2024-08-14T11:59:38-05:00 2023-09-30 991856619 GRANT THORNTON ADVISORS LLC 53 STATE STREET SUITE 1600 BOSTON MA 02109 990 2022-10-01 570870199 CONWAY HOSPITAL FOUNDATION INC CONW 8433478037 300 SINGLETON RIDGE ROAD CONWAY SC 29526 DAVID MIER CFO 8433478037 2024-08-14 1 1 ERIN COUTURE P01390592 6177237900 2022 2024-08-08 14:25:15Z BRIAN ARGO 300 SINGLETON RIDGE ROAD CONWAY SC 29526 1792960 0 X HTTPS://WWW.CMCFOUNDATIONSC.COM/ X 1988 SC FUND RAISING FOR ADVANCEMENT OF HEALTH CARE OBJECTIVES OF CONWAY HOSPITAL, INC. 16 14 0 20 0 0 743042 560634 0 0 341659 251489 -78978 -35249 1005723 776874 251403 329350 0 0 0 0 0 0 0 23583 23788 274986 353138 730737 423736 6019466 6899377 12652 23189 6006814 6876188 X THE CONWAY HOSPITAL FOUNDATION IS A NOT-FOR-PROFIT CORPORATION ESTABLISHED IN 1988 AS A CHARITABLE ORGANIZATION TO PROVIDE SUPPORT TO CONWAY HOSPITAL IN ITS EFFORT TO FULLFILL ITS MISSION AND GOALS. (SEE SCHEDULE O) DESCRIPTION OF ORGANIZATION MISSIONTHE FOUNDATION IS DEDICATED TO IMPROVING THE QUALITY OF LIFE OF ALL INDIVIDUALS IN THE CONWAY HOSPITAL SERVICE AREA. THE ORGANIZATION DEVELOPS COOPERATION BETWEEN THE HOSPITAL STAFF AND BOARD, MEDICAL STAFF, THE COMMUNITY, AND OTHER SUPPORTING ORGANIZATIONS THROUGH EDUCATIONAL AND PROMOTIONAL ACTIVITIES. RESOURCES FOR THE FOUNDATION DERIVE FROM FUND RAISING, DONATIONS, GRANTS, AND OTHER SOURCES WHERE APPROPRIATE TO ASSURE LONG TERM GROWTH AND DEVELOPMENT. CRITICAL SUCCESS FACTORS: DEVELPOMENT OF FINANCIAL RESOURCES, MANAGEMENT OF FINANCIAL AND OR HUMAN RESOURSES, RESPONSIVENESS TO THE HOSPITAL, COMMITMENT TO PLANNING, LEADERSHIP BY BOARD AND STAFF. 0 0 329350 329350 TO PROVIDE FINANCIAL ASSISTANCE FOR HOSPITAL PROJECTS RELATED TO NURSING, SCHOLARSHIPS, COMMUNITY OUTREACH, MATERNAL/CHILD CARE AND HEALTH REACH SERVICES FOR THE UNDERPRIVILEGED THROUGH CONWAY HOSPITAL, INC. AND AFFILIATES. 329350 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 2 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 16 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 SC X DAVID MIER 8433478037 300 SINGLETON RIDGE ROAD CONWAY SC 29526 BRET BARR PRESIDENT (TO 12/22); DIRECTOR 1.00 40.00 X X 0 848609 48857 BRIAN ARGO TREAS (TO 12/22); PRES (AS OF 01/23) 1.00 40.00 X X 0 454044 48149 CHRISTY EVERETTE CHAIRMAN 1.00 0.00 X X 0 0 0 DELAN STEVENS VICE CHAIRMAN 1.00 0.00 X X 0 0 0 DR SRINIVAS VUPPALA SECRETARY 1.00 0.00 X X 0 0 0 DR REGINALD DAVES DIRECTOR 1.00 0.00 X 0 0 0 MARJORIE O'GRADY DIRECTOR 1.00 0.00 X 0 0 0 MATT HARPER DIRECTOR (AS OF 10/22) 1.00 0.00 X 0 0 0 ROBERT HUCKS DIRECTOR 1.00 0.00 X 0 0 0 JERRY JENERETTE DIRECTOR 1.00 0.00 X 0 0 0 WILLIAM MARSH DIRECTOR 1.00 0.00 X 0 0 0 GEORGE MCGRATH DIRECTOR 1.00 0.00 X 0 0 0 KEVIN MCHUGH DIRECTOR (AS OF 10/22) 1.00 0.00 X 0 0 0 WAYNE STATON DIRECTOR 1.00 0.00 X 0 0 0 DAVID SLIGH DIRECTOR (AS OF 10/22) 1.00 0.00 X 0 0 0 HEATHER VON HERRMANN DIRECTOR 1.00 0.00 X 0 0 0 DAVID MIER TREASURER (AS OF 01/23) 1.00 40.00 X 0 250029 10107 TED MILFORD VICE PRESIDENT, FOUNDATION 8.00 