DrK
The intent of the YATN RNAV is for QR to obtain vis crit. for a visual segment into Atherton Hosp at night. Ops manual has an extensive supplement describing visual lead-points, procedures, etc, which permits the use of the approach. At no time was landing at the airfield seriously considered, it's a referance only for the approach due to the high terrain at Atherton. An RNAV to the hospital HLS would require an unuseable MDA.
Lobby to get the airfield upgraded and licensed, and you may get general use apporoval - but I doubt it. IMHO the MDA appears to be too close to the TH for safe FW ops at night, but mind you I'm just a rotor-head.
Same deal Dick, lobby to get YIGM upgraded and licensed and you'll probably get approval. The RNAV approach and RWY are fine.
SNID