Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year
(or fiscal year beginning in)
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(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf .... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) .. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2023 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2023 |
(iii) Distributable Amount for 2023 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2023 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2023: | ||||
| a From 2018....... | ||||
| b From 2019....... | ||||
| c From 2020....... | ||||
| d From 2021....... | ||||
| e From 2022....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2023 distributable amount | ||||
|
i
Carryover from 2018 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2023 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2023 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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7 Excess distributions carryover to 2024. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2019..... | ||||
| b Excess from 2020..... | ||||
| c Excess from 2021..... | ||||
| d Excess from 2022..... | ||||
| e Excess from 2023..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
|---|
| Software ID: | 23017437 |
| Software Version: | 2023v5.1 |
| Return Reference | Explanation |
|---|---|
| Form 990, Part VI, Line 3 Delegation of management duties | THE MEDICAL CENTER'S BOARD OF DIRECTORS RENEWED A MANAGEMENT AGREEMENT WITH CHI ST. VINCENT INFIRMARY MEDICAL CENTER, D/B/A CHI ST. VINCENT, AN ARKANSAS NONPROFIT CORPORATION AND A SUBSIDIARY OF CATHOLIC HEALTH INITIATIVES. THE GOAL OF THE AGREEMENT IS TO DEVELOP A LEVEL OF INTEGRATION AND COORDINATION THAT RESULTS IN MORE ACCESSIBLE, HIGH QUALITY, CLINICALLY-INTEGRATED, AND LOWER COST CARE FOR THE COMMUNITIES OF CENTRAL ARKANSAS SERVED WHILE ENHANCING THE OVERALL HEALTH OF THOSE COMMUNITIES. UNDER THE AGREEMENT, EACH PARTY RETAINS ITS NAME, GOVERNANCE AND AUTONOMY. THE CHIEF EXECUTIVE OFFICER IS AN EMPLOYEE OF CHI ST. VINCENT. TOTAL MANAGEMENT FEES PAID BY THE MEDICAL CENTER FOR THE YEAR ENDED DECEMBER 31, 2023 WERE $2,199,526. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | THE REVIEW PROCESS OF FORM 990 INCLUDES A REVIEW BY THE CFO AND CEO OF THE ORGANIZATION. THE FORM 990 IS THEN PRESENTED TO ALL BOARD MEMBERS OF THE GOVERNING BODY OF THE ORGANIZATION FOR REVIEW PRIOR TO FILING WITH THE IRS. |
| Form 990, Part VI, Line 12c Conflict of interest policy | THE CONWAY REGIONAL HEALTH SYSTEM BOARD REVIEWS THE GOVERNING BOARD CONFLICT OF INTEREST POLICY ANNUALLY DURING THE JANUARY BOARD MEETING. A NEW CONFLICT OF INTEREST STATEMENT IS REQUIRED OF EACH BOARD MEMBER EVERY YEAR. THESE STATEMENTS ARE REVIEWED BY THE CHAIRMAN, PRESIDENT, AND CFO FOR MONITORING. BOARD MEMBERS WHO HAVE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST IN MATTERS BROUGHT BEFORE THE BOARD ARE TO ALERT THE OTHER MEMBERS OF THE BOARD BEFOREHAND. THE CONFLICTED BOARD MEMBER IS TO WITHDRAW FROM THE MEETING DURING SAID DISCUSSION UNTIL THE MATTER HAS BEEN VOTED ON. IF THE MEMBER FAILS TO WITHDRAW VOLUNTARILY, THE CHAIRMAN IS EMPOWERED TO REQUIRE WITHDRAWAL FROM THE ROOM DURING DISCUSSION AND VOTE ON THE MATTER. IN THE EVENT THE CONFLICT OF INTEREST AFFECTS THE CHAIRMAN, THE VICE CHAIRMAN IS THEN EMPOWERED TO REQUIRE THE CHAIRMAN'S WITHDRAWAL. |
| Form 990, Part VI, Line 19 Required documents available to the public | THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| Form 990, Part VIII, Line 2f Other Program Service Revenue | MEDICAL OFFICE BUILDING RENTAL - Total Revenue: 669976, Related or Exempt Function Revenue: 669976, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; CAFETERIA SALES - Total Revenue: 2070919, Related or Exempt Function Revenue: 2070919, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; GAIN ON INVESTMENT IN CRRH - Total Revenue: 677924, Related or Exempt Function Revenue: 677924, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; REFERENCE LAB - Total Revenue: 1084715, Related or Exempt Function Revenue: , Unrelated Business Revenue: 1084715, Revenue Excluded from Tax Under Sections 512, 513, or 514: ; |
| Form 990, Part VIII, Line 11d Other Miscellaneous Revenue | ALL OTHER - Total Revenue: 98563, Related or Exempt Function Revenue: , Unrelated Business Revenue: 44440, Revenue Excluded from Tax Under Sections 512, 513, or 514: 54123; |
| Form 990, Part IX, Line 11g Other Fees | PHYSICIAN FEES - Total Expense: 3461544, Program Service Expense: 2502291, Management and General Expenses: 959253, Fundraising Expenses: ; EQUIPMENTS SERVICE - Total Expense: 3543300, Program Service Expense: 2561391, Management and General Expenses: 981909, Fundraising Expenses: ; AGENCY STAFF - Total Expense: 3070079, Program Service Expense: 2219308, Management and General Expenses: 850771, Fundraising Expenses: ; CONTRACTS - Total Expense: 5030937, Program Service Expense: 3636778, Management and General Expenses: 1394159, Fundraising Expenses: ; MEDICAL SERVICES - Total Expense: 1506168, Program Service Expense: 1088783, Management and General Expenses: 417385, Fundraising Expenses: ; PURCHASED SERVICES - Total Expense: 11116160, Program Service Expense: 8035682, Management and General Expenses: 3080478, Fundraising Expenses: ; CLEANING & LAUNDRY SERVICE - Total Expense: 748613, Program Service Expense: 541160, Management and General Expenses: 207453, Fundraising Expenses: ; BILLING SERVICES - Total Expense: 54580, Program Service Expense: 39455, Management and General Expenses: 15125, Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | INVESTMENT INCOME FROM K-1S INCLUDED IN REVENUE - -8580; |
| FORM 990, PART VI, SECTION B, LINE 15A & 15B | CONWAY REGIONAL MEDICAL CENTER CONTRACTED GALLAGHER COMPENSATION CONSULTANTS TO PROVIDE A COMPENSATION ANALYSIS FOR THE CEO AND ALL EXECUTIVE LEVEL POSITIONS. THE BOARD EXECUTIVE COMPENSATION COMMITTEE REVIEWED THE DATA AND MADE RECOMMENDATIONS TO THE FULL BOARD FOR FORMAL APPROVAL OF THE COMPENSATION OF THE CEO AND OTHER OFFICERS. |
| Software ID: | 23017437 |
| Software Version: | 2023v5.1 |