2025-08-14T11:23:08-05:00 2024-09-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2023-10-01 870560763 UTAH NAVAJO HEALTH SYSTEM INC UTAH 4356513291 PO BOX 130 MONTEZUMA CREEK UT 84534 MICHAEL JENSEN CEO 4356513291 2025-08-14 1 0 MICHAEL J PETERSON CPA P01833529 2187224705 2025-08-14 2023 2025-03-06 01:10:19Z MICHAEL JENSEN PO BOX 130 MONTEZUMA CREEK UT 84534 87535890 0 X WWW.UNHSINC.ORG X 1999 UT TO IMPROVE QUALITY OF LIFE THROUGH COMPREHENSIVE, SELF-EMPOWERED, CULTURALLY-SENSITIVE HEALTHCARE AND AMAZING CUSTOMER SERVICE. 8 0 553 30 0 0 30433889 29551497 50270054 57068937 915396 812255 169254 102252 81788593 87534941 157069 87625 0 0 47435882 55542923 0 0 283601 29163391 34466274 76756342 90096822 5032251 -2561881 99590837 99575603 7844787 9283474 91746050 90292129 X TO IMPROVE QUALITY OF LIFE THROUGH COMPREHENSIVE, SELF-EMPOWERED, CULTURALLY-SENSITIVE HEALTHCARE AND AMAZING CUSTOMER SERVICE. 0 0 28188319 87625 28405773 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 20,000 PATIENTS IN THEIR 4 CLINICS IN TAX YEAR 2023. 13340008 0 13442917 THE ORGANIZATION PROVIDES PHARMACY SERVICES 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 CLOSE TO 10,000 PATIENTS IN THEIR 4 CLINICS IN TAX YEAR 2023. 9155387 0 9226015 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 HEALTH SERVICES FOR THOSE WHO QUALIFY. QUALIFYING FOR THE PROGRAM IS BASED ON ANNUAL HOUSEHOLD INCOME. THE HEALTH SYSTEM SERVED OVER 8,000 PATIENTS IN THEIR 5 CLINICS IN TAX YEAR 2023. 5619477 0 5662827 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 HEALTH SERVICES FOR THOSE WHO QUALIFY. QUALIFYING FOR THE PROGRAM IS BASED ON ANNUAL HOUSEHOLD INCOME. THE HEALTH SYSTEM SERVED OVER 1,500 PATIENTS IN THEIR 8 CLINICS AND SERVICE OFFICES IN TAX YEAR 2023. 5619477 0 5662827 56303191 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 184 0 553 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 UT X ANDREW EVANS CFO 4356513291 PO BOX 130 MONTEZUMA CREEK UT 84534 WILFRED JONES CHAIR 5.00 X X 29877 0 0 DARRELL WILLIAMS VICE-CHAIR 5.00 X X 45859 0 0 LORISSA JACKSON TREASURER 5.00 X X 28283 0 0 MELINDA FARLEY SECRETARY 5.00 X X 49669 0 0 GLORIA BEGAYE DIRECTOR 5.00 X 26023 0 0 CASSANDRA BELETSO DIRECTOR 5.00 X 17954 0 0 HERMAN KINSEL DIRECTOR (BEG. 08/2024) 5.00 X 0 0 0 EDWARD TAPAHA DIRECTOR 5.00 X 16706 0 0 L VAL JONES CHIEF MEDICAL OFFICER/PHYSICIAN 50.00 X 649301 0 45939 MICHAEL JENSEN CHIEF EXECUTIVE OFFICER 50.00 X 363888 0 45882 A BYRON CLARKE IV CHIEF OPERATING OFFICER 50.00 X 256279 0 48149 ANDREW EVANS CHIEF FINANCIAL OFFICER 50.00 X 279886 0 36458 BRIAN OLSEN DENTAL DIRECTOR 50.00 X 325299 0 45653 CASEY MCCULLLOUGH PHYSICIAN 50.00 X 544366 0 42142 DOMINICK RUYBAL PHYSICAN 50.00 X 374501 0 20963 WENDELL KEY PHYSICIAN 50.00 X 395957 0 35831 DANE LYMAN PHYSICIAN 50.00 X 543397 0 42546 3947245 0 363563 76 0 1 0 ATHENA HEALTH COMPANY PO BOX 415615 BOSTON MA 02241 EMR SOFTWARE SERVICES 1199703 PRECISION REHABILITATION INC PO BOX 745 BLANDING UT 84511 PHYSICAL THERAPY SERVICES 1150606 BLUE MOUNTAIN HOSPITAL 802 SOUTH 200 WEST BLANDING UT 84511 MEDICAL & LAB SERVICES 1110818 SCRIPTPRO PO BOX 411097 KANSAS CITY MO 64141 PHARMACY SOFTWARE SERVICES 650934 COOK FOOT & ANKLE LLC 25543 ROAD N 6 LOOP CORTEZ CO 81321 CONTRACT PODIATRY SERVICES 358625 27 29377466 174031 29551497 PATIENT FEES FOR SERVICE 624100 51256477 51256477 MEDICAID TRANSPORT REVENUE 480000 4965447 4965447 CAFETERIA 722514 331405 331405 515608 515608 57068937 707996 707996 105208 0 949 105208 -949 104259 104259 102252 102252 102252 87534941 56737532 0 1245912 36625 36625 51000 51000 2152919 649674 1503245 34796996 26186620 8460244 150132 1588050 666796 908776 12478 14334857 5938579 8287280 108998 2670101 2012085 646023 11993 182339 182339 240563 240563 90886 90886 7186094 6970889 215205 42146 2695 39451 550875 121508 429367 6831 6831 630367 53693 576674 1947742 1152242 795500 535910 18425 517485 998 493 505 4597337 4597337 1166769 1166769 MED & DENTAL SUPPLIES 12327857 10803738 1524119 EQUIPMENT RENTAL 3394651 1067345 2327306 REPAIR AND MAINTENANCE 577055 77253 499802 DUES & SUBSCRIPTIONS 163270 10441 152829 824584 483090 341494 90096822 56303191 33510030 283601 110950 88121 15851975 10820133 2434750 2494016 2678180 8175759 2780906 2340168 892777 594263 90918812 27770677 64062117 63148135 6944016 8270233 396721 340047 3438445 3304728 99590837 99575603 6031945 7623894 135773 136996 1677069 1522584 7844787 9283474 X 91746050 90292129 91746050 90292129 99590837 99575603 -2561881 1107960 0 X 0 0 0 X 22394315 34136010 28700069 30433890 29551497 145215781 22394315 34136010 28700069 30433890 29551497 145215781 145215781 265622 239483 289574 827961 707996 2330636 147546417 221533758 0.98420 0.98520 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1460898 1460898 58687768 9976726 48711042 1262720 702989 559731 23215382 14799052 8416330 6292044 2291910 4000134 63148135 OPERATING LEASE LIABILITY 1522584 1522584 1 SAN JUAN JUNIOR LIVESTOCK 158 S 200 E BLANDING UT 84511 833366322 501(C)(3) 21625 0 FOOD PURCHASE FOR COMMUNITY FOOD DONATIONS SAN JUAN FOUNDATION PO BOX 814 BLANDING UT 84511 942842652 501(C)(3) 15000 0 CONSTRUCTION OF LOCAL DAY CARE CENTER IN COMMUNITY 2 0 SUPPORT FOR FUNERAL SERVICES 24 36000 OTHER COMMUNITY BENEFITS 1000 15000 PART I, LINE 2: FROM UNHS' DONATION POLICY: -EACH YEAR, UNHS' BOARD OF DIRECTORS WILL APPROVE A DONATION/CONTRIBUTION BUDGET. -ALL REQUESTS FOR DONATIONS/CONTRIBUTIONS MUST BE CHECKED AGAINST THE YEARLY DONATION/CONTRIBUTION BUDGET. IF THAT BUDGET HAS BEEN EXHAUSTED NO DONATIONS/CONTRIBUTION CAN BE MADE UNLESS UNHS' FINANCE COMMITTEE INCREASES THE YEARLY DONATION/CONTRIBUTION BUDGET. -DONATION/CONTRIBUTIONS REQUESTS CAN BE APPROVED BY THE CEO, COO, OR THE CFO AFTER VERIFICATION OF AVAILABLE FUNDS WITHIN THE DONATION/CONTRIBUTION BUDGET. -NO DONATIONS/CONTRIBUTIONS WILL BE GIVEN TO INDIVIDUALS; RATHER DONATIONS, CONTRIBUTIONS CAN ONLY BE MADE TO GROUPS OR ORGANIZATIONS THAT SUPPORT MORE THAN ONE INDIVIDUAL. -DONATIONS FROM SCHOOL GROUPS MUST COME WITH A SIGNATURE FROM THE SCHOOL PRINCIPAL. -REQUESTS FOR DONATIONS EXCEEDING $5,000.00 MUST BE IN WRITING. -DONATIONS TO ANNUAL EVENTS WILL BE INCLUDED AS A SEPARATE ITEM IN DONATION. -ALL EMPLOYEES AND BOARD MEMBERS MUST FOLLOW THE SAME POLICY IN MAKING REQUESTS OR DECISIONS. -BEREAVEMENT AND HOSPITAL STATS $50.00 CAP UNLESS SPECIAL CONDITIONS EXIST. X X 0 0 0 0 0 0 0 0 0 L VAL JONES CHIEF MEDICAL OFFICER/PHYSICIAN 632656 0 2500 0 14145 0 16500 0 29439 0 695240 0 0 0 CASEY MCCULLLOUGH PHYSICIAN 542199 0 2167 0 0 0 12688 0 29454 0 586508 0 0 0 DANE LYMAN PHYSICIAN 539144 0 2137 0 2116 0 12076 0 30470 0 585943 0 0 0 WENDELL KEY PHYSICIAN 383776 0 2187 0 9994 0 13747 0 22084 0 431788 0 0 0 MICHAEL JENSEN CHIEF EXECUTIVE OFFICER 335076 0 2277 0 26535 0 15514 0 30368 0 409770 0 0 0 DOMINICK RUYBAL PHYSICAN 372133 0 2368 0 0 0 10722 0 10241 0 395464 0 0 0 BRIAN OLSEN DENTAL DIRECTOR 307752 0 2137 0 15410 0 16058 0 29595 0 370952 0 0 0 ANDREW EVANS CHIEF FINANCIAL OFFICER 259634 0 2385 0 17867 0 13796 0 22662 0 316344 0 0 0 A BYRON CLARKE IV CHIEF OPERATING OFFICER 253927 0 2352 0 0 0 14785 0 33364 0 304428 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE CEO, CFO, AND COO PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE AND THEN PRESENTED TO THE BOARD OF DIRECTORS. 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 ARE HANDLED BY THE BOARD OF DIRECTORS AND IS REVIEWED ANNUALLY BY ALL MEMBERS OF THE BOARD OF DIRECTORS. THE CEO REVIEWS AND EVALUATES THE CFO, COO, AND CMO 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, JUST AS THE FORM 990.