2017-08-15T11:13:15-05:00 2016-09-30 BKD LLP 2800 Post Oak Blvd Ste 3200 HOUSTON TX 77056 990 2015-10-01 752600873 SHANNON CLINIC % SHANNON CLINIC ATTN ADMIN SHAN 3256581511 PO BOX 22000 SAN ANGELO TX 76902 STACI WETZ CFO 3256581511 2016-05-15 true Jana Kirksey P01261744 7134994600 2015 2021-01-29 14:40:06Z SHANE PLYMELL PO BOX 22000 SAN ANGELO TX 76902 149515240 false X SHANNONHEALTH.COM X 1995 TX FOUNDED ON A LEGACY OF CARING, SHANNON IS A LOCALLY OWNED HEALTHCARE SYSTEM DEDICATED TO PROVIDING EXCEPTIONAL HEALTHCARE FOR OUR FAMILY, FRIENDS, AND NEIGHBORS. 17 0 278 10 0 0 0 0 136780927 149515240 751 -571 0 0 136781678 149514669 0 0 0 0 93895508 100903066 0 0 0 80374232 89670336 174269740 190573402 -37488062 -41058733 28276438 33749390 25031778 28607787 3244660 5141603 X OUR 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. false false 181145725 0 149515240 PROVIDE HEALTHCARE SERVICES AS A MULTI-SPECIALTY PHYSICIAN CLINIC AT LOCATIONS THROUGHOUT SAN ANGELO AND NEARBY COMMUNITIES REGARDLESS OF ABILITY TO PAY, INCLUDING CALL COVERAGE FOR SHANNON MEDICAL CENTER, AN AFFILIATED NON-PROFIT HOSPITAL. SHANNON CLINIC IS ORGANIZED AND OPERATED TO PROVIDE ACCESS AND CARE FOR RESIDENTS OF ITS SERVICE AREA, INCLUDING MEDICALLY INDIGENT PATIENTS. RECRUITMENT FOR PROVIDERS INCLUDES NEW PHYSICIANS AND MID-LEVEL PROVIDERS TO EXPAND URGENT CARE AND PRIMARY CARE ACCESS TO COMMUNITIES SERVED, AND SPECIALISTS TO ALLOW SHANNON MEDICAL CENTER TO PROVIDE CARE TO ITS PATIENTS REGARDLESS OF ABILITY TO PAY. 181145725 true false false false false false false false false false true false false true true false false true false false false false false false false false false false false true false false false false false false true false false false false false false true true true false false true 93 0 true 278 true false false false false false false false false false false X 17 0 false true false false true true true true true false false false true true true true true true true false X SHANNON CLINIC ATTN ADMIN 3256581511 120 E BEAUREGARD SAN ANGELO TX 76903 X JOHN HARVEY PHYSICIAN/DIVISION CHAIRMAN 40.0 0.0 X X 351386 0 73805 WILLIAM WHITEHEAD PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 471538 0 79444 ANTHONY DEMORY PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 680247 0 83219 JOE MIMS PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 513070 0 84599 IRVIN ZEITLER MEDICAL DIRECTOR 5.0 35.0 X 0 548544 46793 DOUG SCHULTZ PHYSICIAN/MEDICAL DIRECTOR 40.0 0.0 X 334045 0 53223 NORMA CERNA PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 309019 0 64939 LAURA ADAMS PHYSICIAN/SECRETARY/VICE CHAIR 40.0 0.0 X X 607544 0 84928 SARAH JACKSON-VANCE PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 338296 0 70047 STEVEN BURGESS PHYSICIAN / SECRETARY 40.0 0.0 X X 396414 0 69558 JASON FELGER PHYSICIAN / BOARD DIRECTOR 40.0 0.0 X 665156 0 98544 RUDY HADDAD PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 1101705 0 55432 CALEB VOSBURG PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 765585 0 87846 ROSS HARPER PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 875893 0 55552 PAUL BORGFELD PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 446871 0 79786 DAVID BOSWELL PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 439221 0 72837 BRYAN HORNER PRESIDENT 10.0 30.0 X 0 843123 23393 JOHN GILBREATH CFO 5.0 35.0 X 0 263462 30776 GARY BOWEN COO 5.0 35.0 X 0 92639 34467 FRANK KUNZE SMM CHIEF OPERATING OFFICER 5.0 35.0 X 0 179276 40309 GARY GIBIAN SMM EXECUTIVE DIRECTOR 5.0 35.0 X 0 541495 82754 LISA HILL GENERAL COUNCIL 5.0 35.0 X 0 279295 46922 CHRISTOPHER HADDAD PHYSICIAN 40.0 0.0 X 1178440 0 55432 LUIS DUARTE PHYSICIAN 40.0 0.0 X 4474935 0 103440 DAVID HUCHTON PHYSICIAN 40.0 0.0 X 1369242 0 83275 DAVID CUMMINGS PHYSICIAN 40.0 0.0 X 1096780 0 76499 RAJ CHERUKU PHYSICIAN 40.0 0.0 X 897461 0 23064 JAMES MELOTT PHYSICIAN/FORMER OFFICER 40.0 0.0 X 321827 0 67416 VIKI FORLANO HALFMANN PHYSICIAN/FORMER OFFICER 40.0 0.0 X 327498 0 67959 CHRIS COLE PHYSICIAN / FORMER OFFICER 40.0 0.0 X 828355 0 101353 18790528 2747834 1997611 189 true true false DELTA LOCUM TENENS 1755 WITTINGTON PLACE STE 800 DALLAS TX 75234 LOCUMS SERVICES 1254495 SHANNON MED MGMT 120 E BEAUREGARD SAN ANGELO TX 76903 MANAGEMENT SERVICES 49592437 SHANNON MEDICAL CTR 120 E HARRIS SAN ANGELO TX 76903 LAB AND LAUNDRY SVC 1071798 ARUP LABORATORIES 500 CHIPETA WAY SALT LAKE CITY UT 84108 OUTSIDE LAB SERVICES 874936 ALLIANCE RECRUITING 900 ROCKMEAD DR STE 274 KINGWOOD TX 77339 LOCUM TENENS 582327 16 0 Service Revenue 621990 132534943 132534943 Lease Income 532000 8740 8740 HOSPITAL BASED PHYSICIANS' ASSISTANCE 900099 14381784 14381784 MISCELLANOUS INCOME 900099 2589773 2589773 149515240 0 0 0 0 0 0 571 -571 -571 -571 0 0 0 0 149514669 149515240 -571 0 0 0 0 9409749 9409749 555280 555280 80178409 79306193 872216 5773038 5752863 20175 1909400 1904631 4769 3077190 3070700 6490 53854818 45776595 8078223 0 37994 37994 0 0 0 7674239 7331857 342382 316630 316630 623673 602715 20958 10229 10229 0 21759 21759 488952 488952 0 0 0 0 905239 905239 242533 198063 44470 Bad Debt 13253981 13253981 Medical Supplies 10264843 10264843 Recruiting 675740 675740 Education 594810 594810 704896 704896 190573402 181145725 9427677 0 0 21285 0 0 0 0 13801150 14875982 0 0 0 0 446212 270668 261972 485927 978791 1004094 15762623 12824312 2555257 2938311 0 0 0 0 0 0 0 0 10233056 14153123 28276438 33749390 10434724 10138166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14597054 18469621 25031778 28607787 X 3244660 5141603 0 0 0 0 3244660 5141603 28276438 33749390 X -41058733 42955676 X false true X true false X 0 0 0 0 0 0 114358708 122449477 130516856 136780927 149515240 653621208 0 0 0 114358708 122449477 130516856 136780927 149515240 653621208 0 0 0 653621208 0 0 0 0 0 114358708 122449477 130516856 136780927 149515240 653621208 1.00000 1.00000 0.00000 0.00000 X 15762623 12824312 2938311 2938311 Retirement Fund 14153123 14153123 0 Pension Fund Liability 16520947 Health Claims Payable 291434 Estimated Malpractice Costs 1657240 18469621 81682929 81682929 67831740 67831740 149514669 122741662 122741662 67831740 67831740 190573402 FIN 48 DISCLOSURE 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. PART XI & XII LINE 4B INCOME/EXPENSE RECLASSES FROM AUDIT $54,577,759 BAD DEBT 13,253,981 ----------- $67,831,740 false true false false false false false false false JAMES MELOTT PHYSICIAN/FORMER