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SHANNON CLINIC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
SHANNON CLINIC (EIN 75-2600873)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-14
IRS object ID
201422269349303167
Schema version
2012v2.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-08-14T14:01:12-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12800 Post Oak Blvd Ste 3200AddressLine1
CityHOUSTONCity
StateTXState
ZIP Code77056ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN752600873EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SHANNON CLINICBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% SHANNON CLINIC ATTNInCareOfName
Name ControlSHANNameControl
Phone3256581511Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 22000AddressLine1
Address Line2SuiteAddressLine2
CitySAN ANGELOCity
StateTXState
ZIP Code76902ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGARY GIBIANName
TitleSMM EXECUTIVE DIRECTORTitle
Phone3256581511Phone
Date Signed2014-08-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameM Paige GerichName
Phone7134994600Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonBRYAN HORNERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 22000AddressLine1
CitySAN ANGELOCity
StateTXState
ZIP Code76902ZIPCode
FieldValueIRS element (for citing)
Gross Receipts122579477GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1995YearFormation
State Legal DomicileTXStateLegalDomicile
Activity Or Mission DescriptionFOUNDED ON A LEGACY OF CARING, SHANNON IS A LOCALLY OWNED HEALTHCARE SYSTEM DEDICATED TO PROVIDING EXCEPTIONAL HEALTHCARE FOR OUR FAMILY, FRIENDS AND NEIGHBORS.ActivityOrMissionDescription
Nbr Voting Members Governing Body19NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees244TotalNbrEmployees
Total Nbr Volunteers10TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year114358708ProgramServiceRevenuePriorYear
Program Service Revenue CY122449477ProgramServiceRevenueCY
Investment Income Prior Year0InvestmentIncomePriorYear
Investment Income Current Year14689InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year114358708TotalRevenuePriorYear
Total Revenue Current Year122464166TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year81073405SalariesEtcPriorYear
Salaries Etc Current Year84917471SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year63728440OtherExpensePriorYear
Other Expenses Current Year67414947OtherExpensesCurrentYear
Total Expenses Prior Year144801845TotalExpensesPriorYear
Total Expenses Current Year152332418TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-30443137RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-29868252RevenuesLessExpensesCY
Total Assets BOY30700792TotalAssetsBOY
Total Assets EOY26687467TotalAssetsEOY
Total Liabilities BOY24998350TotalLiabilitiesBOY
Total Liabilities EOY19163637TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY5702442NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY7523830NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionOUR MISSION IS TO BE THE PREMIERE 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.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense145236903Expense
Revenue122449477Revenue
DescriptionPROVIDE 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.Description
Total Program Service Expense145236903TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096113NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees244NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members19NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSHANNON CLINIC ATTNNamePerson
Telephone Number3256581511TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ADMINISTRATION 120 E BEAUREGARDAddressLine1
