2016-08-13T11:03:45-05:00 2015-09-30 BKD LLP 2800 Post Oak Blvd Ste 3200 HOUSTON TX 77056 990 2014-10-01 208367966 SHANNON MEDICAL MANAGEMENT % SHANNON MED MGMT ATTN ADMIN SHAN 3256581511 PO BOX 22000 SAN ANGELO TX 76902 STACI WETZ CFO 7134994600 2016-08-15 true Jana Kirksey P01261744 7134994600 2014 2016-09-27 15:27:22Z BRYAN HORNER PO BOX 22000 SAN ANGELO TX 76902 48596555 false X WWW.SHANNONHEALTH.COM X 2007 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. 5 0 974 0 0 0 0 0 44310559 48478019 0 117958 2399 578 44312958 48596555 0 0 0 0 30674894 33636358 0 0 0 11866901 12592445 42541795 46228803 1771163 2367752 2285418 2298434 2453968 2765950 -168550 -467516 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. false false 38111418 48478597 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. 38111418 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 false false false false false false false true false false false true X 0 0 974 true false false false false false false false false false false X 5 0 false false false false true true false true true false false false true true true true true true true false X SHANNON MED MGMT ATTN ADMIN 3256581511 120 E BEAUREGARD SAN ANGELO TX 76903 GARY GIBIAN EXECUTIVE DIRECTOR 40.0 0.0 X X 414004 0 80755 JOHN GILBREATH CHIEF FINANCIAL OFFICER 40.0 0.0 X X 248329 0 52357 LEN MERTZ CHAIRMAN 1.0 2.0 X X 0 0 0 BRYAN HORNER PRESIDENT 8.0 32.0 X X 0 692737 14336 SHANE PLYMELL SECRETARY 8.0 32.0 X X 0 470258 48508 FRANK KUNZE CHIEF OPERATING OFFICER 40.0 0.0 X X 0 0 0 GARY BOWEN CHIEF OPERATING OFFICER 40.0 0.0 X 240706 0 59145 MARK DUNCAN SPORTS MEDICINE DIRECTOR 40.0 0.0 X 123858 0 16303 WEST HERBERT LEAD EKG/TREAD TECH 40.0 0.0 X 104864 0 21375 SHERYL MOON DIRECTOR OF BUSINESS OFFICE 40.0 0.0 X 100879 0 10032 1232640 1162995 302811 6 false true false ALLSCRIPTS 8529 SIX FORKS ROAD FORUM IV RALEIGH NC 27615 STATEMENT PROCESSING 528428 PER-SE TECHNOLOGIES PO BOX 742526 ATLANTA GA 30374 OUTSIDE BILLING 135853 NUANCE COMMUNICATIONS ONE WAYSIDE ROAD BURLINGTON MA 01803 DICTATION SERVICES 620276 MEDI-COMM SERVICES OF LUBBOCK 2514 82ND STREET SUITE B LUBBOCK TX 79423 COLLECTION SERVICES 334802 WHITE PLUME TECHNOLOGIES LLC TWO METROPLEX DR SUITE 310 BIRMINGHAM AL 35209 SOFTWARE SUPPORT 138389 7 0 Medical Records Income 900099 66487 66487 Lease Income 532000 5907 5907 Management Fees 900099 48405625 48405625 48478019 38 38 0 0 0 0 0 117920 117920 117920 117920 0 0 0 Miscellaneous Revenue 900099 578 578 578 48596555 48478597 117958 0 0 0 0 1095296 1095296 0 0 25980355 23607775 2372580 621117 602596 18521 4052195 3589019 463176 1887395 1701662 185733 0 0 15604 15604 0 0 0 2091662 1865246 226416 26020 26020 1047265 228411 818854 2251927 100011 2151916 0 5439546 5435482 4064 116709 72135 44574 0 0 0 0 477799 347820 129979 17975 17975 Equipment Costs 212602 96486 116116 Collection Fees 324569 324569 DUES/MEMBERSHIP/LICENSE 210301 7643 202658 Recruiting 142972 68979 73993 217494 37564 179930 46228803 38111418 8117385 0 0 0 0 0 0 0 297316 0 0 0 0 0 0 0 0 0 199847 215705 7053341 5093643 1707796 1959698 0 0 0 0 0 0 0 0 80459 123031 2285418 2298434 1987362 2295661 0 0 0 0 0 0 0 0 0 0 0 0 0 0 466606 470289 2453968 2765950 X -168550 -467516 0 0 0 0 -168550 -467516 2285418 2298434 X 2367752 -2666718 X X false true X true false X X X 1 SHANNON CLINIC 752600873 4 false 46228803 0 SHANNON MEDICAL CENTER 752559845 3 true 0 0 2 46228803 0 false false false false false false false false false false false false false false false false false 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 it's 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. 7053341 5093643 1959698 1959698 Pension Fund 123031 123031 0 Pension Plan Liability 154445 Health Claim Payable 315844 470289 48592635 48592635 3920 3920 48596555 46224883 46224883 3920 3920 46228803 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 Other Change Bad Debt $3920 X X X X false true false false false false false false false GARY GIBIAN EXECUTIVE DIRECTOR 307780 0 70833 0 35391 0 56339 0 24416 0 494759 0 27311 0 JOHN GILBREATH CHIEF FINANCIAL OFFICER 186790 0 42642 0 18897 0 44196 0 8161 0 300686 0 18106 0 GARY BOWEN CHIEF OPERATING OFFICER 189906 0 43353 0 7447 0 44194 0 14951 0 299851 0 0 0 BRYAN HORNER PRESIDENT 0 550607 0 125130 0 17000 0 10400 0 3936 0 707073 0 0 SHANE PLYMELL SECRETARY 0 456653 0 7551 0 6054 0 42961 0 5547 0 518766 0 0 SCHEDULE J, PART I, LINE 4B Part 1, Question 4 SERP Detail Name Amount Bryan Horner NONE Nonqualified Plan Participants Name Amount Bryan Horner NONE Gary Gibian 27,311 John Gilbreath 18,107 Frank Kunze NONE Shane Plymell 32,561 FOR EXECUTIVES - PARTICIPANTS IN THE 457F RETIREMENT ALLOWANCE PLAN ARE KEY EMPLOYEES WHOSE COMPENSATION IS HIGHER THAN 125,000 AND THEY QUALIFY AS A MEMBER OF A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES. EACH QUARTER, 8% OF THEIR BASE SALARY FOR THE PRECEEDING YEAR IS CONTRIBUTED INTO A MUTUAL FUND ACCOUNT. ALL MUTUAL FUND ACCOUNTS HAVE A DEFERRED VESTING DATE OF TWO YEARS OR 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. 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. THE BOARD WILL REVIEW AFTER THE FORM IS FILED. 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 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 B, LINE 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 XI, Line 9 Transfer to/from affiliate (2,666,718) Form 990, Part XII, Line 2C Shannon Medical Management does not have an audit committee, but there is a Shannon Health System audit compliance committe 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. TRUSTEES SHANNON WEST TEXAS HOSPITAL PO BOX 49 SAN ANGELO TX 76902 750800679 TRUST TX 501(C)(3) 11B NA false SHANNON RURAL HEALTH CLINICS INC 120 E HARRIS AVE SAN ANGELO TX 76903 752940211 HEALTHCARE TX 501(C)(3) 11C SMC 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 HEALTH SYSTEM 120 E HARRIS AVE SAN ANGELO TX 76903 752602411 SUPPORT SVCS TX 501(C)(3) 11A NA false SHANNON CLINIC 120 E BEAUREGARD SAN ANGELO TX 76903 752600873 HEALTHCARE TX 501(C)(3) 9 SHS true SHANNON BUSINESS SERVICES INC 120 E HARRIS AVE SAN ANGELO TX 76903 432038769 SUPPORT SVCS TX 501(C)(3) 11B SMC false SHANNON MEDICAL CENTER 120 E HARRIS AVE SAN ANGELO TX 76903 752559845 SUPPORT SVCS TX 501(C)(3) 3 NA false SHANNON MEDICAL CENTER PIONEER FDN 120 E HARRIS AVE SAN ANGELO TX 76903 352229303 SUPPORT TX 501(C)(3) 11A SMC false REGIONAL CANCER TREATMENT CENTER 102 N MAGDALEN STE 120 San Angelo TX 76903 752225955 RADIOTHERAPY TX NA LEGACY MANAGEMENT SERVICES 2018 PULLIAM ST SAN ANGELO TX 76903 752544450 UTILIZ. REVIEW TX NA C-CORPORATION 0 0 false LEGACY HEALTH SOLUTIONS 2018 PULLIAM ST SAN ANGELO TX 76903 200720762 MEDICAL INSURANCE TX NA C-CORPORATION 0 0 false false false false false false false false false false false true true true true true true true true true SHANNON CLINIC 1L 48405625 BOOK VALUE