2012-08-14T15:43:42-05:00 2011-09-30 BKD LLP 2800 Post Oak Blvd Ste 3200 HOUSTON TX 77056 990 2010-10-01 752559845 SHANNON MEDICAL CENTER SHAN 3254818644 120 E HARRIS AVENUE SAN ANGELO TX 76903 SHANE PLYMELL 2012-08-15 M Paige Gerich 7134994600 2010 2016-02-24 21:20:13Z BRYAN HORNER 120 E HARRIS AVENUE SAN ANGELO TX 76903 243448362 false X SHANNONHEALTH.COM X 1994 TX OUR MISSION, IN FULFILLING OUR LEGACY, IS TO CREATE AN ENVIRONMENT COMMITTED TO THE VALUES OF ACCOUNTABILITY, SERVICE, PRIDE, INTEGRITY, RESPECT AND EXCELLENCE. CONTINUED ON SCHEDULE O 14 11 2011 135 279833 -83419 688760 87802 215025470 226867384 1586435 2070667 3218314 3616606 220518979 232642459 5833 243804 0 0 82846919 88378080 0 0 0 106549525 110114453 189402277 198736337 31116702 33906122 236180979 264993302 41908132 49297983 194272847 215695319 OUR MISSION, IN FULFILLING OUR LEGACY, IS TO CREATE AN ENVIRONMENT COMMITTED TO THE VALUES OF ACCOUNTABILITY, SERVICE, PRIDE, INTEGRITY, RESPECT AND EXCELLENCE. CONTINUED ON SCHEDULE O false false 155378321 156002 230204157 PROVIDING TOTAL MEDICAL CARE TO THE CITIZENS OF WEST TEXAS. 155378321 true false false false false false false false false true false false true true false false true false false false false false false false false true true true false true false false false false false false true false false false false false false true true true false false true 130 0 true 2011 true true true false false false false false false false false false false false X 14 11 false false false false true true true true true false false false true true true true true true true false X SHANNON MEDICAL CENTER 3256536741 120 E HARRIS AVENUE SAN ANGELO TX 76903 X BRYAN HORNER 32.0 X X 522768 0 69570 LEN MERTZ 2.0 X X 33992 109650 6588 JAMES JOHNSON 2.0 X X 30371 31558 288 JOE HENDERSON 2.0 X 31685 33615 396 ORAN BERRY III 2.0 X 28937 29000 6588 VIRGINIA NOELKE 2.0 X 20350 0 0 MIKE BOYD 2.0 X 1368 0 0 MIKE OLIPHANT 2.0 X 28850 30000 5292 STEVE CECIL 2.0 X 28750 29000 8328 JOANNA RICE 2.0 X 22000 0 0 JIM BOB BRAME MD 2.0 X 22500 0 0 PAMELA TALLEY 2.0 X 24350 0 0 EMMETE FLYNN MD 2.0 X 20000 521150 89738 MICHELLE SNUGGS MD 2.0 X 20350 574831 111615 KELLY SHANE PLYMELL 32.0 X 262412 0 42479 DR IRVIN ZEITLER 37.0 X 425732 1763 67700 WILMA STUART 40.0 X 239827 0 37953 PATRICIA TIPTON 40.0 X 276497 0 34261 MARVIN HILL 40.0 X 271261 0 35376 LANCE KEILERS 40.0 X 150572 0 22377 TIMOTHY HARTIN 40.0 X 240004 0 52644 Pauline James 40.0 X 156356 0 21831 2858932 1360567 613024 52 false true false SAN ANGELO EMERGENCY PHYSICIANS PA PO BOX 62566 SAN ANGELO TX 76906 PHYSICIAN GROUP 874346 CARDIOTHORACIC VASCULAR SURGEONS 1010 W 40TH ST AUSTIN TX 78756 PHYSICIAN GROUP 772447 SIEMENS MEDICAL SOLUTIONS INC PO BOX 120001 DALLAS TX 75312 REPAIRS/MAINTENANCE 501746 ENVISION TELEPHARMACY 503 E HANCOCK ALPINE TX 79830 CONTRACT LABOR 563128 EXECUTIVE HEALTH RESOURCES PO BOX 822688 PHILADELPHIA PA 19182 CONSULTING GROUP 465886 15 87802 87802 Net Patient Revenue 621990 226450315 226225963 224352 Rental Income 532000 417069 417069 226867384 1920733 1920733 0 0 10943889 11948 10800966 4937 142923 7011 149934 149934 0 0 0 Cafeteria 900099 1421325 1421325 Regional Cancer Treatment 900099 732273 732273 All Other Misc Revenue 1463008 1407527 55481 3616606 232642459 230204157 279833 2070667 243804 243804 0 0 0 1981942 1981942 125916 125916 68586394 53078459 15507935 4446900 3442119 1004781 8108090 6273934 1834156 5128838 3876416 1252422 312420 312420 136705 136705 120934 120934 0 0 0 13418383 8395367 5023016 1032805 38192 994613 4849986 418035 4431951 1974553 211574 1762979 0 2774724 454774 2319950 378512 215179 163333 0 0 0 0 9567205 4946939 4620266 