SHANNON CLINIC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
SHANNON CLINIC (EIN 75-2600873)
Tax period
2019-10-01 to 2020-09-30
Filed
2021-08-13
IRS object ID
202132259349302878
Schema version
2019v5.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2021-08-13T18:58:15-05:00ReturnTs
Tax Period End2020-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line114241 DALLAS PARKWAY SUITE 1100AddressLine1Txt
CityDALLASCityNm
State AbbreviationTXStateAbbreviationCd
ZIP75254ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN752600873EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Shannon ClinicBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% JULIAN BESERILInCareOfNm
Business Name ControlSHANBusinessNameControlTxt
Phone3256581511PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 22000AddressLine1Txt
CitySan AngeloCityNm
State AbbreviationTXStateAbbreviationCd
ZIP76902ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJULIAN BESERILPersonNm
Person TitleCFOPersonTitleTxt
Phone3256581511PhoneNum
Signature2021-08-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKevin EnsmingerPreparerPersonNm
PTINP01310558PTIN
Phone9727028262PhoneNum
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKELLY SHANE PLYMELLPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 22000AddressLine1Txt
CitySAN ANGELOCityNm
State AbbreviationTXStateAbbreviationCd
ZIP76902ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$191,624,814GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressSHANNONHEALTH.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1995FormationYr
Legal Domicile StateTXLegalDomicileStateCd
Activity Or MissionFOUNDED ON A LEGACY OF CARING, SHANNON IS A LOCALLY OWNED HEALTHCARE DEDICATED TO PROVIDING EXCEPTIONAL HEALTHCARE FOR OUR FAMILY, FRIENDS, AND NEIGHBORS.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee348TotalEmployeeCnt
Total Volunteers10TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$3,600CYContributionsGrantsAmt
PY Program Service Revenue$192,713,594PYProgramServiceRevenueAmt
CY Program Service Revenue$191,563,249CYProgramServiceRevenueAmt
PY Investment Income$12,578PYInvestmentIncomeAmt
CY Investment Income$57,965CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$192,726,172PYTotalRevenueAmt
CY Total Revenue$191,624,814CYTotalRevenueAmt
PY Grants And Similar Paid$5,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$126,786,137PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$124,499,606CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$123,180,936PYOtherExpensesAmt
CY Other Expenses$121,828,204CYOtherExpensesAmt
PY Total Expenses$249,972,073PYTotalExpensesAmt
CY Total Expenses$246,327,810CYTotalExpensesAmt
PY Revenues Less Expenses-$57,245,901PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$54,702,996CYRevenuesLessExpensesAmt
Total Assets BOY$38,695,692TotalAssetsBOYAmt
Total Assets EOY$41,105,861TotalAssetsEOYAmt
Total Liabilities BOY$39,224,923TotalLiabilitiesBOYAmt
Total Liabilities EOY$54,708,080TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$529,231NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$13,602,219NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionOUR MISSION IS TO BE THE PREMIER HEALTH CARE PROVIDER OF PHYSICIAN SERVICES IN THE COMMUNITIES WE SERVE UTILIZING THE RESOURCES AVAILABLE TO US. WE STRIVE TO PROVIDE THE BEST ACCESS, SERVICE AND MEDICAL MANAGEMENT AVAILABLE TO OUR PATIENTS WHILE SIMULTANEOUSLY PROTECTING THE VIABILITY OF OUR ORGANIZATION AND ITS EMPLOYEES.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$234,785,250ExpenseAmt
Revenue$191,563,249RevenueAmt
DescPROVIDE HEALTH CARE SERVICES AS A MULTI-SPECIALTY PHYSICIAN CLINIC AT LOCATIONS THROUGHOUT SAN ANGELO AND NEARBY COMMUNITIES REGARDLESS OF ABILITY TO PAY, INCLUDING CALL COVERAGE FOR SHANNON MEDICAL CENTER, AN AFFILIATED NON-PROFIT HOSPITAL. SHANNON CLINIC IS ORGANIZED AND OPERATED TO PROVIDE ACCESS AND CARE FOR RESIDENTS OF ITS SERVICE AREA, INCLUDING MEDICALLY INDIGENT PATIENTS. RECRUITMENT FOR PROVIDERS INCLUDES NEW PHYSICIANS AND MID-LEVEL PROVIDERS TO EXPAND URGENT CARE AND PRIMARY CARE ACCESS TO COMMUNITIES SERVED, AND SPECIALISTS TO ALLOW SHANNON MEDICAL CENTER TO PROVIDE CARE TO ITS PATIENTS REGARDLESS OF ABILITY TO PAY.Desc
