2014-03-20 21:26:07 - Despite unfounded allegations of misuse of funding, Sage Memorial Hospital, the largest hospital in the Navajo Nation, is alive, well, and doing great things for the community.
Conditions at Sage Memorial Hospital were not always prosperous. Prior to 2007, Sage faced closure by the Arizona Department of Health Services because facilities did not meet required State standards. Having radically cut services (such as OB/GYN, inpatient pediatrics and nursery, as well as surgery), to avoid sanctions, the former management ultimately presented the Sage Board of Directors with a closure plan.
Instead of following the closure plan, the Board of Directors embarked on a determined effort to reverse course, hiring a new management team, Razaghi Healthcare, to lead a five-year initiative to turn the hospital around. In 2012, Razaghi Healthcare was proudly able to report that the turnaround efforts were successful; Sage’s finances were once again stable, and the
quality of healthcare was excellent.
Sage Memorial Hospital is now alive, well, and doing great things for patients and the community.
Our patients are receiving the best care in the Navajo Nation, and their confidence in Sage, its doctors, nurses, and management is reflected not only in words, but also in numbers. In 2008, Sage treated 6,890 patients in the emergency department and urgent care; by 2012, that number reached 12,737, an 84% increase. During that same period, the number of patients in the main hospital rose from 1,727 to 2,733, an increase of 60% in four years.
On December 20, 2013, Sage received the “Gold Seal of Approval” by the Joint Commission. On October 1, 2013, the Arizona Department of Health Services renewed Sage’s Rural General Hospital license for three years; Sage is the only on-Reservation facility to have such a State license. In June 2012, Sage received one of only two “Best in Class Hospital Awards” —out of 900 organizations—from the American Hospital Association for Diversity in Leadership and Governance. The Association stated: “Your hard work and dedication serves as model to other hospitals and healthcare systems in their efforts.” And in March 2010, the Department of Health and Human Services awarded Sage’s then-CEO, Ahmad Razaghi—out of 679 tribally or federally managed healthcare facilities—the “Chief Executive Office Managerial Excellence Award.”
Although it would have been the easiest course of action, no services were cut during the process of rejuvenating the hospital. Rather, services were greatly expanded, facilities were improved and renovated, and the purchase of state-of-the-art equipment ensured that Sage could provide the best patient care in the region.
More importantly, Sage has achieved stability in personnel. Doctors and nurses no longer stay just a few months, enabling Sage’s patients to now create lasting relationships with their providers. This success was attained at great monetary cost, through the remodeling of employee housing, the Employee Wellness Center, and renovating and reopening the Employee Child Care facility.
These advances were overseen by a dedicated and qualified Board of Directors, comprised of eight members, including a Doctoral candidate in the field of education, several persons holding Master’s degrees, a former Community Health Representative, a management employee at another hospital, and individuals who broke anti-Navajo political barriers (see Shepherd v. Platt, 865 P.2d 107 [AZ. App. 1993, establishing the right of Ambrose Shepherd to hold country office over the objection that Navajos living on the Reservation were not entitled to representation in Country offices.
Under the Board’s leadership, Sage has expanded services in the dental and optometry programs, medical laboratory and imaging, the pharmacy, and the emergency department. For example, when the Board hired Razaghi Healthcare, Sage had an obsolete CT Scan from the late 1970s, (the only other working CT Scan of this vintage was in Mexico.) Sage has now replaced this equipment with a modern CT Scan. The Emergency Department, the CLIA-certified Laboratory, and Urgent Care units are now open 24/7, and staffed at all hours with Emergency Physicians—not just “on-call” doctors like at other hospitals in the area. Before these adjustments, pharmaceuticals were stored in an unlocked Craftsman toolbox; now, Sage has a state-of-the-art automated and secured dispensing unit.
As the leading provider of Native American healthcare consulting and management, Razaghi Healthcare rightfully charged for its services (less than fair market value, as determined by an independent healthcare appraisal firm), and its contract included a provision for a Success Fee. Once the turnaround was deemed a triumph, Sage paid what it owed to Razaghi Healthcare. Unfortunately, this successful relationship has not been without some controversy. Disgruntled ex-employees and an ex-Board member came out claiming fraud and misuse of money, including federal funds. The local newspapers published the accusations without any good faith attempt to determine their legitimacy. Indeed, there is not a shred of truth to the allegations put forth by these newspapers; Sage has received five “clean” audits from three different independent auditors from October 2007 through September 2012, and the audit for 2013 will be the same. Rumors were circulating, for example, around the “mystery” of Sage’s diabetes program, when in actuality, Sage has properly accounted for all federal funds used for the diabetes program, and has, in fact, supplemented those federal funds almost dollar-for-dollar with Sage’s own money. An ensuing Federal Investigation has brought forth no evidence indicating the validity of any of these rumors, supporting Sage and Razaghi Healthcare in their opinions that they are defaming and entirely unfounded.
Sage is proud of the relationship it has built with Razaghi Healthcare and the achievements they have made together over the past few years. Yes, these achievements have not been made without overcoming difficult, even painful, obstacles. Some employees had to be let go, and parties competing for the same land lease rights have strongly opposed Sage’s expansion efforts. Despite these roadblocks, Sage Memorial Hospital’s first priority has, and always will be, serving its patients. We will continue to improve and expand, and we want the community to have confidence that our competence, dedication, and integrity will continue to achieve award-winning results.
Stenson Wauneka, Chairman of the Board, Sage Memorial Hospital
Christi El-Meligi, Chief Executive Officer, Sage Memorial Hospital