NAVAJO HEALTH FOUNDATION-SAGE MEMORIAL HOSPITAL INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- NAVAJO HEALTH FOUNDATION-SAGE MEMORIAL HOSPITAL INC (EIN 23-7314364)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-08-10
- IRS object ID
- 201212239349301906
- Schema version
- 2010v3.4
- 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) |
|---|---|---|
| Timestamp | 2012-08-10T17:33:34-05:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12 E ROWAN STE 2 | AddressLine1 |
| City | SPOKANE | City |
| State | WA | State |
| ZIP Code | 99207 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237314364 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NAVAJO HEALTH FOUNDATION | BusinessNameLine1 |
| Business Name Line2 | SAGE MEMORIAL HOSPITAL INC | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NAVA | NameControl |
| Phone | 9287554500 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 457 | AddressLine1 |
| City | GANADO | City |
| State | AZ | State |
| ZIP Code | 86505 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CHARITY L ASKIE | Name |
| Title | DIRECTOR OF FINANCE | Title |
| Phone | 9287554500 | Phone |
| Date Signed | 2012-08-10 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MICHAEL R BELL | Name |
| Phone | 5094894524 | Phone |
| Date Prepared | 2012-08-10 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | AHMAD RAZAGHI | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 457 | AddressLine1 |
| City | GANADO | City |
| State | AZ | State |
| ZIP Code | 86505 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 29013146 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.SAGEMEMORIAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1974 | YearFormation |
| State Legal Domicile | AZ | StateLegalDomicile |
| Activity Or Mission Description | PROVIDES QUALITY HEALTHCARE SERVICES IN A FISCALLY RESPONSIBLE MANNER | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 8 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 308 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 479995 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 525294 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 25810665 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 28115328 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 57183 | InvestmentIncomePriorYear |
| Investment Income Current Year | 49548 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 51684 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 26347843 | TotalRevenuePriorYear |
| Total Revenue Current Year | 28741854 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 1632 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 8888 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 5866 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 9801072 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 9862259 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 17530625 | OtherExpensePriorYear |
| Other Expenses Current Year | 15282453 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 27333329 | TotalExpensesPriorYear |
| Total Expenses Current Year | 25159466 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -985486 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 3582388 | RevenuesLessExpensesCY |
| Total Assets BOY | 15619706 | TotalAssetsBOY |
| Total Assets EOY | 18731887 | TotalAssetsEOY |
| Total Liabilities BOY | 7437792 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 5879153 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 8181914 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 12852734 | NetAssetsOrFundBalancesEOY |
| Mission Description | OUR MISSION IS TO PROVIDE QUALITY PATIENT CARE IN A FISCALLY RESPONSIBLE MANNER FOCUSING ON THE PATIENTS PHYSICAL, SOCIAL AND SPIRITUAL WELL-BEING. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 18354430 | Expense |
| Grants | 8888 | Grants |
| Revenue | 28115328 | Revenue |
| Description | NAVAJO HEALTH FOUNDATION- SAGE MEMORIAL HOSPITAL CONTRACTED WITH INDIAN HEALTH SERVICE WITH A SELF-DETERMINATION CONTRACT WHICH PROVIDED CARE TO APPROXIMATELY 400 INPATIENTS AND 45,000 OUTPATIENTS, AS WELL AS PROVIDING EMERGENCY CARE AND DENTAL CARE SERVICES. SAGE MEMORIAL HOSPITAL SERVES PRIMARILY MEMBERS OF THE NAVAJO NATION. SAGE MEMORIAL HOSPITAL ADMINISTERED SPECIAL DIABETES PREVENTION AND TREATMENT PROJECTS FOR NAVAJOS. DEVELOPED PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY RESPONSE PLAN. | Description |
| Total Program Service Expense | 18354430 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 232 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 308 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 8 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | AZ | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHARITY L ASKIE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9257554615 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 457 | AddressLine1 |
| City | GANADO | City |
| State | AZ | State |
| ZIP Code | 86505 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (14 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| KELEWOOD MAYBELLE | |||||||
| HEALTH BOARD SECRETARY | 1.00 | X | X | 12500 | 0 | 0 | |
| DEDMAN APRIL N | |||||||
| BOARD OF DIRECTORS | 1.00 | X | 4000 | 0 | 0 | ||
| SHEPHERD AMBROSE | |||||||
| BOARD OF DIRECTORS | 1.00 | X | 6750 | 0 | 0 | ||
| SIMPSON ANDREW | |||||||
| HEALTH BOARD VICE PRESIDENT | 1.00 | X | X | 11250 | 0 | 0 | |
| YAZZIE LINDA A | |||||||
| HEALTH BOARD PRESIDENT | 1.00 | X | X | 7500 | 0 | 0 | |
| WAUNEKA STETSON | |||||||
| HEALTH BOARD TRESURER | 1.00 | X | X | 5500 | 0 | 0 | |
| BALDWIN DOROTHY | |||||||
| HEALTH BOARD MEMBER | 1.00 | X | 14500 | 0 | 0 | ||
| MOORE JOYCE | |||||||
| HEALTH BOARD MEMBER | 1.00 | X | 4000 | 0 | 0 | ||
| RAZAGHI AHMAD | |||||||
| CHIEF EXECUTIVE OFFICER | 60.00 | X | 126571 | 0 | 0 | ||
| ASKIE CHARITY | |||||||
| DIRECTOR OF FINANCE | 60.00 | X | 49826 | 0 | 10075 | ||
| ANDEMICHAEL MERON | |||||||
| DIRECTOR OF DENTAL | 40.00 | 195484 | 0 | 12575 | X | ||
| LABIB- KIYARASH FARID | |||||||
| ONSITE ADMINISTRATOR | 80.00 | 534240 | 0 | 10075 | X | ||
| GOLPARIAN MOHAMMAD | |||||||
| DIRECTOR OF MEDICAL STAFF | 80.00 | 219472 | 0 | 0 | X | ||
| WRAY JEREMY | |||||||
| DIRECTOR OF EMERGENCY DEPARTMENT | 80.00 | 279059 | 0 | 0 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1470652 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 32725 | TotalOtherCompensation |
| Number Individuals GT100 K | 5 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| SKILLED STAFFING SOLUTIONS | |||||
| 7910 HOSBROOK LANE | CINCINNATI | OH | 45243 | PROFESSIONAL STAFFING | 418625 |
| STAFF CARE INC | |||||
| PO BOX 281923 | ATLANTA | GA | 30384 | PROFESSIONAL STAFFING | 393268 |
| AMN HEALTHCARE INC | |||||
| FILE 56157 | LOS ANGELES | CA | 90074 | PROFESSIONAL STAFFING | 370508 |
| NATIONWIDE NURSES | |||||
| PO BOX 21228 DEPT 115 | TULSA | OK | 74121 | OTHER SERVICES | 363243 |
| RPH ON THE GO INC | |||||
| PO BOX 102460 | ATLANTA | GA | 30368 | OTHER SERVICES | 339859 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
