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← SHANNON HEALTH SYSTEM

Form 990 for tax year 2022

Filed by SHANNON HEALTH SYSTEM.

Totals

Total revenue
$331,774
Total expenses
$314,781
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$0
Investment income
$212,600
Other revenue
$119,174
Total assets, end of year
$18,959,348
Total liabilities, end of year
$0
Net assets or fund balances, end of year
$18,959,348
Program services expenses (Part IX)
$0
Management and general expenses
$314,781
Fundraising expenses
$0
Program service expenses (Part III)
$0

Program services were 0.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 3 · Investment income

    total $212,600 · excluded $212,600

  • 4 · Income from investment of tax-exempt bond proceeds

    total $0

  • 5 · Royalties

    total $0

  • 6c · Rental income or loss

    real property $0 · personal property $0

  • 6d · Net rental income or loss

    total $0

  • 7d · Net gain or loss

    total $0

  • 8a · Fundraising events: gross income

    $0

  • 8b · Fundraising events: direct expenses

    $0

  • 8c · Net income from fundraising events

    total $0

  • 9a · Gaming: gross income

    $0

  • 9b · Gaming: direct expenses

    $0

  • 9c · Net income from gaming

    total $0

  • 10a · Gross sales of inventory

    $0

  • 10b · Cost of goods sold

    $0

  • 10c · Net income from sales of inventory

    total $0

  • 11a · Other revenue: INCOME FROM JOINT VENTURE INVESTMENTS

    total $119,174 · related or exempt $672,557 · unrelated business -$553,383

  • 11e · Other revenue, total

    $119,174

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $0

  • 2 · Grants to domestic individuals

    total $0

  • 3 · Grants to foreign organizations and individuals

    total $0

  • 4 · Benefits paid to or for members

    total $0

  • 5 · Compensation of officers, directors and key employees

    total $0

  • 6 · Compensation of disqualified persons

    total $0

  • 7 · Other salaries and wages

    total $0

  • 8 · Pension plan contributions

    total $0

  • 9 · Other employee benefits

    total $0

  • 10 · Payroll taxes

    total $0

  • 11a · Fees: management

    total $0

  • 11b · Fees: legal

    total $200,004 · management and general $200,004

  • 11c · Fees: accounting

    total $14,054 · management and general $14,054

  • 11d · Fees: lobbying

    total $0

  • 11e · Fees: professional fundraising services

    total $0

  • 11f · Fees: investment management

    total $0

  • 11g · Fees: other

    total $0

  • 12 · Advertising and promotion

    total $0

  • 13 · Office expenses

    total $0

  • 14 · Information technology

    total $0

  • 15 · Royalties

    total $0

  • 16 · Occupancy

    total $0

  • 17 · Travel

    total $0

  • 18 · Travel or entertainment for public officials

    total $0

  • 19 · Conferences, conventions and meetings

    total $0

  • 20 · Interest

    total $0

  • 21 · Payments to affiliates

    total $0

  • 22 · Depreciation, depletion and amortization

    total $0

  • 23 · Insurance

    total $100,723 · management and general $100,723

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $38,364,782 · end of year $17,642,030

  • 2 · Savings and temporary cash investments

    beginning of year $0 · end of year $0

  • 3 · Pledges and grants receivable

    beginning of year $0 · end of year $0

  • 4 · Accounts receivable

    beginning of year $0 · end of year $0

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 7 · Other notes and loans receivable

    beginning of year $0 · end of year $0

  • 8 · Inventories for sale or use

    beginning of year $0 · end of year $0

  • 9 · Prepaid expenses and deferred charges

    beginning of year $349,073 · end of year $353,162

  • 10c · Land, buildings and equipment, net

    beginning of year $0 · end of year $0

  • 11 · Investments: publicly traded securities

    beginning of year $0 · end of year $0

  • 12 · Investments: other securities

    beginning of year $291,599 · end of year $964,156

  • 13 · Investments: program-related

    beginning of year $0 · end of year $0

  • 14 · Intangible assets

    beginning of year $0 · end of year $0

  • 15 · Other assets

    beginning of year $0 · end of year $0

  • 17 · Accounts payable and accrued expenses

    beginning of year $0 · end of year $0

  • 18 · Grants payable

    beginning of year $0 · end of year $0

  • 19 · Deferred revenue

    beginning of year $0 · end of year $0

  • 20 · Tax-exempt bond liabilities

    beginning of year $0 · end of year $0

  • 21 · Escrow or custodial account liability

    beginning of year $0 · end of year $0

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 23 · Secured mortgages and notes payable

    beginning of year $0 · end of year $0

  • 24 · Unsecured notes and loans payable

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $0 · end of year $0

  • 27 · Net assets without donor restrictions

    beginning of year $39,005,454 · end of year $18,959,348

  • 28 · Net assets with donor restrictions

    beginning of year $0 · end of year $0

Mission and programs · 2022

Mission

THE MISSION OF SHANNON HEALTH SYSTEM IS TO IMPROVE THE HEALTH & WELLNESS OF THE PEOPLE OF ITS COMMUNITIES BASED ON IDENTIFIED NEEDS & WITHIN OUR RESOURCES TO PROVIDE THE BROADEST ACCESS TO OUR SERVICES.

Activities or mission (Part I)

SHANNON HEALTH SYSTEM IMPROVES THE HEALTH & WELLNESS OF THE PEOPLE OF ITS COMMUNITIES BASED ON IDENTIFIED NEEDS & WITHIN OUR RESOURCES TO PROVIDE THE BROADEST ACCESS TO OUR SERVICES.

  • PROVIDE SUPPORTING SERVICES TO SHANNON MEDICAL CENTER, AN IRC SECTION 501(C)(3) EXEMPT ORGANIZATION.

    Revenue $672,557

As filed on the 2022 return.

Listed in Part VII

  • Kelly Shane Plymell

    PRESIDENT

    Total calculated
    $1,184,101
    From this org
    $0
    From related orgs
    $1,069,858
    Other
    $114,243
    Hours/week
    24 + 16 related

    Schedule J breakdown matched by us

    Base
    $0 + $764,365 related
    Bonus
    $0 + $217,956 related
    Other
    $0 + $87,537 related
    Deferred
    $0 + $96,004 related
    Nontaxable benefits
    $0 + $18,239 related
    Filer's total
    $0 + $1,184,101 related
  • Dr Ross Harper

    Director

    Total calculated
    $1,177,675
    From this org
    $0
    From related orgs
    $1,064,361
    Other
    $113,314
    Hours/week
    2 + 38 related

    Schedule J breakdown matched by us

    Base
    $0 + $631,099 related
    Bonus
    $0 + $352,595 related
    Other
    $0 + $80,667 related
    Deferred
    $0 + $76,521 related
    Nontaxable benefits
    $0 + $36,793 related
    Filer's total
    $0 + $1,177,675 related
  • Dr Jason Felger

    Director

    Total calculated
    $999,260
    From this org
    $0
    From related orgs
    $874,060
    Other
    $125,200
    Hours/week
    2 + 38 related

    Schedule J breakdown matched by us

    Base
    $0 + $709,496 related
    Bonus
    $0 + $64,800 related
    Other
    $0 + $99,764 related
    Deferred
    $0 + $88,400 related
    Nontaxable benefits
    $0 + $36,800 related
    Filer's total
    $0 + $999,260 related
  • Joseph Wooldridge

    CFO

    Total calculated
    $495,803
    From this org
    $0
    From related orgs
    $417,708
    Other
    $78,095
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $326,149 related
    Bonus
    $0 + $63,473 related
    Other
    $0 + $28,086 related
    Deferred
    $0 + $59,856 related
    Nontaxable benefits
    $0 + $18,239 related
    Filer's total
    $0 + $495,803 related
  • Steve Cecil

    TRUSTEE

    Total calculated
    $71,962
    From this org
    $0
    From related orgs
    $71,962
    Other
    $0
    Hours/week
    2 + 6 related
  • Michael Ted Weatherford

    TRUSTEE

    Total calculated
    $70,794
    From this org
    $0
    From related orgs
    $70,794
    Other
    $0
    Hours/week
    2 + 6 related
  • Mike Oliphant

    TRUSTEE

    Total calculated
    $69,275
    From this org
    $0
    From related orgs
    $69,275
    Other
    $0
    Hours/week
    2 + 6 related
  • Oran Berry III

    SECRETARY

    Total calculated
    $65,869
    From this org
    $0
    From related orgs
    $65,869
    Other
    $0
    Hours/week
    2 + 6 related
  • Jeffrey McCormick

    TRUSTEE

    Total calculated
    $53,650
    From this org
    $0
    From related orgs
    $53,650
    Other
    $0
    Hours/week
    2 + 6 related
  • Freddy Moore

    TRUSTEE

    Total calculated
    $52,800
    From this org
    $0
    From related orgs
    $52,800
    Other
    $0
    Hours/week
    2 + 6 related
  • Will Griffis

    Director

    Total calculated
    $22,850
    From this org
    $0
    From related orgs
    $22,850
    Other
    $0
    Hours/week
    2 + 4 related
  • James A Boyd Jr

    Director

    Total calculated
    $21,350
    From this org
    $0
    From related orgs
    $21,350
    Other
    $0
    Hours/week
    2 + 4 related
  • Martha Visney

    Director

    Total calculated
    $20,350
    From this org
    $0
    From related orgs
    $20,350
    Other
    $0
    Hours/week
    2 + 4 related
  • Mario Castillo

    Director

    Total calculated
    $18,850
    From this org
    $0
    From related orgs
    $18,850
    Other
    $0
    Hours/week
    2 + 4 related
  • Len Mertz

    CHAIRMAN

    Total calculated
    $15,194
    From this org
    $0
    From related orgs
    $15,194
    Other
    $0
    Hours/week
    2 + 38 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

SCHEDULE J, PART I, LINE 3
MANAGEMENT COMPENSATION: The compensation of the CEO is determined and paid by, Shannon Medical Center, a related organization using the following methods: - COMPENSATION SURVEY OR STUDY - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACT - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
SCHEDULE J, PART I, LINE 4B
NON-QUALIFIED RETIREMENT PLAN (457F): PARTICIPANT W-2 DEFERRED COMP PAYOR ------------ --------- --------------- ----------- KELLY SHANE PLYMELL 87,537 83,805 SMC JOSEPH WOOLDRIDGE 28,086 47,656 SMC ROSS HARPER, MD 80,367 64,321 SC JASON FELGER, MD 78,574 76,200 SC

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • LEGACY MANAGEMENT SERVICES

    C CORP · UTILIZ REVIEW · TX · controlled entity

    Directly controlled by NA

  • LEGACY HEALTH SOLUTIONS

    C CORP · MED INSURANCE · TX · controlled entity

    Directly controlled by NA

Provenance

Return type
form_990
Tax year
2022
Filed
15 August 2024
IRS schema version
2022v5.0
Source object
202442289349302409

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