2018-08-15T08:45:08-05:00 2017-09-30 BKD LLP 2700 Post Oak Blvd Ste 1500 HOUSTON TX 77056 990 2016-10-01 752559845 Shannon Medical Center % SHANNON MEDICAL CENTER SHAN 3256536741 120 E Harris Avenue San Angelo TX 76903 SHANE PLYMELL CEO 3256536741 2018-08-15 true M P Gerich P00226776 7134994600 2016 2022-09-23 18:48:47Z shane plymell 120 E Harris Avenue SAN ANGELO TX 76903 342194699 false X SHANNONHEALTH.COM X 1994 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. 14 11 2278 127 364242 19764055 19944675 317208266 311672004 3486031 7790583 4221387 2606237 344679739 342013499 118657 61295 0 0 109947423 117015555 0 0 0 171569367 166190141 281635447 283266991 63044292 58746508 392361351 406369557 58327107 58153337 334034244 348216220 FOUNDED ON A LEGACY OF CARING, SHANNON IS A LOCALLY OWNED HEALTHCARE SYSTEM DEDICATED TO PROVIDING EXCEPTIONAL 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0.0 X 182471 0 10978 THOMAS PERKINS DIRECTOR OF IT 40.0 0.0 X 185809 0 11121 3853869 1622524 494545 99 false true false LOTT BROTHERS PO BOX 203594 AUSTIN TX 78720 CONSTRUCTION 14969532 HEALTH CAROUSEL LLC PO BOX 714216 CINCINNATI OH 45271 STAFFING SERVICES 1084378 KANSAS CITY SERIES LOCKTON COMPANI PO BOX 802707 KANSAS CITY MS 64180 INSURANCE 605967 SIGNET HEALTH CORP 235 W HICKORY SUITE 201 DENTON TX 76201 CONSULTING 420019 AVANT HEALTHCARE PROFESSIONALS PO BOX 60839 CHARLOTTE NC 28260 STAFFING SERVICES 414637 19 19944675 19944675 Net Patient Revenue 621990 311185296 311094568 90728 Rental Income 532000 486708 486708 311672004 2048393 125554 1922839 0 0 0 0 0 5923390 181200 5923390 -181200 5742190 5742190 0 0 0 0 0 0 0 0 0 Cafeteria 900099 1855353 1855353 All Other Misc Revenue 900099 750884 602924 147960 2606237 342013499 314039553 364242 7665029 61295 61295 0 0 0 2786961 2786961 185809 185809 95558026 74436424 21121602 2750634 2167830 582804 9221703 7052608 2169095 6512422 4941207 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5122978 5122978 85317071 61660401 23656670 1381 1381 152712535 111619966 41092569 52811542 1723803 51087739 120959956 INT IN NET ASSETS - SHANNON TR 145125154 Self Insurance Trust 3775341 Interest Receivable 334658 149235153 0 Asset Retirement Obligation 978137 Accrued Pension Cost 966503 Malpractice Costs 1158720 Due to/from third party payors 3332286 Long Term Incentive Accrual 129837 6565553 302874603 1610710 -21236771 -19626061 322500664 19512835 19512835 342013499 262030220 262030220 21236771 21236771 283266991 SCHEDULE D, PART XI, LINE 2D & PART XII, LINE 4B INCOME & EXPENSES INCLUDED IN FORM 990 NOT ON BOOKS BAD DEBT (INCLUDED W/ REVENUE ON AUDIT) $ 21,175,476 GRANTS INCLUDED IN REVENUE ON AUDIT 61,295 ----------- $ 21,236,771 SCHEDULE D, PART XI, LINE 4B INCOME INCLUDED ON THE RETURN NOT ON BOOKS CONTRIBUTIONS RECORDED TO NET ASSETS $ 19,512,835 SCHEDULE D, PART XIV 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. true true true X true X true true true false true true 14749719 14749719 0.05210 21019103 23151343 -2132241 486128 231042 255086 0.00090 36254950 23382385 12872564 0.05300 511459 511459 0.00180 591762 591762 0.00210 10123418 10123418 0.03570 151368 151368 0.00050 150617 150617 0.00050 11528624 11528624 0.04060 47783574 23382385 24401188 0.09360 true 21260042 90677710 85144201 5533509 X true true 1 1 SHANNON MEDICAL CENTER 120 E HARRIS AVENUE SAN ANGELO TX 76903 SHANNONHEALTH.COM X X X X SHANNON MEDICAL CENTER 01 false false true X X X X X X X X 16 true false false true X SEE PART V, SECTION C X true 17 true SEE PART V, SECTION C false true X 200. 