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NORTHERN VALLEY INDIAN HEALTH INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
NORTHERN VALLEY INDIAN HEALTH INC (EIN 94-1747220)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-08-28
IRS object ID
201342409349300819
Schema version
2012v2.0
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)
Timestamp2013-08-28T14:32:45-07:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MANNURRUTIANELSONCPAs & ASSOC LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12901 Douglas Blvd Suite 290AddressLine1
CityRosevilleCity
StateCAState
ZIP Code956613824ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN941747220EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1NORTHERN VALLEY INDIAN HEALTH INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlNORTNameControl
Phone5309344641Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1207 NORTH BUTTE STREETAddressLine1
CityWILLOWSCity
StateCAState
ZIP Code95988ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKenneth SwearingerName
TitleChairpersonTitle
Date Signed2013-08-28DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJustin J Williams CPAName
PTINP00851793PTIN
Phone9169290540Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts18877973GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web SiteWWW.NVIH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1971YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionTo provide health services to eligible american indians in the service areas of Colusa, Glenn, and Yolo counties and portions of Butte and Tehama counties. Medical and dental services are provided to the general community as well.ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees255TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year4747170ContributionsGrantsPriorYear
Contributions Grants Current Year5773315ContributionsGrantsCurrentYear
Program Service Revenue Prior Year9610360ProgramServiceRevenuePriorYear
Program Service Revenue CY13089080ProgramServiceRevenueCY
Investment Income Prior Year12854InvestmentIncomePriorYear
Investment Income Current Year15578InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year14370384TotalRevenuePriorYear
Total Revenue Current Year18877973TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year8220615SalariesEtcPriorYear
Salaries Etc Current Year10412370SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year3583750OtherExpensePriorYear
Other Expenses Current Year5267591OtherExpensesCurrentYear
Total Expenses Prior Year11804365TotalExpensesPriorYear
Total Expenses Current Year15679961TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2566019RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3198012RevenuesLessExpensesCY
Total Assets BOY12310046TotalAssetsBOY
Total Assets EOY17502402TotalAssetsEOY
Total Liabilities BOY2014228TotalLiabilitiesBOY
Total Liabilities EOY4008572TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY10295818NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY13493830NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTo provide health services to eligible american indians in the service areas of Colusa, Glenn, and Yolo counties and portions of Butte and Tehama counties. Medical and dental services are provided to the general community as well.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense7696682Expense
Revenue13089080Revenue
DescriptionGeneral public - Northern Valley Indian Health provides medical, dental, and behavioral health services to the public and collects fees for these services from individuals, health care insurers, medi-cal and medicare.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense4207514Expense
DescriptionDepartment of Health and Human Services - Indian Health ServicesNorthern Valley Indian Health, Inc. provided comprehensive health services to the native-american population of Yolo, Colusa, Glenn and portions of tehama and butte counties of california. Comprehensive health services include direct patient care, prenatal care, immunizations, and health promotion and disease prevention.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense175265Expense
DescriptionDepartment of Health and Human Services - Indian Health Services Diabetes ProgramThis program provides diabetes detection and testing services to the Native-American population of Yolo, Colusa, Glenn, and portions of Tehama and Butte Counties.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp296441TotalOfOtherProgramServiceExp
Total Program Service Expense12375902TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096117NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingfalseComplianceWithBackupWitholding
Number Of Employees255NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocstrueChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonLarissa TambleNamePerson
Telephone Number5303614602TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1207 North Butte StreetAddressLine1
CityWillowsCity
StateCAState
ZIP Code95988ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (19 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Dennis Ramirez
Board Member4.000.00335000
Regina Dock
Board Member4.000.00230000X
Donna Rose
Board Member4.000.00430000X
Darrylene Swearinger
Board Member4.000.00450000X
Julia Fred
Board Secretary4.000.00810000XX
Sandra Knight
Treasurer4.000.00695000XX
Paulita Hopper
Vice Chair4.000.00755000XX
Kenneth Swearinger
Chairperson4.000.00625000XX
Larissa Tamble
Fiscal Director40.000.008370800X
Inder Wadhwa
Executive Dir.40.000.0018711000X
David Reed
Dental Director40.000.006943500X
Andrew Miller
Medical Director40.000.0020492400X
Michael Clarke
Behavior Health Director40.000.0010442200X
Walid Faraj
Physician40.000.0017135500X
Chester Austin
Physician40.000.0015254000X
Randall Taylor
Dentist40.000.0016627300X
Rina Ambaram
Dentist40.000.0016267600X
Thomas Lewis
Dentist40.000.0016065000X
Gretchen Murray
Secretary4.000.00637500X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1512768TotalReportableCompFromOrg
Number Individuals GT100 K8NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Just For Grins
490 B W Zia RdSanta FeNM87505Lab Fees128784
Hobbs Straus Dean & Walker
2594 Rio Linda BlvdSacramentoCA95815Legal119439
Gregory Weil
125 Yellowstone Dr Ste 100ChicoCA95973Lab Fees112001
Billson Construction Co Inc
3 Commerce Court Suite 100ChicoCA95928Construction102421
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
Government Grants5773315GovernmentGrants
Total Contributions5773315TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionHealth ServicesDescription
Business Code621400BusinessCode
Total Revenue Column13089080TotalRevenueColumn
Related Or Exempt Function Income13089080RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue13089080TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column15578TotalRevenueColumn
Exclusion$15,578ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column18877973TotalRevenueColumn
Related Or Exempt Function Income13089080RelatedOrExemptFunctionIncome
Exclusion$15,578ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total813247Total
Program Services539224ProgramServices
Management And General274023ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total8192416Total
Program Services7156510ProgramServices
Management And General1035906ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total687667Total
Program Services560919ProgramServices
Management And General126748ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total719040Total
Program Services608891ProgramServices
Management And General110149ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total145149Total
Program Services25809ProgramServices
Management And General119340ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total518331Total
Program Services475518ProgramServices
Management And General42813ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total3281Total
Program Services3281ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total81774Total
Program Services19666ProgramServices
Management And General62108ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total195565Total
Program Services46945ProgramServices
Management And General148620ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total265429Total
Program Services161964ProgramServices
Management And General103465ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total109740Total
Program Services6424ProgramServices
Management And General103316ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total597238Total
Management And General597238ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total69662Total
Management And General69662ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
EQUIPMENT45267940671745962
Contract Health Services580816580816
Subcontract5964815923814100
program supplies856368856368

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total795078Total
Program Services334469ProgramServices
Management And General460609ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total15679961Total
Program Services12375902ProgramServices
Management And General3304059ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1825934BOY
EOY3106168EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1447408BOY
EOY1456252EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY651408BOY
EOY233376EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1285791BOY
EOY3148239EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY6401BOY
EOY307EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis11990891LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec3165217LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY6367926BOY
EOY8825674EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY725178BOY
EOY732386EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY12310046BOY
EOY17502402EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY786015BOY
EOY1064503EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY106559BOY
EOY131173EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1032078BOY
EOY2769835EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY89576BOY
EOY43061EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2014228BOY
EOY4008572EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY10295818BOY
EOY13493830EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY10295818BOY
EOY13493830EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY12310046BOY
EOY17502402EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses3198012ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3920319CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3727919CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4179556CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4747170CurrentTaxYearMinus1Year
Current Tax Year5773316CurrentTaxYear
Total22348280Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6834734CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8709792CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8816849CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year9610360CurrentTaxYearMinus1Year
Current Tax Year13089080CurrentTaxYear
Total47060815Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10755053CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12437711CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12996405CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14357530CurrentTaxYearMinus1Year
Current Tax Year18862396CurrentTaxYear
Total69409095Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50969409095PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6449CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years498CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1404CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year12854CurrentTaxYearMinus1Year
Current Tax Year15578CurrentTaxYear
Total36783Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6449CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years498CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1404CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year12854CurrentTaxYearMinus1Year
Current Tax Year15578CurrentTaxYear
Total36783Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Total0Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Total0Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10761502CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12438209CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12997809CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14370384CurrentTaxYearMinus1Year
Current Tax Year18877974CurrentTaxYear
Total69445878Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99950PublicSupportPercentage509
Prior Year Support Percentage0.99940PriorYearSupportPercentage
Investment Income Percentage0.00050InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00060PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis944489OtherCostOrOtherBasis
Book Value944489BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis8630663OtherCostOrOtherBasis
Depreciation1832410Depreciation
Book Value6798253BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2415739OtherCostOrOtherBasis
Depreciation1332807Depreciation
Book Value1082932BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings8825674TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Rounding$3
Capital Lease$43,058
FieldValueIRS element (for citing)
Total Of Amounts43061TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt18877973TotRevenueEtcAuditedFinclStmt
Revenue Subtotal18877973RevenueSubtotal
Total Revenue Per Form99018877973TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt15679961TotExpensesEtcAuditedFinclStmt
Expenses Subtotal15679961ExpensesSubtotal
Total Expenses Per Form99015679961TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierPart XIdentifier
Return ReferencePart X : FIN48 FootnoteReturnReference
ExplanationNVIH, pursuant to a determination letter from the Internal Revenue Service, is exempt from Federal and State income taxes under Section 501(c)(3) of the Internal Revenue code and Section 23701(d) of the California Revenue and Taxation Code. Therefore, no provision for income taxes has been made. The accounting standard on accounting for uncertainty in income taxes addresses the determination of whether tax benefits claimed or expected to be claimed on a tax return should be recorded in the financial statements. Under that guidance, the Organization may recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by taxing authorities based on the technical merits of the position. Examples of tax positions include the tax-exempt status of the Organization and various positions related to the potential sources of unrelated business taxable income (UBIT). The tax benefits recognized in the financial statements from such a position are measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. There were no unrecognized tax benefits identified or recorded as liabilities at December 31, 2012 and December 31, 2011.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
Walid Faraj
Physician1625048851171355
Thomas Lewis
Dentist1571993451160650
Rina Ambaram
Dentist1612141462162676
Randall Taylor
Dentist1648181455166273
Inder Wadhwa
Executive Dir.187110187110
Gretchen Murray
Secretary63756375
Chester Austin
Physician1436858855152540
Andrew Miller
Medical Director204924204924

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableGoverning documents, policies and financial statements are available upon request at the Organization's office.