32.00 X 0 269776 30171 0 1822458 137284 0 0 1 0 0 217806 71450 271378 21429 560634 145626 145626 988200 882337 105863 105863 105863 98500 217806 133749 -35249 -35249 776874 0 0 216240 329350 329350 16583 16583 7205 7205 353138 329350 23788 0 269621 160389 138601 90323 5560437 6575784 27000 45000 23807 27881 6019466 6899377 85 2106 12567 21083 12652 23189 X 1858230 2104701 4148584 4771487 6006814 6876188 6019466 6899377 423736 445638 0 X 0 1 X 1 0 X X 1 CONWAY HOSPITAL INC 570314381 3 1 329350 0 1 329350 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 135889 145626 135889 145626 0 0 126646 100859 0 0 9243 44767 5886186 6303045 398121 426955 25625 28500 6309932 6758500 0 0 0 6309932 6758500 94649 101378 6215283 6657122 217535 232999 0 0 217535 232999 9243 7857 217535 217535 0 217535 305578 0 0 0 0 23772 329350 329350 217535 100.000000000000 217535 0 131579 277415 348812 261568 251403 1270777 0 217535 0 1053242 329350 0 329350 0 0 1382592 191459 348812 261568 251403 329350 SCHEDULE A, PART IV, SECTION D, LINE 3 DAVID MIER IS THE TREASURER OF CONWAY HOSPITAL FOUNDATION, INC. (EIN#57-0870199)(SUPPORTING ORGANIZATION) AND ALSO THE CHIEF FINANCIAL OFFICER OF CONWAY HOSPITAL, INC. (EIN# 57-0314381)(SUPPORTED ORGANIZATION). THE SUPPORTED ORGANIZATION, CONWAY MEDICAL CENTER, HAS A SIGNIFICANT VOICE IN THE INVESTMENT POLICIES THRU THE ABOVE MENTIONED OFFICER, DAVID MIER, WHO SERVES AS CHAIRMAN OF THE INVESTMENT COMMITTEE OF CONWAY MEDICAL CENTER. THE COMMITTEE REVIEWS ALL INVESTMENT POLICIES AND INVESTMENT DECISIONS WITH HELP ON AN OUTSIDE FINANCIAL ADVISOR. THE SUPPORTED ORGANIZATION, CONWAY MEDICAL CENTER, DIRECTS THE USE OF CONWAY HOSPITAL FOUNDATION'S INCOME OR ASSETS DURING THE YEAR BY MAKING RECOMMENDATIONS AND REQUESTS REGARDING WHERE SUPPORT IS REQUIRED. THE FOUNDATION REGULARLY SUPPORTS ALL RECOMMENDATIONS AND REQUESTS SUBJECT TO FUND RESTRICTIONS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5799342 451162 700499 318207 6632796 6134330 552465 -642686 244767 5799342 5087278 369502 937342 259792 6134330 4863082 293401 255994 325199 5087278 4270811 671786 233327 312842 4863082 0.29790 0.56530 0.13680 0 0 0 X 1573312 445638 350800 796438 776874 0 776874 703938 350800 350800 353138 0 353138 PART V, LINE 4: ENDOWMENT FUND THE FOUNDATION HAS ENDOWMENTS DESIGNATED FOR THE BENEFIT OF VARIOUS OPERATIONAL DEPARTMENTS OF THE HOSPITAL. PART X, LINE 2: TAX LIABILITY FOR UNCERTAIN TAX POSITION (ASC740) FOR THE YEARS ENDED SEPTEMBER 30, 2023 AND 2022, MANAGEMENT OF THE FOUNDATION BELIEVES IT HAS ADEQUATE SUPPORT FOR ALL MATERIAL TAX POSITIONS AND THAT IT IS MORE-LIKELY-THAN-NOT, BASED ON THE TECHNICAL MERITS, THAT THE POSITIONS WILL BE SUSTAINED UPON EXAMINATION. ACCORDINGLY, THE FOUNDATION HAS NOT RECORDED ANY RESERVES OR RELATED ACCRUALS FOR INTEREST AND PENALTIES FOR UNCERTAIN INCOME TAX POSITIONS AS OF SEPTEMBER 30, 2023 OR 2022. GOLF 266329 171329 95000 2825 33000 12292 69635 TENNIS 35052 31552 3500 3500 238 3 14925 14925 12259 316306 217806 98500 