200. X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 INPUT FROM COMMUNITY REPRESENTATIVES COMMUNITY INPUT WAS PROVIDED THROUGH KEY STAKEHOLDER INTERVIEWS OF FIVE STAKEHOLDERS AND A COMMUNITY SURVEY WITH 54 RESPONSES. RESULTS AND FINDINGS ARE DESCRIBED IN THE KEY STAKEHOLDER INTERVIEW RESULTS SECTION OF THE 2016 CHNA REPORT. SCHEDULE H, PART V, SECTION B, LINE 22D ALL PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE WILL BE RESPONSIBLE FOR PAYMENT OF THE AMOUNT GENERALLY BILLED (AGB) FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. THE LOOK BACK METHOD WILL BE USED TO CALCULATE AGB DISCOUNT TO BE APPLIED TO GROSS BILLED CHARGES TO DETERMINE THE AMOUNT OF PATIENT RESPONSIBILITY. THIS CALCULATION WILL BE PERFORMED ON AN ANNUAL BASIS. SCHEDULE H, PART V, SECTION B, LINE 11 THE BELOW CHNA ACTION PLAN INCLUDES DETAILS ON HOW SHANNON MEDICAL CENTER IS ADDRESSING SIGNIFICANT NEEDS IDENTIFIED IN THE CHNA CONDUCTED IN 2016. THE NEEDS ARE CATEGORIZED IN THREE PRIORITY AREAS: HEALTHY LIVING, PREVENTION AND DISEASE MANAGEMENT, AND EDUCATION. PRIORITY 1: HEALTHY LIVING -SHANNON PARTNERS WITH SAN ANGELO INDEPENDENT SCHOOL DISTRICT TO HOST AN EVENT TO PROMOTE PHYSICAL ACTIVITY FOR CHILDREN AND FAMILIES TO ADDRESS THE GROWING CONCERN OF CHILDHOOD OBESITY. THE KIDS' MARATHON EVENT PROVIDES AN OPPORTUNITY FOR STUDENTS, RANGING IN AGES FROM KINDERGARTEN THROUGH SIXTH GRADE, TO PARTICIPATE IN A PROGRAM THAT ENCOURAGES HEALTHY HABIT FORMATION EARLY IN LIFE. STUDENTS ACCUMULATE LAPS/MILES DURING A THREE-MONTH PERIOD LEADING UP TO THE EVENT, AND PARTICIPATE IN THE FINAL LAP CELEBRATION. -EACH OCTOBER SHANNON ORGANIZES THE PINK RIBBON RUN FOR CANCER AWARENESS AND EDUCATION. THIS EVENT FEATURES A 1 MILE WALK/RUN, AND A 5K, 10K RACE. -SHANNON PARTNERS WITH THE LOCAL RESTAURANT ASSOCIATION AND RESTAURANTS TO PROMOTE HEALTHIER CHOICE RESTAURANTS THROUGHOUT THE COMMUNITY. -WORKING WITH EMPLOYERS IN THE COMMUNITY TO OFFER WORKSITE WELLNESS PROGRAMS TO THEIR EMPLOYEES. SOME ACTIVITIES INCLUDE: PROVIDING FLU SHOTS, BIOMETRIC SCREENINGS, EDUCATIONAL LUNCH AND LEARNS, HEALTH FAIRS, HEALTH COACHING, AND RESOURCES. -SHANNON OFFERS AN EMPLOYEE WELLNESS PROGRAM FOR SHANNON ASSOCIATES AND SPOUSES. SOME ACTIVITIES INCLUDE: BIOMETRIC SCREENINGS, HEALTH COACHING, EDUCATIONAL RESOURCES, CHALLENGES, AND HEALTHIER OPTIONS IN THE CAFETERIA. PRIORITY 2: PREVENTION AND DISEASE MANAGEMENT -SHANNON IS ONE OF THE COLLABORATING ORGANIZATIONS OF THE TOM GREEN COUNTY PARTNERSHIP FOR BETTER HEALTH. THE PARTNERSHIP BEGAN IN JANUARY 2012 AS A RESULT OF AN INITIATIVE BY THE DEPARTMENT OF STATE HEALTH SERVICES TO REDUCE POTENTIALLY PREVENTABLE HOSPITALIZATIONS. THE COALITION IMPLEMENTS EVIDENCE-BASED STRATEGIES TO PREVENT HOSPITALIZATIONS FOR THE FOLLOWING THREE CONDITIONS: CONGESTIVE HEART FAILURE (CHF), CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) AND DIABETES COMPLICATIONS. -THE SHANNON CARE COORDINATION PROGRAM IS DESIGNED TO ASSIST IN THE HEALTHCARE OF CHRONICALLY ILL PATIENTS WITH MULTIPLE DISEASES PROCESSES. THIS PROGRAM PROVIDES AN INTENSIVE COMPREHENSIVE TEAM APPROACH TO MANAGING HIGH RISK PATIENTS BY UTILIZING PATIENT NAVIGATORS THAT REPORT TO AN INTERDISCIPLINARY TEAM AT SHANNON. ONGOING CARE OF THE IDENTIFIED HIGH RISK PATIENTS INCLUDES WEEKLY VISITS FROM THE PATIENT NAVIGATOR AND/OR MEMBER OF THE SHANNON TEAM IN ORDER TO ADDRESS HEALTH CARE ISSUES AS THEY ARISE. THE TEAM COORDINATES THE PATIENTS' HEALTHCARE WITH THE PRIMARY CARE PROVIDER'S GUIDANCE. -PROVIDE INDIGENT/CHARITY CARE SERVICES FOR LOW-INCOME CHILDREN, ADULTS AND ELDERLY. -PARTNERSHIP WITH SHANNON CLINIC: -THE EXPANSION TO THREE URGENT CARE CLINIC LOCATIONS. THEY ARE OPEN SEVEN DAYS PER WEEK WITH EXTENDED HOURS. -PHYSICIAN RECRUITMENT TO INCREASE ACCESS - INCLUDING THE ADDITION OF AN ENDOCRINOLOGIST. -OPENING THE ACCESS CLINIC TO PROVIDE FOLLOW-UP APPOINTMENTS POST-DISCHARGE FOR PATIENTS THAT DO NOT HAVE A PRIMARY CARE PROVIDER. -PARTNERSHIP WITH MHMR SERVICES OF THE CONCHO VALLEY TO PROVIDE PRIMARY CARE SERVICES IN THE BEHAVIORAL HEALTH SETTING. PRIORITY 3: EDUCATION -SHANNON PROVIDES A HOST OF COMMUNITY EDUCATION EVENTS RELATED TO TOPICS SUCH AS CANCER PREVENTION AND SCREENINGS, DIABETES EDUCATION, FITNESS AND NUTRITION, AND CARDIOVASCULAR HEALTH. THROUGH EVENTS LIKE GO RED, HEALTH PROFESSIONALS RELAY CURRENT HEALTH INFORMATION TO THE PUBLIC. -SHANNON HOSTS A FREE ONLINE HEALTH LIBRARY AS WELL AS THE WORDS OF WELLNESS HEALTH BLOG TO ACCESS HEALTH-RELATED INFORMATION. -SHANNON HOSTS THREE HEALTHBEAT LIVE TELEVISION SEGMENTS EACH WEEK ON THE NEWS TO RELAY CURRENT HEALTH INFORMATION AND EDUCATIONAL TIPS. -SHANNON PROVIDES A MONTHLY 'HOUSE CALL' ARTICLE IN THE LOCAL NEWSPAPER. THIS ARTICLE IS PROVIDED BY SHANNON PHYSICIAN THAT DISCUSSES EDUCATION AND DETECTION OF DISEASE. -SHANNON PROVIDES HEALTH AND WELLNESS PRESENTATIONS TO NUMEROUS NON-PROFITS, BUSINESSES AND ORGANIZATIONS. SOME OF THE ORGANIZATIONS INCLUDE: SAN ANGELO INDEPENDENT SCHOOL DISTRICT, EDUCATION SERVICES CENTER REGION 15, REECE ALBERT, DEVON ENERGY, AND ANGELO STATE UNIVERSITY. -REPRESENTATIVES FROM DIFFERENT DEPARTMENTS PROVIDE SUPPORT AND PARTICIPATE IN LOCAL HEALTH FAIRS AND HEALTH-RELATED COMMUNITY EVENTS. -SHANNON'S TRAUMA SERVICE DEPARTMENT COORDINATES THE ANNUAL GUS ECKHARDT TRAUMA SYMPOSIUM. THIS IS A FULL DAY OF TRAUMA RELATED EDUCATION FOR ALL HEALTH CARE PRACTITIONERS IN THE REGION. -NURSING, PHYSICAL THERAPY, SPEECH THERAPY, OCCUPATIONAL THERAPY, SOCIAL WORK, AND PSYCHOLOGY STUDENTS PARTICIPATE IN CLINICAL ROTATIONS AT SHANNON AS PART OF THEIR SCHOOL REQUIREMENTS. EXPLANATION OF NEEDS NOT ADDRESSED THERE ARE NEEDS THAT SHANNON WILL NOT ADDRESS IN THE CURRENT IMPLEMENTATION STRATEGY THAT ARE CLEARLY IMPORTANT TO IMPROVING THE HEALTH OF THE COMMUNITY. HOWEVER, THEY ARE CONSIDERED TO HAVE LESS IMMEDIATE IMPACT AND WILL BE ADDRESSED IN A FUTURE PLAN, OR IF THE OPPORTUNITY ARISES, COULD BE INCORPORATED WITHIN A CURRENT STRATEGY. SHANNON WILL CONTINUE TO EXPLORE POTENTIAL PARTNERSHIPS AND INTERNAL STRATEGIES TO FIND A WAY TO PROVIDE THESE ESSENTIAL SERVICES TO OUR PATIENTS. SCHEDULE H, PART V, SECTION B, LINES 7A & 10A CHNA AVAILABLE ON HOSPITAL FACILITY'S WEBSITE HTTPS://WWW.SHANNONHEALTH.COM/EDUCATION-RESOURCES/HEALTH-NEEDS-ASSESSMENT. ASPX IMPLEMENTATION STRATEGY AVAILABLE ON HOSPITAL FACILITY'S WEBSITE: https://www.shannonhealth.com/media/204664/Signed-Implementation-Plan-2017 .pdf SCHEDULE H, PART V, SECTION B LINE 16A FAP WEBSITE URL: https://www.shannonhealth.com/media/224035/501r-Financial-Assistance-Polic y-English-2017.pdf SCHEDULE H, PART V, SECTION B LINE 16B FAP APPLICATION FORM URL: https://www.shannonhealth.com/media/192408/Shannon-Financial-Responsibilit y-Report.pdf SCHEDULE H, PART V, SECTION B LINE 16C PLAIN LANGUAGE SUMMARY OF FAP URL: https://www.shannonhealth.com/media/224029/501r-SMC-Financial-Assistance-P olicy-Summary-English-2017.pdf 2 SHANNON SURGERY CENTER 120 E HARRIS AVENUE SAN ANGELO TX 76903 AMBULATROY SURGERY CENTER SHANNON HOME HEALTH 2030 PULLIAM STE 6 SAN ANGELO TX 76905 HOME HEALTH CENTER SCHEDULE H, PART III, SECTION A, LINE 4 DESCRIPTION OF BAD DEBT SEE PAGES 9-10 OF THE ATTACHED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION A, LINES 2 & 3 COSTING METHODOLOGY LINE 2: AMOUNT REPORTED ON LINE 2 IS BASED ON BAD DEBTS PER THE AUDITED FINANCIAL STATEMENTS. LINE 3: THE ORGANIZATION IS UNABLE TO ESTIMATE THE AMOUNT FOR LINE 3 AND HAS ELECTED TO LEAVE IT BLANK. SCHEDULE H, PART III, SECTION B SURPLUS OR SHORT FALL SHORTFALL: N/A COSTING METHODOLOGY: THE RATIO OF COST TO CHARGES USED IN THE CALCULATION OF COSTS FOR MEDICARE WAS TAKEN FROM THE MEDICARE COST REPORT. SCHEDULE H, PART III, SECTION C, LINE 9B WRITTEN DEBT COLLECTION POLICY CHARITY CARE AND DISCOUNTING FOR UNINSURED PATIENTS WHO ARE NOT ELIGIBLE FOR GOVERNMENT HEALTH CARE PROGRAMS AND WHOSE FINANCIAL CONDITION IS SUCH THAT THEY ARE NOT ABLE TO PAY FOR HOSPITAL SERVICES MAY BE ELIGIBLE FOR ASSISTANCE UNDER THE SHANNON MEDICAL CENTER CHARITY CARE PROGRAM. PATIENTS WHO ARE UNINSURED, DO NOT QUALIFY FOR COVERAGE UNDER GOVERNMENT HEALTH CARE PROGRAMS, MAY BE ELIGIBLE FOR A 50% DISCOUNT OFF THE TOTAL BILL FOR HOSPITAL SERVICES, IF THE SERVICES ARE PAID FOR WHEN RECEIVED OR WITHIN 30 DAYS OF DISCHARGE. COLLECTION OF ACCOUNTS RECEIVABLE PATIENTS / GUARANTOR WILL BE RESPONSIBLE FOR PAYMENT OF SERVICES RECEIVED AT SHANNON MEDICAL CENTER. PATIENTS / GUARANTORS WILL BE RESPONSIBLE FOR FULL CHARGES, OR PATIENT PORTION NOT COVERED BY INSURANCE. PAYMENT WILL BE REQUESTED PRIOR TO OR ON THE DATE OF SCHEDULED ELECTIVE SERVICES. FULL CHARGES OR PATIENT PORTION NOT COVERED BY INSURANCE FOR URGENT / EMERGENT SERVICES WILL BE COLLECTED UPON DISCHARGE. PATIENTS WHO ARE UNABLE TO PAY THE FULL AMOUNT OF THEIR RESPONSIBILITY AT THE TIME OF SERVICE CAN MAKE PAYMENT ARRANGEMENTS UNDER THE FOLLOWING GUIDELINES: A. BALANCE OF OUTPATIENT SERVICES MUST BE PAID WITHIN SIX (6) MONTHS FROM THE DATE OF SERVICE UNLESS INDIGENT STATUS IS PROVEN B. BALANCE OF INPATIENT SERVICES MUST BE PAID WITHIN TWELVE (12) MONTHS FROM THE DATE OF DISCHARGE UNLESS INDIGENT STATUS IS PROVEN. MONTHLY STATEMENTS WILL BE SENT THROUGHOUT THE COLLECTION CYCLE. COLLECTION LETTERS WILL BE UTILIZED AT THE DISCRETION OF THE PATIENT ACCOUNT REPRESENTATIVE. ACCOUNTS WILL BE REVIEWED FOR OUTSIDE COLLECTION AGENCY PLACEMENT ANYTIME FOLLOWING 90 DAYS FROM THE DATE OF SERVICE. MEDICARE ACCOUNTS WILL NOT BE CONSIDERED FOR PLACEMENT UNTIL 120 DAYS FROM THE FIRST NOTICE OF PATIENT RESPONSIBILITY IN ACCORDANCE WITH MEDICARE REGULATIONS. ANY OVERPAYMENT OF AN ACCOUNT WILL BE REVIEWED FOR REFUND WITHIN 30 DAYS FROM THE DATE THE CREDIT BALANCE IS CREATED BY THE OVERPAYMENT. CREDIT BALANCES ON MEDICARE ACCOUNTS WILL BE PROCESSED THROUGH THE NORMAL CREDIT BALANCE PROCESS AND REPORTED ON A QUARTERLY BASIS IN COMPLIANCE WITH MEDICARE REGULATIONS. SCHEDULE H, PART V, SECTION B NEEDS ASSESSMENT THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT GATHERED OVERALL HEALTH INFORMATION OF THE COMMUNITY. ANALYSIS OF THE COMMUNITY NEEDS ASSESSMENT DATA PROVIDED A MEANS TO EVALUATE AND PRIORITIZE AREAS OF GREATEST NEED. TO FACILITATE PRIORITIZATION OF IDENTIFIED HEALTH NEEDS, A RANKING AND PRIORITIZATION PROCESS WAS USED. HEALTH NEEDS WERE RANKED BASED ON THE FOLLOWING FIVE FACTORS: -HOW MANY PEOPLE ARE AFFECTED BY THE ISSUE OR SIZE OF THE ISSUE? -WHAT ARE THE CONSEQUENCES OF NOT ADDRESSING THIS PROBLEM? -THE IMPACT OF THE PROBLEM ON VULNERABLE POPULATIONS -HOW IMPORTANT THE PROBLEM IS TO THE COMMUNITY? -PREVALENCE OF COMMON THEMES EACH FACTOR RECEIVED A RATING SCORE BETWEEN 0 AND 5. RATINGS WERE BASED ON THE PERCENTAGE OF THE COMMUNITY WHO ARE IMPACTED BY THE IDENTIFIED NEED. THE FOLLOWING SCALE WAS UTILIZED: >25% OF THE COMMUNITY= 5; >15% AND <25%=4; >10% AND <15%=3; >5% AND <10%=2 AND <5%=1. BELOW ARE THE ISSUES WITH THE TOP FIVE SCORES. BY FOCUSING PRIMARILY ON HEALTH NEEDS WITH HIGHER TOTAL SCORES, OVERALL