SHANNON CLINIC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
SHANNON CLINIC (EIN 75-2600873)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-08-09
IRS object ID
201322219349301177
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)
Timestamp2013-08-09T15:00:07-05:00Timestamp
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)
EIN752600873EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SHANNON CLINICBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% SHANNON CLINIC 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 Receipts114358708GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1995YearFormation
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 Body19NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees223TotalNbrEmployees
Total Nbr Volunteers10TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year101441273ProgramServiceRevenuePriorYear
Program Service Revenue CY114358708ProgramServiceRevenueCY
Investment Income Prior Year0InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year101441273TotalRevenuePriorYear
Total Revenue Current Year114358708TotalRevenueCurrentYear
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 Year74866569SalariesEtcPriorYear
Salaries Etc Current Year81073405SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year56498751OtherExpensePriorYear
Other Expenses Current Year63728440OtherExpensesCurrentYear
Total Expenses Prior Year131365320TotalExpensesPriorYear
Total Expenses Current Year144801845TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-29924047RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-30443137RevenuesLessExpensesCY
Total Assets BOY26891851TotalAssetsBOY
Total Assets EOY30700792TotalAssetsEOY
Total Liabilities BOY21898425TotalLiabilitiesBOY
Total Liabilities EOY24998350TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY4993426NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY5702442NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionOUR MISSION IS TO BE THE PREMIERE 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.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense138046506Expense
Revenue114358708Revenue
DescriptionPROVIDE 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 CENTER TO PROVIDE CARE TO ITS PATIENTS REGARDLESS OF ABILITY TO PAY.Description
Total Program Service Expense138046506TotalProgramServiceExpense
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 AssetstrueReportOtherAssets
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 MembertrueBsnssRltnshpThruFamilyMember
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 With1096105NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees223NumberOfEmployees
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 Members19NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
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 CLINIC 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 (34 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationOther CompensationOtherCompensationReportable Comp From Related OrgsReportableCompFromRelatedOrgsKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
JOHN HARVEY
PHYSICIAN/DIVISION VICE CHAIR40.0XX31250867844
VIKI FORLANO HALFMANN
PHYSICIAN/DIVISION VICE CHAIR40.0XX29757866694
HARVEY RUSSWURM
PHYSICIAN/BOARD DIRECTOR40.0X28645651357
CORNELIUS CHINN
PHYSICIAN/BOARD DIRECTOR40.0X35722564273
MICHAEL WAGNON
PHYSICIAN/BOARD DIRECTOR40.0X34484952801
WILLIAM WHITEHEAD
PHYSICIAN/BOARD DIRECTOR40.0X44857277220
CHRIS COLE
PHYSICIAN/DIVISION CHAIRMAN40.0XX104337557608
JOLIE BAILEY
PHYSICIAN/DIVISION SECRETARY40.0XX38463875674
ANTHONY DEMORY
PHYSICIAN/DIVISION VICE CHAIR40.0XX86334681393
LAURA ADAMS
PHYSICIAN/BOARD DIRECTOR40.0X57033475911
JOE MIMS
PHYSICIAN/BOARD DIRECTOR40.0X54960357695
SCOTT GIPSON
PHYSICIAN/BOARD DIRECTOR40.0X39441971678
CHARLES MARSH
PHYSICIAN/BOARD DIRECTOR40.0X59822749745
LUIS DUARTE
PHYSICIAN/BOARD DIRECTOR40.0X2656397104149
IRVIN ZEITLER
MEDICAL DIRECTOR5.0X61727444238
ROSS CARMICHAEL
PHYSICIAN/DIVISION SECRETARY40.0XX25735523406
D'LAINE WESTMORELAND
PHYSICIAN/BOARD DIRECTOR20.0X14915232417
JOSEPH ZUBAK
PHYSICIAN/BOARD DIRECTOR40.0X50059584435
MARK MURPHY
PHYSICIAN/BOARD DIRECTOR40.0X28131041877
BRYAN HORNER
PRESIDENT5.0X47524568720
TIMOTHY HARTIN
SECRETARY/GENERAL COUNCIL5.0X60164278111
DOUG SCHULTZ
PHYSICIAN/MEDICAL DIRECTOR40.040164939975X
GARY GIBIAN
SMM EXECUTIVE DIRECTOR5.081406342049X
TIMOTHY HOPKINS
PHYSICIAN40.0144622488509X
KENNETH BREEDLOVE
PHYSICIAN40.099543686686X
MICHAEL SICKELS
PHYSICIAN40.099125490023X
VICTOR SCHULZE III
PHYSICIAN40.0102316656137X
DAVID HUCHTON
PHYSICIAN40.0103328686294X
JAMES MELOTT
PHYSICIAN/FORMER DIV CHAIR40.028905165442X
JAMES BARNETT
PHYS/FORMER BOARD VICE CHAIR40.041842072358X
STEPHEN CAINELLI
PHYSICIAN/FORMER SECRETARY40.045645450366X
CHARLES JONES
PHYSICIAN/FORMER OFFICER40.024180945088X
JOHN GILBREATH
CFO5.045359221838X
GARY BOWEN
COO5.058558225795X
FieldValueIRS element (for citing)
Total Reportable Comp From Org17592688TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2080751TotalReportableCompFrmRltdOrgs
Total Other Compensation2171793TotalOtherCompensation
Number Individuals GT100 K164NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
DELTA LOCUM TENENS
1755 WITTINGTON PLACE STE 800DALLASTX75234LOCUMS SERVICES813761
SHANNON MED MGMT
120 E BEAUREGARDSAN ANGELOTX76903MANAGEMENT SERVICES41045847
MAYO COLLABORATIVE SERVICES
PO BOX 9146MINNEAPOLISMN554809146OUTSIDE LAB SERVICES739232
CARDIOTHORACIC VASCULAR SURGEONS
1010 W 40TH STAUSTINTX78756PHYS CONTRACT SERV'S285000
SHANNON MEDICAL CTR
120 E HARRISSAN ANGELOTX76903LAB & LAUNDRY SVC699297
FieldValueIRS element (for citing)
Number Of Contractors GT100 K15NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Service Revenue621990104978340104978340
Lease Income53200039543954
HOSPITAL BASED PHYSICIANS' ASSISTANCE90009973600007360000
MISCELLANEOUS INCOME90009920164142016414
FieldValueIRS element (for citing)
Total Program Service Revenue114358708TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