2825 36500 12292 82132 133749 -35249 1 CONWAY HOSPITAL INC 300 SINGLETON RIDGE ROAD CONWAY SC 29526 570314381 501(C)(3) 329350 0 FINANCIAL ASSISTANCE FOR HOSPITAL PROJECTS 1 PART I, LINE 2: FOUNDATION BOARD APPROVES BUDGET PRIOR TO BEGINNING THE FISCAL YEAR DETAILING CONWAY HOSPITAL, INC PROJECTS THAT WILL BE FUNDED DURING THE YEAR. BOARD ALSO APPROVES OTHER EXPENDITURES FOR FUNDING AS FUNDS ARE AVAILABLE. FOUNDATION RECEIVES DOCUMENTATION OF ITEMS TO BE FUNDED FOR REVIEW PRIOR TO FUNDING BEING PROVIDED. SCHEDULE I, PART II, LINE 1, COLUMN (H) NAME OF ORGANIZATION OR GOVERNMENT: CONWAY HOSPITAL, INC (H) PURPOSE OF GRANT OR ASSISTANCE; TO PROVIDE FINANCIAL ASSISTANCE FOR HOSPITAL PROJECTS FOR THE ADVANCEMENT OF HEALTH CARE OBJECTIVES OF CONWAY HOSPITAL, INC. 0 1 0 0 0 0 0 0 0 BRET BARR PRESIDENT (TO 12/22); DIRECTOR 0 740635 0 92907 0 15067 0 16517 0 32340 0 897466 0 0 BRIAN ARGO TREAS (TO 12/22); PRES (AS OF 01/23) 0 406681 0 21500 0 25863 0 14486 0 33663 0 502193 0 0 TED MILFORD VICE PRESIDENT, FOUNDATION 0 256876 0 12900 0 0 0 8478 0 21693 0 299947 0 0 DAVID MIER TREASURER (AS OF 01/23) 0 184279 0 65750 0 0 0 1938 0 8169 0 260136 0 0 PART I, LINE 3 A RELATED ORGANIZATION USES THE FOLLOWING METHODS TO ESTABLISH COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY AND APPROVAL BY THE COMPENSATION COMMITTEE. PART I, LINE 4B SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN COMPENSATION FOR KEY EXECUTIVES IS PROVIDED BY A RELATED ENTITY CONWAY HOSPITAL, INC. DURING THE YEAR ENDED SEPTEMBER 30, 2023 CONWAY HOSPITAL, INC. AND KEY EXECUTIVES HELD JOINTLY OWNED SPLIT-DOLLAR AGREEMENTS THROUGH AN INSURANCE COMPANY. THE FOLLOWING EXECUTIVES PARTICIPATED IN THE PLAN DURING THE YEAR: BRET BARR CERTAIN EXECUTIVES PARTICIPATED IN A CAPITAL ACCUMULATION PLAN PROVIDED BY THE COMPANY. THE FOLLOWING EMPLOYEES RECEIVED DISTRIBUTIONS FROM THE PLAN. ALL AMOUNTS ARE INCLUDED IN THE EMPLOYEE'S W-2. BRET BARR - $15,067 BRIAN ARGO - $10,841 FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS THE ORGANIZATION PROVIDED THE 990 TO THE GOVERNING BODY PRIOR TO ITS FILING FOR REVIEW BY THE GOVERNING BODY. THE TREASURER DISCUSSES THE VARIOUS ASPECTS OF FORM 990 FOR THE ORGANIZATION WITH THE GOVERNING BODY AND DISCUSSES THE INFORMATION THAT IS REPORTED IN FORM 990 ABOUT THE ORGANIZATION AND ITS AVAILABILITY FOR PUBLIC INSPECTION. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY MONITORING & ENFORCEMENT 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. FORM 990, PART VI, SECTION C, LINE 19 HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANICAL STATEMENTS AVAILABLE UPON WRITTEN REQUEST TO THE MANAGEMENT OF THE ORGANIZATION AT THE CONWAY OFFICES. CONWAY HOSPITAL INC 300 SINGLETON RIDGE ROAD CONWAY SC 29526 570314381 HOSPITAL SC 501(C)(3) LINE 3 CONWAY HOSPITAL HOLDINGS LLC 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 CONWAY HOSPITAL INC B 329350 FMV CONWAY HOSPITAL INC C 71450 FMV CONWAY HOSPITAL INC N 292800 FMV CONWAY HOSPITAL INC O 58000 FMV