THE FORT DEFIANCE INDIAN HOSPITAL BOARD INCORPORATION: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- THE FORT DEFIANCE INDIAN HOSPITAL BOARD INCORPORATION (EIN 86-0817397)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-08-15
- IRS object ID
- 201242289349304279
- Schema version
- 2010v3.4
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-15T18:19:34-05:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6100 UPTOWN BLVD NE STE 400 | AddressLine1 |
| City | ALBUQUERQUE | City |
| State | NM | State |
| ZIP Code | 87110 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 860817397 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE FORT DEFIANCE INDIAN HOSPITAL | BusinessNameLine1 |
| Business Name Line2 | BOARD INC DBA TSEHOOTSOOI MEDICAL CENT | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | FORT | NameControl |
| Phone | 9287298000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 649 | AddressLine1 |
| City | FORT DEFIANCE | City |
| State | AZ | State |
| ZIP Code | 86504 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DR LEONARD LELAND | Name |
| Title | CHIEF EXECUTIVE OFFICER | Title |
| Phone | 9287298000 | Phone |
| Date Signed | 2012-08-15 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MARLA CASTNER | Name |
| Phone | 5058787200 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DR LELAND LEONARD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 649 | AddressLine1 |
| City | FORT DEFIANCE | City |
| State | AZ | State |
| ZIP Code | 86504 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 104774987 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | FDIHB.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1995 | YearFormation |
| State Legal Domicile | AZ | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE HEALTHCARE SERVICES TO THE COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 756 | TotalNbrEmployees |
| Total Nbr Volunteers | 107 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 73703148 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 54862937 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 28672731 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 48073245 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1117 | InvestmentIncomePriorYear |
| Investment Income Current Year | -113797 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 690570 | OtherRevenuePriorYear |
| Other Revenue Current Year | 353723 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 103067566 | TotalRevenuePriorYear |
| Total Revenue Current Year | 103176108 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 24738148 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 60277947 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 24931402 | OtherExpensePriorYear |
| Other Expenses Current Year | 36774038 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 49669550 | TotalExpensesPriorYear |
| Total Expenses Current Year | 97051985 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 53398016 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 6124123 | RevenuesLessExpensesCY |
| Total Assets BOY | 58417852 | TotalAssetsBOY |
| Total Assets EOY | 66957253 | TotalAssetsEOY |
| Total Liabilities BOY | 4983380 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 7398658 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 53434472 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 59558595 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO PROVIDE SUPERIOR AND COMPASSIONATE HEALTHCARE TO OUR COMMUNITY BY RAISING THE LEVEL OF HEALTH, HOZHO AND QUALITY OF LIFE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 37299083 | Expense |
| Revenue | 46236011 | Revenue |
| Description | PROVIDE MEDICAL CARE TO COMMUNITY. THIS INCLUDES PHYSICIAN SALARIES, MEDICAL SUPPLIES, TRANSPORTATION, MEDICAL EQUIPMENT AND CONTRACT HEALTH SERVICES. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 17373681 | Expense |
| Description | PROVIDE NURSING SERVICES TO SUPPORT HEALTHCARE PROVIDED TO THE COMMUNITY. THIS INVOLVES SUPPLIES, NURSING SALARIES AND OTHER EQUIPMENT NEEDED TO PROVIDE NURSING SERVICES | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2618010 | Expense |
| Description | COMMUNITY HEALTH SERVICES EXPENSES | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 6148433 | Expense |
| Revenue | 1837234 | Revenue |
| Description | CONTRACT HEALTH SERVICES AND SUPPORT SERVICES INCLUDING HUMAN RESOURCES, FINANCE, OPERATIONS AND EXECUTIVE DIVISIONS | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 6148433 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 1837234 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 63439207 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 66 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 756 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 1 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 1 | LocalChapters |
| Policies Reference Chapters | 1 | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | AZ | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RACHEL SORRELL CHIEF FINANCIAL OFFICER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9287298250 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 649 | AddressLine1 |
| City | FORT DEFIANCE | City |
| State | AZ | State |
| ZIP Code | 86504 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (20 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| ROY DEMPSEY | |||||||
| BOARD PRESIDENT | 2.00 | X | X | 18200 | 0 | 0 | |
| CALEB ROANHORSE | |||||||
| BOARD VICE-PRESIDENT | 2.00 | X | X | 21000 | 0 | 0 | |
| MARTIN ASHLEY | |||||||
| BOARD TREASURER | 2.00 | X | X | 14800 | 0 | 0 | |
| LORRAINE NELSON | |||||||
| BOARD SECRETARY | 2.00 | X | X | 18200 | 0 | 0 | |
| MARTIN BEGAY | |||||||
| DIRECTOR | 2.00 | X | 8200 | 0 | 0 | ||
| JERRY FREDDIE | |||||||
| DIRECTOR | 2.00 | X | 12800 | 0 | 0 | ||
| DR RAYMOND REID | |||||||
| DIRECTOR | 2.00 | X | 9600 | 0 | 0 | ||
| TIM GOODLUCK | |||||||
| DIRECTOR | 2.00 | X | 12800 | 0 | 0 | ||
| ELMER MILFORD | |||||||
| DIRECTOR | 2.00 | X | 1500 | 0 | 0 | ||
| LELAND ANTHONY | |||||||
| DIRECTOR | 2.00 | X | 18600 | 0 | 0 | ||
| DR LELAND LEONARD | |||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | X | 247939 | 0 | 33167 | ||
| VIVIAN SANTISTEVAN | |||||||
| CHIEF HUMAN RESOURCES OFFICER | 40.00 | X | 188745 | 0 | 20743 | ||
| TAL MOORE | |||||||
| CHIEF ADMINISTRATIVE OFFICER | 40.00 | X | 103840 | 0 | 8173 | ||
| DR DAVID DOWNING | |||||||
| CHIEF MEDICAL OFFICER | 40.00 | X | 225027 | 0 | 37469 | ||
| VALONIA HARDY | |||||||
| CHIEF OF COMMUNITY HEALTH | 40.00 | X | 113654 | 0 | 10768 | ||
| RACHEL SORRELL | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | X | 65165 | 0 | 5264 | ||
| TORI DAVIDSON | |||||||
| CHIEF NURSING OFFICER | 40.00 | X | 131866 | 0 | 19938 | ||
| DANIEL JOHNSON | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | X | 270043 | 0 | 17240 | ||
| NAZHONE P YAZZIE | |||||||
| DOCTOR | 40.00 | 224848 | 0 | 4236 | X | ||
| JOHN GARSON | |||||||
| DOCTOR | 40.00 | 261580 | 0 | 20895 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1968407 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 177893 | TotalOtherCompensation |
| Number Individuals GT100 K | 9 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| SMILING DRAGON LLC | |||||
| PO BOX 402 | MEDANALES | NM | 87548 | CRNA | 175348 |
| MICHAEL MALIK | |||||
| 1020 W 122ND ST | LOS ANGELES | CA | 90044 | ER PHYSICIAN | 171360 |
| STAFF CARE | |||||
| 5001 STATESMAN DR | IRVING | TX | 75063 | MEDICAL OFFICER | 148941 |
| RICHARD ROUGEUX | |||||
| 511 NINTH STREET APT 8 | LAS VEGAS | NM | 87701 | PEDIATRICIAN | 145560 |
| ROBIN LE | |||||
| 24749 FAY AVE | MORENO | CA | 92551 | DENTIST | 142843 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 8 | NumberOfContractorsGT100K |
| Government Grants | 54861937 | GovernmentGrants |
| All Other Contributions | 1000 | AllOtherContributions |
| Total Contributions | 54862937 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICE RE | Description |
| Business Code | 624100 | BusinessCode |
| Total Revenue Column | 48073245 | TotalRevenueColumn |
| Related Or Exempt Function Income | 48073245 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 48073245 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2571 | TotalRevenueColumn |
| Exclusion | $2,571 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1014158 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1482511 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -468353 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -468353 | TotalRevenueColumn |
| Exclusion | -$468,353 | ExclusionAmount |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 116368 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -116368 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -116368 | TotalRevenueColumn |
| Exclusion | -$116,368 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| MISCELLANEOUS | 900099 | 478132 | $478,132 |
| CAFETERIA INCOME | 722210 | 343944 | $343,944 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 822076 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 103176108 | TotalRevenueColumn |
| Related Or Exempt Function Income | 48073245 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $239,926 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1232636 | Total |
| Program Services | 831436 | ProgramServices |
| Management And General | 401200 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 48210696 | Total |
| Program Services | 32701054 | ProgramServices |
| Management And General | 15509642 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 705165 | Total |
| Program Services | 442861 | ProgramServices |
| Management And General | 262304 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8233553 | Total |
| Program Services | 5449087 | ProgramServices |
| Management And General | 2784466 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1895897 | Total |
| Program Services | 1151188 | ProgramServices |
| Management And General | 744709 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 648928 | Total |
| Management And General | 648928 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 116624 | Total |
| Management And General | 116624 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11814981 | Total |
| Program Services | 8520174 | ProgramServices |
| Management And General | 3294807 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31896 | Total |
| Program Services | 7653 | ProgramServices |
| Management And General | 24243 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2522838 | Total |
| Program Services | 684791 | ProgramServices |
| Management And General | 1838047 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 524783 | Total |
| Program Services | 22727 | ProgramServices |
| Management And General | 502056 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1192925 | Total |
| Management And General | 1192925 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 711704 | Total |
| Program Services | 332973 | ProgramServices |
| Management And General | 378731 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 302253 | Total |
| Program Services | 135844 | ProgramServices |
| Management And General | 166409 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 844563 | Total |
| Management And General | 844563 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 577258 | Total |
| Management And General | 577258 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 6617063 | 6617063 | |
| CONTRACT HEALTH SERVICE | 6149432 | 6149432 | |
| MISCELLANEOUS | 4017215 | 180063 | 3837152 |
| NON CAPITAL EQUIPMENT | 698826 | 212861 | 485965 |
| REPAIRS & MAINTENANCE | 2749 | 2749 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 97051985 | Total |
| Program Services | 63439207 | ProgramServices |
| Management And General | 33612778 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 42573169 | BOY |
| EOY | 49828679 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8969455 | BOY |
| EOY | 9476633 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1788568 | BOY |
| EOY | 1694957 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 273129 | BOY |
| EOY | 1117400 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 6130103 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1290519 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4813531 | BOY |
| EOY | 4839584 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58417852 | BOY |
| EOY | 66957253 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4983380 | BOY |
| EOY | 7398658 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4983380 | BOY |
| EOY | 7398658 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 45184155 | BOY |
| EOY | 48988906 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4813531 | BOY |
| EOY | 4839584 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3436786 | BOY |
| EOY | 5730105 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 53434472 | BOY |
| EOY | 59558595 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58417852 | BOY |
| EOY | 66957253 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 6124123 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 27801 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus1 Year | 73703148 | CurrentTaxYearMinus1Year |
| Current Tax Year | 54862937 | CurrentTaxYear |
| Total | 128593886 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 27801 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus1 Year | 73703148 | CurrentTaxYearMinus1Year |
| Current Tax Year | 54862937 | CurrentTaxYear |
| Total | 128593886 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 128593886 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | 691687 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1016729 | CurrentTaxYear |
| Total | 1708416 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | 822076 | CurrentTaxYear |
| Total | 822076 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 131124378 | TotalSupport |
| Gross Receipts From Admissions Etc | 76745976 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.98070 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.99010 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 179405 | OtherCostOrOtherBasis |
| Depreciation | 8965 | Depreciation |
| Book Value | 170440 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5950698 | OtherCostOrOtherBasis |
| Depreciation | 1281554 | Depreciation |
| Book Value | 4669144 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 4839584 | TotalOfBookValueLandBuildings |
| Total Revenue | 103176108 | TotalRevenue |
| Total Expenses | 97051985 | TotalExpenses |
| Excess Or Deficit For Year | 6124123 | ExcessOrDeficitForYear |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | 6124123 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 104658619 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 1482511 | OtherRevenues |
| Revenue Not Rptd F990 | 1482511 | RevenueNotRptdF990 |
| Revenue Subtotal | 103176108 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 103176108 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 98534496 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 1482511 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 1482511 | ExpensesNotRptdF990 |
| Expenses Subtotal | 97051985 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 97051985 | TotalExpensesPerForm990 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2564427 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2564427 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02640 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 44138443 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 36367346 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7771097 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08010 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 46702870 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 36367346 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 10335524 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10650 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Direct Offsetting Revenue | 1000 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -1000 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Direct Offsetting Revenue | 1000 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -1000 | NetCommunityBenefitExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 46702870 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 36368346 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 10334524 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10650 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 93 | NumberOfActivitiesOrPrograms |
| Persons Served | 19265 | PersonsServed |
| Total Community Building Expense | 170000 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 170000 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00180 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 6 | NumberOfActivitiesOrPrograms |
| Persons Served | 9565 | PersonsServed |
| Total Community Building Expense | 25500 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 25500 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 5 | NumberOfActivitiesOrPrograms |
| Persons Served | 20 | PersonsServed |
| Total Community Building Expense | 3000 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 3000 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 8 | NumberOfActivitiesOrPrograms |
| Persons Served | 37645 | PersonsServed |
| Total Community Building Expense | 3000 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 3000 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 6 | NumberOfActivitiesOrPrograms |
| Persons Served | 10100 | PersonsServed |
| Total Community Building Expense | 2000 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2000 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 37 | PersonsServed |
| Total Community Building Expense | 2700 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2700 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 10000 | PersonsServed |
| Total Community Building Expense | 55000 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 55000 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 123 | NumberOfActivitiesOrPrograms |
| Persons Served | 86632 | PersonsServed |
