SHANNON MEDICAL MANAGEMENT: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- SHANNON MEDICAL MANAGEMENT (EIN 20-8367966)
- Tax period
- 2018-10-01 to 2019-09-30
- Filed
- 2020-08-17
- IRS object ID
- 202032309349302578
- Schema version
- 2018v3.3
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-08-17T13:49:25-05:00 | ReturnTs |
| Tax Period End | 2019-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14241 DALLAS PARKWAY SUITE 1100 | AddressLine1Txt |
| City | DALLAS | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75254 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 208367966 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Shannon Medical Management | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % JULIAN BESERIL | InCareOfNm |
| Business Name Control | SHAN | BusinessNameControlTxt |
| Phone | 3256581511 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 22000 | AddressLine1Txt |
| City | San Angelo | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 76902 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JULIAN BESERIL | PersonNm |
| Person Title | cfo | PersonTitleTxt |
| Phone | 3256581511 | PhoneNum |
| Signature | 2020-08-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kevin R Ensminger | PreparerPersonNm |
| PTIN | P01310558 | PTIN |
| Phone | 9727028262 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 167.68.126.162 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 76915820202305000007 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2020-08-17 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | B49B3FF6BBBA87B030C59CEAC7889EA9C46574FC | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | EB976710118F518B8933A72D91D1D85239D99EDA | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-09-22 18:59:49Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SHANE PLYMELL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 22000 | AddressLine1Txt |
| City | SAN ANGELO | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 76902 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $64,483,978 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SHANNONHEALTH.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2007 | FormationYr |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Activity Or Mission | FOUNDED ON A LEGACY OF CARING, SHANNON IS A LOCALLY OWNED HEALTHCARE SYSTEM DEDICATED TO PROVIDING EXCEPTIONAL HEALTHCARE FOR OUR FAMILY, FRIENDS, AND NEIGHBORS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 3 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 1 | VotingMembersIndependentCnt |
| Total Employee | 1051 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $62,769,600 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $64,483,676 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $303 | PYOtherRevenueAmt |
| CY Other Revenue | $302 | CYOtherRevenueAmt |
| PY Total Revenue | $62,769,903 | PYTotalRevenueAmt |
| CY Total Revenue | $64,483,978 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $44,899,088 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $45,175,006 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $15,555,452 | PYOtherExpensesAmt |
| CY Other Expenses | $16,690,992 | CYOtherExpensesAmt |
| PY Total Expenses | $60,454,540 | PYTotalExpensesAmt |
| CY Total Expenses | $61,865,998 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,315,363 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,617,980 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,857,170 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,707,629 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,320,658 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,486,000 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$463,488 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$1,778,371 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE SUPPORT SERVICES FOR SHANNON CLINIC IN SUPPORT OF ITS MISSION TO BE THE PREMIERE HEALTH CARE PROVIDER OF PHYSICIAN SERVICES IN THE COMMUNITIES SERVED. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $51,898,455 | ExpenseAmt |
| Revenue | $64,483,978 | RevenueAmt |