Form 990, Part VI, Line 15bForm 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesThe Board reviews comparabiity studies and deliberates on performance to determine salary of officers and employees.
Form 990, Part VI, Line 15aForm 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top ManagementThe Board reviews comparabiity studies and deliberates on performance to determine salary of officers and employees.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsThe Organization adheres to a conflict of interest policy. The policy is reviewed and updated as needed. In addition the officers, directors, and key employees communicate any conflicts of interest annually to management.
Form 990, Part VI, Line 11bForm 990, Part VI, Line 11b: Form 990 Review ProcessUpon completion of the 990, the Federal Form 990 is presented to the Board of Directors for review and approval. Once the 990 is approved by the Board, the Chairperson signs the Federal Form 990, State form 199 and other associated documents for subsequent delivery.
Form 990, Part VI, Line 4Form 990, Part VI, Line 4: Description of Significant Changes to Organizational DocumentsTHE ORGANIZATION REVISED THEIR BYLAWS TWICE DURING THE CURRENT YEAR.
Form 990, Part III, Line 4dForm 990, Part III, Line 4d: Other Program Services DescriptionOTHER PROGRAM SERVICES 4: FEMA/EFSP - Federal Emergency Management Agency (Emergency Food and Shelter Program) - Provides assistance to supplement and expand ongoing efforts to provide shelter, food and supportive services for needy families and individuals. OTHER PROGRAM SERVICES 5: CA DHS WIC - Butte County, State of California, Department of Health Services (Women and Infant Children Supplemental Food Program (WIC)) - This program distributes montly food vouchers to eligible patients of NVIH based on the results of individual evaluations of nutritional needs. OTHER PROGRAM SERVICES 6: CA DADP CALWORKS - State of California, Health and welfare Agency (CalWORKS Program) - Provides mental health and substance abuse services to the Native-American population of Yolo, Colusa, Glenn, and portions of Tehama and Butte counties of California. OTHER PROGRAM SERVICES 7: SCNAC - Sierra Cascade Nutrition and Activity Consortium - Funding provided as part of the Nutrition and Activity Promotion at California State University, Chico, to promote culturally appropriate health eating and physically active lifestyles. OTHER PROGRAM SERVICES 8: CRIHB CAIRS - California American Indian Recovery Services - Statewide substance abuse treatment and recovery support program administered by the California Rural Indian Health Board (CRIHB). OTHER PROGRAM SERVICES 9: CRIHB DSC - Dental Sealant Challenge Award - To encourage Tribal/Urban dental programs to increase dental sealant measures for dental patients. The award was administered by the Dental Support Center of the California Rural Indian Health Board (CRIHB). OTHER PROGRAM SERVICES 10: OTHER PROGRAM SERVICES 11: Blue Shield of California Foundation Grant - Agreement made with Board of Trustees of the Blue Shield of California Foundation for general operating support through the Community Clinic and Consortium Core Support Initiative grant. OTHER PROGRAM SERVICES 12: CSU Chico Food Stamp - CSU, Chico Research Foundation Acting on Behalf of the Center for Nutrition and Activity Promotion (CNAP) Food Stamp Outreach Program - Under this program, NVIH informs members of low-income households about the availability, eligibility requirements, application procedures and benefits of food stamps. OTHER PROGRAM SERVICES 13: The Regents of the University of California, Davis (UC Davis) - Under this program, NVIH trains community members in research techniques and institutional board review activities. OTHER PROGRAM SERVICES 14: HRSA - Small Health Care Provider Quality Improvement administered by the Department of Health and Human Services - To expand delivery of health care services in rural areas, for the planning and implementation of integrated health care networks in rural areas, and for planning and implementation of small health care provider quality improvement activities. OTHER PROGRAM SERVICES 15: CRIHB MAA - California Rural Indian Health Board (CRIHB) Medicaid Administrative Activities (MAA) - Under this program, NVIH improves the availability and accessibility of Medi-Cal services to eligible individuals.