SHANNON CLINIC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
SHANNON CLINIC (EIN 75-2600873)
Tax period
2018-10-01 to 2019-09-30
Filed
2020-08-17
IRS object ID
202042309349301594
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

FieldValueIRS element (for citing)
Return2020-08-17T13:48:04-05:00ReturnTs
Tax Period End2019-09-30TaxPeriodEndDt

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 Begin2018-10-01TaxPeriodBeginDt

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
Signature2020-08-17SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKevin EnsmingerPreparerPersonNm
PTINP01310558PTIN
Phone9727028262PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address167.68.126.162IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id76915820202305000006FederalOriginalSubmissionId
Federal Original Submission Id2020-08-17FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdB49B3FF6BBBA87B030C59CEAC7889EA9C46574FCAtSubmissionCreationDeviceId
At Submission Filing Device IdEB976710118F518B8933A72D91D1D85239D99EDAAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-09-23 17:36:50ZBuildTS

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$192,726,172GrossReceiptsAmt
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 Employee300TotalEmployeeCnt
Total Volunteers10TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$170,090,402PYProgramServiceRevenueAmt
CY Program Service Revenue$192,713,594CYProgramServiceRevenueAmt
PY Investment Income$31,184PYInvestmentIncomeAmt
CY Investment Income$12,578CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$170,121,586PYTotalRevenueAmt
CY Total Revenue$192,726,172CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$5,000CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$118,433,563PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$126,786,137CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$106,476,793PYOtherExpensesAmt
CY Other Expenses$123,180,936CYOtherExpensesAmt
PY Total Expenses$224,910,356PYTotalExpensesAmt
CY Total Expenses$249,972,073CYTotalExpensesAmt
PY Revenues Less Expenses-$54,788,770PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$57,245,901CYRevenuesLessExpensesAmt
Total Assets BOY$40,414,446TotalAssetsBOYAmt
Total Assets EOY$38,695,692TotalAssetsEOYAmt
Total Liabilities BOY$35,387,116TotalLiabilitiesBOYAmt
Total Liabilities EOY$39,224,923TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$5,027,330NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$529,231NetAssetsOrFundBalancesEOYAmt
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$238,834,550ExpenseAmt
Revenue$192,713,594RevenueAmt
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 CENTERTO PROVIDE CARE TO ITS PATIENTS REGARDLESS OF ABILITY TO PAY.Desc
Total Program Service Expenses$238,834,550TotalProgramServiceExpensesAmt
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
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
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 With Officer EntfalseBusinessRlnWithOfficerEntInd
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
Employee300EmployeeCnt
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 BodyfalseForm990ProvidedToGvrnBodyInd
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
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 (28 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
LINDY BANKES
PHYSICIAN/BOARD SECRETARY40.00.0Yes (X)Yes (X)$904,085$0$54,924
PAUL BORGFELD
PHYSICIAN/MEDICAL DIRECTOR40.00.0Yes (X)$459,027$0$60,091
DAVID BOSWELL
PHYSICIAN/MEDICAL DIRECTOR40.00.0Yes (X)$501,191$0$80,973
NORMA CERNA
PHYSICIAN/BOARD DIRECTOR40.00.0Yes (X)$328,593$0$76,455
JASON FELGER
PHYSICIAN/MEDICAL DIRECTOR40.00.0Yes (X)$812,025$0$113,397
RUDY HADDAD
PHYSICIAN/CHAIRMAN40.00.0Yes (X)Yes (X)$1,701,652$0$113,785
VICKI FORLAND HALFMANN
PHYSICIAN/BOARD DIRECTOR40.00.0Yes (X)$382,106$0$75,883
ROSS HARPER
PHYSICIAN/BOARD DIRECTOR40.00.0Yes (X)$951,429$0$103,404
SARAH JACKSON VANCE
