BUCKTAIL MEDICAL CENTER: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- BUCKTAIL MEDICAL CENTER (EIN 24-0701920)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-05-16
- IRS object ID
- 202211369349311136
- Schema version
- 2020v4.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-05-16T15:02:55-05:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 460722692 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SICKLER TARPEY & ASSOCIATES | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 227 JEFFERSON AVENUE | AddressLine1Txt |
| City | TYRONE | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16686 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 240701920 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BUCKTAIL MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BUCK | BusinessNameControlTxt |
| Phone | 5709231000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 PINE STREET | AddressLine1Txt |
| City | RENOVO | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 177641618 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TIMOTHY REEVES NHA | PersonNm |
| Person Title | ADMINISTRATOR | PersonTitleTxt |
| Phone | 5709231000 | PhoneNum |
| Signature | 2022-05-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | TIMOTHY | PersonFirstNm |
| Person Last | REEVES NHA | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CHRISTOPHER DEANTONIO | PreparerPersonNm |
| PTIN | P00976440 | PTIN |
| Phone | 8146844640 | PhoneNum |
| Preparation | 2022-05-16 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TIMOTHY REEVES NHA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 PINE STREET | AddressLine1Txt |
| City | RENOVO | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 177641618 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,546,763 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1909 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | BUCKTAIL 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 Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 97 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,434,617 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,526,792 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,557,612 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $5,019,879 | CYProgramServiceRevenueAmt |
| PY Investment Income | $496 | PYInvestmentIncomeAmt |
| CY Investment Income | $92 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $9,992,725 | PYTotalRevenueAmt |
| CY Total Revenue | $7,546,763 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,365,584 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,435,125 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,180,378 | PYOtherExpensesAmt |
| CY Other Expenses | $4,285,102 | CYOtherExpensesAmt |
| PY Total Expenses | $7,545,962 | PYTotalExpensesAmt |
| CY Total Expenses | $8,720,227 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,446,763 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,173,464 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,959,067 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,714,893 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,664,648 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,589,410 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,294,419 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $125,483 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | BUCKTAIL 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 Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $4,964,417 | ExpenseAmt |
| Revenue | $3,254,153 | RevenueAmt |
| Desc | BUCKTAIL 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,694,357 | ExpenseAmt |
| Revenue | $1,765,726 | RevenueAmt |
| Desc | BUCKTAIL MEDICAL CENTER PROVIDES NURSING HOME FACILITIES WITH 43 BEDS. SERVICES ALSO INCLUDE PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, EXERCISE AND RECREATIONAL ACTIVITIES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $7,658,774 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | Yes (1) | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 17 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 97 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5709231000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 PINE STREET | AddressLine1Txt |
| City | RENOVO | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 177641618 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| ROBERT GETZ SR | ||||||
| BOARD PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JOHN LUGG | ||||||
| VICE-PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MARTHA SYKES | ||||||
| SECRETARY/TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| WILLIAM FORNWALT | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| TRACY BRUNO | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| CONSTANCE LINBERG | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JOHN KURUTZ | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| BRIGITTE MORGAN | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DR ALAN EDWARDS MD | ||||||
| MEDICAL DIRECTOR | 40.00 | Yes (X) | $0 | $0 | $0 | |
| TIMOTHY REEVES NHS | ||||||
| DIRECTOR | 40.00 | Yes (X) | $100,183 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $100,183 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| EMCARE INC | |||||
| 7032 COLLECTION CENTER DRIVE | CHICAGO | IL | 60693 | PHYSICIAN SERVICES | $841,344 |
| BENCHMARK THERAPIES INC | |||||
| PO BOX 870 | HUNTINGDON | PA | 16652 | THERAPY SERVICES | $713,036 |
| PLEXSUM STAFFING SOLUTIONS INC | |||||
| PO BOX 568 | REEDSVILLE | PA | 17084 | AGENCY STAFFING | $344,968 |
| HEALTHLAND INC | |||||
| PO BOX 11407 | BIRMINGHAM | AL | 35246 | IT SUPPORT | $178,442 |
| ALLIED RESOURCES STAFFING SOLUTIONS | |||||
| 135 DOWLIN FORGE ROAD | EXTON | PA | 19341 | AGENCY NURSING | $153,042 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,412,970 | GovernmentGrantsAmt |
