2019-08-15T18:00:25-05:00 2018-09-30 BKD LLP 2700 Post Oak Blvd Ste 1500 HOUSTON TX 77056 990 2017-10-01 752600873 Shannon Clinic % SHANNON CLINIC ATTN SHAN 3256581511 PO Box 22000 San Angelo TX 76902 SHANE PLYMELL ceo 3256581511 2019-08-15 true Kevin R Ensminger P01310558 7134994600 167.68.126.162 76915820192275000013 2019-08-15 P 9CE27632F8A31BDEDC66663DBA4FDD4224869B4E 21E6481FF4EC5D606F81E380A49442717B3AD96E 2017 2019-02-21 02:37:17Z SHANE PLYMELL PO Box 22000 SAN ANGELO TX 76902 170121586 false X SHANNONHEALTH.COM X 1995 TX FOUNDED ON A LEGACY OF CARING, SHANNON IS A LOCALLY OWNED HEALTHCARE A LOCALLY OWNED HEALTHCARE SYSTEM DEDICATED TO PROVIDING EXCEPTIONAL HEALTHCARE FOR OUR FAMILY, FRIENDS, AND NEIGHBORS. 17 0 302 10 0 1160 0 0 163895183 170090402 0 31184 0 0 163895183 170121586 0 0 0 0 110776515 118433563 0 0 0 97500847 106476793 208277362 224910356 -44382179 -54788770 36784642 40414446 33790969 35387116 2993673 5027330 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 214029441 170090402 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. 214029441 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 true false false true false false false false false false true true true false false true 90 0 true 302 true true true false false false false false false false false false X 17 0 false true false false true true true true true false false false true true true true true true true false X SHANNON CLINIC ATTN 3256581511 ADMINISTRATION 120 E BEAUREGARD SAN ANGELO TX 76903 X VIKI FORLANO HALFMANN PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 373983 0 72765 JOE MIMS PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 611751 0 84701 NORMA CERNA PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 306158 0 72014 ANDREW T KINGMAN PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 601269 0 91895 CALEB VOSBURG PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 801602 0 96990 DAVID BOSWELL PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 473031 0 76217 JASON FELGER PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 787913 0 102907 JENNY WIGGINS-SMITH PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 544672 0 90030 LINDY BANKES PHYSICIAN/BOARD SECRETARY 40.0 0.0 X X 745670 0 73278 PAUL BORGFELD PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 473019 0 80987 ROSS HARPER PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 850046 0 104641 RUDY HADDAD PHYSICIAN/CHAIRMAN 40.0 0.0 X X 1449370 0 109525 SARAH JACKSON-VANCE PHYSICIAN/CHAIRMAN 40.0 0.0 X X 481668 0 67999 STEVEN BURGESS THRU 81718 PHYSICIAN/CHAIRMAN 40.0 0.0 X X 486149 0 69746 KELLY SHANE PLYMELL CEO/PRESIDENT 5.0 35.0 X 0 672914 92952 IRVIN ZEITLER MEDICAL DIRECTOR (THRU 3/1/18) 5.0 35.0 X 0 536467 72392 DOUG SCHULTZ PHYSICIAN/MEDICAL DIRECTOR 40.0 0.0 X 417098 0 54380 LISA HILL GENERAL COUNSEL 5.0 35.0 X 0 388965 67732 CHRIS BARNETT MEDICAL DIRECTOR 5.0 35.0 X 0 603757 56571 CHRIS