Total Program Service Expenses$234,785,250TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (true)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document84IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee348EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (true)DelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldTXStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJULIAN BESERILPersonNm
Phone3256581511PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ADMINISTRATION 120 E BEAUREGARDAddressLine1Txt
CitySAN ANGELOCityNm
State AbbreviationTXStateAbbreviationCd
ZIP76903ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeIndKey EmployeeKeyEmployeeInd
Luis Duarte
PHYSICIAN40.00.0Yes (X)$7,190,048$0$114,178
Christopher Haddad
PHYSICIAN40.00.0Yes (X)$1,974,104$0$117,683
Rudy Haddad
PHYSICIAN/BOARD CHAIRMAN40.00.0$1,826,345$0$117,951Yes (X)Yes (X)
Steve Ritter
PHYSICIAN40.00.0Yes (X)$1,705,604$0$67,146
Cheruku Rajanarender
PHYSICIAN40.00.0Yes (X)$1,574,199$0$85,302
David Huchton
Physician40.00.0Yes (X)$1,460,198$0$97,535
Chris Cole
Physician/Former Officer40.00.0$1,012,225$0$111,086Yes (X)
Lindy Bankes
PHYSICIAN/BOARD VICE CHAIRMAN40.00.0$1,038,661$0$81,736Yes (X)Yes (X)
Ross Harper
Physician/Board Secretary40.00.0$996,779$0$106,571Yes (X)Yes (X)
Kelly Shane Plymell
President10.030.0$0$901,359$103,706Yes (X)
Caleb Vosburg
Physician/Board Director40.00.0$819,543$0$105,260Yes (X)
Norma Cerna
Physician/Board Director40.00.0$819,543$0$83,256Yes (X)
Jason Felger
Physician/Board Director36.04.0$782,629$0$115,993Yes (X)
Andrew T Kingman
Physician/Medical Director40.00.0$758,566$0$99,572Yes (X)
Joe Mims
Physician/Board Director40.00.0$710,883$0$84,233Yes (X)
Christopher Barnett
Physician/Medical Director2.038.0$0$660,733$81,879Yes (X)
Jenny Wiggins-Smith
Physician/Medical Director40.00.0$607,281$0$91,215Yes (X)
Linda Adams
Physician/Former Officer40.00.0$548,156$0$79,563Yes (X)
Doug Schultz
Physician/Medical Director40.00.0$534,225$0$71,082Yes (X)
David Boswell
Physician/Medical Director40.00.0$486,093$0$80,809Yes (X)
Paul Borgfeld
PHYSICIAN/Medical Director40.00.0$465,699$0$86,871Yes (X)
Joe Harvey
Physician/Former Officer40.00.0$461,420$0$85,826Yes (X)
Sarah Jackson Vance
Physician/Board Director40.00.0$446,799$0$72,675Yes (X)Yes (X)
Kelly Koenig
Physician/Medical Director40.00.0$422,201$0$90,644Yes (X)Yes (X)
Vicki Forlano Halfmann
Physician/Board Director40.00.0$428,213$0$77,987Yes (X)
Ricardo Villareal
CAO5.035.0$0$364,004$69,688Yes (X)
Julian Beseril
CFO5.035.0$0$275,010$41,327Yes (X)
Allen Graves
General Council5.035.0$0$275,863$33,885Yes (X)
Staci Wetz
Former CFO1.039.0$0$263,153$37,053Yes (X)
Irvin Zeitler MD
Former Medical Director0.00.0$101,510$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$27,069,414TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,562,092TotReportableCompRltdOrgAmt
Total Other Compensation$2,309,759TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K245IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
SHANNON MEDICAL MANAGEMENT
120 E BEAUREGARDSAN ANGELOTX76903MANAGEMENT SERVICES$64,340,521
ARUP LABORATORIES
500 CHIPETA WAYSALT LAKE CITYUT84108OUTSIDE LAB SERVICES$1,534,638
PULMONARY CRITICAL CARE CONSULTAN
1305 W 34TH STREET STE 400AUSTINTX78705LOCUMS SERVICES$276,000
SHANNON MEDICAL CENTER
120 E HARRISSAN ANGELOTX76903LAB & LAUNDRY SVCS$4,517,800
HAYES LOCUMS LLC
6700 N ANDREWS AVE STE 600FT LAUDERDALEFL33309LOCUMS SERVICES$364,099
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K8CntrctRcvdGreaterThan100KCnt
All Other Contributions$3,600AllOtherContributionsAmt
Total Contributions$3,600TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Service Revenue621990$172,336,964$172,336,964