CitySAN ANGELOCity
StateTXState
ZIP Code76903ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (31 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationOther CompensationOtherCompensationAverage Hours Per Week RelatedAverageHoursPerWeekRelatedReportable Comp From Related OrgsReportableCompFromRelatedOrgsKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
JOHN HARVEY
PHYSICIAN/DIVISION CHAIR40.0XX30558966916
VIKI FORLANO HALFMANN
PHYSICIAN/DIVISION VICE CHAIR40.0XX29419360923
HARVEY RUSSWURM
PHYSICIAN/BOARD DIRECTOR40.0X31968646146
CORNELIUS CHINN
PHYSICIAN/BOARD DIRECTOR40.0X35381760640
MICHAEL WAGNON
PHYSICIAN/BOARD DIRECTOR40.0X33944753967
WILLIAM WHITEHEAD
PHYSICIAN/BOARD DIRECTOR40.0X44723376237
CHRIS COLE
PHYSICIAN/DIVISION CHAIRMAN40.0XX110362851551
ANTHONY DEMORY
PHYSICIAN/DIVISION VICE CHAIR40.0XX72706875386
LAURA ADAMS
PHYSICIAN/BOARD DIRECTOR40.0X62026075109
JOE MIMS
PHYSICIAN/BOARD DIRECTOR40.0X54894651638
CHARLES MARSH
PHYSICIAN/BOARD DIRECTOR40.0X53556446553
LUIS DUARTE
PHYSICIAN/BOARD DIRECTOR40.0X325146297492
IRVIN ZEITLER
MEDICAL DIRECTOR5.0X6421737.0464293
ROSS CARMICHAEL
PHYSICIAN/DIVISION SECRETARY40.0XX25642547321
D'LAINE WESTMORELAND
PHYSICIAN/BOARD DIRECTOR20.0X8344618906
JOSEPH ZUBAK
PHYSICIAN/BOARD DIRECTOR40.0X49654584420
MARK MURPHY
PHYSICIAN/BOARD DIRECTOR40.0X36064427390
NORMA CERNA
PHYSICIAN/BOARD DIRECTOR40.0X2346368747
ERIC IGLER
PHYSICIAN/BOARD DIRECTOR40.0X42556771509
BRYAN HORNER
PRESIDENT5.0X4386039.0662358
TIMOTHY HARTIN
SECRETARY/GENERAL COUNCIL5.0X5772540.0260654
DOUG SCHULTZ
PHYSICIAN/MEDICAL DIRECTOR40.037030639277X
GARY GIBIAN
SMM EXECUTIVE DIRECTOR5.08360040.0371642X
TIMOTHY HOPKINS
PHYSICIAN40.0176395987592X
KENNETH BREEDLOVE
PHYSICIAN40.0109243484005X
MICHAEL SICKELS
PHYSICIAN40.0108710983966X
VICTOR SCHULZE III
PHYSICIAN40.0108839454401X
DAVID HUCHTON
PHYSICIAN40.0103093483959X
JAMES MELOTT
PHYSICIAN/FORMER DIV CHAIR40.027738565037X
JOHN GILBREATH
CFO5.04357140.0200892X
GARY BOWEN
COO5.05729240.0212891X
FieldValueIRS element (for citing)
Total Reportable Comp From Org17414677TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2172730TotalReportableCompFrmRltdOrgs
Total Other Compensation1869353TotalOtherCompensation
Number Individuals GT100 K173NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
DELTA LOCUM TENENS
1755 WITTINGTON PLACE STE 800DALLASTX75234LOCUMS SERVICES1435939
SHANNON MED MGMT
120 E BEAUREGARDSAN ANGELOTX76903MANAGEMENT SERVICES41125419
MAYO COLLABORATIVE SERVICES
PO BOX 9146MINNEAPOLISMN554809146OUTSIDE LAB SERVICES876754
WEATHERBY LOCUMS
6451 NORTH FEDERAL HWY STE 800FORT LAUDERDALEFL33308PHYS CONTRACT SERV'S454541
SHANNON MEDICAL CTR
120 E HARRISSAN ANGELOTX76903LAB & LAUNDRY SVC818620
FieldValueIRS element (for citing)
Number Of Contractors GT100 K10NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Service Revenue621990108654870108654870
Lease Income53200057875787
HOSPITAL BASED PHYSICIANS' ASSISTANCE9000991048617410486174
Miscellanous Income90009933026463302646
FieldValueIRS element (for citing)
Total Program Service Revenue122449477TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other130000Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other115311Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other14689Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column14689TotalRevenueColumn
Exclusion$14,689ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column122464166TotalRevenueColumn
Related Or Exempt Function Income122449477RelatedOrExemptFunctionIncome
Exclusion$14,689ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total12134587Total
Program Services12134587ProgramServices

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total925119Total
Program Services925119ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total61003988Total
Program Services60443510ProgramServices
Management And General560478ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total6604885Total
Program Services6604885ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1663267Total
Program Services1654058ProgramServices
Management And General9209ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2585625Total
Program Services2585625ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total42047602Total
Program Services35740462ProgramServices
Management And General6307140ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total12066Total
Management And General12066ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total45408Total
Management And General45408ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5104278Total
Program Services4987594ProgramServices
Management And General116684ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total226574Total
Program Services226574ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total548398Total
Program Services548398ProgramServices

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total4290Total
Program Services4290ProgramServices

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total60449Total
Program Services60449ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total358016Total
Program Services358016ProgramServices

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total8881Total
Program Services8881ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1038172Total
Program Services1038172ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total780570Total
Program Services736040ProgramServices
Management And General44530ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
Bad Debt88053518805351
Medical Supplies67397686739768
Recruiting413997413997
EDUCATION396137396137

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total824990Total
Program Services824990ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total152332418Total
Program Services145236903ProgramServices
Management And General7095515ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY19201BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY14832617BOY
EOY16182025EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY73804BOY
EOY846934EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY122381BOY
EOY131310EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1428110BOY
EOY994724EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis12447167LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec10204472LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY2612909BOY
EOY2242695EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY11611770BOY
EOY6289779EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY30700792BOY
EOY26687467EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY10764082BOY
EOY9686158EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY361708BOY
EOY236382EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY13872560BOY
EOY9241097EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY24998350BOY
EOY19163637EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY5702442BOY
EOY7523830EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5702442BOY
EOY7523830EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY30700792BOY
EOY26687467EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-29868252ReconcilationRevenueExpenses
Reconcilation Other Changes31689640ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3271CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6349CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total9620Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years91838780CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years94414909CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years101441273CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year114358708CurrentTaxYearMinus1Year
Current Tax Year122449477CurrentTaxYear
Total524503147Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years91842051CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years94421258CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years101441273CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year114358708CurrentTaxYearMinus1Year
Current Tax Year122449477CurrentTaxYear
Total524512767Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total509524512767PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Total0Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Total0Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Total0Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Total0Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years91842051CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years94421258CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years101441273CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year114358708CurrentTaxYearMinus1Year
Current Tax Year122449477CurrentTaxYear
Total524512767Total
FieldValueIRS element (for citing)
Public Support Percentage5091.00000PublicSupportPercentage509
Prior Year Support Percentage1.00000PriorYearSupportPercentage
Investment Income Percentage0.00000InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00000PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years
Current Year Minus4 YearsCurrentYearMinus4Years
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis12447167OtherCostOrOtherBasis
Depreciation10204472Depreciation
Book Value2242695BookValue
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildings
Total Of Book Value Land Buildings2242695TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionRetirement FundDescription
Book Value6289779BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets6289779TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
Pension Fund Liability$6,289,779
Health Claims Payable$221,838
Estimated Malpractice Costs$2,729,480
FieldValueIRS element (for citing)
Total Of Amounts9241097TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt71050735TotRevenueEtcAuditedFinclStmt
Revenue Subtotal71050735RevenueSubtotal
Other Revenues Not Included51413431OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt51413431RevenueNotRptdOnFinStmt
Total Revenue Per Form990122464166TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt100918987TotExpensesEtcAuditedFinclStmt
Expenses Subtotal100918987ExpensesSubtotal
Other Expenses Not Included51413431OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt51413431ExpensesNotRptdOnFinStmt
Total Expenses Per Form990152332418TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierExplanationExplanation
FIN 48 DISCLOSUREMANAGEMENT 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.
PART XI & XII LINE 4BINCOME/EXPENSE RECLASSES FROM AUDIT $42,608,082 BAD DEBT 8,805,349 ----------- $51,413,431

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (30 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgs
JAMES MELOTT
PHYSICIAN/FORMER DIV CHAIR2128882750036997470001803734242266622
JOHN HARVEY
PHYSICIAN/DIVISION CHAIR2364923000039097470001991637250560245
VIKI FORLANO HALFMANN
PHYSICIAN/DIVISION VICE CHAIR2208003102642367470001392335511648339
HARVEY RUSSWURM
PHYSICIAN/BOARD DIRECTOR25720141235212503100015146365832
CORNELIUS CHINN
PHYSICIAN/BOARD DIRECTOR2718922932352602470001364041445773567
MICHAEL WAGNON
PHYSICIAN/BOARD DIRECTOR2779572703234458354181854939341449979
WILLIAM WHITEHEAD
PHYSICIAN/BOARD DIRECTOR3713542851347366562002003752347060470
CHRIS COLE
PHYSICIAN/DIVISION CHAIRMAN888139148573669163100020551115517975678
ANTHONY DEMORY
PHYSICIAN/DIVISION VICE CHAIR53011213773859218551262026080245477300
LAURA ADAMS
PHYSICIAN/BOARD DIRECTOR45624889911741015500020109695369103083
JOE MIMS
PHYSICIAN/BOARD DIRECTOR4546515138642909310002063860058438734
CHARLES MARSH
PHYSICIAN/BOARD DIRECTOR41624135000843233100015553582117104267
LUIS DUARTE
PHYSICIAN/BOARD DIRECTOR258981350191515973477257202353348954294504
IRVIN ZEITLER
MEDICAL DIRECTOR39038973904583615856528510
BRYAN HORNER
PRESIDENT538661106697310001286070621817000
TIMOTHY HARTIN
SECRETARY/GENERAL COUNCIL243654462521147331837917000
DOUG SCHULTZ
PHYSICIAN/MEDICAL DIRECTOR320007210002929931000827740958322474
TIMOTHY HOPKINS
PHYSICIAN132779828892814723377257103351851551208699
KENNETH BREEDLOVE
PHYSICIAN8637431485738011863800202051176439109632
MICHAEL SICKELS
PHYSICIAN8614461485737709063800201661171075115926
VICTOR SCHULZE III
PHYSICIAN876086148573637353100023401114279573369
DAVID HUCHTON
PHYSICIAN895779375009765561000229591114893179945
JOHN GILBREATH
CFO1745256390334531011824446319977
GARY BOWEN
COO1768506468390331825927018329573
ROSS CARMICHAEL
PHYSICIAN/DIVISION SECRETARY21007030000163552860418717303746
JOSEPH ZUBAK
PHYSICIAN/BOARD DIRECTOR43096138918266666421120209580965
GARY GIBIAN
SMM EXECUTIVE DIRECTOR28225059735523203128045524229657
MARK MURPHY
PHYSICIAN/BOARD DIRECTOR2868147160222281683510555388034
NORMA CERNA
PHYSICIAN/BOARD DIRECTOR205663282926818747243383
ERIC IGLER
PHYSICIAN/BOARD DIRECTOR32298160796417905140020109497076

