Sage Memorial Hospital Wins The 2025 Bond Buyer Deal Of The Year.
The Arizona IDA is proud to highlight the recognition of the Sage Memorial Hospital project in Ganado, Arizona, which has received The Bond Buyer’s 2025 National Deal of the Year Award, the highest honor in the municipal finance industry. This follows its earlier win as the Bond Buyer 2025 Deal of the Year in the Healthcare Finance category.
Arizona IDA served as the conduit issuer for the $80 million tax-exempt bond financing. The transaction marks the first successful non-rated tax-exempt health care revenue bond offering for a hospital with an entirely indigenous management team and governance. This project has established a replicable pathway to the market for indigenous health systems across the country. The Arizona IDA is proud to support projects like Sage Memorial Hospital that provide lasting benefits for communities throughout our state.
At the Arizona IDA, we assist eligible borrowers in securing lower-cost, long-term financing for major capital projects through tax-exempt bonds to support community development efforts such as healthcare, affordable housing, education, and more. This help enables borrowers to build modern facilities, expand services, upgrade infrastructure, and promote long-term stability.
Deal of the Year
Sage Memorial Hospital wins 2025 Deal of the Year award
From: BondBuyer.com
December 2, 2025
LINK: Click Here
Sage Memorial Hospital won The Bond Buyer’s 24th annual Deal of the Year award for its $80 million offering of unrated tax-exempt bonds that recapitalized construction of a replacement hospital, an expanded outpatient clinic and badly needed workforce housing serving the Navajo community in Ganado, Arizona.
The project — which was financed by hospital revenue bonds offered through conduit issuer Arizona Industrial Development Authority also won Deal of the Year in the Health Care Financing category — restores nearby access to surgery, dialysis, intensive care, and labor and delivery, turning structural barriers on reservation land into a platform for long-term, community-centered care. Crucially, the team leveraged Sage’s status as a tribal contractor to pledge non-traditional revenue agreements alongside net patient revenues, opening a replicable path to market for indigenous health systems.
“This selection speaks to the heart of what these awards celebrate,” said Mike Scarchilli, Editor in Chief of The Bond Buyer, at Tuesday’s gala. “It is not simply the size of a transaction, nor is it novelty for novelty’s sake. It is the clarity of purpose, the precision of structure and the courage to open a door that has too often been closed. This transaction stood out for transforming access into outcomes and financial ingenuity into community impact.”
The deal represents a major landmark in furthering Native American healthcare infrastructure as tribal governments face hurdles when issuing munis, including tax code restrictions, limited tools and land ownership issues. The transaction also demonstrates a non-profit healthcare provider’s ability to leverage nontraditional revenue sources — enabled by tribal contractor status — to secure tax-exempt munis.
The Bond Buyer’s editors and senior reporters considered a range of factors when judging entries, including: creativity, the ability to pull a complex transaction together under challenging conditions, the ability to serve as a model for other financings and the public purpose for which a deal’s proceeds were used. Common characteristics of Deal of the Year award-winning transactions include:
- Deals for new issuers, credits created to meet a specific or ongoing financing need, or issuers that have been substantially transformed so that they appear new to investors and function as a new credit from a portfolio manager’s perspective.
- “Turnaround stories” from issuers that were either long absent from the market or unable to gain market access.
- Deals that establish new types of security, harness previously untapped revenue sources, or open a new sector to financing.
- Deals that create a new type of financing for a traditional area of government, bringing new resources to an area where other options were unavailable because of revenue or political obstacles.
- Refundings or restructurings that either achieved an otherwise unattainable savings or indenture change goal for the issuer or use derivatives or other financial tools to reduce risk and/or total debt-service cost.
- Deals that set a record in terms of total dollar size or number of participating issuers or attract significant interest from non-traditional investors in municipal finance.
Sage Memorial Hospital’s Deal of the Year winner “embodies those characteristics in especially meaningful ways,” Scarchilli said.
Sage Memorial Hospital Wins The Bond Buyer’s 2025 National Deal of the Year Award
From: SageMemorial.com
By: Christian Bigwater
December 10, 2025
LINK: Click Here
GANADO, Ariz. – Sage Memorial Hospital has been named the overall 2025 Deal of the Year by The Bond Buyer, the municipal finance industry’s highest honor. The hospital’s $80 million unrated tax-exempt bond issuance was selected as the national winner from 10 exceptional finalists at the 24th Annual Deal of the Year Awards gala held Dec. 2, at Guastavino’s in New York City.
The project, which was financed by the hospital revenue bond offered through a conduit issuer, Arizona Industrial Development Authority, also won Deal of the Year in the healthcare financing category. The groundbreaking transaction marks the first-ever successful non-rated tax-exempt health care revenue bond offering for a hospital with an entirely indigenous management team and governance.
