2025-02-26T13:56:55-07:00 2024-06-30 812030609 Bakulesh Patel CPA 2070 Trestle Glen Rd Walnut Creek CA 94598 990 2023-07-01 942151392 ROUND VALLEY INDIAN HEALTH CENTER INC ROUN 7079836404 PO Box 247 Covelo CA 95428 Marilyn Horne Fiscal Officer 7079836404 2025-02-26 1 1 Bakulesh Patel P01484348 9252661245 2025-02-25 X 2023 2025-03-06 01:10:19Z Marilyn Horne PO Box 247 Covelo CA 95428 10074626 0 X RoundValleyIndianHealthCenter.com X 1967 CA Out patient Medical/Dental/Health Facility- To Provide Low Cost Primary Health Care services to Native Americans and other medically underserves rural residents of Covelo and Round Valley, California 7 7 84 0 0 0 6751774 7369940 3110522 2286939 50587 325266 541367 92481 10454250 10074626 0 0 0 0 4205407 4708042 0 0 0 3485391 4236662 7690798 8944704 2763452 1129922 13107204 11590152 6127573 3480599 6979631 8109553 PROVIDE LOW COST PRIMARY HEALTH CARE SERVICES TO NATIVE AMERICANS AND OTHER MEDICALLY UNDERSERVEDRURAL RESIDENTS OF COVELO AND ROUND VALLEY, CALIFORNIA 0 0 4193490 0 5344092 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 765333 0 2698645 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. 148072 0 148073 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. 1360231 0 1883817 Various other Healthcare, Welfare and Education related programs with the Primary objective of serving the local indigenous and resident Indians of the Round Valley and Covelo area 1360231 0 1883817 6467126 1 1 0 0 0 0 0 0 0 0 1 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 54 0 1 84 1 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 1 1 0 0 0 CA X Marilyn Horne 7079836404 PO Box 247 Covelo CA 95428 Snehal Raisoni MD Clinic Director 40 0 X X 335760 0 0 Karan Dhillon DDS Dental Director 40 0 X X 277792 0 0 Kevin Mack Psy.D 40 0 X X 255106 0 0 Otis Brotherton Executive Director 40 0 X X 168579 0 0 Vicki Shively PHN Clinic Nurse 40 0 X 131600 0 0 Marilyn Horne Fiscal Manager 40 0 X X 107377 0 0 Marvin Trotter MD Medical Doctor 40 0 X 106882 0 0 Virginia Scribner Deputy Executive Director 40 0 X X 73980 0 0 Linda Lohne Interim Executive Director 30 0 X X 70278 0 0 JoAnna Gonzales Board Chair 10 0 X 0 0 0 Amanda Want Board Secretary 10 0 X 0 0 0 Miranda Want Board Treasurer 10 0 X 0 0 0 Marian Azbill Board Vice Chair 10 0 X 0 0 0 Jill Hoaglen Board Member 10 0 X 0 0 0 Esther Bryant Board Member 10 0 X 0 0 0 Kim Stillwell Board Member 10 0 X 0 0 0 1527354 0 0 7 0 1 0 DT-Trac Consulting and Billing Service 210 North Broadway Miller SD 57362 Patients Billings Services 158792 Hachet Mountain Construction P O Box 1117 Covelo CA 95428 Construction 114427 2 0 0 0 0 6784903 585037 0 7369940 Patients Billings Revenues 621400 2286939 2286939 0 0 0 0 0 0 2286939 247293 247293 0 0 77973 77973 0 0 0 0 0 0 0 0 0 0 0 Various Health Related Services Revenues 621400 92481 92481 0 0 0 0 0 0 92481 10074626 2704686 0 0 X 1527354 1107140 420214 0 2511465 2235441 276024 0 336412 276327 60085 0 332811 229010 103801 0 33818 0 33818 0 1231511 625586 605925 235258 150431 84827 0 335575 0 335575 0 82326 82326 0 Contract Hlth, Substance Abuse & Emergency Services 845086 844886 200 0 Rent, Utilities, Bld & Equip Maint, Telephone, etc 497864 253581 244283 0 Medical Waste, Laboratory , Patients Transport Etc. 147885 122163 25722 0 Medical and Pharmacy Supplies 654390 591321 63069 0 172949 31240 141709 0 8944704 6467126 2477578 0 4285524 3600318 2074168 926153 7357744 4981283 2367042 2376461 4380470 4687220 13107204 11590152 731838 427288 5265527 2910787 130208 142524 6127573 3480599 X 6325998 7526769 653633 582784 6979631 8109553 13107204 11590152 1129922 0 0 0 0 0 X 0 1 X 1 1 1 X 4215266 6059954 7502079 9862296 9656879 37296474 0 0 0 0 0 0 4215266 6059954 7502079 9862296 9656879 37296474 37296474 5091 78878 83969 71149 296142 33081 45496 246388 692256 104327 76302 21758 536627 92481 831495 38904194 10944711 0.95867 0.95661 X Schedule A, Part II, Line 10 Various Health related services RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 376775 0 376775 4925808 0 3259275 1666533 0 0 0 0 1631474 0 1398479 232995 423687 0 323529 100158 2376461 Growth and Income Mutual Funds, MM Funds, etc 3082853 F US Treasuries 1604367 F 4687220 0 Vacation Payable 142524 142524 10074626 0 0 0 0 0 10074626 0 0 0 10074626 8944704 0 0 0 0 0 8944704 0 0 0 8944704 X 1 1 X 0 0 0 0 0 0 0 0 0 Snehal Raisoni MD Clinic Director 335760 0 0 0 0 0 0 0 0 0 335760 0 0 0 Kevin Mack Psy.D 255106 0 0 0 0 0 0 0 0 0 255106 0 0 0 Karan Dhillon DDS Dental Director 277792 0 0 0 0 0 0 0 0 0 277792 0 0 0 Otis Brotherton Executive Director 168579 0 0 0 0 0 0 0 0 0 168579 0 0 0 Schedule J, Part I, Line 1a Since the Clinic is located in remote rural area it is necessary and a requirement that outside area physicians and dentist reside in the clinic provided residences. Schedule J, Part I, Line 3 The Job Position- Duties, Responsibilities and Compensation are discussed and approved by the Board Form 990, Part VI, Section A, Line 8b Each Committee does not have authority to act on behalf of the governing body Form 990, Part VI, Section B, Line 11b Before filing the Form 990 and related schedules etc. Tax Returns are reviewed by the Fiscal Officer and a copies are made available to the Executive Director and the Board Members Form 990, Part VI, Section C, Line 19 The Governing Documents, Conflict of Interest Policy, and Financial Statements are made available to the public upon written request Form 990, Part IX, Line 11g These Other services are Locum Doctors and other Health Providers $588,420, Contract IT and Network Support Services and Patients Billings Services $547,170, and Others Professional and Contract Services $95,921.. This Federal Return filing is late as there was sickness/vacancy experienced in our fiscal department, and thus could not file the extension due on or by November 15, 2024. Also, since the entity is located in remote rural area there is significant difficulties in hiring adequate staffing. In the past the entity has normally filed extension by the due date and hardly filed late. We would sincerely appreciate kind consideration of our circumstances and waive the late filing penalties. Thank you