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
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column114358708TotalRevenueColumn
Related Or Exempt Function Income114358708RelatedOrExemptFunctionIncome

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)
Total11873741Total
Program Services11873741ProgramServices

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total996552Total
Program Services996552ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total56908217Total
Program Services56369956ProgramServices
Management And General538261ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total7357482Total
Program Services7357482ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1534002Total
Program Services1524527ProgramServices
Management And General9475ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2403411Total
Program Services2403411ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total39945725Total
Program Services33953866ProgramServices
Management And General5991859ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total4225Total
Management And General4225ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total41091Total
Management And General41091ManagementAndGeneral

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)
Total5871483Total
Program Services5744042ProgramServices
Management And General127441ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total250568Total
Program Services250568ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total495927Total
Program Services495927ProgramServices

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total4198Total
Program Services4198ProgramServices

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total110576Total
Program Services110576ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total327925Total
Program Services327925ProgramServices

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total12495Total
Program Services12495ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1083354Total
Program Services1083354ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total42987Total
Management And General42987ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesFundraisingFundraising
Bad Debt777557477755740
Medical Supplies62762936276293
Recruiting446551446551
Equipment Costs423857423857

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total615611Total
Program Services615611ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total144801845Total
Program Services138046506ProgramServices
Management And General6755339ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY21958BOY
EOY19201EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY13839031BOY
EOY14832617EOY

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)
BOY142856BOY
EOY73804EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY97664BOY
EOY122381EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1469448BOY
EOY1428110EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis12244024LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec9631115LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY2951313BOY
EOY2612909EOY

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)
BOY8369581BOY
EOY11611770EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY26891851BOY
EOY30700792EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY10565006BOY
EOY10764082EOY

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)
BOY483421BOY
EOY361708EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY10849998BOY
EOY13872560EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY21898425BOY
EOY24998350EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY4993426BOY
EOY5702442EOY

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)
BOY4993426BOY
EOY5702442EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY26891851BOY
EOY30700792EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-30443137ReconcilationRevenueExpenses
Reconcilation Other Changes31152153ReconcilationOtherChanges
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)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2078CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3271CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6349CurrentTaxYearMinus2Years
Total11698Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years85042238CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years91838780CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years94414909CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year101441273CurrentTaxYearMinus1Year
Current Tax Year114358708CurrentTaxYear
Total487095908Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years85044316CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years91842051CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years94421258CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year101441273CurrentTaxYearMinus1Year
Current Tax Year114358708CurrentTaxYear
Total487107606Total
FieldValueIRS element (for citing)
Public Support Total509487107606PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Total0Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years85044316CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years91842051CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years94421258CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year101441273CurrentTaxYearMinus1Year
Current Tax Year114358708CurrentTaxYear
Total487107606Total
FieldValueIRS element (for citing)
Public Support Percentage5091.00000PublicSupportPercentage509
Prior Year Support Percentage0.99920PriorYearSupportPercentage
Investment Income Percentage0.00000InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00063PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

