2024-08-15T12:44:35-05:00 2023-09-30 Forvis Mazars LLP 14241 DALLAS PARKWAY SUITE 1100 DALLAS TX 75254 990 2022-10-01 270075630 Shannon Real Estate Services % JOSEPH WOOLDRIDGE SHAN 3256536741 120 East Harris San Angelo TX 76903 JOSEPH WOOLDRIDGE CFO 3256536741 2024-08-15 true Noelle Alberto P01704142 9727028262 2022 2024-08-08 14:25:15Z JOSEPH WOOLDRIDGE 120 E HARRIS SAN ANGELO TX 76903 10412368 false X WWW.SHANNONHEALTH.COM X 2003 TX FOUNDED ON A LEGACY OF CARING, SHANNON IS A LOCALLY OWNED HEALTHCARE SYSTEM DEDICATED TO PROVIDING EXCEPTIONAL HEALTHCARE FOR OUR FAMILY, FRIENDS, AND NEIGHBORS. 14 11 0 0 0 0 0 0 8272548 10412368 -47903 -155964 0 0 8224645 10256404 0 0 0 0 0 0 0 0 0 4139244 5275724 4139244 5275724 4085401 4980680 75192989 101412680 41631 130485 75151358 101282195 X OUR MISSION, IN FULFILLING OUR LEGACY, IS TO CREATE AN ENVIRONMENT COMMITTED TO THE VALUES OF ACCOUNTABILITY, SERVICE, PRIDE, INTEGRITY, RESPECT, AND EXCELLENCE. WE WILL FOSTER GROWTH TOWARD THE HIGHEST QUALITY OF CARE AND CUSTOMER SERVICE AND WILL STRIVE FOR EFFICIENT FINANCIAL PERFORMANCE. WE WILL HIRE AND DEVELOP THE BEST PEOPLE TO ACCOMPLISH THE TASKS. false false 5275724 10412368 THE ORGANIZATION HOUSES ALL REAL ESTATE THAT SUPPORTS SHANNON MEDICAL CENTER, AN IRC SECTION 501(C)(3) ORGANIZATION. 5275724 true false false false false false false false false false true false false false false false false true false false false false false false false false false false false true false false false false false false false false false false false false false true true true false false true 0 0 0 false false false false false false false false false false false false X 14 11 false false false false true true true true true false false true true true true true true false false false X JOSEPH WOOLDRIDGE 3256536741 120 EAST HARRIS SAN ANGELO TX 76903 KELLY SHANE PLYMELL CEO 2.0 38.0 X X 0 1069858 114243 Dr Ross Harper Director 1.0 39.0 X 0 1064361 113314 DR JASON FELGER DIRECTOR 1.0 39.0 X 0 874060 125200 DR JAMES BARNETT CMO 1.0 39.0 X 0 668838 83026 Pamela Bradshaw COO 2.0 38.0 X 0 545031 83352 JOSEPH WOOLDRIDGE CFO 1.0 39.0 X 0 417708 78095 STACI WETZ CONTROLLER/FORMER CFO 1.0 39.0 X 0 165100 23814 STEVE CECIL TRUSTEE 1.0 7.0 X 0 71962 0 MICHAEL TED WEATHERFORD TRUSTEE 1.0 7.0 X 0 70794 0 MICHAEL OLIPHANT TRUSTEE/Secretary/Treasurer 1.0 7.0 X X 0 69275 0 ORAN BERRY II TRUSTEE/Vice Chairman 1.0 7.0 X X 0 65870 0 JEFFREY MCCORMICK TRUSTEE 1.0 7.0 X 0 53650 0 FREDDY MOORE TRUSTEE 1.0 7.0 X 0 52800 0 WILLIAM C GRIFFIS DIRECTOR 1.0 5.0 X 0 22850 0 JAMES A BOYD JR DIRECTOR 1.0 5.0 X 0 21350 0 MARTHA VISNEY DIRECTOR 1.0 5.0 X 0 20350 0 MARIO CASTILLO DIRECTOR 1.0 5.0 X 0 18850 0 LEN MERTZ TRUSTEE/CHAIRMAN 1.0 39.0 X X 0 15194 0 0 5287901 621044 0 true true false 0 0 Program Rent 532000 10412368 10412368 10412368 0 0 0 0 0 0 155964 -155964 -155964 -155964 0 0 0 0 0 0 0 0 0 0 0 10256404 