Lease Income532000$5,465$5,465
Other Operating Revenue900099$2,925,426$2,925,426
HOSPITAL BASED PHYSICIANS' ASSISTANCE900099$16,295,394$16,295,394
FieldValueIRS element (for citing)
Total Program Service Revenue$191,563,249TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$39,602TotalRevenueColumnAmt
Exclusion$39,602ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$18,363OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$18,363OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$18,363TotalRevenueColumnAmt
Exclusion$18,363ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$191,624,814TotalRevenueColumnAmt
Related Or Exempt Func Income$191,563,249RelatedOrExemptFuncIncomeAmt
Exclusion$57,965ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$11,801,199TotalAmt
Program Services$11,801,199ProgramServicesAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$1,856,427TotalAmt
Program Services$1,856,427ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$98,094,931TotalAmt
Program Services$97,149,954ProgramServicesAmt
Management And General$944,977ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$6,994,654TotalAmt
Program Services$6,909,959ProgramServicesAmt
Management And General$84,695ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,885,846TotalAmt
Program Services$1,875,067ProgramServicesAmt
Management And General$10,779ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$3,866,549TotalAmt
Program Services$3,851,588ProgramServicesAmt
Management And General$14,961ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$67,454,082TotalAmt
Program Services$57,335,970ProgramServicesAmt
Management And General$10,118,112ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$47,406TotalAmt
Management And General$47,406ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$8,796,690TotalAmt
Program Services$8,725,053ProgramServicesAmt
Management And General$71,637ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$24,912TotalAmt
Program Services$24,912ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$482,480TotalAmt
Program Services$477,731ProgramServicesAmt
Management And General$4,748ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$33,666TotalAmt
Program Services$33,666ProgramServicesAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$48,643TotalAmt
Program Services$44,000ProgramServicesAmt
Management And General$4,643ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$264,938TotalAmt
Program Services$264,938ProgramServicesAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,038,214TotalAmt
Program Services$882,516ProgramServicesAmt
Management And General$155,699ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$125,602TotalAmt
Program Services$43,709ProgramServicesAmt
Management And General$81,893ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Bad Debt$27,667,142$27,667,142
Medical Supplies$14,175,893$14,175,893
Recruiting & New Hire Expense$218,925$218,925
Education$665,006$661,996$3,010

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$784,605TotalAmt
Program Services$784,605ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$246,327,810TotalAmt
Program Services$234,785,250ProgramServicesAmt
Management And General$11,542,560ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$13,802,099BOYAmt
EOY$12,852,895EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$912,869BOYAmt
EOY$911,622EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$577,201BOYAmt
EOY$1,228,924EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$564,731BOYAmt
EOY$471,038EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$19,316,158LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$17,165,571LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,760,787BOYAmt
EOY$2,150,587EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$20,078,005BOYAmt
EOY$23,490,795EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$38,695,692BOYAmt
EOY$41,105,861EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$12,992,061BOYAmt
EOY$13,960,537EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$3,625,416EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$26,232,862BOYAmt
EOY$37,122,127EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$39,224,923BOYAmt
EOY$54,708,080EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$529,231BOYAmt
EOY-$13,602,219EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$529,231BOYAmt
EOY-$13,602,219EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$38,695,692BOYAmt
EOY$41,105,861EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$54,702,996ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$41,630,008OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$3,600CurrentTaxYearAmt
Total$3,600TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$149,515,240CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$163,809,253CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$170,090,402CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$192,713,594CurrentTaxYearMinus1YearAmt
Current Tax Year$191,563,249CurrentTaxYearAmt
Total$867,691,738TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$149,515,240CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$163,809,253CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$170,090,402CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$192,713,594CurrentTaxYearMinus1YearAmt
Current Tax Year$191,566,849CurrentTaxYearAmt
Total$867,695,338TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$867,695,338PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$29,184CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$7,578CurrentTaxYearMinus1YearAmt
Current Tax Year$39,602CurrentTaxYearAmt
Total$76,364TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$29,184CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$7,578CurrentTaxYearMinus1YearAmt
Current Tax Year$39,602CurrentTaxYearAmt
Total$76,364TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$149,515,240CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$163,809,253CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$170,119,586CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$192,721,172CurrentTaxYearMinus1YearAmt
Current Tax Year$191,606,451CurrentTaxYearAmt
Total$867,771,702TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99991PublicSupportCY509Pct
Public Support PY5091.00000PublicSupportPY509Pct
Investment Income CY0.00009InvestmentIncomeCYPct
Investment Income PY0.00000InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
LandLandGrp
BuildingsBuildingsGrp
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$19,316,158OtherCostOrOtherBasisAmt
Depreciation$17,165,571DepreciationAmt
Book Value$2,150,587BookValueAmt
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildingsGrp
Total Book Value Land Buildings$2,150,587TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescRetirement FundDesc
Book Value$23,490,795BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$23,490,795TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
Pension Fund Liability$25,626,812
Health Claims Payable$286,520
Estimated Malpractice Costs$2,672,800
PAYABLE TO MEDICARE$8,535,995
FieldValueIRS element (for citing)
Total Liability$37,122,127TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$95,903,221TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$95,903,221RevenueSubtotalAmt
Other Revenues Not Included$95,721,593OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$95,721,593RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$191,624,814TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$150,606,217TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$150,606,217ExpensesSubtotalAmt
Other Expenses Not Included$95,721,593OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$95,721,593ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$246,327,810TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule D, Part X, LINE 2ASC 740 FOOTNOTE: 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.
