FURP.ORG / PUBLIC DATA EXPLORER

SHANNON MEDICAL MANAGEMENT: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
SHANNON MEDICAL MANAGEMENT (EIN 20-8367966)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-08-09
IRS object ID
201302219349301500
Schema version
2011v1.5
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)
Timestamp2013-08-09T15:00:08-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12800 Post Oak Blvd Ste 3200AddressLine1
CityHOUSTONCity
StateTXState
ZIP Code77056ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN208367966EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SHANNON MEDICAL MANAGEMENTBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% SHANNON MED MGMT ATTNInCareOfName
Name ControlSHANNameControl
Phone3256581511Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 22000AddressLine1
CitySAN ANGELOCity
StateTXState
ZIP Code76902ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameBRYAN HORNERName
TitlePRESIDENTTitle
Date Signed2013-08-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameM Paige GerichName
Phone7134994600Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonBRYAN HORNERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 22000AddressLine1
CitySAN ANGELOCity
StateTXState
ZIP Code76902ZIPCode
FieldValueIRS element (for citing)
Gross Receipts40009208GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2007YearFormation
State Legal DomicileTXStateLegalDomicile
Activity Or Mission DescriptionFOUNDED ON A LEGACY OF CARING, SHANNON IS A LOCALLY OWNED HEALTHCARE SYSTEM DEDICATED TO PROVIDING EXCEPTIONAL HEALTHCARE FOR OUR FAMILY, FRIENDS AND NEIGHBORS.ActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members1NbrIndependentVotingMembers
Total Nbr Employees863TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year36240280ProgramServiceRevenuePriorYear
Program Service Revenue CY40008101ProgramServiceRevenueCY
Investment Income Prior Year553InvestmentIncomePriorYear
Investment Income Current Year72InvestmentIncomeCurrentYear
Other Revenue Prior Year1076OtherRevenuePriorYear
Other Revenue Current Year1035OtherRevenueCurrentYear
Total Revenue Prior Year36241909TotalRevenuePriorYear
Total Revenue Current Year40009208TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year24660148SalariesEtcPriorYear
Salaries Etc Current Year27588892SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year9852218OtherExpensePriorYear
Other Expenses Current Year10516744OtherExpensesCurrentYear
Total Expenses Prior Year34512366TotalExpensesPriorYear
Total Expenses Current Year38105636TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1729543RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1903572RevenuesLessExpensesCY
Total Assets BOY728382TotalAssetsBOY
Total Assets EOY1484413TotalAssetsEOY
Total Liabilities BOY2231534TotalLiabilitiesBOY
Total Liabilities EOY2286916TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-1503152NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-802503NetAssetsOrFundBalancesEOY
Mission DescriptionTO 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.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense32439631Expense
Revenue40008101Revenue
DescriptionPROVIDE 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.Description
Total Program Service Expense32439631TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees863NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members1NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSHANNON MED MGMT ATTNNamePerson
Telephone Number3256581511TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ADMINISTRATION 120 E BEAUREGARDAddressLine1
CitySAN ANGELOCity
StateTXState
ZIP Code76903ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationOther CompensationOtherCompensationReportable Comp From Related OrgsReportableCompFromRelatedOrgsHighest Compensated EmployeeHighestCompensatedEmployee
GARY GIBIAN
EXECUTIVE DIRECTOR40.0XX34204981406
JOHN GILBREATH
CHIEF FINANCIAL OFFICER40.0XX22183845359
LEN MERTZ
CHAIRMAN1.0XX12633116250
BRYAN HORNER
PRESIDENT5.0XX47524568720
KELLY SHANE PLYMELL
SECRETARY5.0XX70081298518
GARY BOWEN
CHIEF OPERATING OFFICER40.0X22579558558
MARK DUNCAN
SPORTS MED DIRECTOR40.011676626533X
FieldValueIRS element (for citing)
Total Reportable Comp From Org906448TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs983488TotalReportableCompFrmRltdOrgs
Total Other Compensation342094TotalOtherCompensation
Number Individuals GT100 K4NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ALLSCRIPTS
8529 SIX FORKS ROAD FORUM IVRALEIGHNC27615STATEMENT PROCESSING410284
PER-SE TECHNOLOGIES
PO BOX 403421ATLANTAGA30384OUTSIDE BILLING444888
STAT TRANSCRIPTION
424 W BAKERVIEW RD SUITE 105-240BELLINGHAMWA98225TRANSCRIPTION SVC230543
MEDI-COMM SERVICES OF LUBBOCK
2514 82ND STREET SUITE BLUBBOCKTX79423COLLECTION SERVICES295323
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Medical Records Income9000996237662376
Management Fees9000993994572539945725
FieldValueIRS element (for citing)
Total Program Service Revenue40008101TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column72TotalRevenueColumn
Exclusion$72ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMiscellaneous RevenueDescription
Business Code900099BusinessCode
Total Revenue Column1035TotalRevenueColumn
Related Or Exempt Function Income1035RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue1035TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column40009208TotalRevenueColumn
Related Or Exempt Function Income40009136RelatedOrExemptFunctionIncome
Exclusion$72ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total975005Total
Management And General975005ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total20484157Total
Program Services18902226ProgramServices
Management And General1581931ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1016117Total
Program Services970874ProgramServices
Management And General45243ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3566771Total
Program Services3329263ProgramServices
Management And General237508ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1546842Total
Program Services1358988ProgramServices
Management And General187854ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total18030Total
Management And General18030ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2048933Total
Program Services1898562ProgramServices
Management And General150371ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total24116Total
Program Services24116ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total969339Total
Program Services226408ProgramServices
Management And General742931ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1487400Total
Program Services44106ProgramServices
Management And General1443294ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4806189Total
Program Services4802468ProgramServices
Management And General3721ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total112568Total
Program Services61658ProgramServices
Management And General50910ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total257013Total
Program Services208911ProgramServices
Management And General48102ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total14329Total
Management And General14329ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Equipment Costs3520612318691201920
Collection Fees307994307994
Education32308232649044
Recruiting26402215024900

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total60062Total
Program Services27422ProgramServices
Management And General32640ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total38105636Total
Program Services32439631ProgramServices
Management And General5666005ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY77876BOY
EOY0EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY55758BOY
EOY90246EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis5472039LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec4144036LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY523995BOY
EOY1328003EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY70753BOY
EOY66164EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY728382BOY
EOY1484413EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1808708BOY
EOY1860924EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY422826BOY
EOY425992EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2231534BOY
EOY2286916EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-1503152BOY
EOY-802503EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-1503152BOY
EOY-802503EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY728382BOY
EOY1484413EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1903572ReconcilationRevenueExpenses
Reconcilation Other Changes-1202923ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type2XSupportingOrg509a3Type2
Certification CheckboxXCertificationCheckbox
Written IRS DeterminationXWrittenIRSDetermination
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1SHANNON CLINICBusinessNameLine1
FieldValueIRS element (for citing)
EIN752600873EIN
Type Of Organization09TypeOfOrganization
Listed In Governing DoctrueListedInGoverningDoc
Supported Organization NotifiedtrueSupportedOrganizationNotified
Organized In UStrueOrganizedInUS
Amount$38,105,636Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts38105636SumOfAmounts

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis5472039OtherCostOrOtherBasis
Depreciation4144036Depreciation
Book Value1328003BookValue
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildings
Total Of Book Value Land Buildings1328003TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
PENSION FUND$66,163
Health Claim Payable$359,829
FieldValueIRS element (for citing)
Total Of Amounts425992TotalOfAmounts
Total Revenue40009208TotalRevenue
Total Expenses38105636TotalExpenses
Excess Or Deficit For Year1903572ExcessOrDeficitForYear
Excess Or Deficit Per FS1903572ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt39995037TotRevenueEtcAuditedFinclStmt
Revenue Subtotal39995037RevenueSubtotal
Other Revenues Not Included14171OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt14171RevenueNotRptdOnFinStmt
Total Revenue Per Form99040009208TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt38091465TotExpensesEtcAuditedFinclStmt
Expenses Subtotal38091465ExpensesSubtotal
Other Expenses Not Included14171OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt14171ExpensesNotRptdOnFinStmt
Total Expenses Per Form99038105636TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FIN 48 DISCLOSUREMANAGEMENT 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.
OTHER CHANGEBAD DEBT $ 1,652.00 EXPENSE INCLUDED IN AUDIT REVENUE 12,519.00 ----------- 14,171.00Part XII & XIII, Line 4B

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgs
GARY GIBIAN
2641004806429885505143089242345519469
JOHN GILBREATH
169275308202174336561879826719712730
BRYAN HORNER
4839598476103038017144616244
KELLY SHANE PLYMELL
255994425244942120660368599
GARY BOWEN
1713003118723308409201763828435312896

