2024-08-15T13:02:06-05:00 2023-09-30 Forvis Mazars LLP 14241 DALLAS PARKWAY SUITE 1100 DALLAS TX 752542961 990 2022-10-01 752600873 Shannon Clinic % JULIAN BESERIL SHAN 3256581511 PO Box 22000 San Angelo TX 76902 JULIAN BESERIL CFO 3256581511 2024-08-15 true NOELLE ALBERTO P01704142 9727028262 2022 2024-08-08 14:25:15Z KELLY SHANE PLYMELL PO Box 22000 SAN ANGELO TX 76902 270665224 false X SHANNONHEALTH.COM X 1995 TX FOUNDED ON A LEGACY OF CARING, SHANNON IS A LOCALLY OWNED HEALTHCARE SYSTEM DEDICATED TO PROVIDING EXCEPTIONAL HEALTHCARE FOR OUR FAMILY, FRIENDS, AND NEIGHBORS. 14 0 417 10 0 0 4571738 0 260581585 270572602 58610 92622 0 0 265211933 270665224 0 0 0 0 169042686 180145838 0 0 0 162673801 179227074 331716487 359372912 -66504554 -88707688 47245266 58681957 49614884 58562262 -2369618 119695 X OUR MISSION IS TO BE THE PREMIER 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. false false 331467547 270572602 PROVIDE 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. 331467547 true false false false false false false false false false true false false true true false false true false false false false false false false false false false false true false false false false false false false false false false false false false true true true false false true 100 0 true 417 true false false false false false false false false false false false false X 14 0 true true false false true true true true true false false true true true true true true true true false X JULIAN BESERIL 3256581511 120 E BEAUREGARD SAN ANGELO TX 76903 X LUIS DUARTE PHYSICIAN 40.0 0.0 X 3399859 0 126483 CHRISTOPHER HADDAD PHYSICIAN 40.0 0.0 X 2230044 0 124340 RAJANARENDER CHERUKU PHYSICIAN 40.0 0.0 X 2091707 0 93075 RUDY HADDAD PHYSICIAN/CHAIRMAN 40.0 0.0 X X 1987805 0 124340 STEVE RITTER PHYSICIAN 40.0 0.0 X 1701342 0 88941 JOSEPH HOBBS PHYSICIAN 40.0 0.0 X 1602641 0 127666 Kelly SHANE PLYMELL PRESIDENT 10.0 30.0 X 0 1069858 114243 ROSS HARPER PHYSICIAN / BOARD DIRECTOR 40.0 0.0 X 1064361 0 116314 ANDREW T KINGMAN PHYSICIAN / BOARD DIRECTOR 40.0 0.0 X 997236 0 105765 JASON FELGER PHYSICIAN / BOARD DIRECTOR 40.0 0.0 X 874060 0 125200 CALEB VOSBURG PHYSICIAN / BOARD DIRECTOR 40.0 0.0 X 875005 0 112829 LINDY BANKES PHYSICIAN / BOARD SECRETARY 40.0 0.0 X 816718 0 89312 JENNY WIGGINS-SMITH PHYSICIAN/MEDICAL DIRECTOR 40.0 0.0 X 743192 0 92913 JOE MIMS PHYSICIAN / BOARD DIRECTOR 40.0 0.0 X 672378 0 86537 DR JAMES C BARNETT PHYSICIAN 2.0 38.0 X 0 668838 83026 DAVID BOSWELL PHYSICIAN/MEDICAL DIRECTOR 40.0 0.0 X 542164 0 101309 Kelly Koenig PHYSICIAN/FORMER OFFICER 40.0 0.0 X 529009 0 94397 DOUG SCHULTZ PHYSICIAN/MEDICAL DIRECTOR 40.0 0.0 X 536785 0 74056 SARAH JACKSON VANCE PHYSICIAN/CHAIRMAN 40.0 0.0 X 472139 0 78003 RICARDO VILLAREAL CHIEF ADMINISTRATIVE OFFICER 5.0 35.0 X 0 470483 65179 NORMA CERNA PHYSICIAN / BOARD DIRECTOR 40.0 0.0 X 443249 0 83300 PAUL BORGFELD PHYSICIAN/MEDICAL DIRECTOR 40.0 0.0 X 417966 0 88420 VICKI HALFMANN FORLAN PHYSICIAN / BOARD DIRECTOR 40.0 0.0 X 437489 0 64354 ALLAN GRAVES GENERAL COUNCIL 5.0 35.0 X 0 422479 78907 JULIAN BESERIL CFO 5.0 35.0 X 0 350987 47610 STACI WETZ FORMER CFO/CONTROLLER 1.0 39.0 X 0 165100 23814 22435149 2982645 2386519 337 true true false SHANNON MEDICAL MANAGEMENT 120 E BEAUREGARD SAN ANGELO TX 76903 MANAGEMENT SERVICES 99699000 COMPHEALTH INC 7259 S Bingham Jct Blvd MIDVALE UT 84047 LOCUMS SERVICES 2921009 WEATHERBY LOCUMS INC 6451 North Federal Highway Suite 7 FORT LAUDERDALE FL 33308 LOCUMS SERVICES 1524582 SHANNON MEDICAL CENTER 120 E HARRIS SAN ANGELO TX 76903 LAB & LAUNDRY SVCS 9106123 DELTA LOCUM TENENS 3100 Olympus Blvd COPPELL TX 75019 LOCUMS SERVICES 569909 12 0 Net Patient Service Revenue 621990 240499649 240499649 Lease Income 532000 42152 42152 Other Operating Revenue 900099 5203228 5203228 HOSPITAL BASED PHYSICIANS' ASSISTANCE 621990 24827573 24827573 270572602 92622 92622 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 270665224 270572602 92622 0 0 0 0 12765488 12765488 0 145864770 138975235 6889535 10808074 8364516 2443558 5102613 3659019 1443594 5604893 4220512 1384381 99699000 84744150 14954850 0 64272 64272 0 0 0 20764413 20623469 140944 20888 20888 570459 555748 14711 66305 56359 9946 0 87626 74573 13053 447414 447414 0 0 0 0 1083179 920702 162477 1295012 1110164 184848 Bad Debt 33066691 33066691 Medical Supplies 20032603 20032603 Equipment Expense 517612 439970 77642 Education 565333 565333 946267 824713 121554 359372912 331467547 27905365 0 0 0 0 0 0 0 16313656 18009690 0 0 0 0 2209028 2071999 1381820 2218090 453546 1288154 25550641 20477342 3156730 5073299 0 0 0 0 0 0 0 0 23730486 30020725 47245266 58681957 21837260 23663499 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27777624 34898763 49614884 58562262 X -2369618 119695 0 0 -2369618 119695 47245266 58681957 X -88707688 91197001 X false true X true false X 0 3600 3625416 4571738 0 8200754 192713594 191563249 233719059 260581585 270572602 1149150089 0 0 0 192713594 191566849 237344475 265153323 270572602 1157350843 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1157350843 7578 39602 32976 58610 92622 231388 0 7578 39602 32976 58610 92622 231388 0 0 192721172 191606451 237377451 265211933 270665224 1157582231 0.99980 0.99980 0.00020 0.00020 X 25550641 20477342 5073299 5073299 Retirement Fund 30019835 Due from Related Org 890 30020725 0 Pension Fund Liability 30123440 Health Claims Payable 615324 Estimated Malpractice Costs 4159999 34898763 137105198 -133560026 -133560026 270665224 270665224 225812886 225812886 133560026 133560026 359372912 Schedule D, Part X, line 2 LIABILITY FOR UNCERTAIN TAX POSITIONS: 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. Schedule D, Part