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SHANNON CLINIC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
SHANNON CLINIC (EIN 75-2600873)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-08-15
IRS object ID
201102279349300130
Schema version
2009v1.7
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)
Timestamp2011-08-15T08:26:08-05:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

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 Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN752600873EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SHANNON CLINICBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSHANNameControl
Phone3256581511Phone

US Address USAddress

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

Officer Officer

FieldValueIRS element (for citing)
NameBRYAN HORNERName
TitlePRESIDENTTitle
Date Signed2011-05-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone7134994600Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

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 Receipts94425909GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
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 Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees171TotalNbrEmployees
Total Nbr Volunteers10TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year271ContributionsGrantsPriorYear
Contributions Grants Current Year6349ContributionsGrantsCurrentYear
Program Service Revenue Prior Year91841780ProgramServiceRevenuePriorYear
Program Service Revenue CY94419560ProgramServiceRevenueCY
Investment Income Prior Year1400InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year91843451TotalRevenuePriorYear
Total Revenue Current Year94425909TotalRevenueCurrentYear
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 Year64385343SalariesEtcPriorYear
Salaries Etc Current Year68380870SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year49384581OtherExpensePriorYear
Other Expenses Current Year51530040OtherExpensesCurrentYear
Total Expenses Prior Year113769924TotalExpensesPriorYear
Total Expenses Current Year119910910TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-21926473RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-25485001RevenuesLessExpensesCY
Total Assets BOY21998827TotalAssetsBOY
Total Assets EOY22520618TotalAssetsEOY
Total Liabilities BOY16998418TotalLiabilitiesBOY
Total Liabilities EOY19602073TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY5000409NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY2918545NetAssetsOrFundBalancesEOY
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
Expense114438935Expense
Revenue94419560Revenue
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 Expense114438935TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
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 With109687NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees171NumberOfEmployees
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
Nbr Voting Governing Body Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
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

Form990 Part VII Section A Form990PartVIISectionA (39 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
JAMES MELOTT
PHYSICIAN / DIVISION CHAIRMAN40.0XX264323062877
JOHN HARVEY
PHYSICIAN/DIVISION VICE CHAIR40.0XX291444064023
VIKI FORLANO HALFMANN
PHYSICIAN / DIVISION SECRETARY40.0XX260013063345
HARVEY RUSSWURM
PHYSICIAN / BOARD DIRECTOR40.0X283945049014
MARY SEGER
PHYSICIAN / BOARD DIRECTOR20.0X164909020270
STEPHEN SAWYER
PHYSICIAN / BOARD DIRECTOR40.0X333337060268
CORNELIUS CHINN
PHYSICIAN / BOARD DIRECTOR40.0X331717064343
MICHAEL WAGNON
PHYSICIAN / BOARD DIRECTOR40.0X322280065607
WILLIAM WHITEHEAD
PHYSICIAN / DIVISION CHAIRMAN40.0XX387021075498
CHRIS COLE
PHYSICIAN/DIVISION VP40.0XX1150606085625
JOLIE BAILEY
PHYSICIAN/DIVISION SECRETARY40.0XX347069070858
ANTHONY DE MORY
PHYSICIAN/BOARD DIRECTOR40.0X751096076659
LAURA ADAMS
PHYSICIAN/BOARD DIRECTOR40.0X532306070432
JOE MIMS
PHYSICIAN/BOARD DIRECTOR40.0X566520053912
SCOTT GIPSON
PHYSICIAN/BOARD DIRECTOR40.0X431029071482
CHARLES MARSH
PHYSICIAN/BOARD DIRECTOR40.0X686721046575
LUIS DUARTE
PHYSICIAN/BOARD DIRECTOR40.0X3112637098765
IRVIN ZEITLER
MEDICAL DIRECTOR5.0X350032237255044
BRYAN HORNER
PRESIDENT/CFO5.0X045748469698
TIMOTHY HARTIN
SECRETARY/GENERAL COUNCIL5.0X020726049461
DOUG SCHULTZ
PHYSICIAN/MEDICAL DIRECTOR40.0360106038929X
TIMOTHY HOPKINS
PHYSICIAN40.01570844085656X
KENNETH BREEDLOVE
PHYSICIAN40.01140132075275X
MICHAEL SICKELS
PHYSICIAN40.01133156085240X
VICTOR SCHULZE III
PHYSICIAN40.01140537076645X
DAVID HUCHTON
PHYSICIAN40.01021015080512X
BRADLEY MCIVER
PHYSICIAN/FORMER DIRECTOR40.0492116078305X
LESLIE WILLIAMSON
PHYSICIAN/FORMER DIRECTOR10.02416705487X
EUGENE STOKES
PHYSICIAN/FORMER DIRECTOR40.0688261045675X
DENVER MARSH JR
PHYSICIAN/FORMER DIRECTOR40.0572410043954X
GREGORY DUNHAM
PHYSICIAN/FORMER DIRECTOR40.0579328076111X
TY HUGHSTON
PHYSICIAN/FORMER DIRECTOR40.0333837067621X
J M CORNELL
PHYSICIAN/FORMER DIRECTOR40.0768097044671X
JOHN GILBREATH
FORMER5.0016533638339X
GARY BOWEN
FORMER5.0016354941149X
JAMES BARNETT
PHYS/FORMER BOARD VICE CHAIR40.0388304066443X
STEPHEN CAINELLI
PHYSICIAN/FORMER SECRETARY40.0462569043983X
DAVID HARVEY
PHYSICIAN40.0763562043713X
PETER CHANG
PHYSICIAN40.0903541062645X
FieldValueIRS element (for citing)
Total Reportable Comp From Org22562455TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1316001TotalReportableCompFrmRltdOrgs
Total Other Compensation2374109TotalOtherCompensation
Number Individuals GT100 K124NumberIndividualsGT100K
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
PO BOX 678082DALLASTX75267LOCUMS SERVICES593136
SHANNON MED MGMT
PO BOX 22000SAN ANGELOTX76903MANAGEMENT SERVICES30631222
MAYO COLLABORATIVE SERVICES
PO BOX 9146MINNEAPOLISMN554809146OUTSIDE LAB SERVICES799065
ALLIANCE RECRUITING RESOURCES
2708 HALIFAX COURTMCKINNEYTX75070PHYS CONTRACT SERV'S241959
SHANNON MEDICAL CTR
PO BOX 1879SAN ANGELOTX76902LAB & LAUNDRY SVC545772
FieldValueIRS element (for citing)
Number Of Contractors GT100 K11NumberOfContractorsGT100K
All Other Contributions6349AllOtherContributions
Total Contributions6349TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE REVENUE6219909375489093754890
LEASE INCOME53200079007900
MISCELLANEOUS INCOME900099656770656770
FieldValueIRS element (for citing)
Total Program Service Revenue94419560TotalProgramServiceRevenue

