2018-08-15T08:52:00-05:00 2017-09-30 BKD LLP 2700 Post Oak Blvd Ste 1500 HOUSTON TX 77056 990 2016-10-01 752600873 Shannon Clinic % SHANNON CLINIC ATTN SHAN 3256581511 PO Box 22000 San Angelo TX 76902 SHANE PLYMELL ceo 3256581511 2018-08-15 true M P Gerich P00226776 7134994600 2016 2022-09-23 18:48:47Z SHANE PLYMELL PO Box 22000 SAN ANGELO TX 76902 163895183 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 0 290 10 0 0 0 0 149515240 163895183 -571 0 0 0 149514669 163895183 0 0 0 0 100903066 110776515 0 0 0 89670336 97500847 190573402 208277362 -41058733 -44382179 33749390 36784642 28607787 33790969 5141603 2993673 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 198339526 163895183 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. 198339526 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 290 true false 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 361789 0 70587 JOE MIMS PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 591949 0 88906 DOUG SCHULTZ PHYSICIAN/MEDICAL DIRECTOR 40.0 0.0 X 345601 0 53904 NORMA CERNA PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 255535 0 69670 ANDREW T KINGMAN PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 592745 0 89197 CALEB VOSBURG PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 786004 0 93692 DAVID BOSWELL PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 436588 0 76168 JASON FELGER PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 650368 0 99950 JENNY WIGGINS-SMITH PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 515112 0 87611 LINDY BANKES PHYSICIAN/BOARD SECRETARY 40.0 0.0 X X 627012 0 72204 PAUL BORGFELD PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 452276 0 79013 ROSS HARPER PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 764803 0 98192 RUDY HADDAD PHYSICIAN/BOARD DIRECTOR 40.0 0.0 X 1188266 0 107072 SARAH JACKSON-VANCE PHYSICIAN/CHAIRMAN 40.0 0.0 X X 436891 0 68340 STEVEN BURGESS PHYSICIAN/CHAIRMAN 40.0 0.0 X X 471371 0 71589 BRYAN HORNER CEO/PRESIDENT (THRU 12/31/16) 10.0 30.0 X 0 847012 23200 KELLY SHANE PLYMELL CEO/PRESIDENT 5.0 35.0 X 0 601058 58148 IRVIN ZEITLER MEDICAL DIRECTOR 10.0 30.0 X 0 565887 45954 LISA HILL GENERAL COUNSEL 20.0 20.0 X 0 319788 41123 DAVID HUCHTON PHYSICIAN 40.0 0.0 X 1473854 0 85584 CHRISTOPHER HADDAD PHYSICIAN 40.0 0.0 X 1333691 0 107072 LUIS DUARTE PHYSICIAN 40.0 0.0 X 4583699 0 106490 RAJ CHERUKU PHYSICIAN 40.0 0.0 X 1251182 0 77077 STEVE RITTER PHYSICIAN 40.0 0.0 X 1299621 0 69792 JAMES MELOTT PHYSICIAN/FORMER OFFICER 40.0 0.0 X 300322 0 69469 JOHN HARVEY PHYSICIAN/FORMER OFFICER 40.0 0.0 X 406805 0 75976 CHRIS COLE PHYSICIAN/FORMER OFFICER 40.0 0.0 X 812405 0 102858 ANTHONY DEMORY PHYSICIAN/FORMER OFFICER 40.0 0.0 X 753664 0 64712 LAURA ADAMS PHYSICIAN/FORMER OFFICER 40.0 0.0 X 570749 0 80218 GARY GIBIAN FORMER SMM EXECUTIVE DIRECTOR 0.0 0.0 X 0 421353 35234 21262302 2755098 2269002 215 true true false SHANNON MEDICAL MANAGEMENT 120 E BEAUREGARD SAN ANGELO TX 76903 MANAGEMENT SERVICES 54649755 ARUP LABORATORIES 500 CHIPETA WAY SALT LAKE CITY UT 84108 OUTSIDE LAB SERVICES 1192560 PULMONARY CRITICAL CARE CONSULTAN 1305 W 34TH STREET STE 400 AUSTIN TX 78705 LOCUMS SERVICES 1012000 SHANNON MEDICAL CENTER 120 E HARRIS SAN ANGELO TX 76903 LAB & LAUNDRY SVCS 959180 HAYES LOCUMS LLC 6700 N ANDREWS AVE STE 600 FT LAUDERDALE FL 33309 LOCUMS SERVICES 852513 16 0 Net Patient Service Revenue 621990 144680476 144680476 Lease Income 532000 7720 7720 HOSPITAL BASED PHYSICIANS' ASSISTANCE 900099 17032314 17032314 MISCELLANOUS INCOME 900099 2174673 2174673 163895183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163895183 163895183 0 0 0 0 8476310 8476310 3043184 3043184 87396863 86213729 1183134 6176517 6144647 31870 2206792 2188083 18709 3476849 3455750 21099 55514409 47187248 8327161 15431 15431 46468 46468 0 0 0 6821299 6621916 199383 325809 325809 589978 550718 39260 12994 12994 0 18389 18389 441666 441666 0 0 0 0 1001458 1001458 153267 98708 54559 Bad Debt 19167997 19167997 Medical Supplies 11383823 11383823 RECRUITING/NEW HIRE EXPENSE 523448 523448 Education 729897 729135 762 754514 754514 208277362 198339526 9937836 0 21285 0 0 0 0 0 14875982 15304473 0 0 0 0 270668 192083 485927 416058 1004094 892070 17155192 13815259 2938311 3339933 0 0 0 0 0 0 0 0 14153123 16640025 33749390 36784642 10138166 13145676 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18469621 20645293 28607787 33790969 X 5141603 2993673 0 0 0 0 5141603 2993673 33749390 36784642 X -44382179 42234249 X false true X true false X 0 0 0 0 0 0 122449477 130516856 136780927 149515240 163809253 703071753 0 0 0 122449477 130516856 136780927 149515240 163809253 703071753 0 0 0 703071753 0 0 0 0 0 122449477 130516856 136780927 149515240 163809253 703071753 1.00000 1.00000 0.00000 0.00000 X 17155192 13815259 3339933 3339933 Retirement Fund 16640025 16640025 0 Pension Fund Liability 19157898 Health Claims Payable 232115 Estimated Malpractice Costs 1255280 20645293 88511621 88511621 75383562 75383562 163895183 132893800 132893800 75383562 75383562 208277362 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 $ 56,215,565 BAD DEBT EXPENSE 19,167,997 ----------- $ 75,383,562 true true false false false false false false false JAMES MELOTT PHYSICIAN/FORMER OFFICER 211378 0 73998 0 14946 0 47468 0 22001 0 369791 0 JOHN HARVEY PHYSICIAN/FORMER OFFICER 286729 0 86481 0 33595 0 48020 0 27956 0 482781 0 VIKI FORLANO HALFMANN PHYSICIAN/BOARD DIRECTOR 246971 0 99269 0 15549 0 47468 0 23119 0 432376 0 CHRIS COLE PHYSICIAN/FORMER OFFICER 602879 0 147710 0 61816 0 72532 0 30326 0 915263 0 ANTHONY DEMORY PHYSICIAN/FORMER OFFICER 609118 0 117657 0 26889 0 35096 0 29616 0 818376 0 LAURA ADAMS PHYSICIAN/FORMER OFFICER 417965 0 124332 0 28452 0 58116 0 22102 0 650967 0 JOE MIMS PHYSICIAN/BOARD DIRECTOR 415196 0 149152 0 27601 0 58876 0 30030 0 680855 0 IRVIN ZEITLER MEDICAL DIRECTOR 0 411286 0 136601 0 18000 0 40347 0 5607 0 611841 BRYAN HORNER CEO/PRESIDENT (THRU 12/31/16) 0 640125 0 188887 0 18000 0 10600 0 12600 0 870212 DOUG SCHULTZ PHYSICIAN/MEDICAL DIRECTOR 302535 0 