XI, Line 2d RECONCILIATION OF REVENUE PER AUDITED FINANCIALS WITH TAX RETURN Management Fees net with audit revenue $(99,699,000) Income/Expense Reclasses from audit (794,335) BAD DEBT EXPENSE (33,066,691) ---------------- Total $(133,560,026) SCHEDULE D, PART XII, LINE 4B RECONCILIATION OF EXPENSES PER AUDITED FINANCIALS WITH TAX RETURN Management Fees net with audit revenue $99,699,000 Income/Expense Reclasses from audit 794,335 BAD DEBT EXPENSE 33,066,691 ---------------- Total $133,560,026 false true false false false false false false false LINDY BANKES PHYSICIAN / BOARD SECRETARY 638526 119780 58412 61040 28272 906030 58112 PAUL BORGFELD PHYSICIAN/MEDICAL DIRECTOR 295675 69563 52728 59361 29059 506386 50748 DAVID BOSWELL PHYSICIAN/MEDICAL DIRECTOR 456733 30000 55431 65200 36109 643473 55131 NORMA CERNA PHYSICIAN / BOARD DIRECTOR 309424 82999 50826 54432 28868 526549 50526 LUIS DUARTE PHYSICIAN 2340575 949777 109507 88872 37611 3526342 87027 JASON FELGER PHYSICIAN / BOARD DIRECTOR 709496 64800 99764 88400 36800 999260 78574 ALLAN GRAVES GENERAL COUNCIL 321480 63669 37330 60668 18239 501386 37330 CHRISTOPHER HADDAD PHYSICIAN 829737 1305618 94689 92560 31780 2354384 94239 RUDY HADDAD PHYSICIAN/CHAIRMAN 822620 1051488 113697 92560 31780 2112145 94239 VICKI HALFMANN FORLAN PHYSICIAN / BOARD DIRECTOR 230162 141939 65388 36560 27794 501843 42908 ROSS HARPER PHYSICIAN / BOARD DIRECTOR 631099 352595 80667 76521 39793 1180675 80367 SARAH JACKSON VANCE PHYSICIAN/CHAIRMAN 303212 118791 50136 62560 15443 550142 49686 ANDREW T KINGMAN PHYSICIAN / BOARD DIRECTOR 648194 283693 65349 68864 36901 1103001 65049 Kelly Koenig PHYSICIAN/FORMER OFFICER 314086 153552 61371 60217 34180 623406 60921 JOE MIMS PHYSICIAN / BOARD DIRECTOR 348440 245630 78308 57525 29012 758915 53998 Kelly SHANE PLYMELL PRESIDENT 764365 217956 87537 96004 18239 1184101 87537 STEVE RITTER PHYSICIAN 518664 1160888 21790 74098 14843 1790283 0 DOUG SCHULTZ PHYSICIAN/MEDICAL DIRECTOR 399399 74851 62535 65075 8981 610841 56355 CALEB VOSBURG PHYSICIAN / BOARD DIRECTOR 531657 270287 73061 77768 35061 987834 72611 JENNY WIGGINS-SMITH PHYSICIAN/MEDICAL DIRECTOR 322944 357819 62429 63312 29601 836105 62130 RAJANARENDER CHERUKU PHYSICIAN 1680828 319659 91220 74576 18499 2184782 68740 JOSEPH HOBBS PHYSICIAN 1117774 484417 450 91555 36111 1730307 0 DR JAMES C BARNETT PHYSICIAN 0 511727 0 90372 0 66739 0 70987 0 12039 0 751864 0 66739 STACI WETZ FORMER CFO/CONTROLLER 153100 12000 0 6362 17452 188914 0 RICARDO VILLAREAL CHIEF ADMINISTRATIVE OFFICER 329026 67402 74055 37772 27407 535662 53275 JULIAN BESERIL CFO 248153 50253 52581 29012 18598 398597 38873 SCHEDULE J, PART I, LINE 3 METHODS USED TO ESTABLISH COMPENSATION: SHANNON CLINIC'S (SC) EXECUTIVES ARE 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 EXECUTIVES. SCHEDULE J, PART I, LINE 4B NONQUALIFIED