FURP.ORG / PUBLIC DATA EXPLORER

SHANNON MEDICAL MANAGEMENT: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
SHANNON MEDICAL MANAGEMENT (EIN 20-8367966)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-08-15
IRS object ID
201242289349300639
Schema version
2010v3.7
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)
Timestamp2012-08-15T08:15:15-05:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate

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 Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN208367966EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SHANNON MEDICAL MANAGEMENTBusinessNameLine1
FieldValueIRS element (for citing)
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 Signed2012-08-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameM Paige GerichName
Phone7134994600Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
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 Receipts36241909GrossReceipts
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 Employees797TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year32445389ProgramServiceRevenuePriorYear
Program Service Revenue CY36240280ProgramServiceRevenueCY
Investment Income Prior Year2025InvestmentIncomePriorYear
Investment Income Current Year553InvestmentIncomeCurrentYear
Other Revenue Prior Year524OtherRevenuePriorYear
Other Revenue Current Year1076OtherRevenueCurrentYear
Total Revenue Prior Year32447938TotalRevenuePriorYear
Total Revenue Current Year36241909TotalRevenueCurrentYear
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 Year22178737SalariesEtcPriorYear
Salaries Etc Current Year24660148SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year8823250OtherExpensePriorYear
Other Expenses Current Year9852218OtherExpensesCurrentYear
Total Expenses Prior Year31001987TotalExpensesPriorYear
Total Expenses Current Year34512366TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1445951RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1729543RevenuesLessExpensesCY
Total Assets BOY630535TotalAssetsBOY
Total Assets EOY728382TotalAssetsEOY
Total Liabilities BOY1904877TotalLiabilitiesBOY
Total Liabilities EOY2231534TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-1274342NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-1503152NetAssetsOrFundBalancesEOY
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
Expense28846562Expense
Revenue36241356Revenue
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 Expense28846562TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
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 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 Employees797NumberOfEmployees
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 (6 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
LEN MERTZ
CHAIRMAN1.0XX01436426588
BRYAN HORNER
PRESIDENT5.0XX052276869570
KELLY SHANE PLYMELL
SECRETARY5.0XX026241242478
GARY GIBIAN
EXECUTIVE DIRECTOR40.0XX321876078698
JOHN GILBREATH
CHIEF FINANCIAL OFFICER40.0XX214523049740
GARY BOWEN
Chief Operating Officer40.0X210613056528
FieldValueIRS element (for citing)
Total Reportable Comp From Org747012TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs928822TotalReportableCompFrmRltdOrgs
Total Other Compensation303602TotalOtherCompensation
Number Individuals GT100 K3NumberIndividualsGT100K
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
24630 NETWORK PLACECHICAGOIL60763STATEMENT PROCESSING379843
PER-SE TECHNOLOGIES
PO BOX 403421ATLANTAGA30384OUTSIDE BILLING492012
STAT TRANSCRIPTION
6475 CAMDEN AVE 101SAN JOSECA95120TRANSCRIPTION SVC339024
MEDI-COMM SVC LUBBOCK
5139 69TH STLUBBOCKTX79424COLLECTION SERVICES259353
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Medical Records Income9000996811868118
Lease Income53139057515751
Management Fees9000993616641136166411
FieldValueIRS element (for citing)
Total Program Service Revenue36240280TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column553TotalRevenueColumn
Exclusion$553ExclusionAmount

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 Column1076TotalRevenueColumn
Related Or Exempt Function Income1076RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue1076TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column36241909TotalRevenueColumn
Related Or Exempt Function Income36241356RelatedOrExemptFunctionIncome
Exclusion$553ExclusionAmount

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)
Total931977Total
Program Services0ProgramServices
Management And General931977ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total18743840Total
Program Services17116061ProgramServices
Management And General1627779ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total928335Total
Program Services883132ProgramServices
Management And General45203ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2660963Total
Program Services2368009ProgramServices
Management And General292954ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1395033Total
Program Services1240323ProgramServices
Management And General154710ManagementAndGeneral

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)
Total22127Total
Management And General22127ManagementAndGeneral

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)
Total2012495Total
Program Services1850443ProgramServices
Management And General162052ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total30665Total
Program Services30665ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total970103Total
Program Services219201ProgramServices
Management And General750902ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1307702Total
Program Services33283ProgramServices
Management And General1274419ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4353422Total
Program Services4346439ProgramServices
Management And General6983ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total105718Total
Program Services48379ProgramServices
Management And General57339ManagementAndGeneral

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)
Total240194Total
Program Services139326ProgramServices
Management And General100868ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total14329Total
Management And General14329ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Equipment Costs412751226156186595
Collection Fees28621128615556
Education305711813312438
Recruiting25476216423834
DUES/MEMBERSHIP/LICENSE16164384412320

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total24290Total
Program Services15371ProgramServices
Management And General8919ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total34512366Total
Program Services28846562ProgramServices
Management And General5665804ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY-17914BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY77876EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY52398BOY
EOY55758EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis4411018LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec3887023LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY524083BOY
EOY523995EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY71968BOY
EOY70753EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY630535BOY
EOY728382EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1519071BOY
EOY1808708EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY385806BOY
EOY422826EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1904877BOY
EOY2231534EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-1274342BOY
EOY-1503152EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-1274342BOY
EOY-1503152EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY630535BOY
EOY728382EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1729543ReconcilationRevenueExpenses
Reconcilation Other Changes-1958353ReconcilationOtherChanges
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 Minus3 Years0CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years122CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total122Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years26735623CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years29873369CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year32445389CurrentTaxYearMinus1Year
Current Tax Year36240280CurrentTaxYear
Total125294661Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years26735623CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years29873491CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year32445389CurrentTaxYearMinus1Year
Current Tax Year36240280CurrentTaxYear
Total125294783Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years26405175CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years29509560CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year32048848CurrentTaxYearMinus1Year
Current Tax Year36166411CurrentTaxYear
Total124129994Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years26405175CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years29509560CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year32048848CurrentTaxYearMinus1Year
Current Tax Year36166411CurrentTaxYear
Total124129994Total
FieldValueIRS element (for citing)
Public Support Total5091164789PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years51120CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8022CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2025CurrentTaxYearMinus1Year
Current Tax Year553CurrentTaxYear
Total61720Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years51120CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8022CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2025CurrentTaxYearMinus1Year
Current Tax Year553CurrentTaxYear
Total61720Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years4998CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3399CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year524CurrentTaxYearMinus1Year
Current Tax Year1076CurrentTaxYear
Total9997Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years26791741CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years29884912CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year32447938CurrentTaxYearMinus1Year
Current Tax Year36241909CurrentTaxYear
Total125366500Total
FieldValueIRS element (for citing)
First5 Years509XFirst5Years509

Schedule D IRS990ScheduleD

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

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis4411018OtherCostOrOtherBasis
Depreciation3887023Depreciation
Book Value523995BookValue
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildings
Total Of Book Value Land Buildings523995TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionPension FundDescription
Book Value70753BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets70753TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Pension Plan Liability$74,069
Health Claim Payable$348,757
FieldValueIRS element (for citing)
Total Of Amounts422826TotalOfAmounts
Total Revenue36241909TotalRevenue
Total Expenses34512366TotalExpenses
Excess Or Deficit For Year1729543ExcessOrDeficitForYear
Other$12,540OtherAmount
Total Adjustments12540TotalAdjustments
Excess Or Deficit Per FS1742083ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt36241909TotRevenueEtcAuditedFinclStmt
Revenue Subtotal36241909RevenueSubtotal
Total Revenue Per Form99036241909TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt34499826TotExpensesEtcAuditedFinclStmt
Expenses Subtotal34499826ExpensesSubtotal
Other Expenses Not Included12540OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt12540ExpensesNotRptdOnFinStmt
Total Expenses Per Form99034512366TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 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 CHANGE12,540 RECLASS FROM SHANNON CLINICSCHEDULE D, PART XI, LINE 8
OTHER CHANGE12,540 RECLASS FROM SHANNON CLINICSCHEDULE D, PART 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 (6 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
LEN MERTZ
014364200000006588015023000
BRYAN HORNER
044678707085905122030380039190059233800
KELLY SHANE PLYMELL
022796503444700030380012098030489000
GARY GIBIAN
24997004464702725904993002876804005740234000
JOHN GILBREATH
16382702916902152703521701452302642630143000
GARY BOWEN
16591802953301516203762001890802671410142000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierNAMES, AMOUNTS, AND DETAILS OF ARRANGEMENTSIdentifier
Return ReferencePART I, QUESTION 4BReturnReference
ExplanationNONQUALIFIED PLAN PARTICIPANTS NAME AMOUNT BRYAN HORNER $ 5,122 GARY GIBIAN 19,969 JOHN GILBREATH 15,916 GARY BOWEN 13,182 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 (14 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 XI, LINE 5TRANSFER TO/FROM AFFILIATES $ (1,970,919) RECLASS FROM SHANNON CLINIC 12,540 OTHER CHANGE 26 ------------- $ (1,958,353)
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:LEN MERTZ TITLE:CHAIRMAN HOURS:22
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:34
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:JOHN GILBREATH TITLE:CHIEF FINANCIAL OFFICER HOURS:5
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/BusinessNameLine1
TRUSTEES SHANNON WEST TEXAS HOSPITAL
PO BOX 49SAN ANGELOTX76902750800679TRUSTTX501(C)(3)11BNA
SHANNON RURAL HEALTH CLINICS INC
120 E HARRIS AVESAN ANGELOTX76903752940211HEALTHCARETX501(C)(3)11CSMC
SHANNON REAL ESTATE SERVICES INC
120 E HARRIS AVESAN ANGELOTX76903270075630SUPPORT SVCSTX501(C)(3)11BSMC
SHANNON CLINIC
120 E HARRIS AVESAN ANGELOTX76903752600873HEALTHCARETX501(C)(3)9SMC
SHANNON BUSINESS SERVICES INC
120 E HARRIS AVESAN ANGELOTX76903432038769SUPPORT SVCSTX501(C)(3)11BSMC
SHANNON MEDICAL CENTER
120 E HARRIS AVESAN ANGELOTX76903752559845SUPPORT SVCSTX501(C)(3)3NA
SHANNON HEALTH SYSTEM
120 E HARRIS AVESAN ANGELOTX76903752602411SUPPORT SVCSTX501(C)(3)11ANA

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
LEGACY HEALTH PLAN INC
2018 PULLIAM STSAN ANGELOTX76903752838410MEDICAL INSURANCETXNAC-CORPORATION000.00000
LEGACY MANAGEMENT SERVICES
2018 PULLIAM STSAN ANGELOTX76903752544450UTILIZ. REVIEWTXNAC-CORPORATION000.00000
LEGACY HEALTH SOLUTIONS
2018 PULLIAM STSAN ANGELOTX76903200720762MED INSURANCETXNAC-CORPORATION000.00000
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