NAVAJO HEALTH FOUNDATION-SAGE MEMORIAL HOSPITAL INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- NAVAJO HEALTH FOUNDATION-SAGE MEMORIAL HOSPITAL INC (EIN 23-7314364)
- Tax period
- 2009-10-01 to 2010-09-30
- Filed
- 2011-08-13
- IRS object ID
- 201102259349300110
- Schema version
- 2009v1.7
- 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 | 2011-08-13T11:01:53-05:00 | Timestamp |
| Tax Period End Date | 2010-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1601 NW EXPRESSWAY SUITE 1900 | AddressLine1 |
| City | OKLAHOMA CITY | City |
| State | OK | State |
| ZIP Code | 73118 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-10-01 | 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 | 2011-08-12 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Carolyn Levings | Name |
| Phone | 4054783334 | Phone |
| Date Prepared | 2011-08-12 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | 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 | 26347843 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| 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 | Provision of health care services | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 8 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 322 | TotalNbrEmployees |
| Total Nbr Volunteers | 20 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 761120 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 479995 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 24177392 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 25810665 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 43889 | InvestmentIncomePriorYear |
| Investment Income Current Year | 57183 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 5550 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 24987951 | TotalRevenuePriorYear |
| Total Revenue Current Year | 26347843 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 500 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 1632 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 7902313 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 9801072 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 10377 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 16726657 | OtherExpensePriorYear |
| Other Expenses Current Year | 17530625 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 24629470 | TotalExpensesPriorYear |
| Total Expenses Current Year | 27333329 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 358481 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -985486 | RevenuesLessExpensesCY |
| Total Assets BOY | 15135726 | TotalAssetsBOY |
| Total Assets EOY | 15619706 | TotalAssetsEOY |
| Total Liabilities BOY | 6040517 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 7437792 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 9095209 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 8181914 | NetAssetsOrFundBalancesEOY |
| Mission Description | Our 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; and promotion of education and training of qualified Native American healthcare professionals. To fulfill this mission, we will provide preventive healing and rehab 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 achieve 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 financially responsible manner. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 1 | SignificantChange |
| Expense | 21153175 | Expense |
| Revenue | 25810665 | Revenue |
| Description | Navajo Health Foundation-Sage Memorial Hospital contracted with Indian Health Service with a self-determination contract which provided care to approximately 417 inpatients and 45,842 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 | 21153175 | 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 | 1 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| 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 |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | 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 |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 159 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 322 | 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 |
| Nbr Voting Governing Body Members | 8 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | 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 | 1 | LocalChapters |
| Policies Reference Chapters | 1 | PoliciesReferenceChapters |
| 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 | 0 | 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 (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| KelewoodMaybelle | ||||||||
| 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 Pres. | 1.00 | X | X | 11250 | 0 | 0 | ||
| Yazzie Linda A | ||||||||
| Health Board President | 1.00 | X | X | 7500 | 0 | 0 | ||
| Wauneka Stetson | ||||||||
| Health Board Treasurer | 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 | |||
| RazaghiAhmad- Mgmt Company | ||||||||
| Chief Executive Officer | 60.00 | X | 114198 | 0 | 17454 | |||
| AskieCharity- Mgmt Company | ||||||||
| Director of Finance | 60.00 | X | 49901 | 0 | 10000 | |||
| AndemichaelMeron | ||||||||
| Director of Dental | 40.00 | 212059 | 0 | 12626 | X | |||
| Labib-Kiyarash Farid | ||||||||
| Director of Pharmacy | 80.00 | 534315 | 0 | 10133 | X | |||
| Taylor Marsha | ||||||||
| Staff Dentist | 80.00 | 100585 | 0 | 118 | X | |||
| Erickson Miles | ||||||||
| Psychiatrist | 80.00 | 116062 | 0 | 2456 | X | |||
| Stewart-Joseph Nicole S | ||||||||
| Staff Dentist | 80.00 | 132559 | 0 | 101 | X | |||
| Wilson Gordon | ||||||||
| Staff Dentist | 80.00 | 133477 | 0 | 1124 | X | |||
| Yazzie Angela | ||||||||
| ER RN Manager | 80.00 | 114450 | 0 | 6300 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1573606 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 60312 | TotalOtherCompensation |
| Number Individuals GT100 K | 8 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 1 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Morgan & Associates | |||||
| 1338 Foothill Dr 160 | Salt Lake City | UT | 84108 | Other Services | 1325952 |
| APG LLC | |||||
| 7500 W Lake Mead Blvd Ste 9104 | Las Vegas | NV | 89128 | Other Services | 1261088 |
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 20 | NumberOfContractorsGT100K |
| Government Grants | 256890 | GovernmentGrants |
| All Other Contributions | 223105 | AllOtherContributions |
| Total Contributions | 479995 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Capitation Revenue | 900099 | 15964016 | 15964016 |