10412368 0 -155964 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78331 78331 0 0 0 0 873975 873975 0 0 0 0 0 4277293 4277293 45726 45726 Supplies 399 399 5275724 5275724 0 0 0 0 0 0 0 0 25657 31684 0 0 0 0 0 0 0 0 0 0 138275871 36894875 75167332 101380996 0 0 0 0 0 0 0 0 0 0 75192989 101412680 40673 116527 0 0 958 13958 0 0 0 0 0 0 0 0 0 0 0 0 41631 130485 X 75151358 101282195 0 0 75151358 101282195 75192989 101412680 X 4980680 21150157 X false true X true false X X X 1 SHANNON MEDICAL CENTER 752559845 3 true 5275724 0 1 5275724 true false false false false false false false false false false false false false false true false 16553414 16553414 119713671 35950783 83762888 285407 196366 89041 1723379 747726 975653 101380996 10256404 10256404 10256404 5275724 5275724 5275724 SCHEDULE D, PART X, LINE 2 ASC 740 FOOTNOTE: 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. false true false false false false false false false DR JASON FELGER DIRECTOR 0 709496 0 64800 0 99764 0 88400 0 36800 0 999260 0 78574 STACI WETZ CONTROLLER/FORMER CFO 0 153100 0 12000 0 0 0 6362 0 17452 0 188914 0 0 Dr Ross Harper Director 0 631099 0 352595 0 80667 0 76521 0 36793 0 1177675 0 80367 KELLY SHANE PLYMELL CEO 0 764365 0 217956 0 87537 0 96004 0 18239 0 1184101 0 87537 Pamela Bradshaw COO 0 375353 0 108072 0 61606 0 65113 0 18239 0 628383 0 61606 DR JAMES BARNETT CMO 0 511727 0 90372 0 66739 0 70987 0 12039 0 751864 0 66739 JOSEPH WOOLDRIDGE CFO 0 326149 0 63473 0 28086 0 59856 0 18239 0 495803 0 28086 SCHEDULE J, PART I, LINE 4B NON-QUALIFIED RETIREMENT PLAN (457F): PARTICIPANT W-2 DEFERRED COMP PAYOR ------------ --------- --------------- ----------- JASON FELGER, MD $78,574 76,200 SC KELLY SHANE PLYMELL 87,537 83,805 SMC PAMELA BRADSHAW 61,606 52,914 SMC JAMES C. BARNETT, MD 66,739 58,787 SMC JOSEPH WOOLDRIDGE 28,086 47,656 SMC ROSS HARPER, MD 80,367 64,321 SC SCHEDULE J, PART I, LINE 3 MANAGEMENT COMPENSATION: THE COMPENSATION OF THE CEO IS DETERMINED AND PAID OUT OF THE RELATED ORGANIZATION, SHANNON MEDICAL CENTER, USING THE FOLLOWING METHODS: - COMPENSATION SURVEY OR STUDY - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACT - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS: SHANNON HEALTH SYSTEM IS THE SOLE MEMBER OF THE CORPORATION AS ESTABLISHED IN THE ARTICLES OF INCORPORATION. FORM 990, PART VI, SECTION A, LINE 7A & 7B MEMBER ELECTION ABILITIES & POWERS: PER THE CORPORATION BYLAWS, THE CORPORATION SHALL HAVE A BOARD OF DIRECTORS, AND THE NUMBER OF BOARD OF DIRECTORS SHALL ALWAYS BE NO LESS THAN THREE. SHANNON HEALTH SYSTEM, THE SOLE MEMBER OF THE CORPORATION, SHALL HAVE FULL VOTING RIGHTS FOR ALL PURPOSES UNDER THE ACT AND SUCH OTHER RIGHTS AS ARE SET FORTH IN THE ARTICLES OF INCORPORATION. ALL DIRECTORS OF THE BOARD ARE APPOINTED BY THE MEMBER AND MAY BE REMOVED AT THE MEMBER'S DISCRETION. THE MEMBER ALSO HAS THE POWER TO APPROVE THE ANNUAL