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 | |||||
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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 |
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| Software ID: | |
| Software Version: |
| Return Reference | Explanation |
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| FORM 990, PART III, LINE 4A, PROGRAM SERVICE DESCRIPTION: | CONWAY HOSPITAL INC. IS A 222 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, 2024, THE HOSPITAL FURNISHED CHARITY CARE IN THE AMOUNT OF $22,635,063 IN FOREGONE CHARGES. THE TOTAL DAYS OF PATIENT CARE WERE 38,783 AND CONWAY HOSPITAL INC. SAW A TOTAL OF 276,485 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. |
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERS OR STOCKHOLDERS CONWAY HOSPITAL HOLDINGS, LLC IS THE SOLE MEMBER OF CONWAY HOSPITAL, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | MEMBERS OR STOCKHOLDERS WHO MAY ELECT THE TRUSTEES OF CONWAY HOSPITAL, INC. ARE ELECTED BY THE MEMBERS OF CONWAY HOSPITAL HOLDINGS, LLC. |
| FORM 990, PART VI, SECTION A, LINE 7B | DECISIONS SUBJECT TO APPROVAL CONWAY HOSPITAL, INC. BOARD OF TRUSTEES SHALL MAKE OR OVERSEE MANAGEMENT AND OPERATIONAL MATTERS OF THE CORPORATION. CONWAY HOSPITAL HOLDINGS, LLC RESERVES TO ITS OWN MEMBERS THE AUTHORITY TO DIRECT ALL FINANCIAL MATTERS AND MATTERS AFFECTING THE PURPOSE, TAX-EXEMPT STATUS OR DISSOLUTION OF THE ORGANIZATION. APPROVAL BY THE MEMBERS OF CONWAY HOSPITAL HOLDINGS, LLC IS REQUIRED FOR ALL AMENDMENTS TO THE GOVERNING DOCUMENTS OF THIS ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 REVIEW PROCESS THE ORGANIZATION'S ACCOUNTING DEPARTMENT PREPARES THE 990 INFORMATION IN CONSULTATION WITH THE VP OF FISCAL SERVICES. AN OUTSIDE TAX ADVISOR 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. |
| FORM 990, 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. |
| FORM 990, PART VI, SECTION B, LINE 15 | PROCESS FOR DETERMINING COMPENSATION 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. |
| FORM 990, PART VI, SECTION C, LINE 19 | HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC CONWAY HOSPITAL MAKES ITS FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AS WELL AS ATTACHING THEM TO THIS RETURN. |
| FORM 990, PART IX, LINE 11G | CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 26,696,412. MANAGEMENT AND GENERAL EXPENSES 6,674,103. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 33,370,515. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 4,548,929. MANAGEMENT AND GENERAL EXPENSES 1,146,132. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,695,061. |
| FORM 990, PART XI, LINE 9: | CAPITAL CONTRIBUTION FROM NOVANT 18,750,000. DONOR RESTRICTIONS- INTEREST IN FOUNDATION 2,028,714. |
| Software ID: | |
| Software Version: |