COMMUNITY HEALTH WILL LIKELY IMPROVE AS THESE NEEDS HAVE THE GREATEST IMPACT ON OVERALL HEALTH AND THE HOSPITAL IS MORE LIKELY TO INFLUENCE A POSITIVE IMPACT ON THESE NEEDS. HEALTH NEED TOTAL SCORE ______________________________________________________________________ LACK OF HEALTH KNOWLEDGE/EDUCATION 22 HEALTHY BEHAVIORS/LIFESTYLE CHANGES 21 ADULT OBESITY 20 POVERTY/FINANCIAL RESOURCES/CHILDREN IN POVERTY 19 DIABETES 19 AS A RESULT FROM THE ANALYSIS, PRIORITIES WERE DETERMINED BY TAKING INTO ACCOUNT THE OVERALL RANKING, THE DEGREE TO WHICH SHANNON CAN INFLUENCE LONG-TERM CHANGE AND THE IDENTIFIED HEALTH NEEDS IMPACT ON OVERALL HEALTH. THE FOLLOWING PRIORITIES WERE IDENTIFIED: -HEALTHY LIVING -PREVENTION AND DISEASE MANAGEMENT -EDUCATION SHANNON MEDICAL CENTER CORRELATED COMMUNITY PRIORITIES HEALTH NEED --------------------------------------------------- HEALTHY LIVING -ADULT OBESITY -UNINSURED -PHYSICAL INACTIVITY -LIMITED ACCESS TO HEALTH FOODS/NUTRITION PREVENTION AND DISEASE MANAGEMENT -DIABETES -LACK OF PRIMARY CARE PHYSICIANS -HIGH BLOOD PRESSURE EDUCATION -LACK OF HEALTH KNOWLEDGE/EDUCATION -HEALTHY BEHAVIORS/LIFESTYLE CHANGES -LANGUAGE/CULTURAL MINDSET THE HOSPITALS' COMMUNITY HEALTH NEEDS ASSESSMENT & IMPLEMENTATION PLAN CAN BE FOUND AT: https://www.shannonhealth.com/education-resources/health-needs-assessment. aspx PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE FINANCIAL ASSISTANCE BROCHURES THAT OUTLINE ACCESS TO INFORMATION ABOUT ASSISTANCE PROGRAMS ARE AVAILABLE IN EACH OF THE REGISTRATION AREAS. WE ALSO HAVE CONTRACTED ELIGIBILITY WORKERS WHO SCREEN PATIENTS FOR ALL SOCIAL SERVICE PROGRAMS AND ASSIST WITH THE APPLICATION PROCESS IF NEEDED. COMMUNITY INFORMATION SHANNON MEDICAL CENTER IS LOCATED IN SAN ANGELO, TEXAS. THE CITY OF SAN ANGELO SERVES AS THE COUNTY SEAT AND POPULATION CENTER OF TOM GREEN COUNTY, WITH AN ESTIMATED POPULATION IN 2017 OF 118,019. TOM GREEN COUNTY'S POPULATION IN 2016 IS REPORTED AT 118,386. THE ESTIMATED POPULATION FOR SHANNON'S SERVICE AREA AS OF 2017, INCLUDING TOM GREEN COUNTY, IS 355,827 (U.S. CENSUS BUREAU, STATE & COUNTY QUICKFACTS). THE COUNTIES INCLUDED IN THE SHANNON SERVICE AREA ARE BROWN, COKE, CONCHO, COLEMAN, CROCKETT, HOWARD, IRION, KIMBLE, MASON, MCCULLOCH, MENARD, MILLS, MITCHELL, NOLAN, PECOS, REAGAN, RUNNELS, SAN SABA, SCHLEICHER, STERLING, SUTTON, TERRELL, TOM GREEN, UPTON, AND VAL VERDE. A BREAKDOWN OF TOM GREEN COUNTY DEMOGRAPHICS IS AS FOLLOWS. (SOURCE: U.S. CENSUS BUREAU, STATE & COUNTY QUICKFACTS, THE COUNTY INFORMATION PROJECT, TEXAS ASSOCIATION OF COUNTIES.) A. Tom Green County Age Distribution 1. Under 18 years old 23.7% (27,970) 2. 18-64 years old 61.3% (72,345) 3. 65 years and older 15.0% (17,702) B. Tom Green County Ethnic Distribution (More than one category may be self-reported) 1. Caucasian 54.0% (64,269) 2. Hispanic 39.3% (46,381) 3. Black 4.5% (5,310) 4. Other 2.2% (2,596) C. Tom Green County (Household) 1. Median Household Income $47,637 (Texas: $54,727) 2. Persons living in poverty level 13.4 % (Texas: 15.6%) D. Tom Green County Health Index 1. Tom Green County uninsured 17.2% (Texas: 18.6%, United States: 10.1%) (Source: U.S. Census Bureau, Quickfacts, 2016) PROMOTION OF COMMUNITY HEALTH In a county with no hospital taxing authority, a hospital whose mission reflects commitment to treating patients without regard to ability to pay is a highly desirable and pivotal point of community health care. For more than 80 years, Shannon has embraced such a mission and follows through on the wishes of our benefactor, Margaret Shannon, in providing care for the people of West Texas. Our FY2017 charity care figure of more than $75,331,969 would be a burden to the taxpayers of Tom Green County, and many other counties whose citizens directly benefit from her generosity. Shannon provides a host of community education events related to topics such as cancer prevention and screenings, diabetes education, fitness and nutrition, and cardiovascular health. Through educational events like Health Beat Live and various community events, health professionals relay current health information to the public. Shannon provides health and wellness presentations to numerous non-profits, businesses and organizations, including the local school districts and Angelo State University. Representatives from different departments provide support and participate in local health fairs and health-related community events where they provide various health screenings and educational material. In addition to public outreach events, Shannon publishes the Health Beat newsletter magazine which is delivered to 30,000 households and produces Health Beat television spots that air during the 6 and 10 p.m. news hours on two local stations. Shannon contributed $106,020 for these programs. Shannon is a proud sponsor and contributor to the local Go Red Luncheon. Go Red is a national initiative aimed at uniting women, men, and their friends and family in the fight against heart disease. The luncheon is designed to help educate and bring awareness to the community about how heart disease affects women and men differently, and how to take steps to address their risk for a heart attack. Shannon understands that continued education and awareness is crucial for women and men to fight this deadly disease. In addition, Shannon offers various free screening services, such as blood pressure checks, at this event. This event is provided at a cost of $16,295 to Shannon. Shannon has recognized a community need to offer supportive services to parents and families suffering from early pregnancy loss, stillbirth, or newborn death. The White Rose Support Group at Shannon hosts a 5-part session called "grieving the child i never knew" to offer insight, encouragement, healing, hope, and sharing for families experiencing perinatal loss. Furthermore, the White Rose Support Group hosts a Walk to Remember and Candlelight event for those who have suffered. These events are provided at a cost of $14,337 to Shannon. Shannon is the only provider that operates the Sexual Assault Nurse Examiner program (SANE) in the Shannon service area. SANE trained nurses work with the Childrens Advocacy Center, the Concho Valley Rape Crisis Center and other community-based organizations to provide training and services related to sexual assault crises. AFFILIATED HEALTH CARE SYSTEM Shannon, a non-profit health system established in the 1930s, provides the communities of West Central Texas with a variety of medical services. Dedicated to the regions health and well-being, Shannon offers diverse clinical services, including a nationally-recognized cardiac care program, nationally-recognized ICU, the regions lead Level III Trauma Facility and AirMed 1 air ambulance serving a 200-mile radius of San Angelo, a dedicated Womens & Childrens Hospital which is home to the Childrens Miracle Network, and the most extensive Senior Health services in the Concho Valley. Shannon continues to collaborate and build relationships with a broad range of agencies, organizations and institutions to build community and organizational capacity. By effectively utilizing resources and working together, Shannon plans to implement strategies to improve the community it serves. STATE FILLING OF COMMUNITY BENEFIT REPORT TEXAS true HOWARD COLLEGE 3501 N US HWY 67 SAN ANGELO TX 76905 756001827 501(C)(3) 19000 ADN & LVN TO RN PROGRAM TEXAS CARE ALLIANCE 7160 DALLAS PARKWAY DALLAS TX 75024 462829563 501(C)(3) 42295 2 SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING USE OF GRANT FUNDS THE ORGANIZATION EVALUATES AND MONITORS DONEES BASED ON PUBLIC AND PRIVATE DATA. X true true X X X X false true false false false false false false false BRYAN HORNER CEO/PRESIDENT (THRU 12/31/16) 640125 0 188887 0 18000 0 10600 0 12600 0 870212 0 MICHELLE SNUGGS MD DIRECTOR/TRUSTEE 0 630110 0 147710 0 42827 0 72532 0 33282 0 926461 KELLY SHANE PLYMELL CEO/PRESIDENT 449578 0 133480 0 18000 0 39795 0 18353 0 659206 0 DR IRVIN ZEITLER MEDICAL DIRECTOR 411286 0 136601 0 18000 0 40347 0 5607 0 611841 0 PAM BRADSHAW CNO/COO 257449 0 32931 0 0 0 5185 0 18092 0 313657 0 ANDREW HUME MD DIRECTOR/TRUSTEE 0 579890 0 44748 0 38921 0 71044 0 31964 0 766567 STACI WETZ CFO 241951 0 31173 0 18000 0 10600 0 18856 0 320580 0 JAMES NAYLOR CHIEF ECHO SONOGRAPHER 188805 0 0 0 0 0 7523 0 8180 0 204508 0 LISA HILL GENERAL COUNSEL 293728 0 26060 0 0 0 28654 0 12469 0 360911 0 MARGARET BENSON CHIEF COMPLIANCE OFFICER 190035 0 0 0 0 0 7601 0 5168 0 202804 0 STEPHEN LUBKE DIRECTOR OF PHARMACY 182471 0 0 0 0 0 7292 0 3686 0 193449 0 THOMAS PERKINS DIRECTOR OF IT 185809 0 0 0 0 0 7432 0 3689 0 196930 0 SCHEDULE J, PART I, LINE 4B NAMES, AMOUNTS, AND DETAILS OF ARRANGEMENTS SERP DETAIL NAME AMOUNT BRYAN HORNER NONE 457(F) DETAIL NAME AMOUNT KELLY S. PLYMELL $29,195 DR. IRVIN ZEITLER $29,747 LISA HILL $18,054 FIXED CONTRIBUTION - THE PARTICIPANT'S ALLOWANCE PERCENTAGE FOR THE PLAN YEAR MULTIPLIED BY THE PARTICIPANT'S BASE SALARY FOR THE PRECEEDING 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 PRECEEDING PLAN YEAR, AS MEASURED DURING THE FISCAL YEAR OF THE COMPANY ENDING IN SUCH PRECEEDING PLAN YEAR. SCHEDULE J, PART I, QUESTION 1A PROVIDED HEALTH, SOCIAL DUES OR INITIATION FEES KELLY SHANE PLYMELL RECEIVES MEMBERSHIP TO BENTWOOD COUNTRY CLUB EXCLUSIVELY FOR BUSINESS USE. ANY PERSONAL USE IS REIMBURSED BY THE OFFICER AND THEREFORE NO AMOUNTS ARE REPORTABLE ON HIS FORM W-2. DIANE ZEITLER DR. IRVIN ZEITLER'S SPOUSE 185809 EMPLOYED BY SMC false LEN MERTZ PERAHEALTH BOARD CHAIR 137047 SMC & PERAHEALTH HAVE CONTRACT false FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS MARGARET SHANNON ESTATE, A TESTAMENTARY TRUST, IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OR STOCKHOLDERS WHO CAN ELECT MEMBERS OF THE GOVERNING BODY THE BOARD OF DIRECTORS SHALL CONSIST OF EACH OF THE SEVEN TRUSTEES OF THE MARGARET SHANNON ESTATE, A TESTAMENTARY TRUST. THE OTHER DIRECTORS SHALL CONSIST OF REPRESENTATIVES OF THE COMMUNITY AND MEMBERS OF THE MEDICAL STAFF OF THE HOSPITAL, TO NUMBER IN AGGREGATE NOT MORE THAN SEVEN WHO ARE APPOINTED BY THE MEMBER AND THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE GOVERNING BODY SUBJECT TO APPROVAL APPROVAL OF THE SOLE MEMBER, THE TRUSTEES OF SHANNON WEST TEXAS MEMORIAL HOSPITAL, IS REQUIRED FOR BUDGETS, LARGE FINANCIAL EXPENDITURES THAT DEVIATE FROM BUDGET, SALE OF PROPERTY, MERGER, ACQUISITION, OR CONSOLIDATION, BORROWING OF MONEY, SEEKING OR GIVING GRANTS, SETTLEMENT OF CLAIMS OR LITIGATION, AMENDMENT OF BYLAWS, AND CONTRACT IN WHICH THE CORPORATION ASSUMES FINANCIAL RISK. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW THE 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 ORGANIZATION'S FINANCE COMMITTEE WILL REVIEW AFTER THE FORM IS FILED. FORM 990, PART VI, SECTION B, LINE 12C PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY WE REGULARLY AUDIT FOR CONFLICT OF INTEREST STATEMENTS IN THE EMPLOYEES RECORDS. PROCEDURE FOR MONITORING: 1. WITHIN 90 DAYS OF BECOMING AN AFFECTED INDIVIDUAL, THAT INDIVIDUAL MUST REVIEW THIS POLICY AND COMPLETE AN SMC CONFLICT OF INTEREST DISCLOSURE FORM. 2. AT LEAST ANNUALLY THEREAFTER, AFFECTED INDIVIDUALS MUST REVIEW THIS POLICY AND COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. 3. THE CONFLICT OF INTEREST DISCLOSURE FORM SHOULD BE SENT TO THE SMC COMPLIANCE OFFICER. 4. AT ANY TIME WHEN AN ACTUAL, POTENTIAL, OR PERCEIVED CONFLICT OF INTEREST ARISES, THE AFFECTED INDIVIDUAL MUST REVISE HIS OR HER CONFLICT OF INTEREST DISCLOSURE FORM AND CONTACT THE SMC COMPLIANCE OFFICER. THE RESPONSIBILITY TO PROMPTLY REPORT SUCH ACTUAL OR POTENTIAL CONFLICTS RESTS WITH THE AFFECTED INDIVIDUAL. 5. THE SMC COMPLIANCE OFFICER WILL REVIEW DISCLOSURES AND DETERMINE WHICH REQUIRE FURTHER ACTION WITH THE SMC GENERAL COUNSEL AND APPROPRIATE SMC EXECUTIVE STAFF. FORM 990, PART VI, SECTION B, LINES 15A & 15B REVIEW OF COMPENSATION INTEGRATED HEALTH STRATEGIES DID AN EXECUTIVE COMPENSATION STUDY IN 2015 AND IT COVERED ALL EXECUTIVE SALARIES. EXECUTIVE COMPENSATION IS REVIEWED ANNUALLY BY THE BOARD OF TRUSTEES' OPERATIONS COMMITTEE, WHICH CONSULTS COMPARABILITY DATA AND KEEPS CONTEMPORANEOUS RECORDS OF ITS DECISIONS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATIONS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OF FUND BALANCES TRANSFERS TO/FROM AFFILIATES $ (49,147,767) CHANGE IN SHANNON TRUST NET ASSETS 22,472,525 NET ASSETS RELEASED FROM RESTRICTION (19,500,000) ------------ $ (46,175,242) 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) 12B SMC true SHANNON HEALTH SYSTEM 120 E HARRIS AVE SAN ANGELO TX 76903 752602411 SUPPORT SVCS TX 501(C)(3) 12A SHANNON EST true SHANNON CLINIC 120 E HARRIS AVE SAN ANGELO TX 76903 752600873 HEALTHCARE TX 501(C)(3) 10 SHS true SHANNON BUSINESS SERVICES INC 120 E HARRIS AVE SAN ANGELO TX 76903 432038769 SUPPORT SVCS TX 501(C)(3) 12B SMC true SHANNON MEDICAL MANAGEMENT 120 E HARRIS AVE SAN ANGELO TX 76903 208367966 SUPPORT SVCS TX 501(C)(3) 10 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 STE 120 SAN ANGELO TX 76903 752225955 RADIOTHERAPY TX NA RELATED 328579 4197055 false 0 true 0.56247 REGIONAL CANCER TREATMENT CTR 102 N MAGDALEN STE 120 SAN ANGELO TX 76903 752225955 RADIOTHERAPY TX NA RELATED 39510 1442538 false 0 false 0.18000 LEGACY MANAGEMENT SERVICES 2018 PULLIAM ST SAN ANGELO TX 76903 752544450 MANAGEMENT TX NA C - CORPORATION 0 0 false LEGACY HEALTH SOLUTIONS 2018 PULLIAM ST SAN ANGELO TX 76903 200720762 MED INSURANCE TX NA C - CORPORATION 0 0 false false false true false false false false false false true true false false true true true true true true SHANNON BUSINESS SERVICES C 69951 BOOK VALUE SHANNON BUSINESS SERVICES J 127933 BOOK VALUE SHANNON BUSINESS SERVICES P 3118780 BOOK VALUE SHANNON BUSINESS SERVICES S 8975387 BOOK VALUE SHANNON BUSINESS SERVICES Q 13020139 BOOK VALUE SHANNON CLINIC P 12672436 BOOK VALUE SHANNON CLINIC Q 8618635 BOOK VALUE SHANNON CLINIC R 88674271 BOOK VALUE SHANNON CLINIC S 92586397 BOOK VALUE SHANNON MEDICAL MANAGEMENT P 1509828 BOOK VALUE SHANNON MEDICAL MANAGEMENT Q 22372106 BOOK VALUE SHANNON MEDICAL MANAGEMENT R 22511964 BOOK VALUE SHANNON REAL ESTATE SERVICES K 540936 BOOK VALUE SHANNON REAL ESTATE SERVICES Q 3820714 BOOK VALUE SHANNON REAL ESTATE SERVICES R 11660843 BOOK VALUE SHANNON REAL ESTATE SERVICES S 2393221 BOOK VALUE SHANNON REAL ESTATE SERVICES P 80681 BOOK VALUE Trustees Shannon West Texas Hospital C 19500000 BOOK VALUE