TY 2017 Form 990 Schedule O

efile Public Visual Render ObjectId: 201922279349301907 - Submission: 2019-08-15 TIN: 57-0314381

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
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Attach to Form 990 or 990-EZ.
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Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2017

Open to Public
Inspection

Name of the organization

Conway Hospital Inc

Employer identification number

57-0314381

Return Reference	Explanation
BUSINESS RELATIONSHIPS	FORM 990, PART VI, LINE 2 PHILIP CLAYTON, BRET BARR, AND BRIAN ARGO HAVE A BUSINESS RELATIONSHIP. ALL THREE ARE BOARD MEMBERS AND OFFICERS OF TAX EXEMPT ORGANIZATIONS RELATED TO THIS ORGANIZATION. JOHN PAT HENRY AND CHARLES JORDAN, BOARD MEMBERS, HAVE 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, LINES 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, Inc. makes its financial statements available to the public upon request as well as attaching them to this return. The governing documents and conflict of interest policy are available upon request.
OTHER CHANGES TO NET ASSETS AND FUND BALANCES	FORM 990, PART XI, LINE 9 CHANGE IN TEMPORARILY RESTRICTED NET ASSETS OF INTEREST IN FOUNDATION $278,761 CHANGE IN PERMANENTLY RESTRICTED NET ASSETS OF INTEREST IN FOUNDATION ($117,281) -------------- TOTAL $161,480 --------------

Return Reference

Explanation

BUSINESS RELATIONSHIPS

FORM 990, PART VI, LINE 2 PHILIP CLAYTON, BRET BARR, AND BRIAN ARGO HAVE A BUSINESS RELATIONSHIP. ALL THREE ARE BOARD MEMBERS AND OFFICERS OF TAX EXEMPT ORGANIZATIONS RELATED TO THIS ORGANIZATION. JOHN PAT HENRY AND CHARLES JORDAN, BOARD MEMBERS, HAVE 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, LINES 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, Inc. makes its financial statements available to the public upon request as well as attaching them to this return. The governing documents and conflict of interest policy are available upon request.

OTHER CHANGES TO NET ASSETS AND FUND BALANCES

FORM 990, PART XI, LINE 9 CHANGE IN TEMPORARILY RESTRICTED NET ASSETS OF INTEREST IN FOUNDATION $278,761 CHANGE IN PERMANENTLY RESTRICTED NET ASSETS OF INTEREST IN FOUNDATION ($117,281) -------------- TOTAL $161,480 --------------

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2017

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