COLE PHYSICIAN 40.0 0.0 X 877204 0 105206 DAVID HUCHTON PHYSICIAN 40.0 0.0 X 1405975 0 88233 CHRISTOPHER HADDAD PHYSICIAN 40.0 0.0 X 1589256 0 108225 LUIS DUARTE PHYSICIAN 40.0 0.0 X 4983536 0 107788 STEVE RITTER PHYSICIAN 40.0 0.0 X 1487234 0 70214 JAMES MELOTT PHYSICIAN/FORMER OFFICER 40.0 0.0 X 361462 0 72018 JOHN HARVEY PHYSICIAN/FORMER OFFICER 40.0 0.0 X 420885 0 56813 ANTHONY DEMORY PHYSICIAN/FORMER OFFICER 40.0 0.0 X 210957 0 46587 LAURA ADAMS PHYSICIAN/FORMER OFFICER 40.0 0.0 X 488969 0 81621 BRYAN HORNER FORMER CEO/PRESIDENT 0.0 5.0 X 0 2544323 2326 21228877 4746426 2276753 24 true true false SHANNON MEDICAL MANAGEMENT 120 E BEAUREGARD SAN ANGELO TX 76903 MANAGEMENT SERVICES 58626406 ARUP LABORATORIES 500 CHIPETA WAY SALT LAKE CITY UT 84108 OUTSIDE LAB SERVICES 1028865 PULMONARY CRITICAL CARE CONSULTAN 1305 W 34TH STREET STE 400 AUSTIN TX 78705 LOCUMS SERVICES 608000 SHANNON MEDICAL CENTER 120 E HARRIS SAN ANGELO TX 76903 LAB & LAUNDRY SVCS 785873 HAYES LOCUMS LLC 6700 N ANDREWS AVE STE 600 FT LAUDERDALE FL 33309 LOCUMS SERVICES 611726 16 0 Net Patient Service Revenue 621990 149588428 149588428 Lease Income 532000 8506 8506 Miscellaneous Income 900099 2415699 2415699 HOSPITAL BASED PHYSICIANS' ASSISTANCE 900099 18077769 18077769 170090402 29184 29184 0 0 0 0 0 2000 2000 2000 2000 0 0 0 0 0 0 0 0 0 0 170121586 170090402 31184 0 0 0 0 9403399 9403399 3559115 3559115 93428103 92245089 1183014 6559827 6509281 50546 1839300 1815324 23976 3643819 3622591 21228 62686020 53283117 9402903 51172 51172 51698 51698 0 0 0 6237057 6223695 13362 59063 59063 523518 515807 7711 24273 24273 0 41185 41185 425700 425700 0 0 0 0 1152263 1152263 549768 475604 74164 Bad Debt 20195134 20195134 Medical Supplies 12528248 12528248 EDUCATION 812321 811180 1141 RECRUITING/NEW HIRE EXPENSE 428413 428413 710960 710960 224910356 214029441 10880915 0 0 0 0 0 0 0 15304473 16757132 0 0 0 0 192083 409181 416058 474274 892070 831077 18331232 14946836 3339933 3384396 0 0 0 0 0 0 0 0 16640025 18558386 36784642 40414446 13145676 12309823 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20645293 23077293 33790969 35387116 X 2993673 5027330 0 0 0 0 2993673 5027330 36784642 40414446 X -54788770 56822427 X false true X true false X 0 0 0 0 0 0 130516856 136780927 149515240 163809253 170090402 750712678 0 0 0 130516856 136780927 149515240 163809253 170090402 750712678 0 0 0 750712678 29184 29184 0 29184 29184 0 0 130516856 136780927 149515240 163809253 170119586 750741862 0.99996 1.00000 0.00004 0.00000 X 18331232 14946836 3384396 3384396 Retirement Fund 18558386 18558386 0 Pension Fund Liability 21203088 Health Claims Payable 244005 Estimated Malpractice Costs 1630200 23077293 86620244 86620244 83501342 83501342 170121586 141409014 141409014 83501342 83501342 224910356 FIN 48 DISCLOSURE 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, PARTS XI & XII LINE 4B RECONCILIATION OF REVENUE & EXPENSES PER AUDITED