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierNAMES, AMOUNTS, AND DETAILS OF ARRANGEMENTSIdentifier
Return ReferencePART 1, QUESTION 4ReturnReference
ExplanationSERP DETAIL NAME AMOUNT BRYAN HORNER NONE NONQUALIFIED PLAN PARTICIPANTS NAME AMOUNT BRYAN HORNER NONE GARY GIBIAN $21,905 JOHN GILBREATH $16,132 GARY BOWEN $14,695 SHANE PLYMELL $19,041 FOR EXECUTIVES & OFFICERS - PARTICIPANTS IN THE 457F RETIREMENT ALLOWANCE PLAN ARE EMPLOYEES WHO ARE UNDER AGE 62 & THEIR EXPECTED COMPENSATION IS HIGHER THAN 125,000. EACH QUARTER, THEY RECEIVE 8% OF THEIR BASE SALARY FOR THE PRECEEDING 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.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (15 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
CLASSES OF MEMBERS OR STOCKHOLDERSFORM 990, PART VI, QUESTION 6SHANNON HEALTH SYSTEM IS THE SOLE MEMBER OF SHANNON MEDICAL MANAGEMENT.
MEMBERS OR STOCKHOLDERS WHO CAN ELECT MEMBERS OF THE GOVERNING BODYFORM 990, PART VI, QUESTION 7ATHE 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.
PROCESS TO REVIEW THE FORM 990FORM 990, PART VI, QUESTION 11BTHE 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 BOARD WILL REVIEW AFTER THE FORM IS FILED.
PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICYFORM 990, PART VI, QUESTION 12COFFICERS, 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.
REVIEW OF COMPENSATIONFORM 990, PART VI, QUESTION 15A & 15BOFFICERS, 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.
EXPLANATION OF COMMITTEE THAT ASSUMES RESPONSIBILITYFORM 990, PART XII, QUESTION 2CSHANNON 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.
NUMBER OF 1099'SFORM 990, PART V, QUESTION 1ACHECKS 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.
GOVERNING DOCUMENTS AVAILABLE TO THE PUBLICFORM 990, PART VI, QUESTION 19COPIES OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS ARE PROVIDED TO THE PUBLIC UPON REQUEST.
OTHER CHANGES IN NET ASSETSFORM 990, PART XII, LINE 5Transfer to/from affiliate (1,202,944) Other Change 21 --------------- (1,202,923)
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:GARY GIBIAN TITLE:EXECUTIVE DIRECTOR HOURS:5
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:JOHN GILBREATH TITLE:CHIEF FINANCIAL OFFICER HOURS:5
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:LEN MERTZ TITLE:CHAIRMAN HOURS:19
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:BRYAN HORNER TITLE:PRESIDENT HOURS:39
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:KELLY SHANE PLYMELL TITLE:SECRETARY HOURS:35
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:GARY BOWEN TITLE:CHIEF OPERATING OFFICER HOURS:5

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
TRUSTEES SHANNON WEST TEXAS HOSPITAL
PO BOX 49SAN ANGELOTX76902750800679TRUSTTX501(C)(3)11BNAfalse
SHANNON RURAL HEALTH CLINICS INC
120 E HARRIS AVESAN ANGELOTX76903752940211HEALTHCARETX501(C)(3)11CSMCfalse
SHANNON REAL ESTATE SERVICES INC
120 E HARRIS AVESAN ANGELOTX76903270075630SUPPORT SVCSTX501(C)(3)11BSMCfalse
SHANNON HEALTH SYSTEM
120 E HARRIS AVESAN ANGELOTX76903752602411SUPPORT SVCSTX501(C)(3)11ANAfalse
SHANNON CLINIC
120 E BEAUREGARDSAN ANGELOTX76903752600873HEALTHCARETX501(C)(3)9SHSfalse
SHANNON BUSINESS SERVICES INC
120 E HARRIS AVESAN ANGELOTX76903432038769SUPPORT SVCSTX501(C)(3)11BSMCfalse
SHANNON MEDICAL CENTER
120 E HARRIS AVESAN ANGELOTX76903752559845SUPPORT SVCSTX501(C)(3)3NAfalse

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1REGIONAL CANCER TREATMENT CENTERBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1102 N MAGDALEN STE 120AddressLine1
CitySan AngeloCity
StateTXState
ZIP Code76902ZIPCode
FieldValueIRS element (for citing)
EIN752225955EIN
Primary ActivityRADIOTHERAPYPrimaryActivity
Legal Domicile StateTXLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeN/APredominantIncomeType
Percentage Ownership0.00000PercentageOwnership

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssets
LEGACY MANAGEMENT SERVICES
2018 PULLIAM STSAN ANGELOTX76903752544450UTILIZ. REVIEWTXNAC-CORPORATION00
LEGACY HEALTH SOLUTIONS
2018 PULLIAM STSAN ANGELOTX76903200720762MEDICAL INSURANCETXNAC-CORPORATION00
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg