Sage looks to reinvent the face of health care in Ganado

GANADO, Ariz., May 22, 2008

S

age Memorial Hospital is a familiar landmark in this community of about 3,000, as it has been for the past 45 years.

Its large stone buildings give it a distinctive face, as substantial as the original Indian Health Service facilities in Fort Defiance and elsewhere on the reservation, though Sage was always private and church-sponsored.

The current hospital was built in 1963 and is the nearest hospital for 40 miles. But it will be making big changes in the upcoming years, with the hospital board of directors hoping to construct a modern health care facility by 2010.

Key in the future development is to preserve the historic stone buildings and general history behind the hospital, said board chair Tomicita Gorman.

The first hospital in Ganado was established in 1911 by the Presbyterian Church, one of several Christian denominations authorized under federal Indian policies of the time to help provide services and proselytize in specific areas of the reservation.

The current hospital is now approaching its 50th anniversary and is showing its age.

In recent years, both its physical age and its roots in a culture of paternalism have led to problems, with patient complaints on the rise and costs increasing.

Patients complained that staff members were not sensitive to their requests for service, or provided it in a disdainful manner. And discontent over salary differences between Native and non-Native physicians became public last year, creating further woes.

The hospital went deep in debt in 2005, resulting in concern that Sage Memorial, by now incorporated as an IHS contract provider under P.L. 93-638, might go under.

Instead, the board of directors found a health care management and investment firm that was constructing a hospital in Blanding, Utah. In February 2007, after a meeting with the hospital board, the firm, Morgan & Associates, agreed to take the reins at Sage.

Under new management, the hospital broke even last year and is now planning to reinvent itself to provide 21st Century health care.

Early last month the hospital board held a public meeting in Ganado to gather community input on what the new Sage Memorial should look like. Plans are still in the developmental stage, Gorman said, but some directions are clear.

For the hospital facility itself, providing new services is the focal point. Obstetrics and diabetes care, such as dialysis, are important additions planned for the new facility.

"We want this to be service-driven," said Sage CEO Ahmad Razaghi.

Getting that across to the public has been difficult, he added.

"The questions we get asked the most are about (preserving) the building," said Razaghi, who came aboard as part of the new management team from Morgan & Associates.

With the investment firm ready to finance construction, the project will be completed much faster than it would take for comparable facility to be built by IHS, he said.

"We can build the hospital facility in 10 months," Razaghi said.

But the hospital is just the centerpiece of a much larger vision that includes a campus devoted to health care and other community services, Gorman said.

The idea is to make space available for stores and restaurants within the proposed campus to bolster the economy and add amenities for the community, she said. For instance, a supermarket is sorely needed in Ganado. And with the addition of restaurants, people would not have to drive the six miles to Burnside to eat at the Burger King.

In addition to having financing available, the new facility will be constructed on a "design and build" platform where design and construction are being done at the same time, thereby condensing the overall timeline.

At the same time, many local residents at the March meeting agreed that the new facility should preserve the site's historical values.

"What we have to do now is make sure all the stakeholders are on board and everyone agrees on the master plan," Razaghi said, referring to the Sage Memorial Hospital board of directors, the Presbytery of the Grand Canyon, and Morgan & Associates.