OFFICER 219679 0 84512 0 17636 0 47164 0 20252 0 389243 0 JOHN HARVEY PHYSICIAN/DIVISION CHAIRMAN 244757 0 71191 0 35438 0 47700 0 26105 0 425191 0 VIKI FORLANO HALFMANN PHYSICIAN/FORMER OFFICER 230440 0 79079 0 17979 0 47164 0 20795 0 395457 0 WILLIAM WHITEHEAD PHYSICIAN/BOARD DIRECTOR 336871 0 104616 0 30051 0 55994 0 23450 0 550982 0 CHRIS COLE PHYSICIAN / FORMER OFFICER 620057 0 188318 0 19980 0 72853 0 28500 0 929708 0 ANTHONY DEMORY PHYSICIAN/BOARD DIRECTOR 583199 0 68509 0 28539 0 56985 0 26234 0 763466 0 JOE MIMS PHYSICIAN/BOARD DIRECTOR 468769 0 42321 0 1980 0 58965 0 25634 0 597669 0 IRVIN ZEITLER MEDICAL DIRECTOR 0 385120 0 139424 0 24000 0 41042 5751 0 595337 BRYAN HORNER PRESIDENT 0 843123 0 0 0 0 23393 0 0 866516 DOUG SCHULTZ PHYSICIAN/MEDICAL DIRECTOR 282027 0 50038 0 1980 0 45220 0 8003 0 387268 0 NORMA CERNA PHYSICIAN/BOARD DIRECTOR 222732 0 47094 0 39193 0 47164 0 17775 0 373958 0 LAURA ADAMS PHYSICIAN/SECRETARY/VICE CHAIR 437179 0 141678 0 28687 0 57428 0 27500 0 692472 0 SARAH JACKSON-VANCE PHYSICIAN/BOARD DIRECTOR 272163 0 65833 0 300 0 58860 0 11187 0 408343 0 STEVEN BURGESS PHYSICIAN / SECRETARY 307327 0 69789 0 19298 0 47164 0 22394 0 465972 0 JASON FELGER PHYSICIAN / BOARD DIRECTOR 560897 0 46738 0 57521 0 71044 0 27500 0 763700 0 RUDY HADDAD PHYSICIAN/BOARD DIRECTOR 805330 0 230632 0 65743 0 32860 0 22572 0 1157137 0 CALEB VOSBURG PHYSICIAN/BOARD DIRECTOR 534458 0 178857 0 52270 0 66396 0 21450 0 853431 0 ROSS HARPER PHYSICIAN/BOARD DIRECTOR 631532 0 188318 0 56043 0 32860 0 22692 0 931445 0 PAUL BORGFELD PHYSICIAN/BOARD DIRECTOR 386640 0 43310 0 16921 0 52124 0 27662 0 526657 0 DAVID BOSWELL PHYSICIAN/BOARD DIRECTOR 283230 0 131512 0 24479 0 53260 0 19577 0 512058 0 CHRISTOPHER HADDAD PHYSICIAN 735152 0 301478 0 141810 0 32860 0 22572 0 1233872 0 LUIS DUARTE PHYSICIAN 2473345 0 1928853 0 72737 0 75940 0 27500 0 4578375 0 DAVID HUCHTON PHYSICIAN 812524 0 525921 0 30797 0 64148 0 19127 0 1452517 0 DAVID CUMMINGS PHYSICIAN 676310 0 331287 0 89183 0 63900 0 12599 0 1173279 0 RAJ CHERUKU PHYSICIAN 361860 0 516911 0 18690 0 10600 0 12464 0 920525 0 JOHN GILBREATH CFO 0 175048 0 33418 0 54996 0 22410 0 8366 0 294238 FRANK KUNZE SMM CHIEF OPERATING OFFICER 0 132733 0 0 0 46543 0 23708 0 16601 0 219585 GARY GIBIAN SMM EXECUTIVE DIRECTOR 0 317089 0 159482 0 64924 0 57682 0 25072 0 624249 LISA HILL GENERAL COUNCIL 0 248594 0 30701 0 0 28375 18547 0 326217 SCHEDULE J, PART I, LINE 4C SERP DETAIL NAME AMOUNT SHANE PLYMELL NONE NONQUALIFIED PLAN PARTICIPANTS NAME AMOUNT ANTHONY DEMORY $ 27,849 CALEB VOSBURG $ 39,370 DAVID BOSWELL $ 24,209 JAMES MELOTT $ 16,946 JASON FELGER $ 39,071 JOHN HARVEY $ 16,748 LAURA ADAMS $ 28,237 NORMA CERNA $ 18,991 PAUL BORGFELD $ 15,631 ROSS HARPER $ 55,803 STEVEN BURGESS $ 18,848 VIKI FORLANO HALFMANN $ 17,289 WILLIAM WHITEHEAD $ 29,751 CHRISTOPHER HADDAD $ 76,067 DAVID CUMMINGS $ 70,883 DAVID HUCHTON $ 30,347 LUIS DUARTE $ 54,047 RUDY HADDAD $ 76,067 PARTICIPANTS IN THE 457F RETIREMENT ALLOWANCE PLAN ARE PHYSICIANS WHO ARE UNDER AGE 55 AND THEIR EXPECTED COMPENSATION IS HIGHER THAN 125,000 OR EXECUTIVES WHO ARE UNDER AGE 62 AND THEIR EXPECTED COMPENSATION IS HIGHER THAN $125,000. EACH QUARTER, THEY RECEIVE 8% OF THEIR BASE SALARY FOR THE PRECEDING YEAR INTO A MUTUAL FUND ACCOUNT. ALL MUTUAL FUND ACCOUNTS HAVE A DEFERRED VESTING DATE OF JUNE 30TH OF THE SECOND CALENDAR YEAR FOLLOWING THE PLAN YEAR FOR WHICH THE MUTUAL FUND ACCOUNT WAS CREATED. IN GENERAL, THE EARLIEST DISTRIBUTION DATE IS AFTER JUNE 30TH OF THE SECOND CALENDAR YEAR FOLLOWING THE PLAN YEAR FOR WHICH THE MUTUAL FUND ACCOUNT WAS CREATED. SCHEDULE J, PART I, LINE 3 METHODS USED TO ESTABLISH COMPENSATION SHANNON CLINIC'S (SC) EXECUTIVE DIRECTOR IS 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 EXECUTIVE DIRECTOR. BRANDI WHITEHEAD W. WHITEHEAD'S SPOUSE 62596 SHANNON CLINIC EMPLOYEE false DAVID VANCE S. JACKSON-VANCE'S SPOUSE 449508 SHANNON CLINIC EMPLOYEE false SUSAN SCHULTZ D. SCHULTZ'S SPOUSE 43176 SHANNON CLINIC EMPLOYEE false FORM 990, PART VI, SECTION A, LINE 3 ADMINISTRATIVE SERVICES FOR SHANNON CLINIC ARE CONTRACTED WITH SHANNON MEDICAL MANAGEMENT. FORM 990, PART VI, SECTION A, LINE 6 SHANNON HEALTH SYSTEM, A 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF SHANNON CLINIC. 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 A, LINE 7B 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 11B 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 AFTER THE FORM IS FILED. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS, AND KEY EMPLOYEES OF SHANNON CLINIC ARE EMPLOYED BY SHANNON MEDICAL CENTER OR ITS AFFILIATES, AND AS SUCH ARE REQUIRED TO DISCLOSE CONFLICTS OF INTEREST AS THEY ARISE, AND ARE REQUIRED TO FILE ANNUAL STATEMENTS AFFIRMING EITHER THE CONFLICTS OF INTEREST THAT THEY MAY HAVE, OR THAT THEY HAVE NO CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A OFFICERS, 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 B, LINE 15B OFFICERS, 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 19 COPIES OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS ARE PROVIDED TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES TRANSFER TO/FROM AFFILIATES 42,955,676 TRUSTEES SHANNON WEST TEXAS HOSPITAL PO BOX 49 SAN ANGELO TX 76902 750800679 TRUST TX 501(C)(3) 11B NA false SHANNON REAL ESTATE SERVICES INC 120 E HARRIS AVE SAN ANGELO TX 76903 270075630 SUPPORT SVCS TX 501(C)(3) 11B SMC false SHANNON RURAL HEALTH CLINICS INC 120 E HARRIS AVE SAN ANGELO TX 76903 752940211 HEALTHCARE TX 501(C)(3) 11C SMC false SHANNON HEALTH SYSTEM 120 E HARRIS AVE SAN ANGELO TX 76903 752602411 HEALTHCARE TX 501(C)(3) 11A NA false SHANNON MEDICAL CENTER 120 E HARRIS AVE SAN ANGELO TX 76903 752559845 HEALTHCARE TX 501(C)(3) 3 NA false SHANNON BUSINESS SERVICES INC 120 E HARRIS AVE SAN ANGELO TX 76903 432038769 SUPPORT SVCS TX 501(C)(3) 11B SMC false SHANNON MEDICAL MANAGEMENT 120 E BEAUREGARD SAN ANGELO TX 76903 208367966 SUPPORT SVCS TX 501(C)(3) 9 SHS true REGIONAL CANCER TREATMENT CENTER 102 N MAGDALEN 120 San Angelo TX 76902 752225955 RADIOTHERAPY TX NA LEGACY MANAGEMENT SERVICES 2018 PULLIAM ST SAN ANGELO TX 76903 752544450 MANAGEMENT TX NA C-CORPORATION false LEGACY HEALTH SOLUTIONS 2018 PULLIAM ST SAN ANGELO TX 76903 200720762 MED INSURANCE TX NA C-CORPORATION false false false false false false false false false false false false false true true true true true true true SHANNON MEDICAL MANAGEMENT 1M 53854818 BOOK VALUE