2020-07-15T10:02:09-05:00 2019-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2018-07-01 870560763 UTAH NAVAJO HEALTH SYSTEM INC UTAH 4356513713 PO BOX 130 1478 HIGHWAY 162 MONTEZUMA CREEK UT 84534 MICHAEL JENSON CEO 4356513713 2020-07-13 1 MICHAEL J PETERSON CPA P01833529 2187224705 2020-06-30 216.54.158.12 2020-07-13 13:45:46 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 9747BB8E0DC0E78824B7C9EDF76D609BB7F00C05 2018 2021-01-29 14:40:06Z X MICHAEL JENSEN PO BOX 130 1478 HIGHWAY 162 MONTEZUMA CREEK UT 84534 45501225 0 X WWW.UNHSINC.ORG X 1999 UT TO IMPROVE QUALITY OF LIFE THROUGH COMPREHENSIVE, SELF-EMPOWERED, CULTURALLY-SENSITIVE HEALTHCARE AND AMAZING CUSTOMER SERVICE. 10 10 380 10 0 0 17822489 19218756 23701326 25999496 371683 239231 0 43742 41895498 45501225 33360 39919 0 0 25303084 27581240 0 0 147324 15167690 19148804 40504134 46769963 1391364 -1268738 71962096 69088589 8105139 6328630 63856957 62759959 TO IMPROVE QUALITY OF LIFE THROUGH COMPREHENSIVE, SELF-EMPOWERED, CULTURALLY-SENSITIVE HEALTHCARE AND AMAZING CUSTOMER SERVICE. 0 0 18941294 39919 15812964 THE ORGANIZATION PROVIDES MEDICAL CARE ON A SLIDING FEE SCALE FOR PATIENTS. A SLIDING SCALE IS IN PLACE TO ADDRESS THE NEEDS OF THE UNINSURED AND UNDERINSURED, PROVIDING REDUCED COSTS ON ALL MEDICAL SERVICES FOR THOSE WHO QUALIFY. QUALIFYING FOR THE PROGRAM IS BASED ON ANNUAL HOUSEHOLD INCOME. THE HEALTH SYSTEM SERVED OVER 14,900 PATIENTS IN THEIR 4 CLINICS IN TAX YEAR 2018. 9407086 0 7853418 THE ORGANIZATION PROVIDES DENTAL CARE ON A SLIDING FEE SCALE FOR PATIENTS. A SLIDING SCALE IS IN PLACE TO ADDRESS THE NEEDS OF THE UNINSURED AND UNDERINSURED, PROVIDING REDUCED COSTS ON ALL MEDICAL SERVICES FOR THOSE WHO QUALIFY. QUALIFYING FOR THE PROGRAM IS BASED ON ANNUAL HOUSEHOLD INCOME. THE HEALTH SYSTEM SERVED OVER 7,400 PATIENTS IN THEIR 4 CLINICS IN TAX YEAR 2018. 2504319 0 2090707 THE ORGANIZATION PROVIDES BEHAVIORAL HEALTH CARE ON A SLIDING FEE SCALE FOR PATIENTS. A SLIDING SCALE IS IN PLACE TO ADDRESS THE NEEDS OF THE UNINSURED AND UNDERINSURED, PROVIDING REDUCED COSTS ON ALL MEDICAL SERVICES FOR THOSE WHO QUALIFY. QUALIFYING FOR THE PROGRAM IS BASED ON ANNUAL HOUSEHOLD INCOME. THE HEALTH SYSTEM SERVED OVER 1,970 PATIENTS IN THEIR 4 CLINICS IN TAX YEAR 2018. 30852699 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 296 0 380 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 UT X ANDREW EVANS 4356513713 PO BOX 130 1478 HIGHWAY 162 MONTEZUMA CREEK UT 84534 CASSANDRA BELETSO DIRECTOR 1.00 X 6288 0 0 GORDON FOLGHERAITOR DIRECTOR 1.00 X 0 0 0 JAMIE HARVEY DIRECTOR 1.00 X 8192 0 0 LORISSA JACKSON DIRECTOR 1.00 X 14274 0 0 WILFRED JONES DIRECTOR 1.00 X 10044 0 0 EDWARD TAPAHA DIRECTOR 1.00 X 6600 0 0 ROBERT WHITEHORSE DIRECTOR 1.00 X 9092 0 0 HARRIETT LANSING CHAIR 1.00 X X 9779 0 0 MELINDA FARLEY VICE CHAIR 1.00 X X 9282 0 0 GLORIA BEGAYE SECRETARY 1.00 X X 9440 0 0 MICHAEL JENSEN CHIEF EXECUTIVE OFFICER 50.00 X 261792 0 35164 ANDREW EVANS CHIEF FINANCIAL OFFICER 50.00 X 0 0 0 WILLIAM HARRISON CHIEF FINANCIAL OFFICER (THRU DEC) 50.00 X 171450 0 16653 A BYRON CLARKE IV CHIEF OPERATING OFFICER 50.00 X 188753 0 24685 L VAL JONES CHIEF MEDICAL OFFICER 40.00 X 519118 0 37127 WENDELL KEY PHYSICIAN 40.00 X 336711 0 33306 CASEY MCCULLOUGH DOCTOR 40.00 X 381925 0 31775 JOSH NIELSON PHYSICIAN 40.00 X 221520 0 30784 PATRICIA SPENCER DOCTOR 40.00 X 239158 0 20357 2403418 0 229851 43 0 1 0 THE KORTE COMPANY PO BOX 146 HIGHLAND IL 62249 CONSTRUCTION SERVICES 19022051 PRECISION REHABILITATION PO BOX 745 BLANDING UT 84511 PHYSICAL THERAPY SERVICES 621902 SENTINEL TECHNOLOGIES PO BOX 85080 CHICAGO IL 606800851 ELECTRONIC SECURITY SYSTEM 540490 UNIVERSITY OF UTAH HOSPITALS AND CLINICS PO BOX 511258 LOS ANGELES CA 90051 MEDICAL SERVICES 454845 ATHENA HEALTHCARE COMPANY PO BOX 415615 BOSTON MA 022415615 ELECTRONIC MEDICAL RECORD & BILLING 433391 27 19133170 85586 19218756 PATIENT FEES FOR SERVICE 624100 25757090 25757090 CAFETERIA 722514 242406 242406 25999496 213211 213211 26020 0 26020 26020 26020 43742 43742 43742 45501225 25757090 0 525379 X 37665 37665 2254 2254 864479 864479 17765462 13687714 3945941 131807 778584 379592 393175 5817 6823508 4213378 2610130 1349207 943908 395599 9700 46900 46900 108791 108791 44087 44087 5061112 4653894 407218 21102 21102 531322 205293 326029 1261098 1172415 88683 683451 683451 889222 382421 506801 244406 244406 7449 7449 3727126 3727126 SUPPLIES - MEDICAL & DE 4410572 3951267 459305 EQUIPMENT 819023 189024 629999 PROVISION FOR DOUBTFUL 417263 417263 DUES AND SUBSCRIPTIONS 205794 205794 670086 101222 568864 46769963 30852699 15769940 147324 74324 44732 28480566 9311241 437479 1064207 1708534 2273176 2905285 2458445 181331 88286 60340798 12377170 32415426 47963628 3692406 3818129 1500000 1500000 566745 566745 71962096 69088589 5455848 3012529 2649291 3316101 8105139 6328630 X 63856957 62759959 63856957 62759959 71962096 69088589 -1268738 169785 1955 0 X 0 0 0 X 17889231 18003990 17823928 17822489 19218756 90758394 17889231 18003990 17823928 17822489 19218756 90758394 90758394 32176 103444 134261 282318 213211 765410 91523804 132904245 0.99160 0.99330 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 969064 969064 4253885 1484968 2768917 926106 628466 297640 11464184 7325060 4139124 42727559 2938676 39788883 47963628 X X 0 0 0 0 0 0 0 0 0 MICHAEL JENSEN CHIEF EXECUTIVE OFFICER 261792 0 0 0 0 0 13090 0 22074 0 296956 0 0 0 WILLIAM HARRISON CHIEF FINANCIAL OFFICER (THRU DEC) 171450 0 0 0 0 0 8572 0 8081 0 188103 0 0 0 A BYRON CLARKE IV CHIEF OPERATING OFFICER 188753 0 0 0 0 0 9438 0 15247 0 213438 0 0 0 L VAL JONES CHIEF MEDICAL OFFICER 519118 0 0 0 0 0 15053 0 22074 0 556245 0 0 0 WENDELL KEY PHYSICIAN 336711 0 0 0 0 0 11232 0 22074 0 370017 0 0 0 CASEY MCCULLOUGH DOCTOR 381925 0 0 0 0 0 9701 0 22074 0 413700 0 0 0 JOSH NIELSON PHYSICIAN 221520 0 0 0 0 0 8710 0 22074 0 252304 0 0 0 PATRICIA SPENCER DOCTOR 239158 0 0 0 0 0 6955 0 13402 0 259515 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY CEO, CFO, AND COO AND THEN PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD REVIEWS THEIR CONFLICT OF INTEREST POLICIES ANNUALLY. THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY THAT DEFINES WHAT A CONFLICT OF INTEREST IS AND THE RESTRICTIONS THAT APPLY TO ALL BOARD MEMBERS. WHEN A CONFLICT ARISES, THE MEMBER THAT IS CONFLICTED HAS A DUTY TO DISCLOSE IN WRITING TO THE CHAIR OF THE BOARD. THE CHAIR OF THE BOARD THEN PRESENTS TO THE FULL BOARD. THE CONFLICTED MEMBER SHALL HAVE THE OPPORTUNITY TO ADDRESS THE BOARD AND PRESENT ANY NECESSARY ITEMS AND RESPOND TO ANY QUESTIONS. AFTER SUCH PRESENTATION THE CONFLICTED MEMBER SHALL ABSTAIN FROM FURTHER DISCUSSION WITH THE ENTIRE BOARD AND FOR THE VOTE ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION COMPARES A NATIONAL AND STATE COMPENSATION STUDY FOR ORGANIZATIONS OF SIMILAR SIZE AND STRUCTURE TO DETERMINE A RANGE OF COMPENSATION. THE CEO'S PERFORMANCE AND COMPENSATION EVALUATION IS HANDLED BY THE BOARD OF DIRECTORS AND THEN IS REVIEWED ANNUALLY BY ALL MEMBERS OF THE BOARD OF DIRECTORS. THE CEO REVIEWS AND EVALUATES THE CFO, COO AND CMO'S COMPENSATIONS AT THE END OF THE FISCAL YEAR. A NEW RATE IS SET ON THE START OF THE NEXT FISCAL YEAR IF ONE IS WARRANTED. REVIEWS ARE DONE ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 ORGANIZING DOCUMENTS ARE AVAILABLE UPON REQUEST, SAME AS THE FORM 990. FORM 990, PART IX, LINE 11G OTHER MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 1,372,907. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,372,907. INPATIENT/OUTPATIENT SERVICES: PROGRAM SERVICE EXPENSES 820,101. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 820,101. RADIOLOGY/X-RAY/IMAGING/LAB: PROGRAM SERVICE EXPENSES 620,268. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 620,268. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 375,135. MANAGEMENT AND GENERAL EXPENSES 407,218. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 782,353. PHYSICAL THERAPY: PROGRAM SERVICE EXPENSES 588,936. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 588,936. DENTAL CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 397,115. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 397,115. EMERGENCY ROOM SERVICES: PROGRAM SERVICE EXPENSES 479,432. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 479,432.