| Desc | PROVIDE SUPPORT SERVICES, INCLUDING NURSING, ANCILLARY HEALTHCARE SERVICES, ADMINISTRATIVE AND TECHNOLOGICAL SUPPORT FOR SHANNON CLINIC, AN AFFILIATED NON-PROFIT MULTI-SPECIALTY PHYSICIAN CLINIC THAT PROVIDES HEALTHCARE THROUGHOUT SAN ANGELO AND NEARBY COMMUNITIES REGARDLESS OF ABILITY TO PAY. SHANNON MEDICAL MANAGEMENT IS ORGANIZED AND OPERATED TO SUPPORT ACCESS AND CARE FOR RESIDENTS OF ITS SERVICE AREA, INCLUDING MEDICALLY INDIGENT PATIENTs. | Desc |
| Total Program Service Expenses | $51,898,455 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1051 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 3 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 1 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JULIAN BESERIL | PersonNm |
| Phone | 3256581511 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 E BEAUREGARD | AddressLine1Txt |
| City | SAN ANGELO | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 76903 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| Len Mertz | |||||||||
| Chairman/Trustee | 1.0 | 39.0 | Yes (X) | Yes (X) | $0 | $3,958 | $4,365 | ||
| Kelly Shane Plymell | |||||||||
| CEO/President | 5.0 | 35.0 | Yes (X) | Yes (X) | $0 | $644,415 | $97,897 | ||
| Ricardo Villareal | |||||||||
| COO/Secretary/Treasurer | 40.0 | 0.0 | Yes (X) | Yes (X) | $245,056 | $0 | $35,742 | ||
| JULIAN BESERIL | |||||||||
| CFO, START: 05/19 | 24.0 | 16.0 | Yes (X) | $0 | $0 | $0 | |||
| West Herbert | |||||||||
| Lead EKG/Tread Tech | 40.0 | 0.0 | $136,713 | $0 | $24,414 | Yes (X) | |||
| Anna Pittman | |||||||||
| Chief Nursing Officer | 40.0 | 0.0 | $136,880 | $0 | $28,592 | Yes (X) | |||
| Mark Duncan | |||||||||
| Sports Medicine Director | 40.0 | 0.0 | $160,922 | $0 | $15,324 | Yes (X) | |||
| Keli Ramsey | |||||||||
| Former COO | 0.0 | 0.0 | $191,066 | $0 | $42,478 | Yes (X) | |||
| John Dolan | |||||||||
| Former Assistant CFO | 40.0 | 0.0 | $160,683 | $0 | $25,118 | Yes (X) | |||
| Staci Wetz | |||||||||
| Former CFO | 1.0 | 39.0 | $0 | $324,641 | $77,929 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,031,320 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $973,014 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $351,859 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ALLSCRIPTS | |||||
| 8529 SIX FORKS ROAD FORUM IV | RALEIGH | TX | 27615 | STATEMENT PROCESSING | $167,655 |
| CHAMPION CLEANING SOLUTIONS | |||||
| 6 DONARE SQUARE | SAN ANTONIO | TX | 78229 | CLEANING SERVICES | $267,495 |
| EXECUTIVE COURIER LLC | |||||
| 4525 SUGAR MAPLE LN | SAN ANGELO | TX | 76904 | COURIER SERVICES | $120,622 |
| MEDI-COMM SERVICES OF LUBBOCK | |||||
| 5717 66TH ST SUITE 116 | LUBBOCK | TX | 79424 | COLLECTION SERVICES | $256,006 |
| STERICYCLE COMMUNICATIONS | |||||
| 26604 NETWORK PLACE | CHICAGO | IL | 60673 | ANSWERING SERVICES | $120,111 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Medical Records Income | 900099 | $142,957 | $142,957 |
| Lease Income | 532000 | $200 | $200 |
| Management Fees | 900099 | $64,340,519 | $64,340,519 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $64,483,676 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Miscellaneous Income | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $302 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $302 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $302 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $64,483,978 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $64,483,978 | RelatedOrExemptFuncIncomeAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,897 | TotalAmt |
| Management And General | $97,897 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,744,325 | TotalAmt |
| Program Services | $31,565,674 | ProgramServicesAmt |
| Management And General | $4,178,651 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,012,029 | TotalAmt |
| Program Services | $797,174 | ProgramServicesAmt |
| Management And General | $214,855 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,804,902 | TotalAmt |
| Program Services | $5,176,338 | ProgramServicesAmt |
| Management And General | $628,564 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,515,853 | TotalAmt |
| Program Services | $2,152,912 | ProgramServicesAmt |
| Management And General | $362,941 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,737 | TotalAmt |
| Management And General | $11,737 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,053,897 | TotalAmt |
| Program Services | $2,833,997 | ProgramServicesAmt |