RETIREMENT PLAN: FIXED CONTRIBUTION - THE PARTICIPANT'S ALLOWANCE PERCENTAGE FOR THE PLAN YEAR MULTIPLIED BY THE PARTICIPANT'S BASE SALARY FOR THE PRECEDING PLAN YEAR. DISCRETIONARY CONTRIBUTION - THE AMOUNT DETERMINED BY THE COMMITTEE, IN ITS SOLE DISCRETION, ON BEHALF OF A PARTICIPANT FOR THE PLAN YEAR BASED UPON CRITERIA ESTABLISHED BY THE COMMITTEE, IN ITS SOLE DISCRETION. THE APPLICABLE PLAN YEAR OF THE DISCRETIONARY CONTRIBUTION SHALL BE PLAN YEAR DURING WHICH IT IS CREDITED TO THE PARTICIPANT'S MUTUAL FUND ACCOUNT PURSUANT TO SECTION 2.1.3.2 OF EXHIBIT A TO THE PLAN. HOWEVER, THE COMMITTEE, IN ITS SOLE DISCRETION, MAY DETERMINE THE AMOUNT OF THE DISCRETIONARY CONTRIBUTION BASED UPON CRITERIA RELATING TO THE PRECEDING PLAN YEAR, AS MEASURED DURING THE FISCAL YEAR OF THE COMPANY ENDING IN SUCH PRECEDING PLAN YEAR. 457(F) DETAIL PARTICIPANT W-2 DEFERRED COMP PAYOR ------------ --------- --------------- ----------- DR. JAMES C. BARNETT $66,739 $58,787 SMC ALLAN GRAVES $37,330 $48,468 SMC KELLY SHANE PLYMELL $87,537 $83,805 SMC LINDY BANKES $58,112 $48,840 SC PAUL BORGFELD $50,748 $47,161 SC DAVID BOSWELL $55,131 $53,000 SC NORMA CERNA $50,526 $42,232 SC LUIS DUARTE $87,027 $76,672 SC JASON FELGER $78,574 $76,200 SC CHRISTOPHER HADDAD $94,239 $80,360 SC RUDY HADDAD $94,239 $80,360 SC VICKI FORLANO HALFMANN $42,908 $24,360 SC ROSS HARPER $80,367 $64,321 SC JOSEPH HOBBS NONE $79,355 SC SARAH JACKSON VANCE $49,686 $50,360 SC ANDREW T. KINGMAN $65,049 $56,664 SC KELLY KOENIG $60,921 $50,360 SC JOE MIMS $53,998 $45,325 SC RAJANARENDER CHERUKU $68,740 $62,376 SC STEVE RITTER NONE $61,899 SC DOUG SHULTZ $56,355 $52,875 SC CALEB VOSBURG $72,611 $65,568 SC JENNY WIGGINS-SMITH $62,130 $51,112 SC RICARDO VILLAREAL $53,275 $25,572 SMM JULIAN BESERIL $38,873 $19,094 SMM FORM 990, PART VI, SECTION A, LINE 3 CONTROL OF MANAGEMENT DUTIES: ADMINISTRATIVE SERVICES FOR SHANNON CLINIC ARE CONTRACTED WITH SHANNON MEDICAL MANAGEMENT, A RELATED ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS: SHANNON HEALTH SYSTEM, A 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF SHANNON CLINIC. FORM 990, PART VI, SECTION A, LINE 7A POWER TO ELECT MEMBERS TO THE GOVERNING BODY: THE SOLE MEMBER, SHANNON HEALTH SYSTEM, APPOINTS THE MEMBERS OF THE BOARD OF DIRECTORS. THE MEMBER EXERCISES ITS POWERS AND AUTHORITY THROUGH THE ACTION OF THE CHAIRMAN OF THE BOARD OF DIRECTORS OF THE MEMBER OR SUCH OTHER PERSON OR PERSONS DESIGNATED BY THE BOARD OF DIRECTORS OF THE MEMBER TO TAKE ACTION. FORM 990, PART VI, SECTION A, LINE 7B APPROVAL OF GOVERNANCE DECISIONS: THE 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. FORM 990, PART VI, SECTION B, LINE 11B REVIEW PROCESS FOR FORM 990: 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 MEMBER'S FINANCE COMMITTEE AND BOARD OF DIRECTORS REVIEW BEFORE THE FORM IS FILED. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST: OFFICERS, 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. Should an actual or potential conflict of interest be identified, it will be addressed within the framework of the "chain of command" established through governance, medical, and administrative structures. Individuals and/or entities are expected to remove themselves from engaging in any aspect of care, treatment, or service that may be negatively impacted due to an actual or potential conflict of interest. FORM 990, PART VI, SECTION B, LINES 15A & 15B COMPENSATION REVIEW PROCESS: OFFICERS, 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. FORM 990, PART VI, SECTION C, LINE 19 PROCESS OF MAKING GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC: COPIES OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS ARE PROVIDED TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: TRANSFER FROM SHANNON MEDICAL CENTER $ 18,124,644 TRANSFER TO SHANNON BUSINESS SERVICES $ (47,435) TRANSFER TO SHANNON REAL ESTATE SERVICES $ (38,633) TRANSFER FROM SHANNON MEDICAL MANAGEMENT $ 86,541,525 TRANSFER TO SHANNON HEALTH SYSTEM $(13,383,018) OTHER TRANSFERS $ (82) --------------- TOTAL $ 91,197,001 FORM 990, PART VI, SECTION A, LINE 2 FAMILY RELATIONSHIPS: RUDY AND CHRISTOPHER HADDAD HAVE A FAMILY RELATIONSHIP. TRUSTEES SHANNON WEST TEXAS HOSPITAL PO BOX 49 SAN ANGELO TX 76902 750800679 TRUST TX 501(C)(3) 12B NA false SHANNON RURAL HEALTH CLINICS INC 120 E HARRIS AVE SAN ANGELO TX 76903 752940211 HEALTHCARE TX 501(C)(3) 12C SMC true SHANNON REAL ESTATE SERVICES INC 120 E HARRIS AVE SAN ANGELO TX 76903 270075630 SUPPORT SVCS TX 501(C)(3) 12A na true SHANNON HEALTH SYSTEM 120 E HARRIS AVE SAN ANGELO TX 76903 752602411 HEALTHCARE TX 501(C)(3) 12B TSWTMH false SHANNON MEDICAL CENTER 120 E HARRIS AVE SAN ANGELO TX 76903 752559845 HEALTHCARE TX 501(C)(3) 3 SHS true SHANNON BUSINESS SERVICES INC 120 E HARRIS AVE SAN ANGELO TX 76903 432038769 SUPPORT SVCS TX 501(C)(3) 12A SMC true SHANNON MEDICAL MANAGEMENT 120 E BEAUREGARD SAN ANGELO TX 76903 208367966 SUPPORT SVCS TX 501(C)(3) 12B SHS true SHANNON MEDICAL CENTER PIONEER FDN 120 E HARRIS AVE SAN ANGELO TX 76903 352229303 SUPPORT TX 501(C)(3) 12A SMC true REGIONAL CANCER TREATMENT CENTER 102 N MAGDALEN 120 San Angelo TX 76902 752225955 RADIOTHERAPY TX NA LEGACY MANAGEMENT SERVICES 2018 PULLIAM ST SAN ANGELO TX 76903 752544450 MANAGEMENT TX NA C-CORPORATION false LEGACY HEALTH SOLUTIONS 2018 PULLIAM ST SAN ANGELO TX 76903 200720762 MED INSURANCE TX NA C-CORPORATION false false false false false false false false false false false false false true true true true true true true SHANNON MEDICAL MANAGEMENT M 99699000 BOOK VALUE SHANNON HEALTH SYSTEM R 13383018 BOOK VALUE SHANNON MEDICAL CENTER S 18124644 BOOK VALUE SHANNON MEDICAL MANAGEMENT S 86541525 BOOK VALUE