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
NAMES, AMOUNTS, AND DETAILS OF ARRANGEMENTSPART 1, QUESTION 4SERP DETAIL NAME AMOUNT BRYAN HORNER NONE NONQUALIFIED PLAN PARTICIPANTS NAME AMOUNT JAMES MELOTT $ 82,378 JOHN HARVEY $ 78,622 VIKI FORLANO HALFMANN $ 60,974 ROSS CARMICHAEL NONE HARVEY RUSSWURM NONE D'LAINE WESTMORELAND $ 28,003 CORNELIUS CHINN $104,288 MICHAEL WAGNON $ 66,330 NORMA CERNA NONE WILLIAM WHITEHEAD $ 82,542 CHRIS COLE $ 97,970 ANTHONY DEMORY $106,612 LAURA ADAMS $145,398 JOE MIMS $ 54,335 CHARLES MARSH $141,062 LUIS DUARTE $363,044 MARK MURPHY NONE IRVIN ZEITLER $ 27,361 ERIC IGLER $ 73,130 BRYAN HORNER NONE TIMOTHY HARTIN $ 17,600 DOUG SCHULTZ $ 33,310 TIMOTHY HOPKINS $293,320 KENNETH BREEDLOVE $146,493 MICHAEL SICKELS $150,115 VICTOR SCHULTZE III $ 91,682 DAVID HUCHTON $233,442 JOSEPH ZUBAK $ 25,944 GARY GIBIAN NONE JOHN GILBREATH NONE GARY BOWEN NONE LISA HILL NONE PARTICIPANTS IN THE 457F RETIREMENT ALLOWANCE PLAN ARE PHYSICIANS WHO ARE UNDER AGE 55 & THEIR EXPECTED COMPENSATION IS HIGHER THAN 125,000 OR EXECUTIVES WHO ARE UNDER AGE 62 & THEIR EXPECTED COMPENSATION IS HIGHER THAN $125,000. EACH QUARTER, THEY RECEIVE 8% OF THEIR BASE SALARY FOR THE PRECEEDING 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. IN THE 457F ACCOUNTS RECEIVABLE PLAN, PARTICIPANTS ARE PHYSICIANS WHOSE ANNUAL COMPENSATION IS HIGHER THAN 125,000 AND ARE ELIGIBLE TO RECEIVE THE A/R CREDIT. ONCE A YEAR, 20% OF THE A/R CREDIT IS FUNDED INTO A MUTUAL FUND ACCOUNT. VESTING IN THE BENEFIT IS 20% EACH YEAR WITH FULL VESTING AFTER 5 YEARS. DISTRIBUTION WILL OCCUR AT THE END OF THE 5 YEARS OR AT TERMINATION OF EMPLOYMENT.
METHODS USED TO ESTABLISH COMPENSATIONSCHEDULE J, PART I, QUESTION 3SHANNON CLINIC'S (SC) EXECUTIVE DIRECTOR IS 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 EXECUTIVE DIRECTOR.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (5 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
MICHELLE CHINN
CORNELIUS CHINN'S SPOUSE67937SHANNON CLINIC EMPLOYEEfalse
SCOTT WESTMORELAND
D. WESTMORELAND'S SPOUSE323992SHANNON CLINIC EMPLOYEEfalse
BRANDI WHITEHEAD
W. WHITEHEAD'S SPOUSE27022SHANNON CLINIC EMPLOYEEfalse
DENVER MARSH
CHARLES MARSH'S BROTHER489533SHANNON CLINIC EMPLOYEEfalse
SUSAN SCHULTZ
DOUG SCHULTZ'S SPOUSE16635SHANNON CLINIC EMPLOYEEfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DELEGATION OF CONTROL TO A MANAGEMENT COMPANY OR OTHER PERSONFORM 990, PART VI, QUESTION 3ADMINISTRATIVE SERVICES FOR SHANNON CLINIC ARE CONTRACTED WITH SHANNON MEDICAL MANAGEMENT.
CLASSES OF MEMBERS OR STOCKHOLDERSFORM 990, PART VI, QUESTION 6SHANNON HEALTH SYSTEM, A 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF SHANNON CLINIC.
MEMBERS OR STOCKHOLDERS WHO CAN ELECT MEMBERS OF THE GOVERNING BODYFORM 990, PART VI, QUESTION 7ATHE 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.
DECISIONS OF GOVERNING BODY SUBJECT TO APPROVAL BY MEMBERS OR STOCKHOLDERSFORM 990, PART VI, QUESTION 7BTHE 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.
PROCESS TO REVIEW THE FORM 990FORM 990, PART VI, QUESTION 11BTHE 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.
PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICYFORM 990, PART VI, QUESTION 12COFFICERS, 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.
REVIEW OF COMPENSATIONFORM 990, PART VI, QUESTION 15A & 15BOFFICERS, 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.
EXPLANATION OF COMMITTEE THAT ASSUMES RESPONSIBILITYFORM 990, PART XII, QUESTION 2CSHANNON CLINIC DOES NOT HAVE AN AUDIT COMMITTEE, BUT THERE IS A SHANNON HEALTH SYSTEM AUDIT COMPLIANCE COMMITTEE THAT OVERSEES THE CONSOLIDATED AUDIT THAT INCLUDES SHANNON CLINIC.
GOVERNING DOCUMENTS AVAILABLE TO THE PUBLICFORM 990, PART VI, QUESTION 19COPIES OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS ARE PROVIDED TO THE PUBLIC UPON REQUEST.
OTHER CHANGES IN NET ASSETS OR FUND BALANCESFORM 990, PART XI, LINE 9TRANSFER TO/FROM AFFILIATES 31,689,640