SCHEDULE D, PART XI, LINE 4BRECONCILIATION OF REVENUE PER AUDITED FINANCIALS WITH TAX RETURN INCOME/EXPENSE RECLASSES FROM AUDIT $ 68,054,451 BAD DEBT EXPENSE 27,667,142 ----------- TOTAL $ 95,721,593
SCHEDULE D, PART XII, LINE 4BRECONCILIATION OF EXPENSES PER AUDITED FINANCIALS WITH TAX RETURN INCOME/EXPENSE RECLASSES FROM AUDIT $ 68,054,451 BAD DEBT EXPENSE 27,667,142 ----------- TOTAL $ 95,721,593

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (30 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Luis Duarte
PHYSICIAN$2,415,846$0$4,673,949$0$100,253$0$85,504$0$28,674$0$7,304,226$0$79,963$0
Christopher Haddad
PHYSICIAN$807,547$0$1,080,168$0$86,389$0$90,720$0$26,963$0$2,091,787$0$86,089$0
Rudy Haddad
PHYSICIAN/BOARD CHAIRMAN$787,337$0$933,619$0$105,389$0$90,720$0$27,231$0$1,944,296$0$86,089$0
Steve Ritter
PHYSICIAN$370,572$0$1,276,848$0$58,184$0$63,560$0$3,586$0$1,772,750$0$56,894$0
Cheruku Rajanarender
PHYSICIAN$1,233,545$0$255,828$0$84,826$0$70,171$0$15,131$0$1,659,501$0$64,536$0
Lindy Bankes
PHYSICIAN/BOARD VICE CHAIRMAN$656,371$0$328,249$0$54,041$0$56,096$0$25,640$0$1,120,397$0$53,741$0
Christopher Barnett
Physician/Medical Director$0$489,730$0$125,669$0$45,334$0$64,195$0$17,684$0$742,612$0$44,044
Julian Beseril
CFO$0$233,425$0$41,364$0$221$0$17,795$0$23,532$0$316,337$0$0
Paul Borgfeld
PHYSICIAN/Medical Director$403,363$0$15,000$0$47,336$0$59,440$0$27,431$0$552,570$0$45,356$0
David Boswell
Physician/Medical Director$299,890$0$135,758$0$50,445$0$55,120$0$25,689$0$566,902$0$50,145$0
Norma Cerna
Physician/Board Director$516,900$0$235,791$66,852$0$50,744$0$32,512$0$902,799$0$66,402$0
Jason Felger
Physician/Board Director$631,537$0$57,172$0$93,920$0$80,456$0$35,537$0$898,622$0$74,230$0
Allen Graves
General Council$0$241,236$0$34,375$0$252$0$13,333$0$20,552$0$309,748$0$0
Vicki Forlano Halfmann
Physician/Board Director$266,004$0$100,802$0$61,407$0$50,744$0$27,243$0$506,200$0$41,117$0
Ross Harper
Physician/Board Secretary$626,669$0$293,918$0$76,192$0$75,138$0$31,433$0$1,103,350$0$75,922$0
Sarah Jackson Vance
Physician/Board Director$270,519$122,939$0$53,341$0$60,720$0$11,955$0$519,474$0$48,587$0
Andrew T Kingman
Physician/Medical Director$507,791$0$192,635$0$58,140$0$64,224$0$35,348$0$858,138$0$57,870$0
Kelly Koenig
Physician/Medical Director$255,935$0$165,966$0$300$0$55,896$0$34,748$0$512,845$0$0$0
Joe Mims
Physician/Board Director$390,882$0$262,890$0$57,111$0$56,247$0$27,986$0$795,116$0$53,301$0
Kelly Shane Plymell
President$0$590,681$0$242,100$0$68,578$0$80,159$0$23,547$0$1,005,065$0$67,888
Doug Schultz
Physician/Medical Director$366,046$0$113,176$0$55,003$0$59,999$0$11,083$0$605,307$0$52,793$0
Ricardo Villareal
CAO$0$280,666$0$78,487$0$4,851$0$46,148$0$23,540$0$433,692$0$4,579
Caleb Vosburg
Physician/Board Director$497,900$0$235,791$0$85,852$0$71,512$0$33,748$0$924,803$0$66,402$0
Jenny Wiggins-Smith
Physician/Medical Director$316,863$0$234,204$0$56,214$0$62,056$0$29,159$0$698,496$0$55,914$0
David Huchton
Physician$1,004,213$0$397,975$0$58,010$0$70,288$0$27,247$0$1,557,733$0$57,320$0
Staci Wetz
Former CFO$0$133,881$0$75,022$0$54,250$0$28,716$0$8,337$0$300,206$0$53,969
Irvin Zeitler MD
Former Medical Director$0$0$40,489$0$61,021$0$0$0$0$0$101,510$0$61,021$0
Linda Adams
Physician/Former Officer$383,854$0$108,133$0$56,169$0$62,056$0$17,507$0$627,719$0$55,479$0
Chris Cole
Physician/Former Officer$597,059$0$293,918$0$121,248$0$75,138$0$35,948$0$1,123,311$0$100,268$0
Joe Harvey
Physician/Former Officer$302,397$0$96,359$0$62,664$0$51,584$0$34,242$0$547,246$0$42,374$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 3METHODS USED TO ESTABLISH COMPENSATION: SHANNON CLINIC'S (SC) EXECUTIVES ARE CONTRACTED THROUGH SHANNON MEDICAL MANAGEMENT (SMM), A RELATED 501(C)(3) ORGANIZATION. THEREFORE, SC RELIES ON THE METHODS USED BY SMM TO ESTABLISH THE COMPENSATION OF THE EXECUTIVES.
SCHEDULE J, PART I, LINE 4BNONQUALIFIED RETIREMENT PLAN: FIXED CONTRIBUTION - THE PARTICIPANT'S ALLOWANCE PERCENTAGE FOR THE PLAN YEAR MULTIPLIED BY THE PARTICIPANT'S BASE SALARY FOR THE PRECEDING PLAN YEAR. DISCRETIONARY CONTRIBUTION - THE AMOUNT DETERMINED BY THE COMMITTEE, IN ITS SOLE DISCRETION, ON BEHALF OF A PARTICIPANT FOR THE PLAN YEAR BASED UPON CRITERIA ESTABLISHED BY THE COMMITTEE, IN ITS SOLE DISCRETION. THE APPLICABLE PLAN YEAR OF THE DISCRETIONARY CONTRIBUTION SHALL BE PLAN YEAR DURING WHICH IT IS CREDITED TO THE PARTICIPANT'S MUTUAL FUND ACCOUNT PURSUANT TO SECTION 2.1.3.2 OF EXHIBIT A TO THE PLAN. HOWEVER, THE COMMITTEE, IN ITS SOLE DISCRETION, MAY DETERMINE THE AMOUNT OF THE DISCRETIONARY CONTRIBUTION BASED UPON CRITERIA RELATING TO THE PRECEDING PLAN YEAR, AS MEASURED DURING THE FISCAL YEAR OF THE COMPANY ENDING IN SUCH PRECEDING PLAN YEAR. 457(F) DETAIL PARTICIPANT W-2 DEFERRED COMP PAYOR ------------ --------- --------------- ----------- LINDY BANKES $53,741 $44,896 SC CHRIS BARNETT, MD $44,044 $52,995 SMC JULIAN BESERIL NONE $17,795 SMM PAUL BORGFELD $45,356 $48,240 SC DAVID BOSWELL $50,145 $43,920 SC NORMA CERNA $66,402 $39,544 SC LUIS DUARTE $79,963 $74,304 SC JASON FELGER $74,230 $69,256 SC ALAN GRAVES NONE $13,333 SMC CHRISTOPHER HADDAD $86,089 $79,520 SC RUDY HADDAD $86,089 $79,520 SC VICKI FORLANO HALFMANN $41,117 $39,544 SC ROSS HARPER $75,922 $63,938 SC JOE HARVEY $42,374 $40,384 SC SARAH JACKSON VANCE $48,587 $49,520 SC ANDREW T. KINGMAN $57,870 $53,024 SC KELLY KOENIG NONE $49,520 SC JOE MIMS $53,301 $45,074 SC KELLY SHANE PLYMELL $67,888 $68,959 SMC CHERUKU RAJANARENDER $64,536 $58,971 SC STEVE RITTER $56,894 $52,360 SC DOUG SHULTZ $52,793 $48,979 SC CALEB VOSBURG $66,402 $60,312 SC RICARDO VILLARREAL $ 4,579 $35,767 SMM JENNY WIGGINS-SMITH $55,914 $50,856 SC STACI WETZ $53,969 $23,100 SMC IRVIN ZEITLER $61,021 NONE SC LINDA ADAMS $55,479 $50,856 SC CHRIS COLE $100,268 $63,938 SC

Schedule L IRS990ScheduleL

FieldValueIRS element (for citing)
Total Balance Due$0TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
RUDY HADDAD
CHRIS HADDAD'S BROTHER$1,826,345SHANNON CLINIC EMPLOYEEfalse
CHRIS HADDAD
RUDY HADDAD'S BROTHER$1,974,104SHANNON CLINIC EMPLOYEEfalse

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3CONTROL OF MANAGEMENT DUTIES: ADMINISTRATIVE SERVICES FOR SHANNON CLINIC ARE CONTRACTED WITH SHANNON MEDICAL MANAGEMENT, A RELATED ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 6MEMBERS OR STOCKHOLDERS: SHANNON HEALTH SYSTEM, A 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF SHANNON CLINIC.
FORM 990, PART VI, SECTION A, LINE 7APOWER TO ELECT MEMBERS TO THE GOVERNING BODY: THE SOLE MEMBER, SHANNON HEALTH SYSTEM, APPOINTS THE MEMBERS OF THE BOARD OF DIRECTORS. THE MEMBER EXERCISES ITS POWERS AND AUTHORITY THROUGH THE ACTION OF THE CHAIRMAN OF THE BOARD OF DIRECTORS OF THE MEMBER OR SUCH OTHER PERSON OR PERSONS DESIGNATED BY THE BOARD OF DIRECTORS OF THE MEMBER TO TAKE ACTION.
FORM 990, PART VI, SECTION A, LINE 7BAPPROVAL OF GOVERNANCE DECISIONS: THE MEMBER HAS THE SOLE AUTHORITY TO ACT WITH RESPECT TO A VARIETY OF SUBJECTS INCLUDING BUDGETING, INCURRENCE OR GUARANTEE OF ANY DEBT, CREATION OR SALE OF ANY SUBSIDIARIES, REAL PROPERTY TRANSACTIONS, MODIFICATIONS OF THE CORPORATION, ARRANGEMENTS BETWEEN THE CORPORATION AND ANY INSURER, ESTABLISHMENT OF TRAINING AND RESIDENCY PROGRAMS, GIVING AND RECEIVING GRANTS, AUDITOR AND LEGAL COUNSEL SELECTION, APPROVAL, ADOPTION, OR AMENDMENT OF: COMPENSATION POLICY THAT ESTABLISHES REASONABLE SALARIES OF OFFICERS, DIRECTORS, PHYSICIANS AND PHYSICIAN EXTENDERS, INSURANCE COVERAGE AND FEE SCHEDULES RELATING TO PATIENT SERVICES, COMMENCEMENT OF LITIGATION BY THE CORPORATION, SELECTION AND APPROVAL OF THE LOCATION OF THE PROVISION OF ANY SERVICES OFFERED BY THE CORPORATION AND ANY OTHER MATTERS WITH RESPECT TO WHICH EXCLUSIVE AUTHORITY IS GRANTED TO THE MEMBER BY LAW, THE ARTICLES, OR THE BYLAWS.
FORM 990, PART VI, SECTION B, LINE 11BREVIEW PROCESS FOR FORM 990: THE ORGANIZATION ENGAGES AN OUTSIDE ACCOUNTING FIRM TO PREPARE FORM 990. ONCE PREPARED, THE FORM IS REVIEWED BY THE ORGANIZATION'S INTERNAL ACCOUNTANTS PRIOR TO FILING. THE MEMBER'S FINANCE COMMITTEE AND BOARD OF DIRECTORS REVIEW BEFORE THE FORM IS FILED.
FORM 990, PART VI, SECTION B, LINE 12CCONFLICT OF INTEREST: OFFICERS, DIRECTORS, AND KEY EMPLOYEES OF SHANNON CLINIC ARE EMPLOYED BY SHANNON MEDICAL CENTER OR ITS AFFILIATES, AND AS SUCH ARE REQUIRED TO DISCLOSE CONFLICTS OF INTEREST AS THEY ARISE, AND ARE REQUIRED TO FILE ANNUAL STATEMENTS AFFIRMING EITHER THE CONFLICTS OF INTEREST THAT THEY MAY HAVE, OR THAT THEY HAVE NO CONFLICTS OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15A & 15BOFFICERS, DIRECTORS, AND KEY EMPLOYEES OF SHANNON CLINIC ARE EMPLOYED BY SHANNON MEDICAL CENTER OR ITS AFFILIATES, AND AS SUCH HAVE THEIR COMPENSATION REVIEWED ANNUALLY BY THE INDEPENDENT SHANNON MEDICAL CENTER BOARD OF TRUSTEES, WHICH CONSULTS COMPARABILITY DATA AND KEEPS CONTEMPORANEOUS RECORDS OF ITS DECISIONS.
FORM 990, PART VI, SECTION C, LINE 19PROCESS OF MAKING GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC: COPIES OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS ARE PROVIDED TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9OTHER CHANGES IN NET ASSETS: TRANSFER TO SHANNON MEDICAL CENTER $(7,327,322) TRANSFER FROM SHANNON BUSINESS SERVICES $205,895 TRANSFER TO SHANNON REAL ESTATE SERVICES $(125) TRANSFER FROM SHANNON MEDICAL MANAGEMENT $61,118,696 TRANSFER TO SHANNON HEALTH SYSTEM $(12,453,278) OTHER TRANSFERS $86,142 --------------- TOTAL $41,630,008

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
TRUSTEES SHANNON WEST TEXAS HOSPITAL
PO BOX 49SAN ANGELOTX76902750800679TRUSTTX501(C)(3)12BNAfalse
SHANNON RURAL HEALTH CLINICS INC
120 E HARRIS AVESAN ANGELOTX76903752940211HEALTHCARETX501(C)(3)12CSMCYes (true)
SHANNON REAL ESTATE SERVICES INC
120 E HARRIS AVESAN ANGELOTX76903270075630SUPPORT SVCSTX501(C)(3)12ASMCYes (true)
SHANNON HEALTH SYSTEM
120 E HARRIS AVESAN ANGELOTX76903752602411HEALTHCARETX501(C)(3)12BTSWTMHYes (true)
SHANNON MEDICAL CENTER
120 E HARRIS AVESAN ANGELOTX76903752559845HEALTHCARETX501(C)(3)3SHSYes (true)
SHANNON BUSINESS SERVICES INC
120 E HARRIS AVESAN ANGELOTX76903432038769SUPPORT SVCSTX501(C)(3)12ASMCYes (true)
SHANNON MEDICAL MANAGEMENT
120 E BEAUREGARDSAN ANGELOTX76903208367966SUPPORT SVCSTX501(C)(3)12BSHSYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1REGIONAL CANCER TREATMENT CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1102 N MAGDALEN 120AddressLine1Txt
CitySan AngeloCityNm
State AbbreviationTXStateAbbreviationCd
ZIP76902ZIPCd
FieldValueIRS element (for citing)
EIN752225955EIN
Primary ActivitiesRADIOTHERAPYPrimaryActivitiesTxt
Legal Domicile StateTXLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1Txt

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
LEGACY MANAGEMENT SERVICES
2018 PULLIAM STSAN ANGELOTX76903752544450MANAGEMENTTXNAC-CORPORATIONfalse
LEGACY HEALTH SOLUTIONS
2018 PULLIAM STSAN ANGELOTX76903200720762MED INSURANCETXNAC-CORPORATIONfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
SHANNON MEDICAL MANAGEMENT
M$67,454,082BOOK VALUE
SHANNON MEDICAL CENTER
R$7,327,322BOOK VALUE
SHANNON BUSINESS SERVICES
S$205,895BOOK VALUE
SHANNON MEDICAL MANAGEMENT
S$61,118,696BOOK VALUE

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