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

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

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 Column94425909TotalRevenueColumn
Related Or Exempt Function Income94419560RelatedOrExemptFunctionIncome

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)
Total11719061Total
Program Services11719061ProgramServices

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total46519671Total
Program Services46089779ProgramServices
Management And General429892ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total6876280Total
Program Services6876280ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1322889Total
Program Services1317888ProgramServices
Management And General5001ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1942969Total
Program Services1942969ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total32373327Total
Program Services27562651ProgramServices
Management And General4810676ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total13451Total
Management And General13451ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total56968Total
Management And General56968ManagementAndGeneral

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)
Total4233484Total
Program Services4124033ProgramServices
Management And General109451ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total129776Total
Program Services129776ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total373683Total
Program Services373683ProgramServices

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total6230Total
Program Services6230ProgramServices

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total118519Total
Program Services118519ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total245382Total
Program Services245382ProgramServices

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total4503Total
Program Services4503ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1062377Total
Program Services1062377ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total421026Total
Program Services374490ProgramServices
Management And General46536ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
BAD DEBT56916895691689
MEDICAL SUPPLIES53905365390536
RECRUITING346919346919
EQUIPMENT COSTS463964463964
DUES/MEMBERSHIP/LICENSES269568269568

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total328638Total
Program Services328638ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total119910910Total
Program Services114438935ProgramServices
Management And General5471975ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY-353910BOY
EOY-416161EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1017013BOY
EOY22118EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY12945303BOY
EOY12347023EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY141836BOY
EOY47774EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY39263BOY
EOY44930EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY761598BOY
EOY768557EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis10540203LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec7357128LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY2222523BOY
EOY3183075EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY5225201BOY
EOY6523302EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY21998827BOY
EOY22520618EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY9090488BOY
EOY9427114EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY109111BOY
EOY612235EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY7798819BOY
EOY9562724EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY16998418BOY
EOY19602073EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY5000409BOY
EOY2918545EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5000409BOY
EOY2918545EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY21998827BOY
EOY22520618EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
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 Years2422CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3035CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2078CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3271CurrentTaxYearMinus1Year
Current Tax Year6349CurrentTaxYear
Total17155Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years87482526CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years87496019CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years85042238CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year91838780CurrentTaxYearMinus1Year
Current Tax Year94414909CurrentTaxYear
Total446274472Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years87484948CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years87499054CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years85044316CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year91842051CurrentTaxYearMinus1Year
Current Tax Year94421258CurrentTaxYear
Total446291627Total
FieldValueIRS element (for citing)
Public Support Total509446291627PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years152438CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years227742CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total380180Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years152438CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years227742CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total380180Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years130494CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years144034CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total274528Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years87767880CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years87870830CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years85044316CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year91842051CurrentTaxYearMinus1Year
Current Tax Year94421258CurrentTaxYear
Total446946335Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99853PublicSupportPercentage509
Prior Year Support Percentage0.99817PriorYearSupportPercentage
Investment Income Percentage0.00085InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00102PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis10540203OtherCostOrOtherBasis
Depreciation7357128Depreciation
Book Value3183075BookValue
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildings
Total Of Book Value Land Buildings3183075TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionRETIREMENT FUNDDescription
Book Value6523302BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets6523302TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
PENSION FUND LIABILITY$6,970,991
HEALTH CLAIMS PAYABLE$142,351
ESTIMATED MALPRACTICE COSTS$2,449,382
FieldValueIRS element (for citing)
Total Of Amounts9562724TotalOfAmounts
Total Revenue94425909TotalRevenue
Total Expenses119910910TotalExpenses
Excess Or Deficit For Year-25485001ExcessOrDeficitForYear
Excess Or Deficit Per FS-25485001ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt94421258TotRevenueEtcAuditedFinclStmt
Revenue Subtotal94421258RevenueSubtotal
Other Revenues Not Included4651OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt4651RevenueNotRptdOnFinStmt
Total Revenue Per Form99094425909TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt119906259TotExpensesEtcAuditedFinclStmt
Expenses Subtotal119906259ExpensesSubtotal
Other Expenses Not Included4651OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt4651ExpensesNotRptdOnFinStmt
Total Expenses Per Form990119910910TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (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 XII & XIII LINE 4C4,651 EXPENSE INCLUDED IN REVENUE ON AUDIT

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 (39 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgs
JAMES MELOTT
2325790304840126004638001649703272000
JOHN HARVEY
2580310317920162104638001764303554670
VIKI FORLANO HALFMANN
2283190300000169404638001696503233580
HARVEY RUSSWURM
2369650450000198003038001863403329590
MARY SEGER
143530020089012900165340373601851790
STEPHEN SAWYER
272430059909099804479801547003936050
CORNELIUS CHINN
3105570196880147204638001796303960600
MICHAEL WAGNON
2942100270320103804479802080903878870
WILLIAM WHITEHEAD
349415036644096205428002121804625190
CHRIS COLE
8831250248331019150063180022445012362310
JOLIE BAILEY
3095720364290106804983802102004179270
ANTHONY DE MORY
50660902427930169405450502215408277550
LAURA ADAMS
4845570465420120705438001605206027380
JOE MIMS
5009540621350343103038002353206204320
SCOTT GIPSON
339691090376096205078002070205025110
CHARLES MARSH
6391720425000504903038001619507332960
LUIS DUARTE
26344600459983018194076637022128032114020
IRVIN ZEITLER
3500306319000160530425490124953500377416
BRYAN HORNER
045748400000303800393180527182
TIMOTHY HARTIN
0183740000235200345910148700256721
DOUG SCHULTZ
329193027032038810303800854903990350
TIMOTHY HOPKINS
135396102151020178107663709019016565000
KENNETH BREEDLOVE
890479024833101322063180012095012154070
MICHAEL SICKELS
8670030248331017822063180022060012183960
VICTOR SCHULZE III
8730560248331019150063180013465012171820
DAVID HUCHTON
97419204561601207060380020132011015270
BRADLEY MCIVER
4569660336780147205622402208205704220
LESLIE WILLIAMSON
2287700012900641048470296550
EUGENE STOKES
6313220532960364303038001529507339360
DENVER MARSH JR
52391703763001086303038001357406163640
GREGORY DUNHAM
5469700300000235805438002173106554390
TY HUGHSTON
3020560300000178104638002124104014580
J M CORNELL
6774010853330536303038001429108127680
JOHN GILBREATH
015972500056110272060111330203675
GARY BOWEN
016156900019800293500117990204698
JAMES BARNETT
3565230300000178104638002006304547470
STEPHEN CAINELLI
4342580235000481103038001360305065520
DAVID HARVEY
7178100435420221003038001333308072750
PETER CHANG
783429010139001872204638001626509661860