| Net Patient Revenue | 900099 | 9644951 | 9644951 |
| Miscellaneous | 900099 | 165560 | 165560 |
| Other Rev-Pharmacy | 900099 | 31238 | 31238 |
| Other Rev-Therapeutic | 900099 | 4900 | 4900 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 25810665 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 57183 | TotalRevenueColumn |
| Exclusion | $57,183 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 26347843 | TotalRevenueColumn |
| Related Or Exempt Function Income | 25810665 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $57,183 | ExclusionAmount |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1632 | Total |
| Program Services | 1632 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 993927 | Total |
| Program Services | 343711 | ProgramServices |
| Management And General | 650216 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7113905 | Total |
| Program Services | 5727004 | ProgramServices |
| Management And General | 1384612 | ManagementAndGeneral |
| Fundraising | 2289 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49110 | Total |
| Program Services | 36771 | ProgramServices |
| Management And General | 12325 | ManagementAndGeneral |
| Fundraising | 14 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1042881 | Total |
| Program Services | 780855 | ProgramServices |
| Management And General | 261732 | ManagementAndGeneral |
| Fundraising | 294 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 601249 | Total |
| Program Services | 450183 | ProgramServices |
| Management And General | 150896 | ManagementAndGeneral |
| Fundraising | 170 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 189456 | Total |
| Management And General | 189456 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37549 | Total |
| Management And General | 37549 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10574103 | Total |
| Program Services | 8543499 | ProgramServices |
| Management And General | 2030604 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 92724 | Total |
| Program Services | 2439 | ProgramServices |
| Management And General | 90285 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4177740 | Total |
| Program Services | 3450566 | ProgramServices |
| Management And General | 719564 | ManagementAndGeneral |
| Fundraising | 7610 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22577 | Total |
| Program Services | 22577 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 333968 | Total |
| Program Services | 324523 | ProgramServices |
| Management And General | 9445 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 503946 | Total |
| Program Services | 423253 | ProgramServices |
| Management And General | 80693 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 165033 | Total |
| Program Services | 93613 | ProgramServices |
| Management And General | 71420 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50244 | Total |
| Management And General | 50244 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 727496 | Total |
| Program Services | 545622 | ProgramServices |
| Management And General | 181874 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 539375 | Total |
| Program Services | 378900 | ProgramServices |
| Management And General | 160475 | ManagementAndGeneral |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Miscellaneous | 99559 | 11172 | 88387 |
| Bad Debt Expense | 16855 | 16855 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27333329 | Total |
| Program Services | 21153175 | ProgramServices |
| Management And General | 6169777 | ManagementAndGeneral |
| Fundraising | 10377 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4420387 | BOY |
| EOY | 5553356 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2682037 | BOY |
| EOY | 1735150 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 278711 | BOY |
| EOY | 283156 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 62810 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 21103764 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 14532016 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6392157 | BOY |
| EOY | 6571748 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1362434 | BOY |
| EOY | 1413486 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15135726 | BOY |
| EOY | 15619706 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4150063 | BOY |
| EOY | 5342139 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1563857 | BOY |
| EOY | 2073672 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 326597 | BOY |
| EOY | 21981 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6040517 | BOY |
| EOY | 7437792 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7477522 | BOY |
| EOY | 6564227 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 964699 | BOY |
| EOY | 964699 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 652988 | BOY |
| EOY | 652988 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9095209 | BOY |
| EOY | 8181914 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15135726 | BOY |
| EOY | 15619706 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 |
| Solicited Assets For Sale | 0 | SolicitedAssetsForSale |
Current Year CurrentYear
| 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 Minus1 Year CurrentYearMinus1Year
| 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 | 59145 | OtherCostOrOtherBasis |
| Book Value | 59145 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 11475572 | OtherCostOrOtherBasis |
| Depreciation | 6754617 | Depreciation |
| Book Value | 4720955 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9569047 | OtherCostOrOtherBasis |
| Depreciation | 7777399 | Depreciation |
| Book Value | 1791648 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 6571748 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Housing Deposits | Description |
| Amount | $21,981 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 21981 | TotalOfAmounts |
| Total Revenue | 26347843 | TotalRevenue |
| Total Expenses | 27333329 | TotalExpenses |
| Excess Or Deficit For Year | -985486 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 72191 | NetUnrealizedGLOnInvestments |
| Total Adjustments | 72191 | TotalAdjustments |
| Excess Or Deficit Per FS | -913295 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 26420034 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 72191 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | 72191 | RevenueNotRptdF990 |
| Revenue Subtotal | 26347843 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 26347843 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 27333329 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 27333329 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 27333329 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Part III, Line 4: | The Organization's collections are objects and artifacts in accordance to proper museum standards and conditions. An outgoing loan agreement is in place with Hubbell Trading Post, Navajo Park Service and will be returned before expiration date, unless justified. | |
| 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: |
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 | 0 | FPGReferenceFreeCare |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 0 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 0 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $16,855 | BadDebtExpenseAmount |
| Amount Attributable To | 4887 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 4067474 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 4052681 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 14793 | MedicareSurplusOrShortfall |
| Written Debt Collection Policy | 0 | WrittenDebtCollectionPolicy |
Form990 Schedule H Part V Form990ScheduleHPartV
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 VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Income Based Criteria | 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. All patients are eligible to apply for Sage Memorial's Charity Care program. The full amount of charges will be determined to be charity care for a patient whose gross family income is at or below 100 percent of the current federal poverty level. A sliding fee schedule shall be used to determine the amount that shall be written off for patients with incomes between 101 and 300 percent of the current poverty level. Charity care is not used very often as most patients qualify for medical services under the Indian Health Services federal program. Patients must prove they are Native American and live in the area to be eligible for the program. | IncomeBasedCriteria |
| Percent Of Total Expense Expln | Part I, Line 7f: Bad Debt is reported at actual costs written off and that all bad debt can be attributable to charity care patients based on the population of the area that they serve as noted in Part I line 3c. | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | Part III, Line 4: Bad debt was convertd to cost using the cost-to-charge ratio derived from Worksheet 2. | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: Financial Statement Note:The carrying amount of patient receivables is reduced by a valuation allowance that reflects management's best estimate of amounts that will not be collected from patients and third-party payors. 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.Part III, Line 8: Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by CMS. | ShortfallAsCommunityBenefit |
| Needs Assessment | Part VI, Line 2: Sage Memorial Hospital works with the Navajo Area Office 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 services that the facilities have provided, the NAO does a needs analysis and passes the information on to the facilities. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: The majority of the patients are Native American and qualify for the Indian 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. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: Navajo Health Foundation/Sage Memorial Hospital is located in Apache County in 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 poverty line. Navajo Health Foundation/Sage Memorial Hospital delivers quality healthcare 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 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. | CommunityInformation |
| Community Building Activities | Part VI, Line 5: Currently, Navajo Health Foundation/Sage Memorial Hospital does not have a Community Building Activity in place at this time. | CommunityBuildingActivities |
| Other Information | 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 their representative on a local level and those elected individuals serve as the board of directors. Those board members go back to their communities 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 preventative 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; and 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 achieve 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 financially responsible manner.Sage Dental Clinic provides services to persons of all ages. With our full-time dentists and hygienist, we are committed 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. | OtherInformation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AndemichaelMeron | |||||||||||||
| 212059 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 212059 | 0 | 0 | 0 |
| Labib-Kiyarash Farid | |||||||||||||
| 534315 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 534315 | 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 | The organization's CEO & Director of Finance are paid by Morgan and Associates, an unrelated management company. The organization relies on the management company to determine the compensation paid for services rendered to the organization. Charity Askie, Director of Finance was compensated by the management company $49,901 plus $10,000 in other compensation. Amad Razaghi was compensated by the management company $114,198 plus $17,454 in other compensation. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990, Part III, line 3 | Changes in Program Services | One clinic, Wide Ruins Clinic, was discontinued in 2010. |
| Form 990, Part VI, Section A, line 3 | There are currently not employees under the management company in 2010. | |
| Form 990, Part VI, Section B, line 11 | The Form 990 is reviewed by the Director of Finance and the Chief Financial Officer before filing. It is then presented to the Board of Directors. | |
| Form 990, Part VI, Section B, line 12c | 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 15b | The organization's CEO & Director of Finance are paid by Morgan and Associates, an unrelated management company. The organization relies on the management company to determine the compensation paid for services rendered to the organization. | |
| Form 990, Part VI, Section C, line 19 | Documents are available upon request. |