Shannon Health's Monopoly: Burdening San Angelo Taxpayers While Failing Public Health

OPINION — Our community is facing measurable harm from a single dominant health care system, Shannon Health, operating under the antitrust protection of a Certificate of Public Advantage (COPA).

Shannon is not just one hospital—it is a network of eight separate entities that move money back and forth among themselves. The last year all eight of their tax returns were seen was 2021, and those filings showed over $600 million in land, buildings, and equipment valuation. I’m not adjusting for depreciation—because normal taxpayers don’t get to depreciate their buildings. Since 2021, commercial property values in San Angelo have appreciated 30 to 50 percent, which means the true market value of those assets is far higher today.

For context, the entire city of San Angelo has just under $9.6 billion in total assessed value. Even at the much lower 2021 property values, Shannon’s holdings make up more than 6 percent of the city’s entire tax base—yet they pay no property taxes. If one were to assume Shannon’s properties have experienced identical valuation increases as your homes and small businesses have, the amount of taxable property Shannon’s non-profit status shields from taxation is more than 10 percent of the county’s property tax base.

And Shannon continues to expand tax-free. Since 2021, Shannon Health added more than $7 million in new property acquisitions that I could verify from the Tom Green County CAD. Every one of those purchases removed hundreds of thousands of dollars per year from the tax rolls—money that must now be made up by San Angelo taxpayers through higher taxes or reduced city services. I’ve done no digging into the other 20+ counties that Shannon covers, but with their smaller tax base, it’s not hard to imagine the impact Shannon’s nonprofit, tax-exempt status would have.

A fact worth noting: Shannon has paid property taxes before. After their purchase of Community Hospital in 2020, they made a payment of over $620,000 for the property taxes due that year. Once the property was converted to nonprofit status, that revenue disappeared permanently from the tax rolls—another annual loss that San Angelo taxpayers now shoulder.

A few more recent examples are:

• West Central Wireless building on Knickerbocker (now a Shannon therapy clinic): In 2024, it was valued near $1 million and generated about $67,000 in property tax revenue—not including sales tax revenue from its former operations. Now, taxpayers get nothing except another tax-exempt building.
• River Crest Hospital purchase: Twelve acres and 50,000 sq. ft. of facilities in the Bluffs, valued at over $5 million, previously contributed about $78,000 annually in property taxes. After Shannon Health acquired River Crest, that revenue is gone.

Shannon likes to claim they are doing San Angelo a favor by being a nonprofit and avoiding a hospital district tax. But if Shannon simply paid property taxes like every other major landowner in town, the revenue would far exceed what a typical hospital district tax would generate. If Shannon truly needs more funding, they could—like Midland, Odessa, Stanton, and Crane—seek voter approval for a hospital district tax. San Angelo taxpayers should not carry this burden while a tax-exempt monopoly continues to expand and make select hospital executives filthy rich on the backs of mostly middle-class residential property taxpayers.

This is not a small, struggling nonprofit. Publicly available numbers show that in 2021 Shannon generated over $15 million in profit, and that was after paying their executives and board members more than $11 million all the while placing liens on citizens who cannot pay their medical bills. Our community is being asked to subsidize a wealthy, powerful organization and then be taken to court when we cannot afford its bills.

Shannon has become the Walmart of healthcare—using its market power to siphon business from independent agencies, then negotiating reimbursement rates so low that no small provider can survive. This is not healthy competition—it is total market control.

Consider Medical Arts Pharmacy, which closed January 31, 2025. The owner told Fox West Texas that Pharmacy Benefit Manager (PBM) reimbursement rates—which Shannon negotiates—made survival impossible. That pharmacy is gone, its $4,000 annual property tax contribution is gone, sales tax generated is gone, and from what I understand, its owner now works for Shannon at the Shannon Pharmacy.

This story is repeating across sectors—home health providers, physical therapists, independent physicians. Each time one of these businesses closes, San Angelo loses jobs, property tax revenue, and healthcare options. Patients are left with fewer choices, less competition, and ultimately higher costs.

Most concerning of all, Shannon’s growing size and privileged status have not improved public health—the very purpose of the COPA. Shannon’s own Community Health Needs Assessments (CHNA), posted on their website, tell the story: from 2019 to 2025

• Obesity: up from 27% to 38%
• Premature deaths: up from 7,700 to 9,300
• Heart-related deaths: up from 63.4 per 100,000 to 197.5 per 100,000
• Heart disease prevalence: Increased from 8% in 2019 to 23% today — That's the Medicare estimate. Another measurement in 2018 stated the prevalence was 31.7%.

In other words, San Angelo residents are sicker, dying younger, and facing more chronic disease—despite Shannon’s size and tax advantages.

And access to care is getting worse. Wait times continue to climb.

I’d like to say good luck if you’ve got a loved one who is pregnant in San Angelo right now. From my count, San Angelo has three permanent OB physicians, with the rest filled by temporary locum tenens just to manage the backlog.

The Certificate of Public Advantage exists to protect the public good—not to shield a monopoly that removes millions from our local tax base, drives out competitors, burdens families with debt, and presides over worsening health outcomes.

Shannon’s size and tax-exempt status allow it to shift an unfair share of the tax burden onto San Angelo residents, weaken competition, and undermine our local economy. I respectfully urge you to remove Shannon’s COPA and restore the conditions necessary for competition and patient choice in San Angelo and Tom Green County.