2023-07-06T06:03:32-05:00 2022-09-30 FORVIS LLP 14241 DALLAS PARKWAY SUITE 1100 DALLAS TX 75254 990 2021-10-01 750800679 Trustees Of Shannon West Texas Memorial Hospital % LEN P MERTZ TRUS 3256558974 PO Box 49 San Angelo TX 76902 LEN P MERTZ MANAGING TRUSTEE 3256558974 2023-02-15 true LEN P MERTZ 999009999 Noelle Alberto P01704142 9727028262 2 2021 2023-04-26 12:10:37Z LEN P MERTZ PO BOX 49 SAN ANGELO TX 76902 79654011 false X N/A X 1932 TX SUPPORT, MAINTENANCE, AND OPERATION OF A HOSPITAL IN WEST TEXAS. 7 7 2 0 0 0 0 0 0 0 6843827 3425006 7114922 13335271 13958749 16760277 1600000 24600000 0 0 369574 377095 0 0 0 2915425 3932814 4884999 28909909 9073750 -12149632 543070815 573298861 52068196 81916815 491002619 491382046 SUPPORT, MAINTENANCE, AND OPERATION OF A HOSPITAL IN WEST TEXAS. false false 24600000 24600000 CONTRIBUTIONS OF CASH OR ASSETS FOR THE OPERATION, MAINTENANCE OR EXPANSION OF THE SHANNON MEDICAL CENTER 24600000 true false false false false false false false false false true false false true false false false true false false false false false false false false false true false true false false false false false false false false false false false false false true true true false false true 12 0 true 2 true false false false false false false false false false false false false X 7 7 false false false false false false false true true false false true true true true true true false false false TX X LEN P MERTZ 3256558974 36 W BEAUREGARD SUITE 700 SAN ANGELO TX 76903 X ORAN H BERRY III TRUSTEE 4.0 4.0 X 49808 23855 0 MICHAEL E OLIPHANT TRUSTEE 4.0 4.0 X 49902 21255 0 JOHN STEVE CECIL TRUSTEE 4.0 4.0 X 43743 25000 0 MICHAEL TED WEATHERFORD TRUSTEE 4.0 4.0 X 47147 21350 0 JEFFREY MCCORMICK TRUSTEE 4.0 4.0 X 30094 24600 0 FREDDY L MOORE TRUSTEE 4.0 4.0 X 29050 24600 0 LEN P MERTZ TRUSTEE 20.0 20.0 X X 30240 0 0 JOE W HENDERSON FORMER TRUSTEE 0.0 0.0 X 12215 0 0 292199 140660 0 0 true false false GOLDMAN SACHS 100 CRESCENT COURT SUITE 100 DALLAS TX 75201 INVESTMENT MGMT 978843 1 0 0 4045365 4045365 0 9588994 9588994 3297403 18079 3279324 0 3279324 3279324 61695296 560000 62625854 249801 -930558 310199 -620359 -620359 0 0 0 0 0 0 0 0 0 0 Damages/O/G Leases 211110 466953 466953 466953 16760277 0 16760277 24600000 24600000 0 0 0 184273 184273 0 159384 159384 0 20669 20669 12769 12769 0 0 26645 26645 0 0 1190370 1190370 4435 4435 0 11220 11220 0 0 34800 34800 0 0 0 1484791 1484791 0 728743 728743 7420 7420 Ad Valorem Taxes 220810 220810 Repairs & Maintenance 120184 120184 Trustee Expenses 98576 98576 Loan Origination Fee 2280 2280 2540 2540 28909909 24600000 4309909 0 0 0 6909386 5778401 0 0 0 0 0 0 0 0 29700753 29700753 0 0 0 0 23975725 2234386 22471795 21741339 155362032 162740564 0 0 0 0 0 0 328626849 353337804 543070815 573298861 0 0 0 0 112078 112078 0 0 0 0 0 0 18019203 17347822 33936915 64456915 0 0 52068196 81916815 X 491002619 491382046 0 0 491002619 491382046 543070815 573298861 X -12149632 -23056916 35585975 X false true X true false X X 1 SHANNON MEDICAL CENTER 752559845 3 true 24600000 0 1 24600000 0 true false false false false false false false false false false false false false false true 2656406 2656406 21194527 2128631 19065896 51138 36217 14921 73654 69538 4116 21741339 Investment in Shannon Medical 352964836 Mineral Interests Nonproducing 400 Accrued Interest Receivable 372568 353337804 5118883 -12070941 -12070941 17189824 -429547 -429547 16760277 4739456 429547 429547 4309909 24600000 24600000 28909909 Schedule