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
TRUSTEES SHANNON WEST TEXAS HOSPITAL
PO BOX 49SAN ANGELOTX76902750800679TRUSTTX501(C)(3)11BNAfalse
SHANNON RURAL HEALTH CLINICS INC
120 E HARRIS AVESAN ANGELOTX76903752940211HEALTHCARETX501(C)(3)11CSMCfalse
SHANNON REAL ESTATE SERVICES INC
120 E HARRIS AVESAN ANGELOTX76903270075630SUPPORT SVCSTX501(C)(3)11BSMCfalse
SHANNON HEALTH SYSTEM
120 E HARRIS AVESAN ANGELOTX76903752602411HEALTHCARETX501(C)(3)11ANAfalse
SHANNON MEDICAL CENTER
120 E HARRIS AVESAN ANGELOTX76903752559845HEALTHCARETX501(C)(3)3NAfalse
SHANNON BUSINESS SERVICES INC
120 E HARRIS AVESAN ANGELOTX76903432038769SUPPORT SVCSTX501(C)(3)11BSMCfalse
SHANNON MEDICAL MANAGEMENT
120 E BEAUREGARDSAN ANGELOTX76903208367966SUPPORT SVCSTX501(C)(3)9SHSfalse

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1REGIONAL CANCER TREATMENT CENTERBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1102 N MAGDALEN 120AddressLine1
CitySan AngeloCity
StateTXState
ZIP Code76902ZIPCode
FieldValueIRS element (for citing)
EIN752225955EIN
Primary ActivityRADIOTHERAPYPrimaryActivity
Legal Domicile StateTXLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeN/APredominantIncomeType

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsControlled OrgControlledOrg
LEGACY MANAGEMENT SERVICES
2018 PULLIAM STSAN ANGELOTX76903752544450MANAGEMENTTXNAC-CORPORATION00false
LEGACY HEALTH SOLUTIONS
2018 PULLIAM STSAN ANGELOTX76903200720762MED INSURANCETXNAC-CORPORATION00false
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg