2023-11-14T14:13:19-06:00 2022-12-31 FORVIS LLP PO BOX 3667 LITTLE ROCK AR 722033667 990 2022-01-01 710797723 CONWAY REGIONAL HEALTH FOUNDATION INC % BILL PACK CONW 5015135184 2302 COLLEGE AVE CONWAY AR 72034 WILLIAM PACK CFO 5013293831 2023-11-14 true WILLIAM PACK 000000000 AMBER SHERRILL P00748683 5013721040 2 2022 2023-04-26 12:10:37Z MATT TROUP 2302 COLLEGE AVENUE CONWAY AR 72034 2354226 false X WWW.CONWAYREGIONAL.ORG/ABOUT/FOUNDATION X 1994 AR THE PURPOSE OF CONWAY REGIONAL HEALTH FOUNDATION, INC. IS TO FOSTER SUPPORT, ENCOURAGE ACTIVITIES, AND ADVANCE THE OBJECTIVES OF CONWAY REGIONAL MEDICAL CENTER, INC. 10 8 0 28 0 0 3949113 1066794 717211 672436 60781 90433 80325 -15852 4807430 1813811 0 3000000 0 0 0 264 151276 58070 646538 2266083 1298548 2417359 4356882 2390071 -2543071 18590246 15507657 32474 146563 18557772 15361094 THE PURPOSE OF CONWAY REGIONAL HEALTH FOUNDATION, INC. IS TO FOSTER SUPPORT, ENCOURAGE ACTIVITIES, AND ADVANCE THE OBJECTIVES OF CONWAY REGIONAL MEDICAL CENTER, INC. false false 3552853 3000000 672436 TO PROVIDE FINANCIAL AID TO CONWAY REGIONAL MEDICAL CENTER, INC. TO SUPPORT PATIENT CARE, PROGRAMS, AND SERVICES. 3552853 true true false false false false false false false false true false false true true false false true false false false false false true true false false true false true false false false false false false false false true false false false false true true true false false true 17 1 true 0 false false false false true true true true false false false false false false false X 10 8 false false false false true false false true true false false true true true true true true false false false AR X BILL PACK 5014502112 2302 COLLEGE AVENUE CONWAY AR 72034 BILL PACK CFO STARTING 8/29/2022 1.0 40.0 X 0 284509 1431 ALAN FINLEY CHIEF OPERATING OFFICER 1.0 40.0 X 0 119864 14109 THAD HARDIN MD BOARD MEMBER 1.0 1.0 X 0 36777 0 ANDREW COLE MD BOARD MEMBER 1.0 1.0 X 0 28761 0 CORNELL MALTBIA BOARD MEMBER 1.0 1.0 X 0 1261 0 BRYAN BRUICH BOARD MEMBER 1.0 1.0 X 0 1177 0 GENA ESTER BOARD MEMBER 1.0 1.0 X 0 792 0 MATTHEW TROUP CHIEF EXECUTIVE OFFICER 1.0 40.0 X 0 765 0 TOM POE BOARD MEMBER 1.0 1.0 X 0 443 0 TROY BROOKS CFO THROUGH 6/17/2022 1.0 40.0 X 0 325 0 JEFF STANDRIDGE BOARD MEMBER 1.0 1.0 X 0 177 0 WAYNE COX BOARD MEMBER 1.0 1.0 X 0 84 0 ANDREA WOODS JD CHAIRMAN 1.0 1.0 X X 0 0 0 BARBARA WILLIAMS PHD RN BOARD MEMBER 1.0 1.0 X 0 0 0 JIM RANKIN JR JD VICE CHAIR 1.0 1.0 X X 0 0 0 SUSAN GATTO BOARD MEMBER 1.0 1.0 X 0 0 0 ANGIE LONGING CHIEF NURSING OFFICER 1.0 40.0 X 0 0 0 0 474935 15540 0 false true false 0 142125 924669 133343 1066794 MEDICAL OFFICE BUILDING RENTAL 531120 672436 672436 672436 90433 90433 0 0 56920 42671 14249 0 14249 14249 0 467646 142125 497744 -30098 -30098 0 0 0 0 0 0 MISCELLANEOUS -3 0 -3 -3 0 -3 -3 1813811 672436 0 74581 3000000 3000000 0 0 0 0 0 264 205 59 0 0 0 270462 270462 0 0 0 58070 58070 0 159512 159512 3737 3737 118174 118174 3938 3065 873 0 379210 291778 83119 4313 76 76 0 0 0 0 231916 180498 51418 0 FOOD & CATERING 9062 9062 REPAIRS & MAINTENANCE 4071 344 98 3629 DUES & MEMBERSHIPS 843 843 MINOR EQUIPMENT 109 85 24 117438 76878 21900 18660 4356882 3552853 157491 646538 35998 32798 7486314 4247742 0 0 28060 0 0 0 0 0 0 0 7500 7500 54661 30680 13203279 8345479 4848379 4857800 1000922 1034384 0 0 0 0 0 0 5128412 5296753 18590246 15507657 16074 81899 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16400 64664 32474 146563 X 14512544 11133789 4045228 4227305 18557772 15361094 18590246 15507657 X -2543071 21760 -675367 X false true X true false X X 1 CONWAY REGIONAL MEDICAL CENTER 710249735 3 true 3000000 0 1 3000000 0 true false false false false false false false