181468 2696 178772 Medical Supplies 45949299 45917217 32082 Bad Debt 24509013 24509013 Equipment Costs 3123017 2409636 713381 Collection Fees 873667 873667 LAB FEES 510579 510579 401183 308472 92711 198736337 155378321 43358016 0 12626800 1535892 3739591 28424 18485033 19062834 248950 359171 3557054 3786391 1693874 1636804 198017669 137593918 59075699 60423751 46531901 54677848 2048449 2628842 784536 784536 87389092 120068809 236180979 264993302 21736914 25473229 2025 2025 20169193 23822729 41908132 49297983 X 115558229 103636284 78714618 112059035 194272847 215695319 236180979 264993302 X 33906122 -12483650 X false true true X false X 5122978 5122978 69803989 46226194 23577795 119941693 88393353 31548340 3149009 2974372 174637 60423750 Int in Net Assets - Shannon Tr 112059035 Self Insurance Trust 7228443 Beneficiary Account 348781 Interest Receiveable 432550 120068809 0 Asset Retirement Obligation 729900 Accrued Pension Cost 15776061 Malpractice Costs 2100053 Due to/from thrid party payors 4838382 Long Term Incentive Accrual 378333 23822729 232642459 198736337 33906122 -1418503 -39789 -1458292 32447830 230940363 -1418503 -1418503 232358866 283593 283593 232642459 198492533 198492533 243804 243804 198736337 FORM 990, PART XI, LINE 8 OTHER CHANGES INTEREST SWAP $ 39,789 ----------- $ 39,789 FORM 990, PART XII, LINE 4B INCOME ON FORM 990 NOT ON BOOKS INTEREST SWAP $ 39,789 GRANTS INCLUDED IN REVENUE ON AUDIT 243,804 -------------- $ 283,593 FORM 990, PART XIII, LINE 4B EXPENSES INCLUDED IN FORM 990 NOT ON BOOKS GRANTS INCLUDED IN REVENUE ON AUDIT $ 243,804 -------------- $ 243,804 UNCERTAIN TAX POSITIONS SCHEDULE D, PART XIV 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. true true true X true X true true true false true true 14203824 14203824 0.08160 23657654 57233004 -33575350 0.00000 433417 338585 94833 0.00050 38294895 57571589 -19276693 0.08210 45399 45399 0.00030 348628 348628 0.00200 410860 0 410860 0.00240 804887 0 804887 0.00470 39099782 57571589 -18471806 0.08680 true 5951612 74569120 46977697 27591423 X true true 1 1 SHANNON MEDICAL CENTER

120 E HARRIS AVENUE SAN ANGELO TX 76903

X X X X SHANNON MEDICAL CENTER 1 3 SHANNON SURGERY CENTER

120 E HARRIS AVENUE SAN ANGELO TX 76903

AMBULATORY SURGERY CENTER SHANNON HOME HEALTH

2030 PULLIAM STE 6 SAN ANGELO TX 76905

HOME HEALTH CARE SHANNON DIALYSIS CENTER

2018 PULLIAM SAN ANGELO TX 76905

DIALYSIS CENTER PART 1, LINE 3C SHANNON MEDICAL CENTER USES FPG TO DETERMINE ELIGIBILITY FOR FREE AND DISCOUNTED CARE. PART I, LINE 7G NOT APPLICABLE PART I, LINE 7, COLUMN F BAD DEBT EXPENSE WAS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) BuT WAS SUBTRACTED FROM TOTAL EXPENSE FOR THE CALCULATION OF "PERCENT OF TOTAL EXPENSE" IN THIS COLUMN. PART I, LINE 7 COSTS FOR LINE 7 WERE CALCULATED USING AN OVERALL COST TO CHARGE RATIO CALCULATED BY THE HOSPITAL'S COST ACCOUNTING SYSTEM. PART III, LINE 4 FOOTNOTE DISCLOSURE REGARDING THE TREATMENT OF BAD DEBTS IS AS FOLLOWS: The System reports patient accounts receivable for services rendered at net realizable amounts from third-party payers, patients and others. The System provides an allowance for doubtful accounts based upon a review of outstanding receivables, historical collection information and existing economic conditions. As a service to the patient, the System bills third-party payers directly and bills the patient when the patients liability is determined. Patient accounts receivable are due in full when billed. Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluation and specific circumstances of the account. AMOUNT REPORTED ON LINE 2 IS BASED ON BAD DEBTS PER THE AUDITED FINANCIAL STATEMENTS AFTER APPLYING THE COST TO CHARGE RATIO. THE ORGANIZATION IS UNABLE TO ESTIMATE THE AMOUNT FOR LINE 3 AND HAS ELECTED TO LEAVE IT BLANK. PART III, LINE 8 THE RATIO OF COST TO CHARGES USED IN THE CALCULATION OF COSTS FOR MEDICARE WAS TAKEN FROM THE MEDICARE COST REPORT. PART III, LINE 9B CHARITY CARE AND DISCOUNTING FOR UNINSURED PATIENTS PATIENTS WHO ARE NOT ELIGIBLE FOR GOVERNMENT HEALTH CARE PROGRAMS AND WHOSE FINANCIAL CONDITION IS SUCH THAT THEY ARE NOT ABLE TO PAY FOR HOSPITAL SERVICES MAY BE ELIGIBLE FOR ASSISTANCE UNDER THE SHANNON MEDICAL CENTER CHARITY CARE PROGRAM. PATIENTS WHO ARE UNINSURED, DO NOT QUALIFY FOR COVERAGE UNDER GOVERNMENT HEALTH CARE PROGRAMS, MAY BE ELIGIBLE FOR A 50% DISCOUNT OFF THE TOTAL BILL FOR HOSPITAL SERVICES, IF THE SERVICES ARE PAID FOR WHEN RECEIVED OR WITHIN 30 DAYS OF DISCHARGE. COLLECTION OF ACCOUNTS RECEIVABLE PATIENTS / GUARANTOR WILL BE RESPONSIBLE FOR PAYMENT OF SERVICES RECEIVED AT SHANNON MEDICAL CENTER. PATIENTS / GUARANTORS WILL BE RESPONSIBLE FOR FULL CHARGES, OR PATIENT PORTION NOT COVERED BY INSURANCE. PAYMENT WILL BE REQUESTED PRIOR TO OR ON THE DATE OF SCHEDULED ELECTIVE SERVICES. FULL CHARGES OR PATIENT PORTION NOT COVERED BY INSURANCE FOR URGENT / EMERGENT SERVICES WILL BE COLLECTED UPON DISCHARGE. PATIENTS WHO ARE UNABLE TO PAY THE FULL AMOUNT OF THEIR RESPONSIBILITY AT THE TIME OF SERVICE CAN MAKE PAYMENT ARRANGEMENTS UNDER THE FOLLOWING GUIDELINES: A. BALANCE OF OUTPATIENT SERVICES MUST BE PAID WITHIN SIX (6) MONTHS FROM THE DATE OF SERVICE UNLESS INDIGENT STATUS IS PROVEN B. BALANCE OF INPATIENT SERVICES MUST BE PAID WITHIN TWELVE (12) MONTHS FROM THE DATE OF DISCHARGE UNLESS INDIGENT STATUS IS PROVEN MONTHLY STATEMENTS WILL BE SENT THROUGHOUT THE COLLECTION CYCLE. COLLECTION LETTERS WILL BE UTILIZED AT THE DISCRETION OF THE PATIENT ACCOUNT REPRESENTATIVE. ACCOUNTS WILL BE REVIEWED FOR OUTSIDE COLLECTION AGENCY PLACEMENT ANYTIME FOLLOWING 90 DAYS FROM THE DATE OF SERVICE. MEDICARE ACCOUNTS WILL NOT BE CONSIDERED FOR PLACEMENT UNTIL 120 DAYS FROM THE FIRST NOTICE OF PATIENT RESPONSIBILITY IN ACCORDANCE WITH MEDICARE REGULATIONS. ANY OVERPAYMENT OF AN ACCOUNT WILL BE REVIEWED FOR REFUND WITHIN 30 DAYS FROM THE DATE THE CREDIT BALANCE IS CREATED BY THE OVERPAYMENT. CREDIT BALANCES ON MEDICARE ACCOUNTS WILL BE PROCESSED THROUGH THE NORMAL CREDIT BALANCE PROCESS AND REPORTED ON A QUARTERLY BASIS IN COMPLIANCE WITH MEDICARE REGULATIONS. PART V IN ADDITION TO ROUTINE HOSPITAL AND SURGERY CENTER OPERATIONS SHANNON MEDICAL CENTER OPERATES ONE DIAGNOSTIC CENTER, ONE WOMEN'S IMAGING CENTER, ONE SKILLED NURSING FACILITY, AND SIX REHABILITATION UNITS. NEEDS ASSESSMENT A. IN 2004, THE UNITED WAY OF THE CONCHO VALLEY CONDUCTED A COMPREHENSIVE NEEDS ASSESSMENT OF TOM GREEN COUNTY AND 13 OTHER SURROUNDING COUNTIES. COUNTIES INCLUDED IN THE NEEDS ASSESSMENT ARE AS FOLLOWS: COKE, CONCHO, CROCKETT, IRION, KIMBLE, MASON, MCCULLOCH, MENARD, REAGAN, RUNNELS, SCHLEICHER, STERLING, SUTTON, AND TOM GREEN. SAN ANGELO AND TOM GREEN COUNTY SERVE AS THE HUB FOR THESE COUNTIES FOR TRADE AS WELL AS MEDICAL SERVICES. THIRTEEN OF THE FOURTEEN COUNTIES ARE CONSIDERED RURAL OR "FRONTIER" BASED ON POPULATION AND PERSONS PER SQUARE MILE. (SOURCE UW NEEDS ASSESSMENT 2004) THE RESULTS OF THE 2004 UNITED WAY NEEDS ASSESSMENT CONFIRM THAT SOCIAL AND HEALTH CONCERN ISSUES STATED IN THE SHANNON NEEDS ASSESSMENT 1994, CONTINUE TO RANK HIGH IN IMPORTANCE MANY YEARS LATER. 