BUDGETS, APPROVE THE PURCHASE, SALE OR MORTGAGE OF PROPERTY, UNDERTAKE MERGERS OR ACQUISITIONS AND APPROVE THE ALTERATION OF THE BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B REVIEW PROCESS FOR FORM 990: THE ORGANIZATION ENGAGES AN OUTSIDE ACCOUNTING FIRM TO PREPARE THE FORM 990. ONCE PREPARED, THE FORM IS REVIEWED BY THE ORGANIZATION'S INTERNAL ACCOUNTANTS PRIOR TO FILING. A COPY WILL BE MADE AVAILABLE TO THE FINANCE COMMITTEE AND BOARD BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C WRITTEN CONFLICT OF INTEREST POLICY: REGULARLY AUDIT FOR CONFLICT OF INTEREST STATEMENTS IN THE EMPLOYEE RECORDS. PROCEDURES 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 BOARD. 4. AT ANYTIME 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 BOARD. THE RESPONSIBILITY TO PROMPTLY REPORT SUCH ACTUAL OR POTENTIAL CONFLICTS RESTS WITH THE AFFECTED INDIVIDUAL. 5. THE BOARD WILL REVIEW DISCLOSURES AND DETERMINE WHICH REQUIRE FURTHER ACTION WITH THE GENERAL COUNSEL AND APPROPRIATE EXECUTIVE STAFF. FORM 990, PART VI, SECTION B, LINE 15A & 15B COMPENSATION REVIEW: SHANNON MEDICAL CENTER ENGAGED GALLAGHER TO PERFORM AN EXECUTIVE COMPENSATION REVIEW IN OCTOBER 2022 WHICH 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 PROCESS OF MAKING GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC: COPIES OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS ARE PROVIDED TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES: TRANSFER FROM SHANNON MEDICAL CENTER: $29,302,306 TRANSFER FROM SHANNON CLINIC: 38,633 TRANSFER TO SHANNON BUSINESS SERVICES: (483,981) TRANSFER TO SHANNON MEDICAL MANAGEMENT: (7,706,801) ---------------- $ 21,150,157 TRUSTEES SHANNON WEST TEXAS HOSPITAL PO BOX 49 SAN ANGELO TX 76902 750800679 TRUST FOR HEA TX 501(C)(3) 12B N/A false SHANNON BUSINESS SERVICES 120 E HARRIS AVE SAN ANGELO TX 76903 432038769 SUPPORT SVCS TX 501(C)(3) 12A SHS true SHANNON RURAL HEALTH CLINICS INC 120 E HARRIS AVE SAN ANGELO TX 76903 752940211 HEALTHCARE TX 501(C)(3) 12C SHS true SHANNON HEALTH SYSTEM 120 E HARRIS SAN ANGELO TX 76903 752602411 SUPPORT SVCS TX 501(C)(3) 12B TSWTH false SHANNON CLINIC 120 E BEAUREGARD AVE SAN ANGELO TX 76903 752600873 HEALTHCARE TX 501(C)(3) 10 SHS true SHANNON MEDICAL CENTER 120 E HARRIS AVE SAN ANGELO TX 76903 722559845 HEALTHCARE TX 501(C)(3) 3 SHS true SHANNON MEDICAL MANAGEMENT 120 E BEAUREGARD SAN ANGELO TX 76903 208367966 SUPPORT SVCS TX 501(C)(3) 12B SHS true SHANNON MEDICAL CENTER PIONEER FDN 120 E HARRIS AVE SAN ANGELO TX 76903 352229303 SUPPORT TX 501(C)(3) 12A SHS true LEGACY MANAGEMENT SERVICES 2018 PULLIAM STREET SAN ANGELO TX 76903 752544450 MANAGEMENT TX C CORP false LEGACY HEALTH SOLUTIONS 2018 PULLIAM STREET SAN ANGELO TX 76903 200720762 MEDICAL INSUR TX C CORP false false false false false false false false false false true false false false false true true false true true SHANNON BUSINESS SERVICES R 483981 FMV