| Government Grants | 256890 | GovernmentGrants |
| All Other Contributions | 268404 | AllOtherContributions |
| Total Contributions | 525294 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| CAPITATION REVENUE | 900099 | 17176498 | 17176498 |
| NET PATIENT REVENUE | 900099 | 10852531 | 10852531 |
| DEPARTMENT MISC REVENU | 900099 | 86299 | 86299 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 28115328 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 49548 | TotalRevenueColumn |
| Exclusion | $49,548 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 322976 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 271292 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 51684 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 51684 | TotalRevenueColumn |
| Exclusion | $51,684 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 28741854 | TotalRevenueColumn |
| Related Or Exempt Function Income | 28115328 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $101,232 | ExclusionAmount |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8888 | Total |
| Program Services | 8888 | ProgramServices |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5866 | Total |
| Program Services | 5866 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1465589 | Total |
| Program Services | 733512 | ProgramServices |
| Management And General | 732077 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7176340 | Total |
| Program Services | 5132389 | ProgramServices |
| Management And General | 2043951 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 57883 | Total |
| Program Services | 33533 | ProgramServices |
| Management And General | 24350 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 496839 | Total |
| Program Services | 287828 | ProgramServices |
| Management And General | 209011 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 665608 | Total |
| Program Services | 385599 | ProgramServices |
| Management And General | 280009 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1293568 | Total |
| Program Services | 371533 | ProgramServices |
| Management And General | 922035 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 212347 | Total |
| Management And General | 212347 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 155260 | Total |
| Management And General | 155260 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6310308 | Total |
| Program Services | 6175777 | ProgramServices |
| Management And General | 134531 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 140649 | Total |
| Program Services | 2801 | ProgramServices |
| Management And General | 137848 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4439138 | Total |
| Program Services | 3233212 | ProgramServices |
| Management And General | 1205926 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 151510 | Total |
| Management And General | 151510 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 551249 | Total |
| Program Services | 548480 | ProgramServices |
| Management And General | 2769 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 616494 | Total |
| Program Services | 470276 | ProgramServices |
| Management And General | 146218 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71644 | Total |
| Management And General | 71644 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 66363 | Total |
| Program Services | 66363 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 844761 | Total |
| Program Services | 725267 | ProgramServices |
| Management And General | 119494 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 191312 | Total |
| Management And General | 191312 | ManagementAndGeneral |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| BAD DEBT EXPENSE | 172806 | 172806 | 0 | |
| MISCELLANEOUS | 65044 | 300 | 64744 | 0 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25159466 | Total |
| Program Services | 18354430 | ProgramServices |
| Management And General | 6805036 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5553356 | BOY |
| EOY | 7964999 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 1211738 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1735150 | BOY |
| EOY | 1870208 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 283156 | BOY |
| EOY | 243331 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 62810 | BOY |
| EOY | 72676 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 21670493 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 15376777 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6571748 | BOY |
| EOY | 6293716 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1413486 | BOY |
| EOY | 1075219 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15619706 | BOY |
| EOY | 18731887 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5342139 | BOY |
| EOY | 4850722 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2073672 | BOY |
| EOY | 1004137 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21981 | BOY |
| EOY | 24294 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7437792 | BOY |
| EOY | 5879153 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6564227 | BOY |
| EOY | 11220858 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 964699 | BOY |
| EOY | 1030967 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 652988 | BOY |
| EOY | 600909 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8181914 | BOY |
| EOY | 12852734 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15619706 | BOY |
| EOY | 18731887 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 3582388 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 1088432 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Collect Used For Preservation | X | CollectUsedForPreservation |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 806316 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 5495 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 8888 | GrantsOrScholarships |
| Administrative Expenses | 68381 | AdministrativeExpenses |
| End Of Year Balance | 734542 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 705976 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 100340 | InvestmentEarningsOrLosses |
| End Of Year Balance | 806316 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 680080 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 25896 | InvestmentEarningsOrLosses |
| End Of Year Balance | 705976 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 26000 | OtherCostOrOtherBasis |
| Book Value | 26000 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 11508717 | OtherCostOrOtherBasis |
| Depreciation | 7183740 | Depreciation |
| Book Value | 4324977 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9821393 | OtherCostOrOtherBasis |
| Depreciation | 8193037 | Depreciation |
| Book Value | 1628356 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 314383 | OtherCostOrOtherBasis |
| Book Value | 314383 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 6293716 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | HOUSING DEPOSITS | Description |
| Amount | $24,294 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 24294 | TotalOfAmounts |
| Total Revenue | 28741854 | TotalRevenue |
| Total Expenses | 25159466 | TotalExpenses |
| Excess Or Deficit For Year | 3582388 | ExcessOrDeficitForYear |
| Prior Period Adjustments | 1088432 | PriorPeriodAdjustments |
| Total Adjustments | 1088432 | TotalAdjustments |
| Excess Or Deficit Per FS | 4670820 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 29013146 | TotRevenueEtcAuditedFinclStmt |
| Donated Srvc And Use Of Facilities | 271292 | DonatedSrvcAndUseOfFacilities |
| Revenue Not Rptd F990 | 271292 | RevenueNotRptdF990 |
| Revenue Subtotal | 28741854 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 28741854 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 25430758 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 271292 | DonatedServicesUseOfFacilities |
| Expenses Not Rptd F990 | 271292 | ExpensesNotRptdF990 |
| Expenses Subtotal | 25159466 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 25159466 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART III, LINE 4: | HUBBELL'S TRADING POST MANAGES ALL COLLECTIONS, OBJECTS AND ARTIFACTS IN ACCORDANCE TO PROPER MUSEUM STANDARDS AND CONDITIONS. | |
| PART V, LINE 4: | THE HOSPITAL'S ENDOWMENT CONSISTS OF SCANDLING MEMORIAL SCHOLARSHIP FUNDS ESTABLISHED TO PROVIDE FINANCIAL SCHOLARSHIP OPPORTUNITIES FOR FULL-TIME NAVAJO COLLEGE STUDENTS. | DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: |
| PART X: | INCOME TAXES THE HOSPITAL HAS BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND A SIMILIAR PROVISION OF THE STATE LAW. HOWEVER, THE HOSPITAL IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE HOSPITAL UNDERGOES AN ANNUAL ANALYSIS OF ITS VARIOUS TAX POSITIONS, ASSESSING THE LIKELIHOOD OF THOSE POSITIONS BEING UPHELD UPON EXAMINATION WITH RELEVANT TAX AUTHORITIES, AS DEFINED BY ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA (GAAP). THE HOSPITAL BELIEVES THAT THEY ARE IN SUBSTANTIAL COMPLIANCE WITH ALL IRS TAX REGULATIONS AND AS OF SEPTEMBER 30, 2011, HAVE NOT RECORDED ANY UNRECOGNIZED TAX BENEFIT OR LIABILITY FOR INCOME TAXES. THE HOSPITAL WILL RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX LIABILITIES IN INCOME TAX IF INCURRED. | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: |
| SCHEDULE D, PART XI, LINE 7, PRIOR PERIOD ADJUSTMENT PRIOR PERIOD ADJUSTMENT TO REFLECT PRIOR YEAR AUDITED FINANCIAL STATMENT AMOUNTS. PRIOR ACCOUNTANT FILED FORM 990 PRIOR TO THE AUDITED FINANCIAL STATEMENTS BEING AVAILABLE, THIS RESULTED IN A DIFFERENCE IN NET ASSETS OF $1,088,432. | ||
| SCHEDULE D, PART V ENDOWMENT FUND PRIOR YEAR BALANCES ARE CARRIED FORWARD FROM PRIOR YEAR FILED 990. CURRENT YEAR ENDING BALANCE IS FROM SEPTEMBER 30, 2011 AUDITED FINANCIAL STATEMENTS. AN ADJUSTMENT TO ADMINISTRATIVE EXPENSES IS MADE TO MATCH AUDITED FINANCIALS. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 0 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 0 | AmountsBudgetedForCharityCare |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $172,806 | BadDebtExpenseAmount |
| Amount Attributable To | 468 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 6500658 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 6027762 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 472896 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 0 | WrittenDebtCollectionPolicy |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NAVAJO HEALTH FDNSAGE MEM HOSPITAL INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 457 | AddressLine1 |
