2013-08-09T15:00:08-05:00 2012-09-30 BKD LLP 2800 Post Oak Blvd Ste 3200 HOUSTON TX 77056 990 2011-10-01 208367966 SHANNON MEDICAL MANAGEMENT % SHANNON MED MGMT ATTN SHAN 3256581511 PO BOX 22000 SAN ANGELO TX 76902 BRYAN HORNER 2013-08-15 true M Paige Gerich 7134994600 2011 2016-02-24 21:20:13Z BRYAN HORNER PO BOX 22000 SAN ANGELO TX 76902 40009208 false X N/A 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 1 863 0 0 0 0 0 36240280 40008101 553 72 1076 1035 36241909 40009208 0 0 0 0 24660148 27588892 0 0 0 9852218 10516744 34512366 38105636 1729543 1903572 728382 1484413 2231534 2286916 -1503152 -802503 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 32439631 40008101 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. 32439631 true false false false false false false false false false true false false false 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 false true 0 0 863 true false false false false false false false false false false X 5 1 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 3256581511 ADMINISTRATION 120 E BEAUREGARD SAN ANGELO TX 76903 X GARY GIBIAN 40.0 X X 342049 81406 JOHN GILBREATH 40.0 X X 221838 45359 LEN MERTZ 1.0 X X 116250 12633 BRYAN HORNER 5.0 X X 568720 47524 KELLY SHANE PLYMELL 5.0 X X 298518 70081 GARY BOWEN 40.0 X 225795 58558 MARK DUNCAN 40.0 X 116766 26533 906448 983488 342094 4 false true false ALLSCRIPTS 8529 SIX FORKS ROAD FORUM IV RALEIGH NC 27615 STATEMENT PROCESSING 410284 PER-SE TECHNOLOGIES PO BOX 403421 ATLANTA GA 30384 OUTSIDE BILLING 444888 STAT TRANSCRIPTION 424 W BAKERVIEW RD SUITE 105-240 BELLINGHAM WA 98225 TRANSCRIPTION SVC 230543 MEDI-COMM SERVICES OF LUBBOCK 2514 82ND STREET SUITE B LUBBOCK TX 79423 COLLECTION SERVICES 295323 4 0 Medical Records Income 900099 62376 62376 Management Fees 900099 39945725 39945725 40008101 72 72 0 0 0 0 0 0 Miscellaneous Revenue 900099 1035 1035 1035 40009208 40009136 72 0 0 0 0 975005 975005 0 20484157 18902226 1581931 1016117 970874 45243 3566771 3329263 237508 1546842 1358988 187854 0 0 18030 18030 0 0 0 2048933 1898562 150371 24116 24116 969339 226408 742931 1487400 44106 1443294 0 4806189 4802468 3721 112568 61658 50910 0 0 0 0 257013 208911 48102 14329 14329 Equipment Costs 352061 231869 120192 0 Collection Fees 307994 307994 Education 32308 23264 9044 Recruiting 26402 21502 4900 60062 27422 32640 38105636 32439631 5666005 0 0 0 0 0 0 0 77876 0 0 0 0 0 0 0 0 0 55758 90246 5472039 4144036 523995 1328003 0 0 0 0 0 0 0 0 70753 66164 728382 1484413 1808708 1860924 0 0 0 0 0 0 0 0 0 0 0 0 0 0 422826 425992 2231534 2286916 X -1503152 -802503 0 0 0 0 -1503152 -802503 728382 1484413 X 1903572 -1202923 X X false true true X false X X X X false false false SHANNON CLINIC 752600873 09 true true true 38105636 1 38105636 5472039 4144036 1328003 1328003 0 PENSION FUND 66163 Health Claim Payable 359829 425992 40009208 38105636 1903572 1903572 39995037 39995037 14171 14171 40009208 38091465 38091465 14171 14171 38105636 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. OTHER CHANGE Part XII & XIII, Line 4B BAD DEBT $ 1,652.00 EXPENSE INCLUDED IN AUDIT REVENUE 12,519.00 ----------- 14,171.00 X X X X false true false false false false false false false GARY GIBIAN 264100 48064 29885 50514 30892 423455 19469 JOHN GILBREATH 169275 30820 21743 36561 8798 267197 12730 BRYAN HORNER 483959 84761 0 30380 17144 616244 KELLY SHANE PLYMELL 255994 42524 49421 20660 368599 GARY BOWEN 171300 31187 23308 40920 17638 284353 12896 NAMES, AMOUNTS, AND DETAILS OF ARRANGEMENTS PART 1, QUESTION 4 SERP 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. CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PART VI, QUESTION 6 SHANNON HEALTH SYSTEM IS THE SOLE MEMBER OF SHANNON MEDICAL MANAGEMENT. MEMBERS OR STOCKHOLDERS WHO CAN ELECT MEMBERS OF THE GOVERNING BODY FORM 990, PART VI, QUESTION 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. PROCESS TO REVIEW THE FORM 990 FORM 990, PART VI, QUESTION 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 BOARD WILL REVIEW AFTER THE FORM IS FILED. PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY FORM 990, PART VI, QUESTION 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. REVIEW OF COMPENSATION FORM 990, PART VI, QUESTION 15A & 15B OFFICERS, DIRECTORS, AND KEY EMPLOYEES OF SHANNON MEDICAL MANAGEMENT ARE EMPLOYED BY SHANNON MEDICAL CENTER OR ITS AFFILIATES, AND AS SUCH HAVE THEIR COMPENSATION REVIEWED ANNUALLY BY THE INDEPENDENT SHANNON MEDICAL CENTER BOARD OF TRUSTEES, WHICH CONSULTS COMPARABILITY DATA AND KEEPS CONTEMPORANEOUS RECORDS OF ITS DECISIONS. EXPLANATION OF COMMITTEE THAT ASSUMES RESPONSIBILITY FORM 990, PART XII, QUESTION 2C SHANNON MEDICAL MANAGEMENT DOES NOT HAVE AN AUDIT COMMITTEE, BUT THERE IS A SHANNON HEALTH SYSTEM AUDIT COMPLIANCE COMMITTEE THAT OVERSEES THE CONSOLIDATED AUDIT THAT INCLUDES SHANNON MEDICAL MANAGEMENT. NUMBER OF 1099'S FORM 990, PART V, QUESTION 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. GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC FORM 990, PART VI, QUESTION 19 COPIES OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS ARE PROVIDED TO THE PUBLIC UPON REQUEST. OTHER CHANGES IN NET ASSETS FORM 990, PART XII, LINE 5 Transfer to/from affiliate (1,202,944) Other Change 21 --------------- (1,202,923) HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:GARY GIBIAN TITLE:EXECUTIVE DIRECTOR HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOHN GILBREATH TITLE:CHIEF FINANCIAL OFFICER HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:LEN MERTZ TITLE:CHAIRMAN HOURS:19 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:BRYAN HORNER TITLE:PRESIDENT HOURS:39 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KELLY SHANE PLYMELL TITLE:SECRETARY HOURS:35 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:GARY BOWEN TITLE:CHIEF OPERATING OFFICER HOURS:5 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 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 CENTER 120 E HARRIS AVE SAN ANGELO TX 76903 752559845 SUPPORT SVCS TX 501(C)(3) 3 NA false REGIONAL CANCER TREATMENT CENTER 102 N MAGDALEN STE 120 San Angelo TX 76902 752225955 RADIOTHERAPY TX NA N/A 0.00000 LEGACY MANAGEMENT SERVICES 2018 PULLIAM ST SAN ANGELO TX 76903 752544450 UTILIZ. REVIEW TX NA C-CORPORATION 0 0 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 true false true false true true true true true