there are other organizations in the county that are specifically focused on this need and CMC will focus its resources in other areas. CMC will continue to be an advocate of creating smoke free environments. Our Community Health Needs Assessment and Implementation Strategy can be found at: http://www.conwaymedicalcenter.com/AboutCMC.aspx Conway Hospital, Inc. Schedule H, Part V, Section B, Question 16 (a,b,c): The URL where our FAP documents can be found: http://www.conwaymedicalcenter.com/PatientsVisitors/BillingandInsurance.as px Schedule H, Part V, Section B, Question 16(i): The financial assistance policy was also provided to patients upon discharge by case managers. Conway Hospital, Inc. Schedule H, Part V, Section B, Question 22: 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. 1 CONWAY HOSP OUTPATIENT DIAGNOSTIC CTR 801 FARRAR DRIVE CONWAY SC 29526 IMAGING MAMMOGRAPHY COSTING METHODOLOGY SCHEDULE H, PART I, LINE 7: Costing Methodology 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 the 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 11 and 12 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. COMMUNITY HEALTH CARE NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 2: Conway Medical Center utilizes the Healthy People 2020 report, the Office of Research and Statistics, SC Budget and Control Board, Small Area Health Insurance Estimates, National Cancer Institute State Cancer Profiles, and the South Carolina Department of Health and Environmental Control in addition to its own data collected through the medical records system to assess the health care needs of Horry County. 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, including the patient areas and waiting rooms, in both English and Spanish (and on our website under patient and family responsibility) that inform patients of our financial assistance policy. The hospital website contains the hospital financial assistance policy and the plain language summary in English and Spanish. 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. All billing statements sent to patients also include a notice that the hospital has an assistance program and how 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. 'si usted no tiene los recursos para pagar su cuenta, por favor pregntenos sobre el programa de asistencia del hospital.' Finally, every hospital registrar, financial counselor, billing employee, and outsourced billing or collection person is taught, and required, to discuss the following insurance or other payment options with patients or responsible guarantor to leave no chance an eligible patient will be missed: Medicare if applicable, Medicaid screened insurance exchange if applicable, the patient is asked about employer coverage and about private purchased health insurance, or if the patient or guarantor indicates that they have no insurance or third party that would be responsible for their bill, they will be referred to the hospital financial assistance program, and counselors are available to assist. DESCRIPTION OF COMMUNITY SERVED SCHEDULE H, PART VI, LINE 4: Conway Medical Centers service area is defined as Horry County for this assessment. 90% of Conway Medical Centers patients come from Horry County. As of the 2010 United States Census, there were 269,291 people, 112,225 households, and 72,254 families residing in the county. The population density was 237.5 inhabitants per square mile (91.7/km2). There were 185,992 housing units at an average density of 164.0 per square mile (63.3/km2). The racial makeup of the county was 79.9% white, 13.4% black or African American, 1.0% Asian, 0.5% American Indian, 0.1% Pacific Islander, 3.1% from other races, and 2.0% from two or more races. Those of Hispanic or Latino origin made up 6.2% of the population. Of the 112,225 households, 27.3% had children under the age of 18 living with them, 47.2% were married couples living together, 12.5% had a female householder with no husband present, 35.6% were non-families, and 26.8% of all households were made up of individuals. The average household size was 2.37 and the average family size was 2.84. The median age was 41.1 years. The median income for a household in the county was $43,142 and the median income for a family was $51,608. Males had a median income of $37,351 versus $29,525 for females. The per capita income for the county was $24,811. About 11.6% of families and 16.1% of the population were below the poverty line, including 25.2% of those under age 18 and 7.5% of those age 65 or over. The population of Horry County in 2016 was 311,020 and is expected to be 341,393 in 2021 which will be 9.77% growth. The 65+ population is expected to increase from 2016 and 2021 by 23.15%, while the population under 65 is only expected to grow by 6.24%. 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 2015/2016 report shows that the outreach program delivered free health screenings to 97 various locations predominately in medically underserved areas of Horry County. There were 2,156 participants who were screened with results as follows: elevated blood pressure; elevated blood glucose; elevated blood cholesterol. 