PHYSICIAN/CHairman40.00.0Yes (X)Yes (X)$465,149$0$69,121
ANDREW T KINGMAN
PHYSICIAN/MEDICAL DIRECTOR40.00.0Yes (X)$687,509$0$96,377
JOE MIMS
PHYSICIAN/BOARD DIRECTOR40.00.0Yes (X)$638,774$0$83,424
DOUG SCHULTZ
PHYSICIAN/MEDICAL DIRECTOR40.00.0Yes (X)$375,584$0$48,153
CALEB VOSBURG
PHYSICIAN/BOARD DIRECTOR40.00.0Yes (X)$791,162$0$100,429
JENNY WIGGINS-SMITH
PHYSICIAN/MEDICAL DIRECTOR40.00.0Yes (X)$661,288$0$94,323
KELLY SHANE PLYMELL
CEO/PRESIDENT24.016.0Yes (X)$0$644,415$97,897
CHRIS BARNETT MD
CHIEF MEDICAL DIRECTOR2.038.0Yes (X)$0$539,296$45,819
julian beseril
cfo, start: 05/195.035.0Yes (X)$0$0$0
LISA HILL
GENERAL COUNSEL5.035.0$0$341,608$70,136Yes (X)
LUIS DUARTE
PHYSICIAN40.00.0$5,677,609$0$92,010Yes (X)
CHRISTOPHER HADDAD
PHYSICIAN40.00.0$1,913,296$0$90,282Yes (X)
DAVID HUCHTON
PHYSICIAN40.00.0$1,351,084$0$94,461Yes (X)
JAMES MELOTT
PHYSICIAN40.00.0$374,183$0$76,100Yes (X)
STEVE RITTER
PHYSICIAN40.00.0$1,549,484$0$72,889Yes (X)
LINDA ADAMS
PHYSICIAN/FORMER OFFICER40.00.0$583,784$0$86,453Yes (X)
CHRIS COLE
PHYSICIAN/FORMER OFFICER40.00.0$957,111$0$78,318Yes (X)
JOE HARVEY
PHYSICIAN/FORMER OFFICER40.00.0$426,037$0$82,889Yes (X)
IRVIN ZIETLERMD
FORMER MEDICAL DIRECTOR2.038.0$151,851$7,971$31,294Yes (X)
staci wetz
former cfo5.035.0$0$324,641$77,929Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$22,644,013TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,857,931TotReportableCompRltdOrgAmt
Total Other Compensation$2,167,216TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K23IndivRcvdGreaterThan100KCnt
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$62,201,390
ARUP LABORATORIES
500 CHIPETA WAYSALT LAKE CITYUT84108OUTSIDE LAB SERVICES$1,438,971
PULMONARY CRITICAL CARE CONSULTAN
1305 W 34TH STREET STE 400AUSTINTX78705LOCUMS SERVICES$400,000
SHANNON MEDICAL CENTER
120 E HARRISSAN ANGELOTX76903LAB & LAUNDRY SVCS$1,372,119
STONE SETTLE ADVERTISING INC
PO BOX 60187SAN ANGELOTX76906ADVERTISING$459,041
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K13CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Service Revenue621990$172,029,290$172,029,290
Lease Income532000$5,650$5,650
OTHER OPERATING REVENUE900099$2,752,967$2,752,967
Hospital Based Physicians' Assistance900099$17,925,687$17,925,687
FieldValueIRS element (for citing)
Total Program Service Revenue$192,713,594TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,578TotalRevenueColumnAmt
Exclusion$7,578ExclusionAmt

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$5,000OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$5,000OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,000TotalRevenueColumnAmt
Exclusion$5,000ExclusionAmt
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$192,726,172TotalRevenueColumnAmt
Related Or Exempt Func Income$192,713,594RelatedOrExemptFuncIncomeAmt
Exclusion$12,578ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$5,000TotalAmt
Program Services$5,000ProgramServicesAmt

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$9,659,575TotalAmt
Program Services$9,659,575ProgramServicesAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$4,542,011TotalAmt
Program Services$4,542,011ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$98,908,823TotalAmt
Program Services$97,909,539ProgramServicesAmt
Management And General$999,284ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$7,402,203TotalAmt
Program Services$7,342,847ProgramServicesAmt
Management And General$59,356ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,417,241TotalAmt
Program Services$2,406,372ProgramServicesAmt
Management And General$10,869ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$3,856,284TotalAmt
Program Services$3,841,889ProgramServicesAmt
Management And General$14,395ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$64,340,519TotalAmt
Program Services$54,689,441ProgramServicesAmt
Management And General$9,651,078ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$45,367TotalAmt
Management And General$45,367ManagementAndGeneralAmt