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
NAMES, AMOUNTS, AND DETAILS OF ARRANGEMENTSPART 1, QUESTION 4NONQUALIFIED PLAN PARTICIPANTS NAME AMOUNT JAMES MELOTT $ 33,207 JOHN HARVEY $ 31,039 VIKI FORLANO HALFMANN $ 32,652 MARY SEGER $ 5,341 STEPHEN SAWYER $ 26,030 CORNELIUS CHINN $ 35,567 MICHAEL WAGNON $ 26,505 WILLIAM WHITEHEAD $ 37,214 CHRIS COLE $ 61,663 JOLIE BAILEY $ 29,493 ANTHONY DE MORY $ 42,200 LAURA ADAMS $ 50,881 JOE MIMS $ 13,166 SCOTT GIPSON $ 31,351 CHARLES MARSH $ 35,441 LUIS DUARTE $152,255 IRVIN ZEITLER $ 12,169 TIMOTHY HARTIN $ 15,538 DOUG SCHULTZ $ 7,639 TIMOTHY HOPKINS $101,200 KENNETH BREEDLOVE $ 61,663 MICHAEL SICKELS $ 61,663 VICTOR SCHULTZE III $ 61,663 DAVID HUCHTON $ 80,967 BRADLEY MCIVER $ 47,884 LESLIE WILLIAMSON $ 22,877 EUGENE STOKES $ 22,925 DENVER MARSH, JR. $ 25,916 GREGORY DUNHAM $ 52,931 TY HUGHSTON $ 30,603 J.M. CORNELL $ 24,069 JOHN GILBREATH $ 12,730 GARY BOWEN $ 12,896 JAMES BARNETT $ 29,552 STEPHEN CAINELLI $ 25,351 DAVID HARVEY $ 50,067 PETER CHANG $ 48,713 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 (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
MICHELLE CHINN
CORNELIUS CHINN'S SPOUSE70200SHANNON CLINIC EMPLOYEEfalse
SUSAN SCHULTZ
DOUG SCHULTZ'S SPOUSE12098SHANNON CLINIC EMPLOYEEfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 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 MEDICAL CENTER, 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 MEDICAL CENTER, 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 XI, 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.
RELATED COMPENSATION HOURS WORKEDFORM 990, PART VIIAVG HOURS WORKED FOR RELATED ORG BRYAN HORNER 39 TIMOTHY HARTIN 40 IRVIN ZEITLER 36 JOHN GILBREATH 40 GARY BOWEN 40
RECONCILIATION OF NET ASSETSBEGINNING NET ASSETS $ 5,000,409 + INCOME $ 94,421,258 - EXPENSES $(119,906,259) + TRANSFER FROM AFFILIATE $ 23,403,137 ------------------ ENDING NET ASSETS $ 2,918,545
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.
FAMILY/BUSINESS RELATIONSHIP WITH ANOTHER OFFICER, DIRECTOR, TRUSTEE, ETCFORM 990, PART VI, QUESTION 2CHARLES MARSH AND DENVER MARSH HAVE A FAMILY RELATIONSHIP.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
TRUSTEES SHANNON WEST TEXAS HOSPITAL
PO BOX 49SAN ANGELOTX76902750800679TRUSTTX501(C)(3)11BNA
SHANNON RURAL HEALTH CLINICS INC
120 E HARRIS AVESAN ANGELOTX76903752940211HEALTHCARETX501(C)(3)11CNA
SHANNON REAL ESTATE SERVICES INC
120 E HARRIS AVESAN ANGELOTX76903270075630SUPPORT SVCSTX501(C)(3)11BNA
SHANNON HEALTH SYSTEM
120 E HARRIS AVESAN ANGELOTX76903752602411SUPPORT SVCSTX501(C)(3)11ANA
SHANNON MEDICAL CENTER
120 E HARRIS AVESAN ANGELOTX76903752559845HEALTHCARETX501(C)(3)3NA
SHANNON BUSINESS SERVICES INC
120 E HARRIS AVESAN ANGELOTX76903432038769SUPPORT SVCSTX501(C)(3)11BNA
SHANNON MEDICAL MANAGEMENT
120 E HARRIS AVESAN ANGELOTX76903208367966SUPPORT SVCSTX501(C)(3)9NA
SHANNON JOINT VENTURES INC
PO BOX 22000SAN ANGELOTX76902752951284DIALYSIS SVCTX501(C)(3)9NA

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
LEGACY HEALTH PLAN INC
2018 PULLIAM STSAN ANGELOTX76903752838410HEALTH PLANTXNAC-CORPORATION000.00000
LEGACY MANAGEMENT SERVICES
2018 PULLIAM STSAN ANGELOTX76903752544450MANAGEMENTTXNAC-CORPORATION000.00000
LEGACY HEALTH SOLUTIONS
2018 PULLIAM STSAN ANGELOTX76903200720762MED INSURANCETXNAC-CORPORATION000.00000
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
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 FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg