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Nonprofiteer
← ROUND VALLEY INDIAN HEALTH CENTER INC

Form 990 for tax year 2022

Filed by ROUND VALLEY INDIAN HEALTH CENTER INC.

Totals

Total revenue
$10,454,250
Total expenses
$7,690,798
Contributions and grants received
$6,751,774
Grants paid
$0
Program service revenue
$3,110,522
Investment income
$50,587
Other revenue
$541,367
Total assets, end of year
$13,107,204
Total liabilities, end of year
$6,127,573
Net assets or fund balances, end of year
$6,979,631
Program services expenses (Part IX)
$6,137,489
Management and general expenses
$1,553,309
Fundraising expenses
$0
Program service expenses (Part III)
$6,137,489

Program services were 79.8% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

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

Revenue

Part VIII, the statement of revenue.

  • 1a · Federated campaigns

    $0

  • 1b · Membership dues

    $0

  • 1c · Fundraising events

    $0

  • 1d · Related organizations

    $0

  • 1e · Government grants (contributions)

    $6,473,920

  • 1f · All other contributions, gifts and grants

    $277,854

  • 1g · Noncash contributions included above

    $0

  • 2a · Program service revenue: Patients Billings Revenues

    total $3,110,522 · related or exempt $3,110,522 · unrelated business $0 · excluded $0

  • 2f · All other program service revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 3 · Investment income

    total $45,496 · related or exempt $45,496 · unrelated business $0 · excluded $0

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

    total $5,091 · related or exempt $5,091 · unrelated business $0 · excluded $0

  • 5 · Royalties

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 6c · Rental income or loss

    real property $0 · personal property $0

  • 7c · Gain or loss

    securities $0 · other assets $0

  • 8a · Fundraising events: contributions included on line 1c

    $0

  • 11a · Other revenue: Various Related Services

    total $4,740 · related or exempt $4,740 · unrelated business $0 · excluded $0

  • 11b · Other revenue: Fire Damage Insurance Proceeds

    total $536,627 · related or exempt $536,627 · unrelated business $0 · excluded $0

  • 11d · All other revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 11e · Other revenue, total

    $541,367

Functional expenses

Part IX, the statement of functional expenses.

  • 5 · Compensation of officers, directors and key employees

    total $1,122,771 · program services $868,773 · management and general $253,998 · fundraising $0

  • 7 · Other salaries and wages

    total $2,359,463 · program services $2,139,542 · management and general $219,921 · fundraising $0

  • 9 · Other employee benefits

    total $412,943 · program services $352,832 · management and general $60,111 · fundraising $0

  • 10 · Payroll taxes

    total $310,230 · program services $267,173 · management and general $43,057 · fundraising $0

  • 11b · Fees: legal

    total $17,180 · program services $0 · management and general $17,180 · fundraising $0

  • 11g · Fees: other

    total $991,998 · program services $779,602 · management and general $212,396 · fundraising $0

  • 22 · Depreciation, depletion and amortization

    total $340,700 · program services $0 · management and general $340,700 · fundraising $0

  • 23 · Insurance

    total $58,263 · program services $0 · management and general $58,263 · fundraising $0

  • 24a · Other expenses: Contract Health, Substance Abuse & Emergency

    total $701,278 · program services $701,278 · management and general $0 · fundraising $0

  • 24b · Other expenses: Rent, Utilities, Telephone, Bld and Equip Maint etc

    total $470,095 · program services $314,694 · management and general $155,401 · fundraising $0

  • 24c · Other expenses: Medical Waste, Laboratory etc.

    total $101,623 · program services $101,623 · management and general $0 · fundraising $0

  • 24d · Other expenses: Medical and Pharmacy Supplies and other

    total $477,394 · program services $423,693 · management and general $53,701

  • 24e · All other expenses

    total $326,860 · program services $188,279 · management and general $138,581 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $7,716,751 · end of year $4,285,524

  • 4 · Accounts receivable

    beginning of year $1,217,963 · end of year $2,074,168

  • 10a · Land, buildings and equipment: cost or other basis

    $7,012,749

  • 10b · Land, buildings and equipment: accumulated depreciation

    $4,645,707

  • 10c · Land, buildings and equipment, net

    beginning of year $1,542,686 · end of year $2,367,042

  • 13 · Investments: program-related

    beginning of year $1,347,550 · end of year $4,380,470

  • 17 · Accounts payable and accrued expenses

    beginning of year $315,711 · end of year $731,838

  • 19 · Deferred revenue

    beginning of year $7,123,577 · end of year $5,265,527

  • 25 · Other liabilities

    beginning of year $169,483 · end of year $130,208

  • 27 · Net assets without donor restrictions

    beginning of year $3,486,512 · end of year $6,325,998

  • 28 · Net assets with donor restrictions

    beginning of year $729,667 · end of year $653,633

Mission and programs · 2022

Mission

PROVIDE LOW COST PRIMARY HEALTH CARE SERVICES TO NATIVE AMERICANS AND OTHER MEDICALLY UNDERSERVEDRURAL RESIDENTS OF COVELO AND ROUND VALLEY, CALIFORNIA

Activities or mission (Part I)

Out patient Medical/Dental Facility- To Provide Low Cost Primary Health Care services to Native Americans and other medically underserves rural residents of Covelo and Round Valley, California

  • THROUGH CONTRACT WITH INDIAN HEALTH SERVICES, DHHS-USA, VARIOUS HEALTH CARE SERVICES ARE PROVIDED TO NATIVE INDIANS WHO ARE RESIDENTS OF ROUND VALLEY, CALIFORNIA. SUCH SERVICES INCLUDE PRIMARY HEALTHCARE DENTAL AND VISION. PROGRAM ALSO PROVIDE SUBSTANCE ABUSE COUNSELING CLINIC SERVICES, CONTRACT HEALTH SERVICES

    Expenses $4,012,780 · Revenue $5,017,290

  • PATIENTS BILLING-THE CLINIC ALSO PROVIDES LOW COST PRIMARY HEALTH CARE SERVICES TO ALL LOCAL RESIDENTS THAT ARE AMONG THE UNDERSERVED LOW INCOME POPULATION. THE INCOME DERIVED IS PRIVATE PATIENTS FEES, MEDICARE, MEDICAL, INSURANCE BILLING CLAIMS. SELF PAY etc.

    Expenses $607,379 · Revenue $3,747,083

  • Through US Department of Health and Human Services contract funding under the Special Diabetes Program for Indians, the Clinic provides various educational programs and activities to treat and manage the diabetes among the qualifying local native Indian residents.

    Expenses $128,422 · Revenue $128,422

  • Various other Healthcare and Welfare related programs with the Primary objective of serving the local indigenous and resident Indians of the Round Valley and Covelo area

    Expenses $1,388,908 · Revenue $1,561,455

As filed on the 2022 return.

Listed in Part VII

  • Snehal Raisoni MD

    Clinic Physician

    Total calculated
    $282,550
    From this org
    $282,550
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $282,550
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $282,550

  • Kevin Mack

    Psy.D

    Total calculated
    $254,189
    From this org
    $254,189
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $254,189
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $254,189

  • Vicki Shively PHN

    Clinic Nurse

    Total calculated
    $131,077
    From this org
    $131,077
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

  • Marvin Trotter MD

    Medical Doctor

    Total calculated
    $106,263
    From this org
    $106,263
    From related orgs
    $0
    Other
    $0
    Hours/week
    20

  • Marilyn Horne

    Fiscal Manager

    Total calculated
    $103,202
    From this org
    $103,202
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

  • Emily Bruton

    Physical Therapist

    Total calculated
    $94,694
    From this org
    $94,694
    From related orgs
    $0
    Other
    $0
    Hours/week
    20

  • Linda Lohne

    Interim Executive Director

    Total calculated
    $79,194
    From this org
    $79,194
    From related orgs
    $0
    Other
    $0
    Hours/week
    30

  • Virginia Scribner

    Deputy Executive Director

    Total calculated
    $71,602
    From this org
    $71,602
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

  • JoAnna Gonzales

    Board Vice Chair

    Total calculated
    $0
    Hours/week
    10

  • Otus Brotherton

    Board Chair

    Total calculated
    $0
    Hours/week
    10

  • Amanda Want

    Board Secretary

    Total calculated
    $0
    Hours/week
    10

  • Miranda Want

    Board Member

    Total calculated
    $0
    Hours/week
    10

  • Marian Azbill

    Board Member

    Total calculated
    $0
    Hours/week
    40

  • Jill Hoaglen

    Board Member

    Total calculated
    $0
    Hours/week
    10

  • Esther Bryant

    Board Treasurer

    Total calculated
    $0
    Hours/week
    10

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

Schedule J

Answered yes

  • 1a · Housing allowance or residence for personal use
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 3 · Approval by the board or compensation committee

Answered no

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

The filer's explanations (Part III)

Schedule J, Part I, Line 1a
Since the Clinic is in remote rural area it is necessary and a requirement that outside area physicians reside in the clinic provided residence.
Schedule J, Part I, Line 3
All positions Titles, Job Descriptions and Compensation are discussed and approved by the Board

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

Grants on this return

No itemized grants to organizations on this return.

Provenance

Return type
form_990
Tax year
2022
Filed
30 April 2024
IRS schema version
2022v5.0
Source object
202401159349302020

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