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 Basis12244024OtherCostOrOtherBasis
Depreciation9631115Depreciation
Book Value2612909BookValue
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildings
Total Of Book Value Land Buildings2612909TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionRETIREMENT FUNDDescription
Book Value11611770BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets11611770TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
PENSION FUND LIABILITY$11,611,770
Health Claims Payable$217,435
Estimated Malpractice Costs$2,043,355
FieldValueIRS element (for citing)
Total Of Amounts13872560TotalOfAmounts
Total Revenue114358708TotalRevenue
Total Expenses144801845TotalExpenses
Excess Or Deficit For Year-30443137ExcessOrDeficitForYear
Excess Or Deficit Per FS-30443137ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt66099996TotRevenueEtcAuditedFinclStmt
Revenue Subtotal66099996RevenueSubtotal
Other Revenues Not Included48258712OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt48258712RevenueNotRptdOnFinStmt
Total Revenue Per Form990114358708TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt96543133TotExpensesEtcAuditedFinclStmt
Expenses Subtotal96543133ExpensesSubtotal
Other Expenses Not Included48258712OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt48258712ExpensesNotRptdOnFinStmt
Total Expenses Per Form990144801845TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierExplanationExplanation
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.
PART XII & XIII LINE 4CINCOME/EXPENSE RECLASSES FROM AUDIT $40,483,140 BAD DEBT 7,775,572 ----------- $48,258,712

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
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 (34 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 OrgsBonusRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgs
JAMES MELOTT
2193723499734682463801906235449316000
JOHN HARVEY
2433653282436319463802146438035216000
VIKI FORLANO HALFMANN
2271353159238851463802031436427216000
HARVEY RUSSWURM
227126400001933030380209773378130
CORNELIUS CHINN
2824903343141304463801789342149816000
MICHAEL WAGNON
2872802803529534349981780339765014418
WILLIAM WHITEHEAD
3740702992544577555802164052579223900
CHRIS COLE
875028486031197443038027228110098332800
JOLIE BAILEY
21976512887535998504592521546031220400
ANTHONY DEMORY
50849930428350564545062688794473924125
LAURA ADAMS
4821612968858485543802153164624524000
JOE MIMS
464067469393859730380273156072980
SCOTT GIPSON
2606239543238364507802089846609720400
CHARLES MARSH
481007425007472030380193656479720
LUIS DUARTE
2403764761751764587663727512276054646257
IRVIN ZEITLER
3856725856655205652250596521703
BRYAN HORNER
48395984761303801714461624400
TIMOTHY HARTIN
23929838813475011266333827515538
DOUG SCHULTZ
34867927032259383038095954416240
TIMOTHY HOPKINS
1271121578201172837663711872153473346257
KENNETH BREEDLOVE
87836848603684656318023506108212232800
MICHAEL SICKELS
85826548603843866318026843108127732800
VICTOR SCHULZE III
860403486031141603038025757107930332800
DAVID HUCHTON
91110637500846806038025914111958030000
JOHN GILBREATH
169275308203656187982671971273021743
GARY BOWEN
1713003118740920176382843531289623308
JAMES BARNETT
3533283000035092463802597849077816000
STEPHEN CAINELLI
388496189964896230380199865068200
ROSS CARMICHAEL
2166503135093551950214562807610
D'LAINE WESTMORELAND
11318818000179642354888691815690
CHARLES JONES
199220225002008929647154412868970
JOSEPH ZUBAK
431415415122766863591208445850300
GARY GIBIAN
2641004806450514308924234551946929885
MARK MURPHY
18406578748184973250093773231870