| All Other Contributions | $113,822 | AllOtherContributionsAmt |
| Total Contributions | $2,526,792 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENU | 900099 | $3,254,153 | $3,254,153 |
| LONG TERM CARE FACILIT | 623000 | $1,765,726 | $1,765,726 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $5,019,879 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $92 | TotalRevenueColumnAmt |
| Exclusion | $92 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,546,763 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,019,879 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $92 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,183 | TotalAmt |
| Management And General | $100,183 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,284,984 | TotalAmt |
| Program Services | $2,666,455 | ProgramServicesAmt |
| Management And General | $618,529 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,049,958 | TotalAmt |
| Program Services | $768,905 | ProgramServicesAmt |
| Management And General | $281,053 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,925 | TotalAmt |
| Program Services | $114,925 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,849 | TotalAmt |
| Program Services | $114,849 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $107,686 | TotalAmt |
| Program Services | $107,686 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $2,652,343 | $2,590,655 | $61,688 |
| PROFESSIONAL FEES | $903,773 | $903,773 | |
| BAD DEBT EXPENSE | $391,526 | $391,526 | $0 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,720,227 | TotalAmt |
| Program Services | $7,658,774 | ProgramServicesAmt |
| Management And General | $1,061,453 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,943,029 | BOYAmt |
| EOY | $1,831,959 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $166,108 | BOYAmt |
| EOY | $530,673 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $782,354 | BOYAmt |
| EOY | $1,157,935 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,812 | BOYAmt |
| EOY | $89,539 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,717 | BOYAmt |
| EOY | $79,619 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $8,440,628 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,511,652 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $863,121 | BOYAmt |
| EOY | $928,976 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,889 | BOYAmt |
| EOY | $10,417 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,857 | BOYAmt |
| EOY | $11,857 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,180 | BOYAmt |
| EOY | $73,918 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,959,067 | BOYAmt |
| EOY | $4,714,893 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,519,535 | BOYAmt |
| EOY | $1,653,708 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,798,705 | BOYAmt |
| EOY | $1,759,435 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,346,408 | BOYAmt |
| EOY | $1,176,267 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,664,648 | BOYAmt |
| EOY | $4,589,410 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,227,228 | BOYAmt |
| EOY | $49,101 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $67,191 | BOYAmt |
| EOY | $76,382 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,294,419 | BOYAmt |
| EOY | $125,483 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,959,067 | BOYAmt |
| EOY | $4,714,893 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,173,464 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $4,529 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 0 | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Protection Natural Habitat | Yes (X) | ProtectionNaturalHabitatInd |
| Preservation Open Space | Yes (X) | PreservationOpenSpaceInd |
| Total Easements | 2 | TotalEasementsCnt |
| Total Acreage | 685.00 | TotalAcreageCnt |
| Written Policy Monitoring | 0 | WrittenPolicyMonitoringInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $144,218 | OtherCostOrOtherBasisAmt |
| Book Value | $144,218 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,438,388 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,992,934 | DepreciationAmt |
| Book Value | $445,454 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $352,958 | OtherCostOrOtherBasisAmt |
| Depreciation | $331,156 | DepreciationAmt |
| Book Value | $21,802 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,505,064 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,187,562 | DepreciationAmt |
| Book Value | $317,502 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $928,976 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| MEDICARE PAYABLE | $23,854 |
| LINE OF CREDIT | $501,750 |
| CAPITAL LEASE OBLIGATION | $9,763 |
| SBA - PAYROLL PROTECTION LOAN | $640,900 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,176,267 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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, 2021. |
| SCHEDULE D PART XI LINE 1 | THE AUDITED FINANCIAL STATEMENTS INCLUDE THE PROVISION FOR BAD DEBT IN THE AMOUNT OF 391,526 IN THE GROSS REVENUE. FOR TAX PURPOSES THIS IS PART OF THE EXPENSES. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 399.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | 0 | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,708 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,708 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,405,447 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,713,617 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $691,830 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07930 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $207 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $77 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $130 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,409,362 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,713,694 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $695,668 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07970 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,409,362 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,713,694 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $695,668 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07970 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,665 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,665 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $700 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $700 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,416 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $416 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $61,659 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $27,565 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $34,094 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00390 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $65,440 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $28,565 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $36,875 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00420 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $293,156 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $89,282 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $663,649 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $792,645 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$128,996 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | Yes (X) | CostAccountingSystemInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BUCKTAIL MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 PINE STREET | AddressLine1Txt |
| City | RENOVO | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17764 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | 549601 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BUCKTAIL MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | 0 | ImplementationStrategyAdoptInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 399.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.BUCKTAILMEDICALCENTER.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.BUCKTAILMEDICALCENTER.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.BUCKTAILMEDICALCENTER.ORG | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Other Actions | Yes (X) | PermitOtherActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| BUCKTAIL MEDICAL CENTER | PART V, SECTION B, LINE 5: BUCKTAIL MEDICAL CENTER POLLED COMMUNITY MEMBERS, OTHER HEALTH PROFESSIOANLS, CLERGY AND BUSINESS COMMUNITY TO GATHER THE INPUT REQUIRED TO PRODUCE AN ACCURATE REPORT. |
| BUCKTAIL MEDICAL CENTER | PART V, SECTION B, LINE 6A: PRR AND CTA |
| BUCKTAIL MEDICAL CENTER | PART V, SECTION B, LINE 11: DEVELOPING PROGRAMS THAT MEET THE NEEDS THAT THE COMMUNITY FELT WERE THE MOST URGENT. |
| BUCKTAIL MEDICAL CENTER | PART V, SECTION B, LINE 13H: FAMILY SIZE; ESTIMATED EXPENSES. |
| BUCKTAIL MEDICAL CENTER | PART V, SECTION B, LINE 18E: FAP APPLICATION(S) AND ASSISTANCE; FAP MAILING(S); FOLLOW-UP LETTERS AND/OR PHONE CALLS; SUBEQUENT BILLING(S); PROMPT PAYMENT DISCOUNT; PAYMENT PLAN. |
| BUCKTAIL MEDICAL CENTER | PART 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; ASSIST PATIENT IN EXPLORING ALTERNATIVE SOURCES OF COVERAGE AND PAYMENT. |
| BUCKTAIL MEDICAL CENTER | PART 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. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - BUCKTAIL MEDICAL CENTER | ||||
| 1001 PINE STREET | RENOVO | PA | 17764 | LONG-TERM CARE |
| 2 - BUCKTAIL MEDICAL CENTER | ||||
| 1001 PINE STREET | RENOVO | PA | 17764 | AMBULANCE |
| 3 - BUCKTAIL MEDICAL CENTER COMMUNITY CLINIC | ||||
| 1001 PINE STREET | RENOVO | PA | 17764 | COMMUNITY CLINIC |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 ELIBIGLE 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 6/30/2021, BUCKTAIL IS REIMBURSED LESS THAN EXPENSE BECAUSE OF NON-ALLOWABLE MEDICARE 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 PROVIDER SUMMARY REPORT TENTATIVE SETTLEMENT FOR FYE 06/30/2020 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 FOR CHNA. BUCKTAIL MEDICAL CENTER COORDINATES WITH LOCAL EMS AND REGIONAL EMERGENCY/COUNTY PROVIDERS TO DETERMINE COMMUNITY NEED(S). |
| 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 H - PART VI, LINE 3 | BUCKTAIL MEDICAL CENTER UTILIZES THE FOLLOWING TO INFORM/EDUCATE PATIENTS FOR ASSISTANCE: 1) PROMINENTLY POSTS, IN ALL REGISTRATION/SERVICE AREAS, FAP PLAIN LANGUAGE SUMMARY; STATE MEDICAID RESOURCE/COMPASS POSTER; CHIP (CHILDREN'S HEALTH INSURANCE PROGRAM) POSTER. 2) MAKES FAP PACKET AVAILABLE AT THE FOLLOWING SERVICE LOCATIONS: PATIENT REGISTRATION; EMERGENCY ROOM; COMMUNITY CLINIC; BUSINESS OFFICE; AND PROVIDES FAP PACKETS IN THE FOLLOWING ADMISSION PACKETS; ACUTE/SWING BED AND SKILLED NURSING/LONG TERM CARE SO FAP IS INCLUDED WITH ADMISSIONS DOCUMENT REVIEW WITH PATIENT. 3) FAP APPLICATION PACKET IS OFFERED TO PATIENT(S) AT TIME OF SERVICE WHEN ABLE TO REGISTER PRIOR TO ANY MEDICALLY NECESSARY/EMERGENCY SERVICE(S). |
| SCHEDULE H - PART VI, LINE 4 | BUCKTAIL MEDICAL CENTER SERVES AN AREA THAT INCLUDES WESTERN CLINTON AND SOUTHERN POTTER COUNTIES. COMMUNITIES SERVED INCLUDE: RENOVO, SOUTH RENOVO, NORTH BEND, HYNER, SHINTOWN, WESTPORT AND HAMMERSLEY FORK IN CLINTON COUNTY AND CROSS FORK 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. BUCKTAIL SERVICES A MEDICALLY UNDERSERVED AREA (MUA) AND A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA). |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE 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 12C | BOARD 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 15 | SALARY 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 18 | ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST. |