D, Part X, Line 2 ASC 740 Footnote: 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 4b RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS: LOSS ON INTEREST RATE SWAP $(411,468) rent expenses (18,079) -------------------- Total $(429,547) SCHEDULE D, PART XII, LINE 2D RECONCILIATION OF EXPENSES PER AUDITED FINANCIAL STATEMENTS: LOSS ON INTEREST RATE SWAP $ 411,468 rent expenses 18,079 -------------------- Total $ 429,547 SCHEDULE D, PART XII, LINE 4B RECONCILIATION OF EXPENSES PER AUDITED FINANCIAL STATEMENTS: GRANTS TO SHANNON MEDICAL CENTER $24,600,000 true SHANNON MEDICAL CENTER 120 E HARRIS AVE SAN ANGELO TX 76903 752559845 501(C)(3) 24600000 FUND CAPITAL EXPENDITURES 1 SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS: SOME TRUSTEES SIT ON THE FINANCE COMMITTEE FOR THE ORGANIZATION RECEIVING THE FUNDS. false false false false false false false false false JOE W HENDERSON FORMER TRUSTEE 11763 0 452 0 0 0 0 0 0 0 12215 0 SCHEDULE J, PART I, LINE 3 TRUSTEE COMPENSATION: THE COMPENSATION REPORTED IS FOR BOARD EXPENSE REIMBURSEMENTS, NOT AS an EMPLOYEE. FORM 990, PART VI, SECTION B, LINE 11B REVIEW PROCESS: PRESENTED TO THE MANAGING TRUSTEE FOR REVIEW AND DISCUSSION WITH THE ACCOUNTING FIRM PREPARING THE RETURN. ANY QUESTIONS OR CONCERNS ARE DEALT WITH AND THE FINAL RETURN IS PRESENTED TO ALL OF THE BOARD OF TRUSTEES FOR FINAL APPROVAL PRIOR TO FILING THE FORM. ANY UNRESOLVED QUESTIONS AT THIS TIME ARE REFERRED TO THE ACCOUNTING FIRM FOR RESPONSE AND EXPLANATION. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: EACH TRUSTEE IS AWARE OF THE CONFLICT OF INTEREST POLICY AND ITS REQUIREMENTS. DURING THE YEAR, TRUSTEES EXCUSE THEMSELVES FROM VOTING ON ISSUES THAT THEY FEEL MAY BE A CONFLICT OF INTEREST. EACH YEAR THE TRUSTEES' BUSINESS AND NONBUSINESS RELATIONSHIPS THAT MAY REQUIRE CONFLICT OF INTEREST NOTIFICATIONS OR PROCEDURES ARE DISCUSSED AND DISCLOSED. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF DOCUMENTS: THESE DOCUMENTS ARE AVAILABLE UPON REQUEST MADE IN WRITING OR IN PERSON AT THE OFFICES OF THE ORGANIZATION. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCE: GRANTS TO SUBSIDIARY $24,600,000 CHANGE IN FAIR VALUE OF INTEREST RATE SWAP $10,985,975 ------------------ TOTAL $35,585,975 FORM 990, PART VI, SECTION A, LINE 1B INDEPENDENT BOARD MEMBERS: THE COMPENSATION REPORTED IS FOR BOARD EXPENSE REIMBURSEMENTS, NOT AS EMPLOYEE WAGES. THEREFORE, THE BOARD MEMBERS LISTED ARE NOT CONSIDERED TO LACK INDEPENDENCE. Shannon Medical Center 120 E Harris San Angelo TX 76903 752559845 Care Hospital TX 501(c)(3) 3 TRUSTEES SWT true SHANNON CLINIC 120 E HARRIS SAN ANGELO TX 76903 752600873 HEALTHCARE TX 501(C)(3) 10 SHS true SHANNON MEDICAL MANAGEMENT 120 E HARRIS SAN ANGELO TX 76903 208367966 SUPPORT SVCS TX 501(C)(3) 10 SHS true SHANNON BUSINESS SERVICES INC 120 E HARRIS SAN ANGELO TX 76903 432038769 SUPPORT SVCS TX 501(C)(3) 12B SMC true SHANNON RURAL HEALTH CLINICS INC 120 E HARRIS SAN ANGELO TX 76903 752940211 HEALTHCARE TX 501(C)(3) 12C SMC true SHANNON HEALTH SYSTEM 120 E HARRIS SAN ANGELO TX 76903 752602411 SUPPORT SVCS TX 501(C)(3) 12A TRUSTEES SWT true SHANNON REAL ESTATE SERVICES INC 120 E HARRIS AVE SAN ANGELO TX 76903 270075630 SUPPORT SVCS TX 501(C)(3) 12B SMC true false true false true false false false true false false false false false false false false true true false SHANNON MEDICAL CENTER B/R 24600000 cash SHANNON REAL ESTATE SERVICES H 297089 BOOK VALUE SHANNON MEDICAL CENTER D 29700753 Cash