| Management And General | $219,900 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $266,533 | TotalAmt |
| Program Services | $265,533 | ProgramServicesAmt |
| Management And General | $1,000 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $715,984 | TotalAmt |
| Program Services | $203,685 | ProgramServicesAmt |
| Management And General | $512,299 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,485,182 | TotalAmt |
| Program Services | $81,884 | ProgramServicesAmt |
| Management And General | $1,403,298 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,818,466 | TotalAmt |
| Program Services | $7,800,658 | ProgramServicesAmt |
| Management And General | $17,808 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $113,356 | TotalAmt |
| Program Services | $99,574 | ProgramServicesAmt |
| Management And General | $13,782 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $828,200 | TotalAmt |
| Program Services | $368,872 | ProgramServicesAmt |
| Management And General | $459,328 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,644 | TotalAmt |
| Management And General | $21,644 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Equipment | $1,551,671 | $56,652 | $1,495,019 |
| Collection Fees | $446,661 | $446,661 | |
| Education | $27,164 | $26,009 | $1,155 |
| Recruiting & New Hire | $36,182 | $36,182 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $314,315 | TotalAmt |
| Program Services | $22,832 | ProgramServicesAmt |
| Management And General | $291,483 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,865,998 | TotalAmt |
| Program Services | $51,898,455 | ProgramServicesAmt |
| Management And General | $9,967,543 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $578,320 | BOYAmt |
| EOY | $21,286 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $210,465 | BOYAmt |
| EOY | $214,221 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $10,116,606 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,795,411 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,994,175 | BOYAmt |
| EOY | $2,321,195 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $74,210 | BOYAmt |
| EOY | $150,927 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,857,170 | BOYAmt |
| EOY | $2,707,629 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,356,225 | BOYAmt |
| EOY | $3,740,222 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $964,433 | BOYAmt |
| EOY | $745,778 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,320,658 | BOYAmt |
| EOY | $4,486,000 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$463,488 | BOYAmt |
| EOY | -$1,778,371 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$463,488 | BOYAmt |
| EOY | -$1,778,371 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,857,170 | BOYAmt |
| EOY | $2,707,629 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $2,617,980 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$3,932,863 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type2 | Yes (X) | SupportingOrgType2Ind |
| IRS Written Determination | Yes (X) | IRSWrittenDeterminationInd |
| Supported Organizations | 2 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (2 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| SHANNON CLINIC | ||||
| 752600873 | 10 | false | $61,865,998 | $0 |
| SHANNON MEDICAL CENTER | ||||
| 752559845 | 3 | Yes (true) | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 2 | SupportedOrganizationsTotalCnt |
| Support Sum | $61,865,998 | SupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | false | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | false | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | false | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | false | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | false | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | false | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | false | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | false | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | false | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | false | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | false | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | false | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | false | ContributionControllerInd |
| Contribution Family | false | ContributionFamilyInd |
| Contribution35 Controlled | false | Contribution35ControlledInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Majority Dir Trst Supported Org | false | MajorityDirTrstSupportedOrgInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE A, PART IV, SECTION A, LINE 1 | THE ORGANIZATION'S GOVERNING DOCUMENTS LIST SHANNON MEDICAL CENTER. THE ORGANIZATION SUPPORTS SHANNON CLINIC WHO PROVIDES SERVICES THAT ALLOW SHANNON MEDICAL CENTER TO ACCOMPLISH ITS MISSION OF PROVIDING CARE TO ITS PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. |
| SCHEDULE A, PART IV, SECTION C, LINE 1 | THE ORGANIZATION HAS RECEIVED A TYPE II SUPPORTING ORGANIZATION DETERMINATION LETTER FROM THE IRS. THE IRS MADE THIS DETERMINATION BASED ON THE FOLLOWING FACTS. THE PRIMARY PURPOSE OF THE ORGANIZATION IS THE PROVISION OF ADMINISTRATIVE SERVICES TO SHANNON CLINIC (SC), THE PHYSICIAN SERVICES COMPONENT OF THE INTEGRATED HEALTH CARE DELIVERY SYSTEM THAT INCLUDES SHANNON MEDICAL CENTER (SMC), SC, THE ORGANIZATION AND SHANNON HEALTH SYSTEM (SHS), EACH OF WHICH IS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX PURSUANT TO SECTION 501(A)[1] BY VIRTUE OF BEING AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3). EACH OF THESE ENTITIES ARE RELATED CORPORATIONS. EFFECTIVE JULY 3, 2008, THE ORGANIZATION'S BYLAWS WERE AMENDED TO, AMONG OTHER THINGS, SUBSTITUTE SHS FOR SMC AS THE ORGANIZATION'S MEMBER. THUS, THE ORGANIZATION'S DIRECTORS ARE APPOINTED AND REMOVABLE BY SHS, NOT SMC. AS SUCH, THE ORGANIZATION REQUESTED AND RECEIVED RECLASSIFICATION AS A TYPE II SUPPORTING ORGANIZATION SINCE A MAJORITY OF ITS OFFICERS AND DIRECTORS ARE EITHER DIRECTORS OF SMC OR MEMBERS OF THE SMC'S SENIOR MANAGEMENT TEAM, PLACING MANAGEMENT AND CONTROL OF THE ORGANIZATION IN THE HANDS OF THE SAME INDIVIDUALS WHO MANAGE SMC. |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp | |
| Buildings | BuildingsGrp | |
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,116,606 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,795,411 | DepreciationAmt |
| Book Value | $2,321,195 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildingsGrp | |
| Total Book Value Land Buildings | $2,321,195 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Pension Fund | Desc |
| Book Value | $150,927 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $150,927 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Pension Plan Liability | $199,972 |
| Health Claims Payable | $545,806 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $745,778 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $64,483,978 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $64,483,978 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $64,483,978 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $61,865,998 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $61,865,998 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $61,865,998 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PART X, LINE 2 | FormAndLineReferenceDesc |
| Explanation | ASC 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. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Kelly Shane Plymell | ||||||||||||||
| CEO/President | $0 | $571,671 | $0 | $100 | $0 | $72,644 | $0 | $76,691 | $0 | $21,206 | $0 | $742,312 | $0 | $72,177 |
| Ricardo Villareal | ||||||||||||||
| COO/Secretary/Treasurer | $244,883 | $0 | $0 | $0 | $173 | $0 | $23,462 | $12,280 | $0 | $0 | $268,518 | $12,280 | $0 | $0 |
| West Herbert | ||||||||||||||
| Lead EKG/Tread Tech | $136,522 | $0 | $0 | $0 | $191 | $0 | $4,369 | $0 | $20,045 | $0 | $161,127 | $0 | $0 | $0 |
| Keli Ramsey | ||||||||||||||
| Former COO | $150,053 | $0 | $0 | $0 | $41,013 | $0 | $26,499 | $0 | $15,979 | $0 | $233,544 | $0 | $30,078 | $0 |
| Anna Pittman | ||||||||||||||
| Chief Nursing Officer | $135,430 | $0 | $0 | $0 | $1,450 | $0 | $11,263 | $0 | $17,329 | $0 | $165,472 | $0 | $0 | $0 |
| John Dolan | ||||||||||||||
| Former Assistant CFO | $158,709 | $0 | $0 | $0 | $1,974 | $0 | $5,116 | $0 | $20,002 | $0 | $185,801 | $0 | $0 | $0 |
| Mark Duncan | ||||||||||||||
| Sports Medicine Director | $158,641 | $0 | $0 | $0 | $2,281 | $0 | $4,928 | $0 | $10,396 | $0 | $176,246 | $0 | $0 | $0 |
| Staci Wetz | ||||||||||||||
| Former CFO | $0 | $276,097 | $0 | $100 | $0 | $48,444 | $0 | $58,154 | $0 | $19,775 | $0 | $402,570 | $0 | $48,159 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | NONQUALIFIED 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 ------------ ------- ---------------- -------- KELLY SHANE PLYMELL $72,177 $65,691 SMC RICARDO VILLAREAL NONE $28,653 SMM ANNA PITTMAN NONE $6,067 SMM KELI RAMSEY $30,078 $23,173 SMM STACI WETZ $48,159 $47,154 SMC | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | SHANNON HEALTH SYSTEM IS THE SOLE MEMBER OF SHANNON MEDICAL MANAGEMENT. |
| FORM 990, PART VI, SECTION A, LINE 7A | 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 B, LINE 11B | THE ORGANIZATION ENGAGES AN OUTSIDE ACCOUNTING FIRM TO PREPARE THE FORM 990. ONCE PREPARED, THE FORM IS REVIEWED BY THE ORGANIZATION'S INTERNAL ACCOUNTANTS PRIOR TO FILING. A COPY WILL BE MADE AVAILABLE TO THE FINANCE COMMITTEE AND BOARD AFTER FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | OFFICERS, DIRECTORS, AND KEY EMPLOYEES OF SHANNON MEDICAL MANAGEMENT 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 & 15B | OFFICERS, DIRECTORS, AND KEY EMPLOYEES OF SHANNON MEDICAL MANAGEMENT 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 19 | COPIES OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS ARE PROVIDED TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XII, LINE 2C | SHANNON MEDICAL MANAGEMENT DOES NOT HAVE AN AUDIT COMMITTEE, BUT THERE IS A SHANNON HEALTH SYSTEM AUDIT COMPLIANCE COMMITTEE THAT OVERSEES THE CONSOLIDATED AUDIT THAT INCLUDES SHANNON MEDICAL MANAGEMENT. |
| FORM 990, PART V, LINE 1A | CHECKS ARE WRITTEN ON BEHALF OF SHANNON MEDICAL MANAGEMENT BY SHANNON CLINIC. ACCORDINGLY ALL FORM 1099'S ARE FILED UNDER THE TAX ID OF SHANNON CLINIC. |
| Form 990, Part XI, Line 9 | Other Changes in Net Assets: Transfer To shannon clinic $(58,253,919) Transfer from Shannon business services 1,099 Transfer from Shannon Real estate services 6,725,888 Transfer from Shannon Medical Center 47,594,069 --------------- Total $(3,932,863) |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| TRUSTEES SHANNON WEST TEXAS HOSPITAL | ||||||||||
| PO BOX 49 | SAN ANGELO | TX | 76902 | 750800679 | TRUST | TX | 501(C)(3) | 12B | NA | false |
| SHANNON REAL ESTATE SERVICES INC | ||||||||||
| 120 E HARRIS AVE | SAN ANGELO | TX | 76903 | 270075630 | SUPPORT SVCS | TX | 501(C)(3) | 12A | SMC | Yes (true) |
| SHANNON RURAL HEALTH CLINICS INC | ||||||||||
| 120 E HARRIS AVE | SAN ANGELO | TX | 76903 | 752940211 | HEALTHCARE | TX | 501(C)(3) | 12C | SMC | Yes (true) |
| SHANNON HEALTH SYSTEM | ||||||||||
| 120 E HARRIS AVE | SAN ANGELO | TX | 76903 | 752602411 | SUPPORT SVCS | TX | 501(C)(3) | 12b | tswth | Yes (true) |
| SHANNON CLINIC | ||||||||||
| 120 E BEAUREGARD | SAN ANGELO | TX | 76903 | 752600873 | HEALTHCARE | TX | 501(C)(3) | 10 | SHS | Yes (true) |
| SHANNON BUSINESS SERVICES INC | ||||||||||
| 120 E HARRIS AVE | SAN ANGELO | TX | 76903 | 432038769 | SUPPORT SVCS | TX | 501(C)(3) | 12A | SMC | Yes (true) |
| SHANNON MEDICAL CENTER | ||||||||||
| 120 E HARRIS AVE | SAN ANGELO | TX | 76903 | 752559845 | SUPPORT SVCS | TX | 501(C)(3) | 3 | SHS | Yes (true) |
| SHANNON MEDICAL CENTER PIONEER FDN | ||||||||||
| 120 E HARRIS AVE | SAN ANGELO | TX | 76903 | 352229303 | SUPPORT | TX | 501(C)(3) | 12A | SMC | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REGIONAL CANCER TREATMENT CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 102 N MAGDALEN STE 120 | AddressLine1Txt |
| City | SAN ANGELO | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 76903 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 752225955 | EIN |
| Primary Activities | RADIOTHERAPY | PrimaryActivitiesTxt |
| Legal Domicile State | TX | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| LEGACY MANAGEMENT SERVICES | |||||||||
| 2018 PULLIAM ST | SAN ANGELO | TX | 76903 | 752544450 | UTILIZ. REVIE | TX | NA | C-CORPORATION | false |
| LEGACY HEALTH SOLUTIONS | |||||||||
| 2018 PULLIAM ST | SAN ANGELO | TX | 76903 | 200720762 | MEDICAL INSUR | TX | NA | C-CORPORATION | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| SHANNON CLINIC | ||
| L | $64,340,519 | BOOK VALUE |
| Shannon Clinic | ||
| r | $58,253,919 | Book value |
| Shannon Real Estate Services | ||
| s | $6,725,888 | Book Value |
| Shannon Medical Center | ||
| s | $47,594,069 | Book Value |