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
NAMES, AMOUNTS, AND DETAILS OF ARRANGEMENTSPART 1, QUESTION 4SERP DETAIL NAME AMOUNT BRYAN HORNER NONE NONQUALIFIED PLAN PARTICIPANTS NAME AMOUNT JAMES MELOTT $ 16,065 JOHN HARVEY $ 19,658 VIKI FORLANO HALFMANN $ 20,265 ROSS CARMICHAEL NONE HARVEY RUSSWURM NONE D'LAINE WESTMORELAND $ 12,159 CORNELIUS CHINN $ 20,265 MICHAEL WAGNON $ 16,379 WILLIAM WHITEHEAD $ 30,270 CHRIS COLE $ 38,332 JOLIE BAILEY $ 25,837 ANTHONY DEMORY $ 30,556 LAURA ADAMS $ 30,397 JOE MIMS $ NONE SCOTT GIPSON $ 26,421 CHARLES MARSH $ NONE LUIS DUARTE $ 52,266 MARK MURPHY $ NONE IRVIN ZEITLER $ 46,528 BRYAN HORNER $ NONE TIMOTHY HARTIN $ 17,121 DOUG SCHULTZ $ NONE TIMOTHY HOPKINS $ 60,319 KENNETH BREEDLOVE $ 38,130 MICHAEL SICKELS $ 37,551 VICTOR SCHULTZE III $ 32,748 DAVID HUCHTON $ 32,506 JAMES BARNETT $ 19,519 STEPHEN CAINELLI $ NONE CHARLES JONES $ NONE JOSEPH ZUBAK $ 26,130 GARY GIBIAN $ 21,905 JOHN GILBREATH $ 16,132 GARY BOWEN $ 14,695 PARTICIPANTS IN THE 457F RETIREMENT ALLOWANCE PLAN ARE PHYSICIANS WHO ARE UNDER AGE 55 & THEIR EXPECTED COMPENSATION IS HIGHER THAN 125,000 OR EXECUTIVES 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. IN THE 457F ACCOUNTS RECEIVABLE PLAN, PARTICIPANTS ARE PHYSICIANS WHOSE ANNUAL COMPENSATION IS HIGHER THAN 125,000 AND ARE ELIGIBLE TO RECEIVE THE A/R CREDIT. ONCE A YEAR, 20% OF THE A/R CREDIT IS FUNDED INTO A MUTUAL FUND ACCOUNT. VESTING IN THE BENEFIT IS 20% EACH YEAR WITH FULL VESTING AFTER 5 YEARS. DISTRIBUTION WILL OCCUR AT THE END OF THE 5 YEARS OR AT TERMINATION OF EMPLOYMENT. OF THE 5 YEARS OR AT TERMINATION OF EMPLOYMENT.
METHODS USED TO ESTABLISH COMPENSATIONSCHEDULE J, PART I, QUESTION 3SHANNON 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.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
MICHELLE CHINN
CORNELIUS CHINN'S SPOUSE68314SHANNON CLINIC EMPLOYEEfalse
SCOTT WESTMORELAND
D. WESTMORELAND'S SPOUSE365327SHANNON CLINIC EMPLOYEEfalse
BRANDI WHITEHEAD
W. WHITEHEAD'S SPOUSE69232SHANNON CLINIC EMPLOYEEfalse
DENVER MARSH
CHARLES MARSH'S BROTHER493679SHANNON CLINIC EMPLOYEEfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (16 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DELEGATION OF CONTROL TO A MANAGEMENT COMPANY OR OTHER PERSONFORM 990, PART VI, QUESTION 3ADMINISTRATIVE SERVICES FOR SHANNON CLINIC ARE CONTRACTED WITH SHANNON MEDICAL MANAGEMENT.
CLASSES OF MEMBERS OR STOCKHOLDERSFORM 990, PART VI, QUESTION 6SHANNON HEALTH SYSTEM, A 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF SHANNON CLINIC.
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 & 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.
DECISIONS OF GOVERNING BODY SUBJECT TO APPROVAL BY MEMBERS OR STOCKHOLDERSFORM 990, PART VI, QUESTION 7BTHE 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.
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 MEMBER'S FINANCE COMMITTEE 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 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.
REVIEW OF COMPENSATIONFORM 990, PART VI, QUESTION 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.
EXPLANATION OF COMMITTEE THAT ASSUMES RESPONSIBILITYFORM 990, PART XII, QUESTION 2CSHANNON CLINIC DOES NOT HAVE AN AUDIT COMMITTEE, BUT THERE IS A SHANNON HEALTH SYSTEM AUDIT COMPLIANCE COMMITTEE THAT OVERSEES THE CONSOLIDATED AUDIT THAT INCLUDES 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 ASSETS OR FUND BALANCESFORM 990, PART XI, LINE 5TRANSFER TO/FROM AFFILIATES 31,152,166 OTHER CHANGE (13) ------------ TOTAL 31,152,153
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:IRVIN ZEITLER TITLE:MEDICAL DIRECTOR HOURS:37
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:BRYAN HORNER TITLE:PRESIDENT HOURS:39
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:TIMOTHY HARTIN TITLE:SECRETARY/GENERAL COUNCIL HOURS:40
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:GARY GIBIAN TITLE:SMM EXECUTIVE DIRECTOR HOURS:40
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:JOHN GILBREATH TITLE:CFO HOURS:40
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:GARY BOWEN TITLE:COO HOURS:40

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 ANGELOTX76903752602411HEALTHCARETX501(C)(3)11ANAfalse
SHANNON MEDICAL CENTER
120 E HARRIS AVESAN ANGELOTX76903752559845HEALTHCARETX501(C)(3)3NAfalse
SHANNON BUSINESS SERVICES INC
120 E HARRIS AVESAN ANGELOTX76903432038769SUPPORT SVCSTX501(C)(3)11BSMCfalse
SHANNON MEDICAL MANAGEMENT
120 E BEAUREGARDSAN ANGELOTX76903208367966SUPPORT SVCSTX501(C)(3)9SHSfalse

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 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

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 ANGELOTX76903752544450MANAGEMENTTXNAC-CORPORATION00
LEGACY HEALTH SOLUTIONS
2018 PULLIAM STSAN ANGELOTX76903200720762MED 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 OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

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