29053 0 14013 0 46094 0 7810 0 399505 0 DAVID HUCHTON PHYSICIAN 882607 0 559798 0 31449 0 64668 0 20916 0 1559438 0 GARY GIBIAN FORMER SMM EXECUTIVE DIRECTOR 0 0 0 0 0 421353 0 0 0 35234 0 456587 NORMA CERNA PHYSICIAN/BOARD DIRECTOR 196947 0 44234 0 14354 0 47449 0 22221 0 325205 0 ANDREW T KINGMAN PHYSICIAN/BOARD DIRECTOR 412295 0 145821 0 34629 0 59871 0 29326 0 681942 0 CALEB VOSBURG PHYSICIAN/BOARD DIRECTOR 544090 0 195306 0 46608 0 67516 0 26176 0 879696 0 DAVID BOSWELL PHYSICIAN/BOARD DIRECTOR 306383 0 109204 0 21001 0 53260 0 22908 0 512756 0 JASON FELGER PHYSICIAN/BOARD DIRECTOR 547524 0 44748 0 58096 0 71044 0 28906 0 750318 0 JENNY WIGGINS-SMITH PHYSICIAN/BOARD DIRECTOR 334133 0 180709 0 270 0 58116 0 29495 0 602723 0 LINDY BANKES PHYSICIAN/BOARD SECRETARY 444738 0 164663 0 17611 0 51260 0 20944 0 699216 0 PAUL BORGFELD PHYSICIAN/BOARD DIRECTOR 420116 0 14063 0 18097 0 55253 0 23760 0 531289 0 ROSS HARPER PHYSICIAN/BOARD DIRECTOR 616823 0 147710 0 270 0 72532 0 25660 0 862995 0 RUDY HADDAD PHYSICIAN/BOARD DIRECTOR 734225 0 390258 0 63783 0 85260 0 21812 0 1295338 0 SARAH JACKSON-VANCE PHYSICIAN/CHAIRMAN 285852 0 124484 0 26555 0 58860 0 9480 0 505231 0 STEVEN BURGESS PHYSICIAN/CHAIRMAN 387429 0 69375 0 14567 0 47468 0 24121 0 542960 0 CHRISTOPHER HADDAD PHYSICIAN 739576 0 530332 0 63783 0 85260 0 21812 0 1440763 0 LUIS DUARTE PHYSICIAN 2460210 0 2061242 0 62247 0 77164 0 29326 0 4690189 0 RAJ CHERUKU PHYSICIAN 880953 0 311960 0 58269 0 63100 0 13977 0 1328259 0 STEVE RITTER PHYSICIAN 329600 0 951331 0 18690 0 60404 0 9388 0 1369413 0 KELLY SHANE PLYMELL CEO/PRESIDENT 0 449578 0 133480 0 18000 0 39795 0 18353 0 659206 LISA HILL GENERAL COUNSEL 0 293728 0 26060 0 0 0 28654 0 12469 0 360911 SCHEDULE J, PART I, LINE 4A Gary Gibian received $326,725 of severance payment during the year. SCHEDULE J, PART I, LINE 4B SERP DETAIL NAME AMOUNT SHANE PLYMELL NONE NONQUALIFIED PLAN PARTICIPANTS NAME AMOUNT ANDREW T. KINGMAN $ 34,389 ANTHONY DEMORY $ 25,599 CALEB VOSBURG $ 33,708 CHRIS COLE $ 41,836 DAVID BOSWELL $ 20,731 DAVID HUCHTON $ 30,999 DOUG SCHULTZ $ 12,033 JAMES MELOTT $ 14,256 JASON FELGER $ 39,646 JOE MIMS $ 25,621 JOHN HARVEY $ 14,905 LAURA ADAMS $ 28,002 LINDY BANKES $ 17,341 LUIS DUARTE $ 43,557 NORMA CERNA $ 14,084 PAUL BORGFELD $ 16,807 RAJ CHERUKU $ 38,979 SARAH JACKSON VANCE $ 26,255 STEVEN BURGESS $ 14,117 VIKI FORLANO HALFMANN $ 14,259 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. 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. RUDY HADDAD PHYSICIAN/BOARD DIRECTOR VARIOUS X 300000 30000 false true true CHRIS HADDAD PHYSICIAN VARIOUS X 300000 30000 false true true 60000 DAVID VANCE S. JACKSON-VANCE'S SPOUSE 479509 SHANNON CLINIC EMPLOYEE false SUSAN SCHULTZ D. SCHULTZ'S SPOUSE 41718 SHANNON CLINIC EMPLOYEE false RUDY HADDAD C. HADDAD'S BROTHER 1188266 SHANNON CLINIC EMPLOYEE false CHRIS HADDAD R. HADDAD'S BROTHER 1333691 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 $ 42,234,249 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 55514409 BOOK VALUE