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$8,959,757TotalAmt
Program Services$8,870,019ProgramServicesAmt
Management And General$89,738ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$32,628TotalAmt
Program Services$32,628ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$492,142TotalAmt
Program Services$482,369ProgramServicesAmt
Management And General$9,773ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$31,312TotalAmt
Program Services$31,312ProgramServicesAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$36,431TotalAmt
Program Services$30,957ProgramServicesAmt
Management And General$5,474ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$453,022TotalAmt
Program Services$453,022ProgramServicesAmt

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$1,165,657TotalAmt
Program Services$990,808ProgramServicesAmt
Management And General$174,849ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,490,410TotalAmt
Program Services$1,417,616ProgramServicesAmt
Management And General$72,794ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Bad Debt$31,493,511$31,493,511
Medical Supplies$12,698,367$12,698,367
Recruiting & New Hire Expense$315,992$315,992
Education$814,692$810,146$4,546

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$811,129TotalAmt
Program Services$811,129ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$249,972,073TotalAmt
Program Services$238,834,550ProgramServicesAmt
Management And General$11,137,523ManagementAndGeneralAmt
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$16,757,132BOYAmt
EOY$13,802,099EOYAmt

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$409,181BOYAmt
EOY$912,869EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$474,274BOYAmt
EOY$577,201EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$831,077BOYAmt
EOY$564,731EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$18,871,804LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$16,111,017LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$3,384,396BOYAmt
EOY$2,760,787EOYAmt

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$18,558,386BOYAmt
EOY$20,078,005EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$40,414,446BOYAmt
EOY$38,695,692EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$12,309,823BOYAmt
EOY$12,992,061EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

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

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$23,077,293BOYAmt
EOY$26,232,862EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$35,387,116BOYAmt
EOY$39,224,923EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$5,027,330BOYAmt
EOY-$529,231EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

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

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,027,330BOYAmt
EOY-$529,231EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$40,414,446BOYAmt
EOY$38,695,692EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$57,245,901ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$51,689,340OtherChangesInNetAssetsAmt
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$0CurrentTaxYearAmt
Total$0TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$136,780,927CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$149,515,240CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$163,809,253CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$170,090,402CurrentTaxYearMinus1YearAmt
Current Tax Year$192,713,594CurrentTaxYearAmt
Total$812,909,416TotalAmt

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$136,780,927CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$149,515,240CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$163,809,253CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$170,090,402CurrentTaxYearMinus1YearAmt
Current Tax Year$192,713,594CurrentTaxYearAmt
Total$812,909,416TotalAmt

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$812,909,416PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year$29,184CurrentTaxYearMinus1YearAmt
Current Tax Year$7,578CurrentTaxYearAmt
Total$36,762TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year$29,184CurrentTaxYearMinus1YearAmt
Current Tax Year$7,578CurrentTaxYearAmt
Total$36,762TotalAmt

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$136,780,927CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$149,515,240CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$163,809,253CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$170,119,586CurrentTaxYearMinus1YearAmt
Current Tax Year$192,721,172CurrentTaxYearAmt
Total$812,946,178TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99996PublicSupportCY509Pct
Public Support PY5091.00000PublicSupportPY509Pct
Investment Income CY0.00005InvestmentIncomeCYPct
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$18,871,804OtherCostOrOtherBasisAmt
Depreciation$16,111,017DepreciationAmt
Book Value$2,760,787BookValueAmt
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildingsGrp
Total Book Value Land Buildings$2,760,787TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescRetirement FundDesc
Book Value$20,078,005BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$20,078,005TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
Pension Fund Liability$22,959,085
Health Claims Payable$473,057
Estimated Malpractice Costs$2,800,720
FieldValueIRS element (for citing)
Total Liability$26,232,862TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$96,219,845TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$96,219,845RevenueSubtotalAmt
Other Revenues Not Included$96,506,327OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$96,506,327RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$192,726,172TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$153,465,746TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$153,465,746ExpensesSubtotalAmt
Other Expenses Not Included$96,506,327OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$96,506,327ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$249,972,073TotalExpensesPerForm990Amt