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 715 children every Thursday. Healthreach provided 1,012 flu shots at 21 events. Safesitter babysitting training classes were provided in June and July with a total of 15 children participating and receiving certification. AFFILIATED HEALTH CARE SYSTEM SCHEDULE H, PART VI, LINE 6: Conway Hospital, Inc. (Conway Hospital, the Hospital or CHI), located in Conway, South Carolina, is a Not-For-Profit acute care hospital founded in 1928. The Hospital has 210 licensed beds and provides inpatient, outpatient and emergency care services generally for residents of Horry and surrounding counties. The Hospital is governed by a 16-member self-perpetuating, independent board of directors. Admitting physicians are practitioners in the local area. Conway Hospital Long-Term Care Services, Inc. (Kingston Nursing Center) is an 88-bed nursing facility located in Conway, South Carolina. The Kingston Nursing Center was incorporated in 1988. Medical Properties, Inc., a wholly owned for-profit subsidiary of the Hospital, operates ASC Holdings and Carolina Bone & Joint. Conway Hospital Emergency Professional Services (CHEPS) and Conway Hospital Anesthesia Professional Services (CHAPS) were both created to keep better track of emergency and anesthesia services performed by the Hospital. Conway Hospital Community Services, Inc., a wholly owned not-for-profit subsidiary, operates employed physician practices. COMMUNITY BENEFIT REPORT STATE FILINGS SCHEDULE H, PART VI, LINE 7: SC true UNITED WAY PO BOX 673 CONWAY SC 29526 570558692 501(C)(3) 9810 GENERAL PURPOSE AMERICAN HEART ASSOC 4217 PARK PLACE COURT GLEN ALLEN VA 23060 135613797 501(C)(3) 5500 GENERAL PURPOSE 2 NURSING SCHOLARSHIPS, BOOKS, TUITION 6 12977 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. 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 false true false false false false false false false PHILIP CLAYTON CEO AND TRUSTEE 485822 0 289037 0 61142 0 232967 0 47811 0 1116779 0 0 0 BRET BARR CFO 283429 0 63957 0 14803 0 67229 0 31996 0 461414 0 0 0 PRESTON STROSNIDER VP OF MEDICAL STAFF 291155 0 183948 0 43296 0 55681 0 26167 0 600247 0 0 0 TONY MINSHEW VP OF NURSING 217546 0 42533 0 0 0 40793 0 12282 0 313154 0 0 0 MATTHEW SECURRO VP OF HUMAN RESOURCES 178921 0 30484 0 0 0 23056 0 26630 0 259091 0 0 0 PAUL RICHARDSON VP OF MEDICAL AFFAIRS 268019 0 68600 0 18000 0 13250 0 23067 0 390936 0 0 0 ANGELA WILLIFORD CHIEF RISK OFFICER 180297 0 40446 0 8169 0 23122 0 29419 0 281453 0 0 0 KEVIN LOVETT VP OF FACILITIES 175163 0 32018 0 1564 0 20350 0 29743 0 258838 0 0 0 BERNARD MASSEY VP OF FOUNDATION 152789 0 35258 0 9362 0 23682 0 11520 0 232611 0 0 0 ROBERT GAJEWSKI DIRECTOR OF PHARMACY 166035 0 3000 0 0 0 8557 0 25782 0 203374 0 0 0 DENNIS FINLEY DIRECTOR OF PHYSICAL THERAPY 133802 0 10929 0 0 0 7365 0 25285 0 177381 0 0 0 GLENN SISK PHARMACIST 145575 0 0 0 0 0 7267 0 0 0 152842 0 0 0 WENDELL BEVERLY CLINICAL PHARMACY COORDINATOR 150275 0 0 0 0 0 7713 0 25782 0 183770 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, TONY MINSHEW, MATTHEW SECURRO, KEVIN LOVETT, BERNARD MASSEY, AND ANGELA WILLIFORD. DURING THE CALENDAR YEAR REPORTED WITHIN THIS YEAR. THE FOLLOWING INDIVIDUALS RECEIVED PAYOUTS FROM THE PLAN: BRET BARR - $10,503 PHILIP CLAYTON - $61,142 KEVIN LOVETT - $1,564 BERNARD C MASSEY - $9,362 PRESTON STROSNIDER - $43,296 ANGELA WILLIFORD - $8,169 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 83703FFY3 2011-09-30 19510000 REFUND 1998 SERIES BOND false false false A 3872931 0 46017931 0 0 0 607931 0 0 0 45410000 0 2009 true false true true B 10998785 0 19510000 0 0 0 146084 0 0 0 19363916 0 1998 true false true true A false false false true false 0 false false false true B false false false 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 2011B 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. Description of Purpose PART I - LINE B, COLUMN (F) THE 2011A SERIES BONDS WERE ISSUED TO REFUND THE OUTSTANDING MATURITIES OF HORRY COUNTY, SOUTH CAROLINA HOSPITAL REVENUE BONDS (CONWAY HOSPITAL, INC) SERIES 1998. BUSINESS RELATIONSHIPS FORM 990, PART VI, LINE 2 PHILIP CLAYTON AND BRET BARR HAVE A BUSINESS RELATIONSHIP. BOTH ARE BOARD MEMBERS AND OFFICERS OF TAX EXEMPT ORGANIZATIONS RELATED TO THIS ORGANIZATION. JOHN PAT HENRY, BOARD MEMBER HAS 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, LINE 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. OTHER CHANGES TO NET ASSETS AND FUND BALANCES FORM 990, PART XI, LINE 9 Transfers - Permanently Restricted $ 18,669 Transfers - Temporarily Restricted $(26,054) ----------- Total $( 7,385) ----------- 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 1380675 5758239 1.00000 true false false true false false false false false false true true true false true true true true true true CONWAY HOSPITAL COMMUNITY SERVICES INC J 237103 CASH(FMV) MEDICAL PROPERTIES INC K 110003 CASH(FMV) CONWAY HOSPITAL COMMUNITY SERVICES INC P 27223102 CASH(FMV) CONWAY LONG-TERM CARE SERVICES INC P 5877417 CASH(FMV) CONWAY HOSPITAL EMERGENCY PROF SERVICES P 5797290 CASH(FMV) CONWAY HOSPITAL ANESTHESIA PROF SERVICES P 4909257 CASH(FMV) MEDICAL PROPERTIES INC P 321635 CASH(FMV) CONWAY HOSPITAL COMMUNITY SERVICES INC Q 3390767 CASH(FMV) CONWAY HOSPITAL EMERGENCY PROF SERVICES Q 2625088 CASH(FMV) CONWAY HOSPITAL ANESTHESIA PROF SERVICES Q 915984 CASH(FMV) CONWAY LONG-TERM CARE SERVICES INC Q 784648 CASH(FMV) MEDICAL PROPERTIES INC Q 325909 CASH(FMV) CONWAY HOSPITAL COMMUNITY SERVICES INC S 13670999 CASH(FMV) CONWAY LONG-TERM CARE SERVICES INC S 5594000 CASH(FMV) CONWAY HOSPITAL EMERGENCY PROF SERVICES S 2985376 CASH(FMV) CONWAY HOSPITAL ANESTHESIA PROF SERVICES S 2011005 CASH(FMV) MEDICAL PROPERTIES INC S 637536 CASH(FMV)