F/S WITH RETURN INCOME/EXPENSE RECLASSES FROM AUDIT $ 63,306,208 BAD DEBT EXPENSE $ 20,195,134 ----------- $ 83,501,342 false true false false false false false false false JAMES MELOTT PHYSICIAN/FORMER OFFICER 220376 0 101552 0 39534 0 47468 0 24550 0 433480 0 0 0 JOHN HARVEY PHYSICIAN/FORMER OFFICER 278222 0 82809 0 59854 0 48020 0 8793 0 477698 0 0 0 VIKI FORLANO HALFMANN PHYSICIAN/BOARD DIRECTOR 224983 0 108627 0 40373 0 47468 0 25297 0 446748 0 0 0 CHRIS COLE PHYSICIAN 597070 0 189000 0 91134 0 72532 0 32674 0 982410 0 0 0 ANTHONY DEMORY PHYSICIAN/FORMER OFFICER 163030 0 47604 0 323 0 35096 0 11491 0 257544 0 0 0 LAURA ADAMS PHYSICIAN/FORMER OFFICER 354494 0 79853 0 54622 0 58116 0 23505 0 570590 0 0 0 JOE MIMS PHYSICIAN/BOARD DIRECTOR 395753 0 161203 0 54795 0 58876 0 25825 0 696452 0 0 0 IRVIN ZEITLER MEDICAL DIRECTOR (THRU 3/1/18) 0 466510 0 69957 0 0 0 66303 0 6089 0 608859 0 0 BRYAN HORNER FORMER CEO/PRESIDENT 0 66562 0 0 0 2477761 0 2326 0 0 0 2546649 0 0 DOUG SCHULTZ PHYSICIAN/MEDICAL DIRECTOR 360819 0 13893 0 42386 0 46094 0 8286 0 471478 0 0 0 DAVID HUCHTON PHYSICIAN 899679 0 452000 0 54296 0 64668 0 23565 0 1494208 0 0 0 NORMA CERNA PHYSICIAN/BOARD DIRECTOR 198282 0 65470 0 42406 0 47449 0 24565 0 378172 0 0 0 ANDREW T KINGMAN PHYSICIAN/BOARD DIRECTOR 430848 0 170151 0 270 0 59871 0 32024 0 693164 0 0 0 CALEB VOSBURG PHYSICIAN/BOARD DIRECTOR 516668 0 209809 0 75125 0 67516 0 29474 0 898592 0 0 0 DAVID BOSWELL PHYSICIAN/BOARD DIRECTOR 303331 0 120134 0 49566 0 53260 0 22957 0 549248 0 0 0 JASON FELGER PHYSICIAN/BOARD DIRECTOR 647569 0 48845 0 91499 0 71044 0 31863 0 890820 0 0 0 JENNY WIGGINS-SMITH PHYSICIAN/BOARD DIRECTOR 312026 0 204035 0 28611 0 58116 0 31914 0 634702 0 0 0 LINDY BANKES PHYSICIAN/BOARD SECRETARY 494848 0 205030 0 45792 0 51260 0 22018 0 818948 0 0 0 PAUL BORGFELD PHYSICIAN/BOARD DIRECTOR 416726 0 15000 0 41293 0 55253 0 25734 0 554006 0 0 0 ROSS HARPER PHYSICIAN/BOARD DIRECTOR 612758 0 189000 0 48288 0 72532 0 32109 0 954687 0 0 0 RUDY HADDAD PHYSICIAN/CHAIRMAN 734925 0 566937 0 147508 0 85260 0 24265 0 1558895 0 0 0 SARAH JACKSON-VANCE PHYSICIAN/CHAIRMAN 303692 0 124706 0 53270 0 58860 0 9139 0 549667 0 0 0 STEVEN BURGESS THRU 81718 PHYSICIAN/CHAIRMAN 338689 0 105033 0 42427 0 47468 0 22278 0 555895 0 0 0 CHRISTOPHER HADDAD PHYSICIAN 759646 0 703873 0 125737 0 85260 0 22965 0 1697481 0 0 0 LUIS DUARTE PHYSICIAN 2510087 0 2379206 0 94243 0 77164 0 30624 0 5091324 0 0 0 STEVE RITTER PHYSICIAN 339700 0 1097729 0 49805 0 60404 0 9810 0 1557448 0 0 0 KELLY SHANE PLYMELL CEO/PRESIDENT 0 609536 0 63378 0 0 0 73458 0 19494 0 765866 0 0 LISA HILL GENERAL COUNSEL 0 339577 0 49388 0 0 0 54299 0 13433 0 456697 0 0 CHRIS BARNETT MEDICAL DIRECTOR 0 573683 0 30074 0 0 0 52951 0 3620 0 660328 0 0 SCHEDULE J, PART I, LINE 4B SERP DETAIL NAME AMOUNT SHANE PLYMELL NONE NONQUALIFIED PLAN PARTICIPANTS NAME AMOUNT CALEB VOSBURG $ 62,225 CHRIS COLE $ 71,154 CHRISTOPHER HADDAD $ 61,924 DAVID BOSWELL $ 49,296 DAVID HUCHTON $ 53,606 DOUG SCHULTZ $ 38,576 JAMES MELOTT $ 38,844 JASON FELGER $ 73,049 JENNY WIGGINS-SMITH $ 28,341 JOE MIMS $ 52,815 JOHN HARVEY $ 41,164 LAURA ADAMS $ 53,932 LINDY BANKES $ 45,522 LUIS DUARTE $ 74,953 NORMA CERNA $ 42,136 PAUL BORGFELD $ 40,003 ROSS HARPER $ 48,018 RUDY HADDAD $ 61,924 SARAH JACKSON VANCE $ 52,970 STEVE RITTER $ 31,115 STEVEN BURGESS $ 41,977 VIKI FORLANO HALFMANN $ 39,083 Participants in the 457f Retirement Allowance Plan are key employees whose expected compensation is higher than $125,000. EACH QUARTER, THEY RECEIVE 8% OF THEIR BASE SALARY FOR THE PRECEDING 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. DATE IS AFTER JUNE 30TH OF THE SECOND CALENDAR YEAR FOLLOWING THE PLAN YEAR FOR WHICH THE MUTUAL FUND ACCOUNT WAS CREATED. YEAR FOR WHICH THE MUTUAL FUND ACCOUNT WAS CREATED. 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. SERP DISTRIBUTION NAME AMOUNT ----------- ----------- BRYAN HORNER 2,477,761 RUDY HADDAD PHYSICIAN/BOARD VARIOUS X 300000 false true true CHRIS HADDAD PHYSICIAN VARIOUS X 300000 false true true DAVID VANCE JACKSON-VANCE'S SPOUSE 513565 SHANNON CLINIC EMPLOYEE false SUSAN SCHULTZ SCHULTZ'S SPOUSE 6924 SHANNON CLINIC EMPLOYEE false RUDY HADDAD CHRIS HADDAD'S BROTHER 1449370 SHANNON CLINIC EMPLOYEE false CHRIS HADDAD RUDY HADDAD'S BROTHER 1589256 SHANNON CLINIC EMPLOYEE false FORM 990, PART VI, SECTION A, LINE 3 ADMINISTRATIVE SERVICES FOR SHANNON CLINIC ARE CONTRACTED WITH SHANNON MEDICAL MANAGEMENT. FORM 990, PART VI, SECTION A, LINE 6 SHANNON HEALTH SYSTEM, A 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF SHANNON CLINIC. FORM 990, PART VI, SECTION A, LINE 7A THE 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. FORM 990, PART VI, SECTION A, LINE 7B 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 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 WILL REVIEW AFTER THE FORM IS FILED. FORM 990, PART VI, SECTION B, LINE 12C 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. FORM 990, PART VI, SECTION B, LINES 15A & 15B 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 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 OR FUND BALANCES TRANSFER TO/FROM AFFILIATES $ 56,822,427 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 false SHANNON REAL ESTATE SERVICES INC 120 E HARRIS AVE SAN ANGELO TX 76903 270075630 SUPPORT SVCS TX 501(C)(3) 12B SMC false SHANNON HEALTH SYSTEM 120 E HARRIS AVE SAN ANGELO TX 76903 752602411 HEALTHCARE TX 501(C)(3) 12A NA false SHANNON MEDICAL CENTER 120 E HARRIS AVE SAN ANGELO TX 76903 752559845 HEALTHCARE TX 501(C)(3) 3 NA false SHANNON BUSINESS SERVICES INC 120 E HARRIS AVE SAN ANGELO TX 76903 432038769 SUPPORT SVCS TX 501(C)(3) 12B SMC false SHANNON MEDICAL MANAGEMENT 120 E BEAUREGARD SAN ANGELO TX 76903 208367966 SUPPORT SVCS TX 501(C)(3) 10 SHS 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 1M 62686020 BOOK VALUE