The innovative financing recapitalized the construction of a state-of-the-art 140,296 sq. ft. hospital. Key features include 16 inpatient beds (7 swing beds), two operating rooms with eight pre/post-op bays, three labor & delivery rooms, two postpartum rooms, and a four-bed ICU. The 24/7 Emergency Department offers two trauma bays and eight exam rooms, backed by advanced imaging (CT, MRI, mammogram, DXA, X-ray, and ultrasound with ECHO). Outpatient and specialty services comprise 30 exam rooms (including telehealth), five specialty clinics, rehabilitation therapy with PT gym, nine optometry rooms (six lanes), 12 dental operatories, a full pharmacy, and complete lab/microbiology services. Behavioral Health and Traditional Healing remain in the existing building. Proceeds also funded “Apartments at Sage” — a 27-unit complex with one-, two-, and three-bedroom units for healthcare professionals. Opened in August 2024, the new hospital is already transforming health care for the Navajo Nation and surrounding communities.
Mike Scarchilli, Editor in Chief of The Bond Buyer, explained the selection in a Dec. 2 article published by the outlet: “This selection speaks to the heart of what these awards celebrate. It is not simply the size of a transaction, nor is it novelty for novelty’s sake. It is the clarity of purpose, the precision of structure and the courage to open a door that has too often been closed. This transaction stood out for transforming access into outcomes and financial ingenuity into community impact.
[The deal] delivered permanent, long-term financing for a mission-critical community facility. It relied on a structure that broadened market access, even without external ratings; it aligned repayment with real operating performance while thoughtfully incorporating targeted support; and it advanced essential services in a place where distance and history have long imposed barriers. Most importantly, it charts a replicable path for others facing similar challenges.”
“This National Deal of the Year award marks a triumphant milestone for Sage Memorial Hospital, symbolizing a remarkable shift in our community’s understanding of financial empowerment,” said Delores Noble, Board Chair of Sage Memorial Hospital. “Historically, our people have demonstrated remarkable resilience, pulling resources to support collective well-being, as seen in our traditional healing ceremonies. This same spirit of collaboration has enabled us to overcome incredible obstacles and bring quality healthcare to our people. Our ancestors would be proud to see their legacy of community-driven progress continue, inspiring a brighter future for generations to come.”
“We are deeply honored by this recognition,” said Melinda White, Chief Executive Officer of Sage Memorial Hospital. “This award belongs to the Navajo people we serve, our dedicated staff, and the partners who refused to accept barriers as permanent. It proves that tribal health systems can compete—and lead—at the highest levels of finance.”
Sage Memorial Hospital extends heartfelt gratitude to its financial advisor Kaufman Hall, its legal counsels Hobbs Strauss Dean & Walker and Mangum, Wall, Stoops & Warden, its placement agent Blaylock Van, its Bond Counsel Norton Rose Fulbright, the Arizona Industrial Development Authority, and importantly, the investors and their counsel who spent the time necessary to understand the Sage Memorial Hospital story.
“The greatest success for Kaufman Hall is seeing the opening of the new Sage Memorial Hospital,” said John Andersen, CFA, Senior Vice President at Kaufman Hall. “Accomplishing this at a time when rural healthcare access broadly, and particularly on indigenous reservations, is under serious threat, is a testament to Sage’s determination, to the deal team that saw it through, and to the investors who recognized the value their participation could make.”
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About Sage Memorial Hospital
Located in Ganado, Arizona, Navajo Health Foundation – Sage Memorial Hospital is a 25-bed critical access hospital and the only tribally owned and operated health care facility of its kind, providing comprehensive services to the Navajo Nation and surrounding communities.
About Kaufman Hall, a Vizient Company
Kaufman Hall, a Vizient company, provides management consulting solutions to help society’s foundational institutions realize sustained success amid changing market conditions. Since 1985, Kaufman Hall has been a trusted advisor to boards and executive management teams, helping them incorporate proven methods, rigorous analytics, and industry-leading solutions into their strategic planning and financial management processes, with a focus on achieving their most challenging goals.
Kaufman Hall services use a rigorous, disciplined, and structured approach that is based on the principles of corporate finance. The breadth and integration of Kaufman Hall advisory services are unparalleled, encompassing strategy; financial and capital planning; performance improvement; treasury and capital markets management; mergers, acquisitions, partnerships, and joint ventures; and real estate.
Please note that content included on this page includes testimonials, as defined by MSRB Rule G-40. This testimonial originated from an individual not affiliated with a current municipal advisory client. This testimonial may not accurately represent the experiences of all clients and should not be interpreted as a guarantee of future performance or success.
MEDIA CONTACT:
Christian Bigwater
Chief Patient Experience Officer
Sage Memorial Hospital
christian.bigwater@sagememorial.com
Office – (928) 755-4532 | Cell – (928) 221-4205
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