| City | GANADO | City |
| State | AZ | State |
| ZIP Code | 86505 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
| Other | DENTAL CARE | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NAVAJO HEALTH FDNSAGE MEM HOSPITALINC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 0 | CHNAConducted |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 4 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (4 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| OUTPATIENT CLINIC | ||||
| PO BOX 457 | GANADO | AZ | 86505 | OUTPATIENT SERVICES |
| SPECIALITY CLINIC | ||||
| PO BOX 457 | GANADO | AZ | 86505 | CARDIOLOGY AND ECHO |
| DENTAL CLINIC | ||||
| PO BOX 457 | GANADO | AZ | 86505 | DENTAL SERVICES |
| GREASEWOOD CLINIC | ||||
| PO BOX 457 | GANADO | AZ | 86505 | DENTAL AND OUTPATIENT SERVICES |
Form990 Schedule H Part VI Form990ScheduleHPartVI (9 entries)
| ExplanationExplanation |
|---|
| PART I, LINE 3C: IT IS THE POLICY OF SAGE MEMORIAL HOSPITAL TO PROVIDE ESSENTIAL MEDICAL SERVICES REGARDLESS OF THE PATIENT'S ABILITY TO PAY. DISCOUNTS ARE OFFERED BASED UPON HOUSEHOLD INCOME AND SIZE. A SLIDING FEE SCHEDULE IS USED TO CALCULATE THE BASIC DISCOUNT AND IS UPDATED EACH YEAR USING THE FEDERAL POVERTY GUIDELINES. ONCE APPROVED, THE DISCOUNT WILL BE HONORED FOR SIX MONTHS, AFTER WHICH THE PATIENT MUST REAPPLY. |
| PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 172806. |
| PART II: CURRENTLY, NAVAJO HEALTH FOUNDATION/ SAGE MEMORIAL HOSPITAL DOES NOT HAVE A COMMUNITY BUILDING ACTIVITY IN PLACE AT THIS TIME. |
| PART III, LINE 4: MANAGEMENT REVIEWS PATIENT RECEIVABLES BY PAYOR CLASS AND APPLIES PERCENTAGES TO DETERMINE ESTIMATED AMOUNTS THAT WILL NOT BE COLLECTED FROM THIRD PARTIES UNDER CONTRACTUAL AGREEMENTS AND AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS DUE TO BAD DEBTS. MANAGEMENT CONSIDERS HISTORICAL WRITE OFF AND RECOVERY INFORMATION IN DETERMINING THE ESTIMATED BAD DEBT PROVISION. MANAGEMENT ALSO REVIEWS ACCOUNTS TO DETERMINE IF CLASSIFICATION AS CHARITY CARE IS APPROPRIATE.BAD DEBT AND CHARITY CARE WAS CONVERTED TO COST USING THE COST-TO-CHARGE RATIO. |
| PART III, LINE 8: MEDICARE ALLOWABLE COSTS OF CARE ARE BASED ON THE COST TO CHARGE RATIO CALCULATED FROM THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. |
| PART VI, LINE 2: SAGE MEMORIAL HOSPITAL WORKS WITH THE NAVAJO AREA OFFICE (NAO) TO DETERMINE NEEDS ASSESSMENTS OF THEIR SERVICE AREA. THIS OFFICE SUPPLIES THE NEEDS ASSESSMENT BASED ON NEEDS THAT HAVE BEEN IDENTIFIED THROUGH ALL FACILITIES SERVING THE AREA AND WHO SEND IN QUARTERLY REPORTS ON SERVICES PROVIDED. AFTER REVIEWING THE SEVICES THAT THE FACILITIES HAVE PROVIDED, THE NAO DOES A NEEDS ANALYSIS AND PASSES THE INFORMATION ON TO THE FACILITIES. |
| PART VI, LINE 3: THE MAJORITY OF THE PATIENTS ARE NATIVE AMERICAN AND QUALIFY FOR THE INDAIN HEALTH SERVICE PROGRAM. THESE PATIENTS QUALIFY FOR THE FEDERAL PROGRAM AND DO NOT CARRY SEPARATE HEALTH INSURANCE. THERE ARE VERY FEW PATIENTS THAT WOULD FALL OUTSIDE THE IHS PROGRAM. CURRENTLY THERE IS NO INFORMATION IN THE PATIENT REGISTRATION AREA AND NO DISCUSSION WITH PATIENTS ON PARTICIPATING IN THE CHARITY CARE PROGRAM. |
| PART VI, LINE 4: NAVAJO HEALTH FOUNDATION/SAGE MEMORIAL HOSPITAL IS LOCATED IN APACHE COUNTY ARIZONA. IT IS ONE OF FOUR FACILITIES LOCATED IN APACHE COUNTY. GANADO IS LOCATED IN A RURAL AREA WITH THE CITY'S POPULATION BEING 660 AND THE OVERALL COUNTY POPULATION OF 38,737 (2005-2009 CENSUS). THE PER CAPITA INCOME FOR THE CITY WAS $9,993. ABOUT 29% OF THE FAMILIES AND 39.2% OF THE POPULATION WERE BELOW THE POVERY LINE. NAVAJO HEALTH FOUNDATION/SAGE MEMORIAL HOSPITAL DELIVERS QUALITY HEALTH CARE SERVICES MOSTLY TO NAVAJO MEMBERS IN ITS CATCHMENT AREA, DEFINED IN AGREEMENT WITH THE INDIAN HEALTH SERVICES AS THE EIGHT AREA CHAPTERS THAT ADD UP TO ABOUT 20,000 PEOPLE IN 1,500 SQUARE MILES. THESE LOCAL CHAPTERS ARE:GANADO, KINLICHEE, KLAGETOH, WIDE RUINS, GREASEWOOD, CORNFIELDS, NAZLINI, AND STEAMBOATADDITIONALLY, DENTAL SERVICES ARE PROVIDED TO THE NAVAJOS FROM THREE MORE CHAPTERS: HOUCK, LUPTON, AND SANDERSTO FACILITATE NON-URGENT CARE TO PEOPLE MORE THAN 15 MILES FROM GANADO, SAGE MEMORIAL HOSPITAL OPERATES THREE FIELD CLINICS: GREASEWOOD, WIDE RUINS, AND SANDERS. ALSO ARRANGEMENTS CAN BE MADE FOR TRANSPORTATION OF PATIENTS THAT HAVE TROUBLE GETTING A RIDE TO AND FROM THE HOSPITAL. |
| PART VI, LINE 6: THERE ARE EIGHT NAVAJO COMMUNITY MEMBERS THAT MAKE UP THE BOARD OF DIRECTORS. THERE ARE EIGHT CHAPTERS (COMMUNITIES) AND EACH CHAPTER ELECTS THIER REPRESENTATIVE ON A LOCAL LEVEL AND THOSE ELECTED INDIVIDUALS SERVE AS THE BOARD OF DIRECTORS. THOSE BOARD MEMBERS GO BACK TO THEIR COMMUNITES AND EDUCATE THEIR COMMUNITY MEMBERS ON WHAT IS HAPPENING AT THE HOSPITAL AND ON THE SERVICES BEING PROVIDED.THE FACILITY EXTENDS MEDICAL STAFF TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITIES. IF THERE IS A SURPLUS, THE FUNDS WOULD GO INTO PATIENT CARE AREAS INCLUDING EDUCATION, INCREASING PATIENT SERVICES, WELLNESS, AND PREVENTIVE CARE TO IT'S PATIENTS.THE NAVAJO HEALTH FOUNDATION MISSION IS TO PROVIDE HIGH QUALITY HEALTHCARE SERVICES TO THE RESIDENTS OF THE AREA IN ACCORDANCE WITH THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATION'S HOLISTIC APPROACH TO HEALTHCARE, FOCUSING ON THE PATIENT'S PHYSICAL, SOCIAL AND SPIRITUAL WELL BEING. WE ARE COMMITTED TO THE PREVENTION OF ILLNESS AND PROMOTION OF HEALTH; DELIVERY OF QUALITY PRIMARY INPATIENT AND OUTPATIENT CARE; PROMOTION OF EDUCATION AND TRAINING OF QUALIFIED NATIVE AMERICAN HEALTHCARE PROFESSIONALS.TO FULFILL THIS MISSION, WE WILL PROVIDE PREVENTIVE HEALING AND REHABILITATIVE SERVICES THROUGH A SYSTEM THAT LINKS NATIVE CULTURE WITH WESTERN MEDICINE; PRESERVE THE DIGNITY OF EACH INDIVIDUAL REGARDLESS OF CREED, RACE, SEX, RELIGION, SOCIAL STATUS, OR PHYSICAL HANDICAP; STRIVE TO ACHEIVE AND MAINTAIN EXCELLENCE IN ALL ASPECTS OF HEALTHCARE; PROMOTE THE EDUCATION AND TRAINING OF NATIVE AMERICAN HEALTHCARE PROFESSIONALS; AND OPERATE THE FACILITY IN A COST-EFFECTIVE AND FINACIALLY RESPONSIBLE MANNER. SAGE DENTAL CLINIC PROVIDES SERVICES TO PERSONS OF ALL AGES. WITH OUR FULL-TIME DENTISTS AND HYGIENIST, WE ARE COMITTED TO PROVIDING YOU WITH PROFESSIONAL AND QUALITY SERVICES. IT SERVICES A WIDE AREA OF 1,800 SQUARE MILES AND 22,000 PATIENTS AND OVER 10% OF THE NAVAJO NATION.SAGE DENTAL OFFERS SERVICES AT FIELD CLINICS IN GREASEWOOD (TWO CHAIRS) AND SANDERS (FOUR CHAIRS) WITH A ROTATING DENTIST FROM THE MAIN CLINIC FOUR TIMES A WEEK. OUR MAIN CLINIC IN GANADO CONSISTS OF EIGHT CHAIRS AND FIVE DENTISTS. WE ARE REACHING ONLY 20% OF OUR POTENTIAL NEED. THE CONTINUED GROWTH OF THE DENTAL CLINIC HAS BEEN A MAJOR PROJECT FOR DIRECTOR ANDEMICHAEL. CONSTANT SEARCH AND RECRUITMENT OF DENTISTS WITH TALENT AND A WILLINGNESS TO PRACTICE IN A RURAL AND REMOTE ENVIRONMENT REMAINS A PRIORITY. WITH THE RISING DEMAND, SAGE DENTAL ONLY ACCEPTS NEW PATIENTS ONE DAY PER MONTH. WALK-INS ARE ACCEPTED EVERY DAY FOR EMERGENCY VISITS. SAGE DENTAL HAS SEALANT PROGRAMS WITH THE LOCAL SCHOOLS AND WE OFFER DIAGNOSIS AND TREATMENT FOR CHILDREN SO THAT GOOD DENTAL HABITS AND CAVITY PREVENTION CAN BEGIN AT AN EARLY AGE. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | SCHOLARSHIP EDUCATION ASSISTANCE TO EMPLOYEES OF SAGE MEMORIAL HOSPITAL, INC. | TypeOfGrant |
| Number Of Recipients | 6 | NumberOfRecipients |
| Amount Of Cash Grant | 8888 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: THE SCHOLARSHIP FUNDS ARE REQUESTED BY THE RECIPIENT THROUGH THE OFFICE OF THE CEO AND ARE APPROVED THROUGH THE OFFICE OF THE CEO. THE APPROVED DOCUMENTATION IS THEN SENT TO THE FINANCE DEPARTMENT TO BE DISBURSED TO THE SCHOOL OR RECIPIENT WITH ALL REQUIRED DOCUMENTATION. CURRENTLY, THE SCHOLARSHIP POLICY IS BEING REVISED AND THE FINANCE DEPARTMENT CONTINUALLY MONITORS THE FINANCE PORTION. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Housing Allowance Or Residence | X | HousingAllowanceOrResidence |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANDEMICHAEL MERON | |||||||||||||
| 195484 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 195484 | 0 | 0 | 0 |
| LABIB- KIYARASH FARID | |||||||||||||
| 534240 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 534240 | 0 | 0 | 0 |
| GOLPARIAN MOHAMMAD | |||||||||||||
| 219472 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 219472 | 0 | 0 | 0 |
| WRAY JEREMY | |||||||||||||
| 279059 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 279059 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SUPPLEMENTAL INFORMATION | Identifier |
| Return Reference | PART III | ReturnReference |
| Explanation | 1A: SAGE PROVIDES SUBSIDIZED HOUSING FOR ALL EMPLOYEES, AND HAS OFFERED A HOUSING ALLOWANCE FOR PROFESSIONAL STAFF. 1B: THIS IS BASED ON THE HOSPITAL'S HOUSING POLICY AND IS INCLUDED IN THE RENTAL AGREEMENTS. THE ORGANIZATION'S CEO HAS A WRITTEN EMPLOYMENT CONTRACT WITH THE BOARD OF DIRECTORS AND ALL OTHER DIRECTORS COMPENSATION IS NEGOTIATED DIRECTLY WITH THE CEO. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS REVIEWED BY THE DIRECTOR OF FINANCE AND THE CHIEF EXECUTIVE OFFICER BEFORE FILLING. IT IS THEN PRESENTED TO THE BOARD OF DIRECTORS. | |
| THE EMPLOYEES AND BOARD OF DIRECTORS ARE COVERED BY THE POLICY. THE LEVEL AT WHICH A DETERMINATION OF WHETHER A CONFLICT EXISTS IS MADE AT THE EXECUTIVE LEVEL. THE EXECUTIVE LEVEL ALSO ACTUALLY REVIEWS THE CONFLICTS. | FORM 990, PART VI, SECTION B, LINE 12C | |
| THE CEO'S SALARY IS DETERMINED THROUGH AN EMPLOYMENT CONTRACT AND AGREEMENT WITH THE BOARD OF DIRECTORS. THE SALARY IS REVIEWED AND APPROVED BY INDEPENDENT PERSONS, AND THERE IS CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. ALL DIRECTORS AND KEY EMPLOYEES COMPENSATION IS NEGOTIATED DIRECTLY WITH THE CEO AND COMPARABLE MARKET VALUE AND EDUCATION IS USED TO DETERMINE THE SALARY. | FORM 990, PART VI, SECTION B, LINE 15 | |
| DOCUMENTS ARE AVAILABLE UPON REQUEST. | FORM 990, PART VI, SECTION C, LINE 19 | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | PRIOR PERIOD ADJUSTMENTS: 1,088,432. | FORM 990, PART XI, LINE 5: |
| CHANGE IN AUDIT OVERSIGHT PROCESS OR SELECTION PROCESS | PROCESS HAS NOT CHANGED FROM PRIOR YEAR. | FORM 990, PART XII, QUESTION 2C |
| OTHER CHANGES IN NET ASSETS OR FUND BALANCES | PRIOR PERIOD ADJUSTMENT TO REFLECT PRIOR YEAR AUDITED FINANCIAL STATEMENT AMOUNTS. PRIOR ACCOUNTANT FILED FORM 990 PRIOR TO THE AUDITED FINANCIAL STATEMNTS BEING AVAILABLE, THIS RESULTED IN A DIFFERENCE IN NET ASSETS OF $1,088,432. | FORM 990, PART XI, LINE 5 |