BUCKTAIL MEDICAL CENTER: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
BUCKTAIL MEDICAL CENTER (EIN 24-0701920)
Tax period
2013-07-01 to 2014-06-30
Filed
2015-05-15
IRS object ID
201521359349307197
Schema version
2013v4.0
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)
Return2015-05-15T16:49:42-05:00ReturnTs
Tax Period End2014-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN460722692PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1SICKLER TARPEY & ASSOCIATESBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1227 JEFFERSON AVENUEAddressLine1
CityTYRONECity
StatePAState
ZIP Code16686ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN240701920EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BUCKTAIL MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlBUCKBusinessNameControlTxt
Phone5709231000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11001 PINE STREETAddressLine1
CityRENOVOCity
StatePAState
ZIP Code177641618ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTIMOTHY REEVES NHAPersonNm
Person TitleADMINISTRATORPersonTitleTxt
Phone5709231000PhoneNum
Signature2015-05-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCHRISTOPHER DEANTONIOPreparerPersonNm
PTINP00976440PTIN
Phone8146844640PhoneNum
Preparation2015-05-15PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTIMOTHY REEVES NHAPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11001 PINE STREETAddressLine1
CityRENOVOCity
StatePAState
ZIP Code177641618ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$6,132,311GrossReceiptsAmt
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 21 HOSPITAL BEDS, 43 NURSING HOME BEDS, AND A COMMUNITY CLINIC OFFERING OUT PATIENT SERVICES.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee114TotalEmployeeCnt
Total Volunteers50TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$39,067PYContributionsGrantsAmt
CY Contributions Grants$916,572CYContributionsGrantsAmt
PY Program Service Revenue$6,364,990PYProgramServiceRevenueAmt
CY Program Service Revenue$5,215,441CYProgramServiceRevenueAmt
PY Investment Income$51PYInvestmentIncomeAmt
CY Investment Income$298CYInvestmentIncomeAmt
PY Other Revenue$567,348PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$6,971,456PYTotalRevenueAmt
CY Total Revenue$6,132,311CYTotalRevenueAmt
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$3,168,236PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$3,050,566CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$3,779,767PYOtherExpensesAmt
CY Other Expenses$4,418,837CYOtherExpensesAmt
PY Total Expenses$6,948,003PYTotalExpensesAmt
CY Total Expenses$7,469,403CYTotalExpensesAmt
PY Revenues Less Expenses$23,453PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,337,092CYRevenuesLessExpensesAmt
Total Assets BOY$3,703,823TotalAssetsBOYAmt
Total Assets EOY$2,998,848TotalAssetsEOYAmt
Total Liabilities BOY$3,643,887TotalLiabilitiesBOYAmt
Total Liabilities EOY$4,220,840TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$59,936NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$1,221,992NetAssetsOrFundBalancesEOYAmt
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 21 HOSPITAL BEDS, 43 NURSING HOME BEDS, AND A COMMUNITY CLINIC OFFERING OUT PATIENT SERVICES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$3,259,180ExpenseAmt
Revenue$2,450,441RevenueAmt
DescBUCKTAIL MEDICAL CENTER PROVIDES HOSPITAL INPATIENT AND OUTPATIENT SERVICES. THE CENTER HAS 21 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$3,677,951ExpenseAmt
Revenue$2,765,298RevenueAmt
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$6,937,131TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
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 Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
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 Document25IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee114EmployeeCnt
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
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
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 ORGANIZATIONBusinessNameLine1
FieldValueIRS element (for citing)
Phone5709231000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11001 PINE STREETAddressLine1
CityRENOVOCity
StatePAState
ZIP Code177641618ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
LENNEA BROWN
BOARD VICE PRESIDENT1.00Yes (X)Yes (X)$0$0$0
HARRIET NUSS
BOARD PRESIDENT1.00Yes (X)Yes (X)$0$0$0
JOHN BRUNO
BOARD MEMBER1.00Yes (X)$0$0$0
ELEANOR KEPLER
BOARD MEMBER1.00Yes (X)$0$0$0
JOHN KURUTZ
BOARD MEMBER1.00Yes (X)$0$0$0
PAUL FANTASKEY
BOARD MEMBER1.00Yes (X)$0$0$0
ANNA KNAUFF
BOARD MEMBER0.00Yes (X)$0$0$0
RAYMOND BRATTON
BOARD MEMBER0.00Yes (X)$0$0$0
CARLA FLACK
BOARD SECRETARY/TREASURER0.00Yes (X)$0$0$0
ORPHA KING
ADMINISTRATOR, CEO40.00Yes (X)$0$0$0
GEORGE GERBER
CONTROLLER40.00Yes (X)$0$0$0
ALVIN BERLOT DO
MEDICAL DIRECTOR40.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
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 (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
HEALTHCARE SERVICES
3220 TILLMAN DRIVE SUITE 300BENSALEMPA19020LAUNDRY, CAFETERIA, MAINTENANCE$730,475
EMCARE INC
100 WITMER ROAD SUITE 220HORSHAMPA19044ER DOCTORS$262,842
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Government Grants$864,491GovernmentGrantsAmt
All Other Contributions$52,081AllOtherContributionsAmt
Total Contributions$916,572TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
LONG TERM CARE FACILIT623000$2,765,149$2,765,149
PATIENT SERVICE REVENU900099$2,450,292$2,450,292
FieldValueIRS element (for citing)
Total Program Service Revenue$5,215,441TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$298TotalRevenueColumnAmt
Related Or Exempt Func Income$298RelatedOrExemptFuncIncomeAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,132,311TotalRevenueColumnAmt
Related Or Exempt Func Income$5,215,739RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$166,050TotalAmt
Program Services$166,050ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,250,336TotalAmt
Program Services$1,838,681ProgramServicesAmt
Management And General$411,655ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$13,213TotalAmt
Program Services$11,013ProgramServicesAmt
Management And General$2,200ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$402,829TotalAmt
Program Services$335,741ProgramServicesAmt
Management And General$67,088ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$218,138TotalAmt
Program Services$181,809ProgramServicesAmt
Management And General$36,329ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$15,000TotalAmt
Management And General$15,000ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$167,041TotalAmt
Program Services$167,041ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$120,565TotalAmt
Program Services$120,565ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$561,377TotalAmt
Program Services$561,377ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$80,388TotalAmt
Program Services$80,388ProgramServicesAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
SUPPLIES$2,257,106$2,257,106
PROFESSIONAL FEES$766,331$766,331
BAD DEBT EXPENSE$451,029$451,029

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$7,469,403TotalAmt
Program Services$6,937,131ProgramServicesAmt
Management And General$532,272ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$44,221BOYAmt
EOY$121,225EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$393,559BOYAmt
EOY$381,374EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$870,347BOYAmt
EOY$559,843EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$30,338BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$82,744BOYAmt
EOY$65,651EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$36,684BOYAmt
EOY$58,475EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$7,896,065LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$6,110,574LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,221,750BOYAmt
EOY$1,785,491EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$9,492BOYAmt
EOY$12,089EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$14,688BOYAmt
EOY$14,700EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,703,823BOYAmt
EOY$2,998,848EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$957,857BOYAmt
EOY$1,376,498EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$765,219BOYAmt
EOY$514,645EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,920,811BOYAmt
EOY$2,329,697EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,643,887BOYAmt
EOY$4,220,840EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$59,936BOYAmt
EOY-$1,221,992EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$59,936BOYAmt
EOY-$1,221,992EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,703,823BOYAmt
EOY$2,998,848EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$1,337,092ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$2,597NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$52,567OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
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 CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$600OtherActivitiesAmt
Total Lobbying Expenditures$600TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationMEMBERSHIP FEE PAID TO THE HOSPITAL AND HEALTH SYSTEM ASSOCIATION OF PENNSYLVANIA.ExplanationTxt

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$3,211,735OtherCostOrOtherBasisAmt
Depreciation$2,248,051DepreciationAmt
Book Value$963,684BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$352,042OtherCostOrOtherBasisAmt
Depreciation$300,769DepreciationAmt
Book Value$51,273BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,107,594OtherCostOrOtherBasisAmt
Depreciation$3,561,754DepreciationAmt
Book Value$545,840BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$80,476OtherCostOrOtherBasisAmt
Book Value$80,476BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,785,491TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$5,736,446TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$2,597NetUnrealizedGainsInvstAmt
Recoveries Prior Year Grants$52,567RecoveriesPriorYearGrantsAmt
Other Revenue-$451,029OtherRevenueAmt
Revenue Not Reported-$395,865RevenueNotReportedAmt
Revenue Subtotal$6,132,311RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$6,132,311TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$7,018,374TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$7,018,374ExpensesSubtotalAmt
Other Expenses Not Included$451,029OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$451,029ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$7,469,403TotalExpensesPerForm990Amt

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, 2014.
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 451,029 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
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent200 DYes (X)Percent200DInd
Free Care Medically Indigent0FreeCareMedicallyIndigentInd
Financial Assistance Budget0FinancialAssistanceBudgetInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$23,175TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$23,175NetCommunityBenefitExpnsAmt
Total Expense0.00310TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$555,851TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$555,851NetCommunityBenefitExpnsAmt
Total Expense0.07440TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$579,026TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$579,026NetCommunityBenefitExpnsAmt
Total Expense0.07750TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$900TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$900NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$23,308TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$23,308NetCommunityBenefitExpnsAmt
Total Expense0.00310TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$24,208TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$24,208NetCommunityBenefitExpnsAmt
Total Expense0.00320TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$603,234TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$603,234NetCommunityBenefitExpnsAmt
Total Expense0.08070TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$461,759BadDebtExpenseAmt
Bad Debt Expense Attributable$50,000BadDebtExpenseAttributableAmt
Reimbursed By Medicare$1,960,039ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$1,960,039CostOfCareReimbursedByMedcrAmt

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 CENTERBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line11001 PINE STREETAddressLine1
CityRENOVOCity
StatePAState
ZIP Code17764ZIPCode
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 CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Facility1FacilityNum
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted12CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available Upon RequestYes (X)RptAvailableUponRequestInd
Develop Community Wide PlanYes (X)DevelopCommunityWidePlanInd
Adopt BudgetYes (X)AdoptBudgetInd
Prioritize Health NeedsYes (X)PrioritizeHealthNeedsInd
All Needs AddressedYes (1)AllNeedsAddressedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Used Deter Elig Free CareYes (1)FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt CareYes (1)FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (1)ExplainedBasisInd
Income LevelYes (X)IncomeLevelInd
State RegulationYes (X)StateRegulationInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
Posted In Emergency RoomYes (X)PostedInEmergencyRoomInd
Posted In Admission OfficeYes (X)PostedInAdmissionOfficeInd
Available On RequestYes (X)AvailableOnRequestInd
FAP Actions On Nonpayment0FAPActionsOnNonpaymentInd
Collection Activities0CollectionActivitiesInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Medicare RatesYes (X)MedicareRatesInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp

FieldValueIRS element (for citing)
Form And Line ReferenceBUCKTAIL MEDICAL CENTERFormAndLineReferenceDesc
ExplanationPART V, SECTION B, LINE 3: BUCKTAIL MEDICAL CENTER POLLED COMMUNITY MEMBERS, OTHER HEALTH PROFESSIOANLS, CLERGY AND BUSINESS COMMUNITY TO GATHER THE INPUT REQUIRED TO PRODUCE AN ACCURATE REPORT.ExplanationTxt
FieldValueIRS element (for citing)
Facility3FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeFacilityFacilityTxt
BUCKTAIL MEDICAL CENTER
1001 PINE STREETRENOVOPA17764LONG-TERM CARE
BUCKTAIL MEDICAL CENTER
1001 PINE STREETRENOVOPA17764AMBULANCE
BUCKTAIL MEDICAL CENTER COMMUNITY CLINIC
1001 PINE STREETRENOVOPA17764COMMUNITY CLINIC

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractYes (X)WrittenEmploymentContractInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11THE 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.
FORM 990, PART XII, LINE 2C:BUCKTAIL MEDICAL CENTER HAS NOT CHANGED IS PROCEDURE FOR OVERSIGHT WITH THE AUDIT.

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