1. SOCIAL CONCERNS (TOM GREEN COUNTY - COMMUNITY CONCERNS) MORE THAN HALF THE RESPONDENTS IN THE UNITED WAY 2004 COMMUNITY NEEDS ASSESSMENT NAMED THE FOLLOWING CONCERNS AS MAJOR OR MODERATE ISSUES OF CONCERN. A. TEEN PREGNANCY 77% B. FAMILY VIOLENCE, ABUSE OF CHILDREN OR ADULTS 71% C. LACK OF AFFORDABLE CARE FOR CHILDREN 65% D. LACK OF AFFORDABLE CARE FOR THE ELDERLY 59% E. RACIAL OR ETHNIC DISCRIMINATION 56% 2. HEALTH CONCERNS (TOM GREEN COUNTY COMMUNITY CONCERNS A. ALCOHOL/DRUG USE 82% B. MENTAL ILLNESS OR EMOTIONAL ISSUES 56% C. LACK OF AFFORDABLE MEDICAL CARE 79% D. LACK OF ADEQUATE AFFORDABLE MEDICAL CARE 51% E. HIV/AIDS 46% 3. TOP FIVE MAJOR ISSUES OVERALL (TOM GREEN COUNTY - HOUSEHOLD CONCERNS) A. NOT HAVING ENOUGH MONEY TO PAY THE DOCTOR, BUY PRESCRIPTIONS, MEDICATIONS OR GET MEDICAL INSURANCE 43% B. FINDING IT DIFFICULT TO BUDGET 40% C. HAVING A LOT OF ANXIETY, STRESS OR DEPRESSION 36% D. NOT BEING ABLE TO FIND WORK 31% E. CHILDREN OR TEENAGERS EXPERIENCING BEHAVIOR OR EMOTIONAL ISSUES 29% B. IN 2010, THE POPULATION OF TOM GREEN COUNTY HAD A HIGHER PERCENTAGE OF ELDERLY - 65 YEARS OR OLDER - THAN THE STATE AVERAGE: 13.8% AND 10.3% RESPECTIVELY. IN ADDITION, THE MEDIAN HOUSEHOLD INCOME LEVEL: $41,398 AND $49,646 RESPECTIVELY. THE INCIDENCE OF A MORE ELDERLY POPULATION AND LOWER INCOME POPULATION IN TOM GREEN COUNTY AS COMPARED TO THE NATIONAL LEVEL HAS BECOME A STATISTICAL TREND OVER THE LAST SEVERAL YEARS. POVERTY LEVELS AND THE AGE OF THE POPULATION HAVE CONTRIBUTED TO AN INCREASE OF 20% IN THE CHARITY CARE CONTRIBUTION MADE BY SHANNON IN THE PAST TWELVE MONTHS ALONE. (SOURCE: U.S. CENSUS BUREAU STATE & COUNTY QUICKFACTS, 2010). PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE FINANCIAL ASSISTANCE BROCHURES ARE AVAILABLE IN EACH OP THE REGISTRATION AREAS THAT OUTLINE ACCESS TO INFORMATION ABOUT ASSISTANCE PROGRAMS. WE ALSO HAVE CONTRACTED ELIGIBILITY WORKERS WHO SCREEN PATIENTS FOR ALL SOCIAL SERVICE PROGRAMS AND ASSIST WITH THE APPLICATION PROCESS IF NEEDED. COMMUNITY INFORMATION SHANNON, A NON-PROFIT HEALTH SYSTEM ESTABLISHED IN THE 1930'S, PROVIDES THE COMMUNITIES OF WEST CENTRAL TEXAS WITH A VARIETY OF MEDICAL SERVICES. DEDICATED TO THE REGION'S HEALTH AND WELL-BEING, THE CENTER OFFERS DIVERSE CLINICAL SERVICES, INCLUDING A NATIONALLY-RECOGNIZED CARDIAC CARE PROGRAM, NATIONALLY-RECOGNIZED ICU, THE REGION'S ONLY LEVEL III TRAUMA FACILITY AND AIRMED 1 AIR AMBULANCE SERVING A 200-MILE RADIUS OF SAN ANGELO, A DEDICATED WOMEN'S & CHILDREN'S HOSPITAL WHICH IS HOME TO THE CHILDREN'S MIRACLE NETWORK, AND THE MOST EXTENSIVE SENIOR HEALTH SERVICES IN THE CONCHO VALLEY. THE ESTIMATED POPULATION FOR ALL THE COUNTIES AS OF 2010, INCLUDING TOM GREEN COUNTY, IS 267,557. THE OUTER COUNTIES ARE BROWN, COKE, COLEMAN, CONCHO, CROCKETT, IRION, KIMBLE, MASON, MCCULLOCH, MENARD, MILLS, REAGAN, RUNNELS, SAN SABA, SCHLEICHER, STERLING, SUTTON, AND VAL VERDE. (SOURCE: U.S. CENSUS BUREAU, STATE, & COUNTY QUICKFACTS.) OUR GOAL IS TO PROVIDE OUR PATIENTS WITH THE MOST COMPASSIONATE AND EFFICIENT SERVICE WHILE ENSURING THE HIGHEST QUALITY CARE. TOM GREEN COUNTY'S POPULATION IN 2010 IS REPORTED AT 110,224. THE CITY OF SAN ANGELO SERVES AS THE COUNTY SEAT AND POPULATION CENTER OF TOM GREEN COUNTY, WITH AN ESTIMATED POPULATION IN 2010 OF 93,200. A BREAKDOWN OF TOM GREEN COUNTY DEMOGRAPHICS IS AS FOLLOWS. (SOURCE: U.S. CENSUS BUREAU, STATE & COUNTY QUICKFACTS, THE COUNTY INFORMATION PROJECT, TEXAS ASSOCIATION OF COUNTIES.) A. TOM GREEN COUNTY AGE DISTRIBUTION 1. UNDER 18 YEARS OLD - 24.1% (26,564) 2. 18-64 YEARS OLD - 62.1% (68,449) 3. 65 YEARS AND OLDER - 13.8% (15,211) B. TOM GREEN COUNTY ETHNIC DISTRIBUTION (MORE THAN ONE CATEGORY MAY BE SELF-REPORTED) 1. CAUCASIAN - 57.9% (63,820) 2. HISPANIC - 35.7% (39,350) 3. BLACK - 4% (4,409) 4. OTHER - 2.4% (2,645) C. TOM GREEN COUNTY (HOUSEHOLD) 1. MEDIAN HOUSEHOLD INCOME - $41,398 (TEXAS: $49,646) 2. PERSONS LIVING BELOW POVERTY LEVEL - 16.8% (TEXAS: 16.8%) D. TOM GREEN COUNTY HEALTH INDEX 1. TOM GREEN COUNTY UNINSURED - 25.7% (TEXAS: 26.3%, UNITED STATES: 16.3%) (SOURCE: U.S. CENSUS BUREAU, SMALL AREA HEALTH INSURANCE ESTIMATES, 2009; U.S. CENSUS BUREAU, INCOME, POVERTY, AND HEALTH COVERAGE IN THE UNITED STATES: 2009.) PROMOTION OF COMMUNITY HEALTH A. TRAUMA PREVENTION SHANNON MEDICAL CENTER'S TRAUMA SERVICE DEPARTMENT COORDINATES THE ANNUAL GUS ECKHARDT TRAUMA SYMPOSIUM. THIS IS A FULL DAY OF TRAUMA RELATED EDUCATION FOR ALL HEALTH CARE PRACTITIONERS IN THE REGION. APPROXIMATELY 150 PHYSICIANS, NURSES, EMTS, STUDENTS, AND ALLIED HEALTH PROFESSIONALS ATTENDED THE 2011 SYMPOSIUM. INJURY PREVENTION MATERIAL COVERING TOPICS SUCH AS BICYCLE SAFETY, CHILD PASSENGER SAFETY, FALL PREVENTION, AND HOME SAFETY TIPS ARE CONTINUALLY PROVIDED BY HEALTH CARE PROFESSIONALS TO TAKE AND DISTRIBUTE AT THEIR PRACTICE AND THEIR COMMUNITY. THE COST TO PUT ON THE SYMPOSIUM IS $8,989. IN 2011, THE TRAUMA SERVICES DEPARTMENT CONDUCTED A BICYCLE RODEO AT SUNSET MALL. OVER 500 HELMETS WERE PURCHASED WITH GRANT FUNDS. CHILDREN WERE GIVEN AN APPROPRIATELY SIZED HELMET AND TAUGHT HOW TO CORRECTLY WEAR IT. AFTER RECEIVING A HELMET, THE KIDS NAVIGATED AN OBSTACLE COURSE THAT TAUGHT SAFE CYCLING SKILLS. THE DEPARTMENT CONTINUES TO EDUCATE ON PREVENTING CHILD DEATHS DUE TO BEING LEFT IN HOT VEHICLES. "BEAT THE HEAT AND CHECK THE BACKSEAT" IS A PROGRAM DEVELOPED IN-HOUSE AT SHANNON THAT PROVIDES INFORMATION ON THE DANGERS OF CHILDREN BEING LEFT IN VEHICLES. A SIMPLE PREVENTION TOOL WITH INSTRUCTIONS ON USE HAS BEEN PURCHASED AND DISTRIBUTED TO MULTIPLE VENUES THROUGHOUT THE CONCHO VALLEY. B. COMMUNITY HEALTH EDUCATION SHANNON PHYSICIANS AND MEDICAL STAFF PROVIDED EDUCATION TO THE COMMUNITY ON A VARIETY OF TOPICS THROUGH THEIR HEALTH BEAT TV SEGMENTS, NEWSLETTER AND HEALTH BEAT LIVE EVENTS. TOPICS INCLUDED PREVENTION FOR WOMEN'S HEALTH, CANCER TREATMENT AND PREVENTION, HEART AND CARDIOVASCULAR TESTING, AND MEDICATION SAFETY. IN 2010-2011, THEY HELD 43 SESSIONS WITH A TOTAL OF 1,387 ATTENDEES. SHANNON CONTRIBUTED $45,377 AS COMMUNITY BENEFIT FOR THESE PROGRAMS. C. HARPER HEALTH INFORMATION CENTER (HHIC) SHANNON MEDICAL CENTER COMMITTED TO MAINTAIN RESOURCES FOR ITS HEALTH INFORMATION CENTER FOR CANCER AND CARDIOVASCULAR DISEASE PATIENTS, THEIR FAMILIES, AND THE COMMUNITY. DURING THIS PAST YEAR, 662 PEOPLE VISITED THE CENTER TO OBTAIN HEALTH-RELATED INFORMATION AND RESOURCES. INFORMATION IN THE CENTER HAS EXPANDED TO INCLUDE PREVAILING HEALTH CONCERNS SUCH AS DIABETES, ASTHMA, SMOKING CESSATION, AND DIET AND EXERCISE. HHIC IS ALSO THE MEETING PLACE FOR SOME SHANNON DEPARTMENTS, REHAB CLASSES, AND SUPPORT GROUPS. AFFILIATED HEALTH CARE SYSTEM A. DONATIONS TO ORGANIZATIONS 1. PERSONNEL SHANNON ASSOCIATES PROVIDE 2,118 HOURS OF LEADERSHIP ON VOLUNTEER BOARDS AND IN VOLUNTEER ACTIVITIES WITH A PERSONNEL VALUE OF $128,622 FOR ORGANIZATIONS SUCH AS AGING ADVOCATES GROUP, AMERICAN CANCER SOCIETY, AMERICAN HEART ASSOCIATION, BENEVOLENCE COOK-OFF, ASU FIT, BIG BROTHER - BIG SISTER, WEST TEXAS BOYS RANCH, CANCER WARRIORS/SURVIVOR SISTERS, CHILDREN'S ADVOCACY CENTER OF SAN ANGELO, CATWALK FOR A CURE, TEE-OFF FOR TATAS, CENTRAL CULINARY HS PROGRAM, CHAMBER OF COMMERCE, CHILDREN'S MIRACLE NETWORK, CHRISTIANS IN ACTION, CLAYBIRD SHOOT, CONCHO VALLEY WATERSHED ASSOCIATION, CRISIS INTERVENTION/DOMESTIC VIOLENCE GROUP, DIABETES SUPPORT GROUP, DIABETES UPDATE, DME DONORSHIP DRIVE, FAMILY CRISIS SHELTER, FLU SHOT CLINICS, CONCHO VALLEY FOODBANK, FORT CONCHO, CAREGIVER RESEARCH INSTITUTE, GOODFELLOW AIRFORCE BASE, HOWARD COLLEGE, KIDNEY SUPPORT GROUP, KIDS' MARATHON, KIMBLE COUNTY FAIR, LIONS CLUB, MEALS FOR THE ELDERLY, MOSAIC TRAILS THERAPEUTIC RIDING, ANGELO STATE PHYSICAL THERAPY PROGRAM, PINK RIBBON RUN, RELAY FOR LIFE, RIO CONCHO MANOR STROKE PROGRAM, STOCK SHOW AND RODEO, ROTARY CLUB, SADIE'S RESCUE, SAFE KIDS COALTION CARSEAT CHECK, SALVATION ARMY, SAN ANGELO BROADWAY ACADEMY, SAN ANGELO CLAYBIRD ASSOCIATION SAFETY COMMITTEE, SAN ANGELO STATE SCHOOL, TAYLOR COUNTY MENTAL HEALTH TASK FORCE, TEXAS MEDICAL BOARD, TEXAS CHEFS' CHAPTER, TEXAS PRENATAL ASSOCIATION REGIONAL CONFERENCE, TEXAS REALTORS ASSOCIATION, TEXAS STATE BAR HEALTH LAW COUNCIL, TOM GREEN COUNTY ACUTE MENTAL HEALTH PROVIDERS, TOM GREEN COUNTY AREA AGENCY ON AGING, TPAPN, 4-H, TEXAS PEER ASSISTANCE PROGRAM FOR NURSES, UNITED BLOOD SERVICES, UNITES WAY OF THE CONCHO VALLEY, VISION CAMP, YMCA AND NUMEROUS OTHER ACTIVITIES. 2. USE OF FACILITIES SHANNON MEDICAL CENTER PROVIDED SPACE FOR 160 MEETINGS FOR 49 OUTSIDE COMMUNITY GROUPS/ORGANIZATIONS IN THE 2010 -2011 FISCAL YEAR. 3. FOOD AND NUTRITION SERVICES 2010 SHANNON MEDICAL CENTER PROVIDED FOOD AND REFRESHMENTS FOR MANY COMMUNITY ORGANIZATIONS. FOR EXAMPLE, $2,091 IN FOOD WAS DONATED TO CENTRAL HIGH SCHOOL (DEBATE TEAM & BAND), SONRISAS, UNITED WAY AGENCY FAIR, THE CIVIC BALLET & THE SAN ANGELO SYMPHONY, PROJECT GRADUATION, SA STATE PARK & GRAPE CREEK DARE GRADUATION. 4. COMMUNITY BUILDING SHANNON MEDICAL CENTER CONTRIBUTED $243,804 TO THE SAN ANGELO YMCA FOR THE CONSTRUCTION OF ITS NEW CARDIO WING. 5. CASH AND GIFTS a. SHANNON DONATED A TOTAL OF $36,343 IN SPONSORSHIPS TO THE COMMUNITY FOR NUMEROUS PROGRAMS INCLUDING: i. ALL VETERANS' COUNCIL - $100 ii. AMERICAN CANCER SOCIETY: RELAY FOR LIFE - $2,000 iii. ANGELO STATE ATHLETIC FOUNDATION - $500 iv. AMERICAN HEART ASSOCIATION: GO RED - $17,305 v. AMERICAN HEART ASSOCIATION: HEART WALK - $1,000 vi. AREA AGENCY ON AGING - $425 vii. CATWALK FOR A CURE/TEE OFF FOR TA-TA'S - $5,000 viii. CONCHO VALLEY AREA AGENCY ON AGING CAREGIVER SEMINAR - $750 ix. CROCKETT COUNTY DEERFEST ASSOCIATION - $500 x. D.E.S.K. - $100 xi. DADDY/DAUGHTER, MOTHER/SON DATE NIGHT - $400 xii. DIABETES ALERT DAY - $13 xiii. GIRL SCOUTS - $500 xiv. HEALTHY FAMILIES - $1,500 xv. JUNIOR LEAGUE OF SA, PROGRAM TO FEED HUNGRY CHILDREN - $500 xvi. ROAD LIZARDS - $800 xvii. SAN ANGELO CHAMBER OF COMMERCE GAFB APPRECIATION DAY - $1,000 xviii. SAN ANGELO INDEPENDENT SCHOOL DISTRICT: RELAYS - $3,000 xix. SAN ANGELO SCHOOLS FOUNDATION - $500 xx. UNITED WAY OF THE CONCHO VALLEY - $100 xxi. VOLUNTEER SERVICE COUNCIL STATE SUPPORTED LIVING CENTER - $350 STATE FILING OF COMMUNITY BENEFIT REPORT TEXAS true SAN ANGELO YMCA 353 S RANDOLPH SAN ANGELO TX 76903 750800698 501 (3) (C ) 243804 CONSTRUCTION OF NEW CARDIO WING 1 0 PROCEDURES FOR MONITORING USE OF GRANT FUNDS SCHEDULE I, PART I, QUESTION 2 THE ORGANIZATION EVALUATES AND MONITORS DONEES BASED ON PUBLIC AND PRIVATY DATA. X true true X X X X false true false false false false false false false BRYAN HORNER 446787 0 70859 0 5122 0 30380 0 39190 0 592338 0 0 0 LEN MERTZ 33992 109650 0 0 0 0 0 0 0 6588 33992 116238 0 0 EMMETE FLYNN MD 20000 521150 0 0 0 0 0 72783 0 16955 20000 610888 0 0 MICHELLE SNUGGS MD 20350 574831 0 0 0 0 0 92043 0 19572 20350 686446 0 0 KELLY SHANE PLYMELL 227965 0 34447 0 0 0 30380 0 12099 0 304891 0 0 0 DR IRVIN ZEITLER 328755 1763 50844 0 46133 0 55205 0 12495 0 493432 1763 0 0 WILMA STUART 207342 0 32485 0 0 0 29340 0 8613 0 277780 0 0 0 PATRICIA TIPTON 276497 0 0 0 0 0 30380 0 3881 0 310758 0 0 0 MARVIN HILL 271261 0 0 0 0 0 30380 0 4996 0 306637 0 0 0 LANCE KEILERS 144237 0 6335 0 0 0 14447 0 7930 0 172949 0 0 0 TIMOTHY HARTIN 199573 0 32473 0 7958 0 45305 0 7339 0 292648 0 0 0 Pauline James 156356 0 0 0 0 0 16842 0 4989 0 178187 0 0 0 NAMES, AMOUNTS, AND DETAILS OF ARRANGEMENTS PART 1, QUESTION 4 SERP DETAIL NAME AMOUNT BRYAN HORNER NONE 457(F) DETAIL NAME AMOUNT BRYAN HORNER 5,122 TIMOTHY HARTIN 7,958 DR. IRVIN ZEITLER 46,133 PROVIDED HEALTH, SOCIAL DUES OR INITIATION FEES SCHEDULE J, PART I, QUESTION 1A BRYAN HORNER & KELLY SHANE PLYMELL RECEIVE MEMBERSHIP TO BENTWOOD COUNTRY CLUB EXCLUSIVELY FOR BUSINESS USE. ANY PERSONAL USE IS REIMBURSED BY THE OFFICER AND THEREFORE NO AMOUNTS ARE REPORTABLE ON THEIR FORM W-2'S. DIANE ZEITLER IRVIN ZEITLER'S SPOUSE 125916 EMPLOYED BY SMC false PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY FORM 990, PART VI, QUESTION 12C WE REGULARLY AUDIT FOR CONFLICT OF INTEREST STATEMENTS IN THE EMPLOYEES RECORDS. PROCEDURE FOR MONITORING: 1. WITHIN 90 DAYS OF BECOMING AN AFFECTED INDIVIDUAL, THAT INDIVIDUAL MUST REVIEW THIS POLICY AND COMPLETE AN SMC CONFLICT OF INTEREST DISCLOSURE FORM. 2. AT LEAST ANNUALLY THEREAFTER, AFFECTED INDIVIDUALS MUST REVIEW THIS POLICY AND COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. 3. THE CONFLICT OF INTEREST DISCLOSURE FORM SHOULD BE SENT TO THE SMC COMPLIANCE OFFICER. 4. AT ANY TIME WHEN AN ACTUAL, POTENTIAL, OR PERCEIVED CONFLICT OF INTEREST ARISES, THE AFFECTED INDIVIDUAL MUST REVISE HIS OR HER CONFLICT OF INTEREST DISCLOSURE FORM AND CONTACT THE SMC COMPLIANCE OFFICER. THE RESPONSIBILITY TO PROMPTLY REPORT SUCH ACTUAL OR POTENTIAL CONFLICTS RESTS WITH THE AFFECTED INDIVIDUAL. 5. THE SMC COMPLIANCE OFFICER WILL REVIEW DISCLOSURES AND DETERMINE WHICH REQUIRE FURTHER ACTION WITH THE SMC GENERAL COUNSEL AND APPROPRIATE SMC EXECUTIVE STAFF. REVIEW OF COMPENSATION FORM 990, PART VI, QUESTION 15A & 15B INTEGRATED HEALTH STRATEGIES DID AN EXECUTIVE COMPENSATION STUDY IN JUNE 2010 AND IT COVERED ALL EXECUTIVE SALARIES. EXECUTIVE COMPENSATION IS REVIEWED ANNUALLY BY THE BOARD OF TRUSTEES' OPERATIONS COMMITTEE, WHICH CONSULTS COMPARABILITY DATA AND KEEPS CONTEMPORANEOUS RECORDS OF ITS DECISIONS. GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC FORM 990, PART VI, QUESTION 19 THE ORGANIZATIONS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. ORGANIZATIONS MISSION CONTINUED FORM 990 PART I QUESTION 1 & PART III QUESTION 1 WE WILL FOSTER GROWTH TOWARD THE HIGHEST QUALITY OF CARE AND CUSTOMER SERVICE AND WILL STRIVE FOR EFFICIENT FINANCIAL PERFORMANCE. WE WILL HIRE AND DEVELOP THE BEST PEOPLE TO ACCOMPLISH THE TASKS. SOLE MEMBER FORM 990 PART VI, QUESTION 6 MARGARET SHANNON ESTATE, A TESTAMENTARY TRUST, IS THE SOLE MEMBER OF THE ORGANIZATION. BOARD OF DIRECTORS ELECTION ABILITIES FORM 990 PART VI, QUESTION 7A THE BOARD OF DIRECTORS SHALL CONSIST OF EACH OF THE SEVEN TRUSTEES OF THE MARGARET SHANNON ESTATE, A TESTAMENTARY TRUST. THE OTHER DIRECTORS SHALL CONSIST OF REPRESENTATIVES OF THE COMMUNITY AND MEMBERS OF THE MEDICAL STAFF OF THE HOSPITAL, TO NUMBER IN AGGREGATE NOT MORE THAN SEVEN WHO ARE APPOINTED BY THE MEMBER AND THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION. REVIEW OF FORM 990 FORM 990 PART VI QUESTION 11A 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 ORGANIZATIONS FINANCE COMMITTEE WILL REVIEW AFTER THE FORM IS FILED DECISIONS OF THE GOVERNING BODY SUBJECT TO APPROVAL FORM 990, PART VI, QUESTION 7B APPROVAL OF THE SOLE MEMBER, THE TRUSTEES OF SHANNON WEST TEXAS MEMORIAL HOSPITAL, IS REQUIRED FOR BUDGETS, LARGE FINANCIAL EXPENDITURES THAT DEVIATE FROM BUDGET, SALE OF PROPERTY, MERGER, ACQUISITION, OR CONSOLIDATION, BORROWING OF MONEY, SEEKING OR GIVING GRANTS, SETTLEMENT OF CLAIMS OR LITIGATION, AMENDMENT OF BYLAWS, AND CONTRACT IN WHICH THE CORPORATION ASSUMES FINANCIAL RISK. OTHER CHANGES IN NET ASSETS OR FUND BALANCES FORM 990, PART XI, LINE 5 Contributions Recorded to Fund Balance $ 128,329 Change in Additional Minimum Pension Liability (2,452,583) Transfers to/from Affiliates (48,605,313) Net Assets released from restriction 6,559,640 Change in Shannon Trust Net Assets 33,344,417 Gain/Loss on Interest Rate Swap Agreement (39,789) Unrealizeed Gain/Loss (1,418,503) Other 152 --------------- (12,483,650) HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:BRYAN HORNER TITLE:CEO/PRESIDENT HOURS:12 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:LEN MERTZ TITLE:CHAIRMAN HOURS:22 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JAMES JOHNSON TITLE:SECRETARY/TREASURER HOURS:14 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOE HENDERSON TITLE:INDIVIDUAL TRUSTEE HOURS:14 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ORAN BERRY III TITLE:INDIVIDUAL TRUSTEE HOURS:14 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:VIRGINIA NOELKE TITLE:DIRECTOR HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MIKE BOYD TITLE:INDIVIDUAL TRUSTEE HOURS:14 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MIKE OLIPHANT TITLE:INDIVIDUAL TRUSTEE HOURS:14 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:STEVE CECIL TITLE:INDIVIDUAL TRUSTEE HOURS:14 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOANNA RICE TITLE:DIRECTOR HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JIM BOB BRAME MD TITLE:DIRECTOR HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:PAMELA TALLEY TITLE:DIRECTOR HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:EMMETE FLYNN MD TITLE:DIRECTOR HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MICHELLE SNUGGS MD TITLE:DIRECTOR HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KELLY SHANE PLYMELL TITLE:CFO HOURS:7 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DR IRVIN ZEITLER TITLE:MEDICAL DIRECTOR HOURS:5 TRUSTEES SHANNON WEST TEXAS HOSPITAL PO BOX 49 SAN ANGELO TX 76902 750800679 TRUST TX 501(C)(3) 11B NA SHANNON RURAL HEALTH CLINICS INC 120 E HARRIS AVE SAN ANGELO TX 76903 752940211 HEALTHCARE TX 501(C)(3) 11C SMC SHANNON REAL ESTATE SERVICES INC 120 E HARRIS AVE SAN ANGELO TX 76903 270075630 SUPPORT SVCS TX 501(C)(3) 11B SMC SHANNON HEALTH SYSTEM 120 E HARRIS AVE SAN ANGELO TX 76903 752602411 SUPPORT SVCS TX 501(C)(3) 11A NA SHANNON CLINIC 120 E HARRIS AVE SAN ANGELO TX 76903 752600873 HEALTHCARE TX 501(C)(3) 9 SMC SHANNON BUSINESS SERVICES INC 120 E HARRIS AVE SAN ANGELO TX 76903 432038769 SUPPORT SVCS TX 501(C)(3) 11B SMC SHANNON MEDICAL MANAGEMENT 120 E HARRIS AVE SAN ANGELO TX 76903 208367966 SUPPORT SVCS TX 501(C)(3) 9 SHS REGIONAL CANCER TREATMENT CENTER 102 N MAGDALEN STE 120 SAN ANGELO TX 76903 752225955 RADIOTHERAPY TX NA RELATED 144752 2410497 false 0 true 0.37970 LEGACY HEALTH PLAN INC 2018 PULLIAM ST SAN ANGELO TX 76903 752838410 HEALTH PLAN TX NA C 0 0 0.00000 LEGACY MANAGEMENT SERVICES 2018 PULLIAM ST SAN ANGELO TX 76903 752544450 MANAGEMENT TX NA C 0 0 0.00000 LEGACY HEALTH SOLUTIONS 2018 PULLIAM ST SAN ANGELO TX 76903 200720762 MED INSURANCE TX NA C 0 0 0.00000 true false true false false false false true true true true false true true true true true true SHANNON CLINIC O 2938133 SHANNON BUSINESS SERVICES P 10340255 SHANNON REAL ESTATE SERVICES R 505192 SHANNON CLINIC K 684214 SHANNON REAL ESTATE SERVICES J 266605 SHANNON BUSINESS SERVICES C 128329 SHANNON MEDICAL MENAGEMENT Q 20393345 SHANNON CLINIC I 80348 SHANNON BUSINESS SERVICES I 63719 SHANNON BUSINESS SERVICES R 8596008 SHANNON CLINIC P 1851526 SHANNON MEDICAL MANAGEMENT P 5450787 SHANNON REAL ESTATE SERVICES Q 2585970 SHANNON REAL ESTATE SERVICES P 6461618