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 REVENUES PER AUDITED FINANCIALS WITH TAX RETURN INCOME/EXPENSE RECLASS FROM AUDIT $65,012,816 BAD DEBT EXPENSE $31,493,511 -------------- TOTAL $96,506,327
SCHEDULE D, PART XII, LINE 4BRECONCILIATION OF EXPENSES PER AUDITED FINANCIALS WITH TAX RETURN INCOME/EXPENSE RECLASS FROM AUDIT $65,012,816 BAD DEBT EXPENSE $31,493,511 -------------- TOTAL $96,506,327

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 (27 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
LINDA ADAMS
PHYSICIAN/FORMER OFFICER$412,019$0$109,724$0$62,041$0$61,280$0$25,173$0$670,237$0$61,351$0
LINDY BANKES
PHYSICIAN/BOARD SECRETARY$490,731$0$357,937$0$55,417$0$31,616$0$23,308$0$959,009$0$55,119$0
PAUL BORGFELD
PHYSICIAN/MEDICAL DIRECTOR$397,851$0$14,120$0$47,056$0$35,920$0$24,171$0$519,118$0$45,766$0
DAVID BOSWELL
PHYSICIAN/MEDICAL DIRECTOR$302,580$0$142,008$0$56,603$0$55,103$0$25,870$0$582,164$0$56,304$0
NORMA CERNA
PHYSICIAN/BOARD DIRECTOR$196,455$0$82,892$0$49,246$0$50,727$0$25,728$0$405,048$0$48,976$0
CHRIS COLE
PHYSICIAN/FORMER OFFICER$605,665$0$249,222$0$102,224$0$74,466$0$3,852$0$1,035,429$0$81,744$0
LUIS DUARTE
PHYSICIAN$2,463,342$0$3,110,474$0$103,793$0$59,240$0$32,770$0$5,769,619$0$84,004$0
JASON FELGER
PHYSICIAN/MEDICAL DIRECTOR$650,606$0$57,172$0$104,247$0$80,439$0$32,958$0$925,422$0$85,067$0
CHRISTOPHER HADDAD
PHYSICIAN$806,835$0$1,008,958$0$97,503$0$65,400$0$24,882$0$2,003,578$0$97,204$0
RUDY HADDAD
PHYSICIAN/CHAIRMAN$776,058$0$809,590$0$116,004$0$88,903$0$24,882$0$1,815,437$0$97,204$0
VICKI FORLAND HALFMANN
PHYSICIAN/BOARD DIRECTOR$219,771$0$100,995$0$61,340$0$50,119$0$25,764$0$457,989$0$41,550$0
ROSS HARPER
PHYSICIAN/BOARD DIRECTOR$616,243$0$249,222$0$85,964$0$74,449$0$28,955$0$1,054,833$0$85,694$0
JOE HARVEY
PHYSICIAN/FORMER OFFICER$281,244$0$79,879$0$64,914$0$50,904$0$31,985$0$508,926$0$45,149$0
DAVID HUCHTON
PHYSICIAN$912,111$0$384,404$0$54,569$0$69,288$0$25,173$0$1,445,545$0$53,879$0
SARAH JACKSON VANCE
PHYSICIAN/CHairman$288,869$0$118,122$0$58,158$0$60,703$0$8,418$0$534,270$0$54,427$0
ANDREW T KINGMAN
PHYSICIAN/MEDICAL DIRECTOR$465,248$0$187,329$0$34,932$0$63,607$0$32,770$0$783,886$0$34,662$0
JAMES MELOTT
PHYSICIAN$213,326$0$118,757$0$42,100$0$50,136$0$25,964$0$450,283$0$41,410$0
JOE MIMS
PHYSICIAN/BOARD DIRECTOR$394,819$0$183,015$0$60,940$0$56,783$0$26,641$0$722,198$0$58,960$0
STEVE RITTER
PHYSICIAN$349,200$0$1,116,924$0$83,360$0$62,551$0$10,338$0$1,622,373$0$63,595$0
DOUG SCHULTZ
PHYSICIAN/MEDICAL DIRECTOR$317,347$0$13,047$0$45,190$0$35,743$0$12,410$0$423,737$0$43,441$0
CALEB VOSBURG
PHYSICIAN/BOARD DIRECTOR$507,303$0$196,644$0$87,215$0$70,959$0$29,470$0$891,591$0$74,315$0
JENNY WIGGINS-SMITH
PHYSICIAN/MEDICAL DIRECTOR$309,838$0$288,734$0$62,716$0$61,263$0$33,060$0$755,611$0$62,417$0
IRVIN ZIETLERMD
FORMER MEDICAL DIRECTOR$0$7,919$31,878$0$119,973$52$31,232$0$0$62$183,083$8,033$119,973
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
LISA HILL
GENERAL COUNSEL$0$293,359$0$0$0$48,249$0$56,934$0$13,202$0$411,744$0$47,639
CHRIS BARNETT MD
CHIEF MEDICAL DIRECTOR$0$490,290$0$100$0$48,906$0$29,833$0$15,986$0$585,115$0$47,616
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 (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 ------------ --------- --------------- ----------- LINDA ADAMS $61,351 $50,080 SC LINDY BANKES $55,119 $20,416 SC PAUL BORGFELD $45,766 $24,720 SC DAVID BOSWELL $56,304 $43,903 SC NORMA CERNA $48,976 $39,527 SC CHRIS COLE $81,744 $63,266 SC LUIS DUARTE $84,004 $48,040 SC JASON FELGER $85,067 $69,239 SC CHRISTOPHER HADDAD $97,204 $54,200 SC RUDY HADDAD $97,204 $77,703 SC VICKI FORLANO HALFMANN $41,550 $38,919 SC ROSS HARPER $85,694 $63,249 SC JOE HARVEY $45,149 $39,704 SC DAVID HUCHTON $53,879 $58,088 SC SARAH JACKSON VANCE $54,427 $49,503 SC ANDREW T. KINGMAN $34,662 $52,407 SC JAMES MELOTT $41,410 $38,963 SC JOE MIMS $58,960 $45,583 SC STEVE RITTER $63,595 $51,351 SC DOUG SHULTZ $43,441 $24,543 SC CALEB VOSBURG $74,315 $59,759 SC JENNY WIGGINS-SMITH $62,417 $50,063 SC KELLY SHANE PLYMELL $72,177 $65,691 SMC IRVIN ZEITLER, MD $119,973 $30,915 SC/SMC LISA HILL $47,639 $45,934 SMC CHRIS BARNETT, MD $47,616 $21,768 SMC staci wetz $48,159 $47,154 smc

Schedule L IRS990ScheduleL

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

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
RUDY HADDAD
CHRIS HADDAD'S BROTHER$1,701,652SHANNON CLINIC EMPLOYEEfalse
CHRIS HADDAD
RUDY HADDAD'S BROTHER$1,913,297SHANNON CLINIC EMPLOYEEfalse
david vance
sarah jackson vance's spouse$524,906SHANNON 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 WILL 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, LINES 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 900, PART XI. LINE 9OTHER CHANGES IN NET ASSETS: TRANSFER TO Shannon Medical Center $(6,438,954) TRANSFER TO SHANNON BUSINESS SERVICES $(61,874) TRANSFER TO SHANNON REAL ESTATE SERVICES $(32,198) TRANSFER FROM SHANNON MEDICAL MANAGEMENT $58,222,366 --------------- TOTAL $51,689,340

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 Managment
M$64,340,519BOOK VALUE
SHANNON BUSINESS SERVICES
R$61,874BOOK VALUE
SHANNON medical center
R$6,438,954book value
SHANNON MEDICAL Management
S$58,222,366BOOK VALUE

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