BUCKTAIL MEDICAL CENTER: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
BUCKTAIL MEDICAL CENTER (EIN 24-0701920)
Tax period
2018-07-01 to 2019-06-30
Filed
2020-05-15
IRS object ID
202021369349304412
Schema version
2018v3.1
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)
Return2020-05-15T15:15:43-05:00ReturnTs
Tax Period End2019-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN460722692PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1SICKLER TARPEY & ASSOCIATESBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1227 JEFFERSON AVENUEAddressLine1Txt
CityTYRONECityNm
State AbbreviationPAStateAbbreviationCd
ZIP16686ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN240701920EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BUCKTAIL MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlBUCKBusinessNameControlTxt
Phone5709231000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11001 PINE STREETAddressLine1Txt
CityRENOVOCityNm
State AbbreviationPAStateAbbreviationCd
ZIP177641618ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTIMOTHY REEVES NHAPersonNm
Person TitleADMINISTRATORPersonTitleTxt
Phone5709231000PhoneNum
Signature2020-05-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCHRISTOPHER DEANTONIOPreparerPersonNm
PTINP00976440PTIN
Phone8146844640PhoneNum
Preparation2020-05-15PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address173.163.162.73IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-05-15IPDt
IP Tm16:05:58IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id893DD865F6FC61467EFBEE9FD6B52AB290752880AtSubmissionCreationDeviceId
At Submission Filing Device Id893DD865F6FC61467EFBEE9FD6B52AB290752880AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTIMOTHY REEVES NHAPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11001 PINE STREETAddressLine1Txt
CityRENOVOCityNm
State AbbreviationPAStateAbbreviationCd
ZIP177641618ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$7,602,399GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1909FormationYr
Legal Domicile StatePALegalDomicileStateCd
Activity Or MissionBUCKTAIL MEDICAL CENTER IS A CRITICAL ACCESS HOSPITAL, NURSING HOME FACILITY AND A COMMUNITY CLINIC SERVING THE HEALTHCARE NEEDS OF WESTERN CLINTON COUNTY, PA. BUCKTAIL MEDICAL CENTER OFFERS 16 HOSPITAL BEDS, 43 NURSING HOME BEDS, AND A COMMUNITY CLINIC OFFERING OUT PATIENT SERVICES.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee122TotalEmployeeCnt
Total Volunteers12TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$634,215PYContributionsGrantsAmt
CY Contributions Grants$1,275,806CYContributionsGrantsAmt
PY Program Service Revenue$5,759,195PYProgramServiceRevenueAmt
CY Program Service Revenue$6,326,188CYProgramServiceRevenueAmt
PY Investment Income$359PYInvestmentIncomeAmt
CY Investment Income$405CYInvestmentIncomeAmt
PY Other Revenue$1,278,321PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$7,672,090PYTotalRevenueAmt
CY Total Revenue$7,602,399CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$3,597,404PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$3,361,548CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$3,550,076PYOtherExpensesAmt
CY Other Expenses$3,937,502CYOtherExpensesAmt
PY Total Expenses$7,147,480PYTotalExpensesAmt
CY Total Expenses$7,299,050CYTotalExpensesAmt
PY Revenues Less Expenses$524,610PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$303,349CYRevenuesLessExpensesAmt
Total Assets BOY$2,115,040TotalAssetsBOYAmt
Total Assets EOY$2,324,854TotalAssetsEOYAmt
Total Liabilities BOY$3,563,844TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,472,176TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$1,448,804NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$1,147,322NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionBUCKTAIL MEDICAL CENTER IS A CRITICAL ACCESS HOSPITAL, NURSING HOME FACILITY AND A COMMUNITY CLINIC SERVING THE HEALTHCARE NEEDS OF WESTERN CLINTON COUNTY, PA. BUCKTAIL MEDICAL CENTER OFFERS 16 HOSPITAL BEDS, 43 NURSING HOME BEDS, AND A COMMUNITY CLINIC OFFERING OUT PATIENT SERVICES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$2,981,729ExpenseAmt
Revenue$2,918,455RevenueAmt
DescBUCKTAIL MEDICAL CENTER PROVIDES HOSPITAL INPATIENT AND OUTPATIENT SERVICES. THE CENTER HAS 16 BEDS TO MEET ITS CRITICAL ACCESS NEEDS AS WELL AS AN EMERGENCY ROOM AND COMMUNITY CLINIC.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$3,500,290ExpenseAmt
Revenue$3,407,733RevenueAmt
DescBUCKTAIL MEDICAL CENTER PROVIDES NURSING HOME FACILITIES WITH 43 BEDS. SERVICES ALSO INCLUDE PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, EXERCISE AND RECREATIONAL ACTIVITIES.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$6,482,019TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation EasementsYes (1)ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee122EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE ORGANIZATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5709231000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11001 PINE STREETAddressLine1Txt
CityRENOVOCityNm
State AbbreviationPAStateAbbreviationCd
ZIP177641618ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
ROBERT GETZ SR
BOARD PRESIDENT1.00Yes (X)Yes (X)$0$0$0
JOHN LUGG
BOARD MEMBER1.00Yes (X)$0$0$0
CONSTANCE LINBERG
BOARD MEMBER1.00Yes (X)$0$0$0
JOHN KURUTZ
BOARD MEMBER1.00Yes (X)$0$0$0
ANNA KNAUFF
BOARD MEMBER1.00Yes (X)$0$0$0
MARTHA SYKES
BOARD SEC/TREAS.1.00Yes (X)Yes (X)$0$0$0
CARLA FLACK
BOARD VICE PRESIDENT1.00Yes (X)Yes (X)$0$0$0
WILLIAM FORNWALT
BOARD MEMBER1.00Yes (X)$0$0$0
ALAN EDWARDS MD
MEDICAL DIRECTOR40.00Yes (X)Yes (X)$0$0$0
GEORGE GERBER
CONTROLLER40.00Yes (X)$78,172$0$0
TIMOTHY REEVES NHS
DIRECTOR40.00Yes (X)$88,777$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$166,949TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
EMCARE INC
7032 COLLECTION CENTER DRIVECHICAGOIL60693PHYSICIAN SERVICES$825,214
BENCHMARK THERAPIES INC
PO BOX 870HUNTINGDONPA16652THERAPY SERVICES$653,879
HEALTHLAND INC
PO BOX 850309MOBILEAL36685IT SERVICES$202,708
OMNICARE INC
PO BOX 78000DETROITMI48278PHARMACY SERVICES$169,928
ALLIED RESOURCES STAFFING SOLUTIONS
135 DOWLIN FORGE ROADEXTONPA19341AGENCY-NURSING$158,618
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
Government Grants$1,113,684GovernmentGrantsAmt
All Other Contributions$162,122AllOtherContributionsAmt
Total Contributions$1,275,806TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
LONG TERM CARE FACILIT623000$3,407,733$3,407,733
PATIENT SERVICE REVENU621990$2,918,455$2,918,455
FieldValueIRS element (for citing)
Total Program Service Revenue$6,326,188TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$405TotalRevenueColumnAmt
Exclusion$405ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,602,399TotalRevenueColumnAmt
Related Or Exempt Func Income$6,326,188RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$405ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$166,949TotalAmt
Management And General$166,949ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,453,780TotalAmt
Program Services$2,027,380ProgramServicesAmt
Management And General$426,400ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$740,819TotalAmt
Program Services$573,098ProgramServicesAmt
Management And General$167,721ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$111,909TotalAmt
Program Services$111,909ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$125,564TotalAmt
Program Services$125,564ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$88,695TotalAmt
Program Services$88,695ProgramServicesAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SUPPLIES$2,566,725$2,510,764$55,961
PROFESSIONAL FEES$824,692$824,692
BAD DEBT EXPENSE$219,917$219,917

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$7,299,050TotalAmt
Program Services$6,482,019ProgramServicesAmt
Management And General$817,031ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$202,770BOYAmt
EOY$274,098EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$166,108EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$787,295BOYAmt
EOY$813,756EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$88,613BOYAmt
EOY$82,854EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$69,528BOYAmt
EOY$66,642EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$8,142,136LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$7,279,977LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$906,157BOYAmt
EOY$862,159EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$12,751BOYAmt
EOY$10,884EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$11,857BOYAmt
EOY$11,857EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$36,069BOYAmt
EOY$36,496EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,115,040BOYAmt
EOY$2,324,854EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,405,137BOYAmt
EOY$1,400,080EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,911,895BOYAmt
EOY$1,843,959EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$246,812BOYAmt
EOY$228,137EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,563,844BOYAmt
EOY$3,472,176EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$1,506,945BOYAmt
EOY-$1,247,095EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$58,141BOYAmt
EOY$99,773EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$1,448,804BOYAmt
EOY-$1,147,322EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,115,040BOYAmt
EOY$2,324,854EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$303,349ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$1,867NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit Committee0AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Protection Natural HabitatYes (X)ProtectionNaturalHabitatInd
Preservation Open SpaceYes (X)PreservationOpenSpaceInd
Total Easements2TotalEasementsCnt
Total Acreage685.00TotalAcreageCnt
Written Policy Monitoring0WrittenPolicyMonitoringInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$144,218OtherCostOrOtherBasisAmt
Book Value$144,218BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,331,998OtherCostOrOtherBasisAmt
Depreciation$2,868,199DepreciationAmt
Book Value$463,799BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$352,958OtherCostOrOtherBasisAmt
Depreciation$322,663DepreciationAmt
Book Value$30,295BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,312,962OtherCostOrOtherBasisAmt
Depreciation$4,089,115DepreciationAmt
Book Value$223,847BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$862,159TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescMEDICARE PAYABLEDesc
Amt$228,137Amt
FieldValueIRS element (for citing)
Total Liability$228,137TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:THE CENTER ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES BY PRESCRIBING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT DETERMINED THERE WAS NO TAX UNCERTAINTIES THAT MET THE REGONITION THRESHOLD FOR FISCAL YEAR END JUNE 30, 2019.
PART XI, LINE 2D - OTHER ADJUSTMENTS:BAD DEBT
PART XII, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT
SCHEDULE D PART XI LINE 1THE AUDITED FINANCIAL STATEMENTS INCLUDE THE PROVISION FOR BAD DEBT IN THE AMOUNT OF 219,917 IN THE GROSS REVENUE. FOR TAX PURPOSES THIS IS PART OF THE EXPENSES.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other399.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance Budget0FinancialAssistanceBudgetInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$586TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$586NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,435,237TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,377,644DirectOffsettingRevenueAmt
Net Community Benefit Expns$57,593NetCommunityBenefitExpnsAmt
Total Expense0.00790TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,866TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,853DirectOffsettingRevenueAmt
Net Community Benefit Expns$13NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,437,689TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,379,497DirectOffsettingRevenueAmt
Net Community Benefit Expns$58,192NetCommunityBenefitExpnsAmt
Total Expense0.00800TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$124,065TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$124,065NetCommunityBenefitExpnsAmt
Total Expense0.01700TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,189TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$775DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,414NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$129,254TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$775DirectOffsettingRevenueAmt
Net Community Benefit Expns$128,479NetCommunityBenefitExpnsAmt
Total Expense0.01760TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,566,943TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,380,272DirectOffsettingRevenueAmt
Net Community Benefit Expns$186,671NetCommunityBenefitExpnsAmt
Total Expense0.02560TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,665TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,665NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$700TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$700NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,802TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,090DirectOffsettingRevenueAmt
Net Community Benefit Expns$712NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,429TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$7,429NetCommunityBenefitExpnsAmt
Total Expense0.00100TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,596TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,090DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,506NetCommunityBenefitExpnsAmt
Total Expense0.00140TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$219,917BadDebtExpenseAmt
Bad Debt Expense Attributable$130,630BadDebtExpenseAttributableAmt
Reimbursed By Medicare$1,589,659ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$1,783,843CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$194,184MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost Accounting SystemYes (X)CostAccountingSystemInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BUCKTAIL MEDICAL CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11001 PINE STREETAddressLine1Txt
CityRENOVOCityNm
State AbbreviationPAStateAbbreviationCd
ZIP17764ZIPCd
FieldValueIRS element (for citing)
State License549601StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1BUCKTAIL MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA Conducted0CHNAConductedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care399.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit Other ActionsYes (X)PermitOtherActionsInd
Collection ActivitiesYes (1)CollectionActivitiesInd
Other ActionsYes (X)OtherActionsInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
BUCKTAIL MEDICAL CENTERPART V, SECTION B, LINE 13H: FAMILY SIZE; ESTIMATED EXPENSES.
BUCKTAIL MEDICAL CENTERPART V, SECTION B, LINE 18E: FAP APPLICATION(S) AND ASSISTANCE; FAP MAILING(S); FOLLOW-UP LETTERS AND/OR PHONE CALLS; SUBSEQUENT BILLING(S); PROMPT PAYMENT DISCOUNT; PAYMENT PLAN.
BUCKTAIL MEDICAL CENTERPART V, SECTION B, LINE 19E: FAP APPLICATION(S) AND ASSISTANCE; FAP MAILING(S); FOLLOW-UP LETTERS AND/OR PHONE CALLS; SUBSEQUENT BILLING(S); PROMPT PAYMENT DISCOUNT; PAYMENT PLAN.
BUCKTAIL MEDICAL CENTERPART V, SECTION B, LINE 20E: FAP APPLICATION(S) AND ASSISTANCE; FAP MAILING(S); FOLLOW-UP LETTERS AND/OR PHONE CALLS; SUBSEQUENT BILLING(S); PROMPT PAYMENT DISCOUNT; PAYMENT PLAN; ASSIST PATIENT IN EXPLORING ALTERNATIVE SOURCES OF COVERAGE AND PAYMENT.
FieldValueIRS element (for citing)
Facility3FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - BUCKTAIL MEDICAL CENTER
1001 PINE STREETRENOVOPA17764LONG-TERM CARE
2 - BUCKTAIL MEDICAL CENTER
1001 PINE STREETRENOVOPA17764AMBULANCE
3 - BUCKTAIL MEDICAL CENTER COMMUNITY CLINIC
1001 PINE STREETRENOVOPA17764COMMUNITY CLINIC

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART III, LINE 2:BUCKTAIL MEDICAL CENTER UTILIZES A MONTHLY CALCULATION TO DETERMINE THE AMOUNT OF BAD DEBT EXPENSE. BUCKTAIL UTILIZES AGED ACCOUNTS RECEIVABLE BY FINANCIAL CLASS; SERVICE TYPE; & CURRENT REIMBURSEMENT RATE(S) TO CALCULATE AN ESTIMATED AMOUNT OF COLLECTIBLE REVENUE BASED ON UNDER/OVER 120 DAYS, LESS ANY CONTRACTUAL ADJUSTMENT(S).
PART III, LINE 3:BUCKTAIL MEDICAL CENTER USES THE FOLLOWING TO DETERMINE THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS POTENTIALLY ELIGIBLE UNDER THE FAP: DETAILED PATIENT BILLING AND SERVICES RECORDS THAT WOULD HAVE BEEN DESIGNATED PATIENT CRITERIA ELIGIBLE TO APPLY FOR FAP. THIS WOULD INCLUDE, BUT NOT BE LIMITED TO STANDARD CHARGES, CO-PAYS, DEDUCTIBLES, NON-COVERED OR LIMITED COVERED SERVICES; BILLING CYCLES; FAP APPLICATIONS/COMPLETION; FAP DENIAL; POTENTIAL INCLUSION IN PREVIOUS CHARITY CARE PROGRAM.
PART III, LINE 4:FOOTNOTE CAN BE FOUND ON AUDITED FINANCIAL STATEMENTS, NOTE 1 - PATIENT ACCOUNTS RECEIVABLE PAGES 8 & 9.
PART III, LINE 8:BASED ON MEDICARE DATA FOR 6/30/2019, BUCKTAIL IS REIMBURSED LESS THAN EXPENSE BECAUSE OF NON-ALLOWABLE MEIDCARE BAD DEBT EXPENSE, DEDUCTION FOR CO-INSURANCES, DEDUCTIBLES AND SEQUESTRATION. THESE AMOUNTS ARE NOT INCLUDED IN PARTS III, SEC. B, LINE 3.BUCKTAIL MEDICAL CENTER UTILIZED THE MEDICARE COST REPORT TENTATIVE SETTLEMENT FOR FYE 06/30/2019 FOR MEDICARE PAYMENT AND COST DATA.
PART III, LINE 9B:SEE BUCKTAIL MEDICAL CENTER BILLING & COLLECTION POLICY.
PART VI, LINE 2:BUCKTAIL MEDICAL CENTER CONDUCTED THE NEEDS ASSESSMENT WITH THE ASSISTANCE OF VARIOUS COMMUNITY ORGANIZATIONS.
PART VI, LINE 4:BUCKTAIL MEDICAL CENTER SERVICE AREA INCLUDES WESTERN CLINTON AND SOUTHERN POTTER COUNTIES. IT SERVES THE COMMUNITIES OF RENOVO, SOUTH RENOVO, NORTH BEND, HYNER, SHINTOWN, WESTPORT, AND HAMERSLEY FORK LOCATED IN CLINTON COUNTY. IT ALSO SERVES CROSS FORK LOCATED IN POTTER COUNTY. THE POPULATION OF THE AREA IS APPROXIMATELY 1,600. THE HOSPITAL IS ISOLATED AND SURROUNDED BY PENNSYLVANIA STATE PARKS AND GAME LAND KNOWN AS THE PENNSYLVANIA WILDS.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE BOARD OF DIRECTORS ARE PROVIDED WITH A DRAFT COPY OF THE TAX FORM 990 AND RELATED SCHEDULES AS WELL AS A DRAFT COPY OF THE AUDITED FINANCIAL STATEMENTS TO REVIEW AND APPROVE BEFORE FINAL SUBMISSION.
FORM 990, PART VI, SECTION B, LINE 12CBOARD MEMBERS SIGN CONFLICT OF INTEREST STATEMENTS AT THE BEGINNING OF THE FISCAL YEAR AND ANY TIME THERE IS A BOARD MEMBER CHANGE. BOARD MEMBERS ARE REQUIRED TO RECUSE THEMSELVES IN THE EVENT THERE EVER COULD BE A CONFLICT OF INTEREST DURING THE COURSE OF OPERATIONS.
FORM 990, PART VI, SECTION B, LINE 15SALARY DETERMINATION FOR TOP MANAGEMENT AND KEY EMPLOYEES IS SET AFTER COMPARISION TO MARKET REQUIREMENTS AND PEER GROUP BENCHMARKS.
FORM 990, PART VI, SECTION C, LINE 18ALL DOCUMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19ALL GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST.

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