false false false false false false false true false RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3356546 3356546 9050507 7616378 1434129 56068 56068 740158 673033 67125 4857800 DEFERRED LEASE 1069648 EXTERNALLY RESTRICTED CASH 4227105 5296753 0 DUE TO AFFILIATES 64664 64664 1700619 21760 540415 562175 1138444 675367 675367 1813811 4897297 540415 540415 4356882 4356882 FORM 990, SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. FORM 990, SCHEDULE D, PART XI, LINE 2D RENTAL EXPENSES $42,671 FUNDRAISING EXPENSE $497,744 ---------- TOTAL $540,415 FORM 990, SCHEDULE D, PART XI, LINE 4B NET ASSETS RELEASED FROM RESTRICTION $675,367 FORM 990, SCHEDULE D, PART XII, LINE 2D RENTAL EXPENSES $42,671 FUNDRAISING EXPENSE $497,744 ---------- TOTAL $540,415 X X X X true DINI SPHERIS INC 3400 CARLISLE ST 348 DALLAS TX 75204 FUNDRAISING CONSULTANT false 358355 58070 300285 358355 58070 300285 AR GOLF TOURNAMENT 99238 35724 63514 600 15223 11700 8201 0 45578 DUCK DERBY 499453 105726 393727 17100 62571 0 26055 0 304499 1 11080 675 10405 0 0 0 675 0 5542 609771 142125 467646 17700 77794 11700 34931 0 355619 497744 -30098 2302 COLLEGE AVENUE CONWAY AR 72034 true CONWAY REGIONAL MEDICAL CENTER 2302 COLLEGE AVENUE CONWAY AR 72034 710249735 501(C)(3) 3000000 N/A N/A GENERAL SUPPORT 1 0 SCHEDULE I, PART I, LINE 2 THE FOUNDATION DID NOT HAVE PROCEDURES IN PLACE TO MONITOR USE OF THE GRANTS BECAUSE ALL GRANTS WERE GIVEN TO RELATED ORGANIZATIONS. false false false false false false false false false BILL PACK CFO STARTING 8/29/2022 0 89762 0 153575 0 41172 0 0 0 0 0 284509 0 0 X 1 1045 X 14169 FMV X 2 15000 FMV X 1 10000 FMV X 15 18330 FMV X MISCELLANEOUS 78 74799 FMV false true true SCHEDULE M, PART I, COLUMN B COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS. SCHEDULE M, PART I, LINE 32B A COMPANY DINISPHERES SERVES AS AN EXPERT FUNDRAISING CONSULTANT TO ASSIST IN THE DEVELOPMENT AND EXECUTION OF A CAPITAL CAMPAIGN STRATEGY. SERVICES WERE USED THROUGH MAY 2022. FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION SHALL HAVE ONE CLASS OF STOCK AND ONE STOCKHOLDER ONLY, WHICH SHALL BE CONWAY REGIONAL MEDICAL CENTER, INC., AN ARKANSAS NONPROFIT CORPORATION. ALL OF THE BUSINESS AND AFFAIRS OF THE CORPORATION SHALL BE MANAGED AND CONTROLLED BY THE STOCKHOLDER. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE TREASURER AND THE PRESIDENT OF THE ORGANIZATION. THE FORM 990 IS THEN PRESENTED TO ALL MEMBERS OF THE GOVERNING BODY OF THE ORGANIZATION FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD MEMBER IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT ANNUALLY. THESE STATEMENTS ARE REVIEWED BY THE CHAIRMAN OF THE BOARD, THE PRESIDENT OF THE ORGANIZATION, AND THE TREASURER OF THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART VII, SECTION A OFFICERS ARE PAID BY AN UNRELATED MANAGEMENT COMPANY FOR 2022. FORM 990, PART XI, LINE 9 NET ASSETS RELEASED FROM RESTRICTION $(675,367) CONWAY REGIONAL MEDICAL CENTER 2302 COLLEGE AVE CONWAY AR 72034 710249735 HOSPITAL AR 501(C)(3) 3 NA false CR HOSPITAL EMPLOYEES' MEDICAL TRUST 2302 COLLEGE AVENUE CONWAY AR 72034 521561768 INSURANCE AR 501(C)(9) CRMC true DARDANELLE REGIONAL LLC 200 NORTH 3RD STREET DARDANELLE AR 72834 834538290 HOSPITAL AR 501(C)(3) 3 CRMC true CONWAY REGIONAL REHABILITATION HOSPITAL 2210 ROBINSON AVENUE CONWAY AR 72034 412136339 REHAB SERVICE AR NA UNRELATED false false INSTITUTIONAL SERVICES CORPORATION 2302 COLLEGE AVENUE CONWAY AR 72034 710575886 PROPERTY OWNERSHI AR NA C CORPORATION true false false false false false false false false false true false false true true true true true true false CONWAY REGIONAL REHABILITATION HOSPITAL LLC J 394450 FMV