| Total Community Building Expense | 261200 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 261200 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00270 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amount Reimbursed By Medicare | 8525860 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 5943793 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 2582067 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | X | CostAccountingSystem |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 0 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 NAHATA' DZIL HEALTH CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | OUTPATIENT SERVICES FOR GENERAL PRIMARY CARE | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 0.01710 | OrganizationProfitOrOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 2 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)
| Facility NumberFacilityNumber | Address Line1Address/AddressLine1 | Address Line2Address/AddressLine2 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Er24 HoursEr24Hours | OtherOther |
|---|---|---|---|---|---|---|---|---|---|
| TSEHOOTSOI MEDICAL CENTER | |||||||||
| 1 | PO BOX 649 CORNER OF ROUTES N7 AND | N12 | FORT DEFIANCE | AZ | 86504 | X | X | X | |
| NAHATA' DZIIL HEALTH CENTER | |||||||||
| 2 | PO BOX 125 CHIIHTOH BLVD 2 | SANDERS | AZ | 86512 | X | OUTPATIENT CLINIC ONLY | |||
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TSEHOOTSOI MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part VI Form990ScheduleHPartVI (8 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: THE FDIHB USES A MIX OF COSTING METHODOLOGIES. COST ACCOUNTING IS USED FOR REVENUES, BUT NOT ENTIRELY FOR EXPENSES. MOST EXPENSES ARE RECORDED TO THE COST CENTERS THEY RELATE TO WITH THE EXCEPTION OF UTILITIES, SOME SUPPLIES AND SMALLER EXPENSES WHICH ARE CENTRALIZED. | ||
| PART II: COMMUNITY SUPPORT - PROVIDES DIRECT AND A MORE COHESIVE ENVIRONMENT OF STAFFING SUPPORT TO IMPROVE PREVENTION, INTERVENTION, AND POST-TERTIARY WELLNESS SERVICES THAT INVOLVE PHYSICAL ACTIVITY BEHAVIOR MODIFICATION, REINFORCEMENT OF HEALTHY BEHAVIORS LEARNED AND PRACTICES, AND INCREASE ADHERENCE AND RETENTION OF PARTICIPATION IN WELLNESS PROGRAM ACTIVITIES TO REDUCE HEALTH RISK FACTORS AND STRENGTHEN PREVENTION OF HEALTH RISKS, REINFORCE SKILLS, AND REDUCE RISK OF RELAPSE AMONG THE CLIENTS WE SERVE. COMMUNITY SUPPORT FOR PUBLIC HEALTH NUTRITION RANGES FROM TECHNICAL ASSISTANCE (SCHOOLS, NAVAJO AREA OFFICE, TRIBAL PROGRAMS, INTERNAL PARTNERS) PRESENTATIONS AT CONFERENCES, NUTRITION EDUCATION, FOOD SECURITY PROJECTS, AND HEALTH FAIRS. THESE ACTIVITIES ARE FUNDED BY THE FOLLOWING GRANTS: AZNN, FIRST THINGS FIRST, AND SDPI. PROGRAM INVOLVEMENT FOR COMMUNITY SUPPORT INCLUDES SUPPORTING THE FOLLOWING COALITIONS (BREASTFEEDING, BREAST CANCER AWARENESS, CANCER AWARENESS, WOMEN'S HEALTH, AND YOUTH PHYSICAL ACTIVITY). IN ADDITION, PROGRAM SUPPORT SERVICES HAVE INCLUDED PROVIDING HEALTH EDUCATION FOR COMMUNITY ON THE FOLLOWING AREAS: TEEN WELLNESS, WOMEN'S HEALTH, AND SUICIDE PREVENTION. ENVIRONMENTAL IMPROVEMENTS - ENVIRONMENTAL IMPROVEMENTS INCLUDE CREATING A MORE FEASIBLE, ACCESSIBLE, AND SAFE PHYSICAL ACTIVITY AREA FOR WORKSITE, CLINICAL INTERVENTION, AFTERSCHOOL ACTIVITIES, COMMUNITY AND FAMILY INVOLVEMENT. ESTABLISH AND OVERSEE COMMUNITY BILLBOARDS SITUATED IN THREE CHAPTER COMMUNITIES WHICH PROMOTE HEALTHY ENVIRONMENTAL MESSAGES; ADVOCATE ON CLEAN AND HEALTHY COMMUNITIES THROUGH SUPPORTING LOCAL COMMUNITY CLEAN UP I.E. REDLAKE COMMUNITY TRASH PICK UP; STEAMBOAT EARTH DAY EVENT AND ADVOCACY TO PROMOTE CLEAN NAVAJO NATION TASK FORCE. FORMERLY ORGANIZED A PROPER TRASH DISPOSAL CAMPAIGN FOR THE ANNUAL TRIBAL PARADE THAT ATTRACTED AN ESTIMATED POPULATION OF 100,000 SPECTATORS FOR ONE-DAY EVENT. PRODUCE WRITTEN MATERIAL TO BE PUBLISHED IN HOSPITAL NEWSLETTER REGARDING ENVIRONMENTAL SAFETY ISSUES: EXTREME WEATHER PREPARATION FOR COLD WEATHER, ROAD SAFETY IN UNSAFE DRIVING CONDITIONS, ETC.LEADERSHIP DEVELOPMENT & TRAINING COMMUNITY MEMBERS - THE ORGANIZATION PROMOTES CAPACITY BUILDING TRAININGS SUCH AS ONE VOICE, TRAINING FOR NAVAJO AREA NUTRITION EDUCATORS, AND TRAININGS FOR TRIBAL EMPLOYEES THROUGH CCDF AND OTHER PARTNERS. IT RECRUITS COMMUNITY MEMBERS TO BE TRAINED IN COMMUNITY ADVOCACY AND NAVAJO WELLNESS TO STRENGTHEN ADVOCACY ROLE IN HEALTH AND WELLNESS. HPDP STAFF MEMBERS COMPLETED A COMBINED 72 HOURS OF COMMUNITY ADVOCACY TRAINING HOURS FOR COMMUNITY POPULATIONS. COALITION BUILDING - COALITION BUILDING TEAMS INVOLVED RESOURCES WHO COLLECTIVELY PLAN, DESIGN, IMPLEMENT AND STRATEGIZE ON PREVENTION AND INTERVENTION PROGRAMS FOR YOUTH TO ELDERLY PARTICIPATION REQUIRING MEETINGS, STRATEGIC PLANNING AND CELEBRATION, ALL TO STRENGTHEN RESOURCE NETWORKING, COMMUNITY IMPACT, AND SHARING OF RESOURCES. IT WORKS WITH THE NAVAJO NATION BREASTFEEDING COALITION AND THE NAVAJO NATION FOOD POLICY TEAM, WHICH ARE BOTH ORGANIZATIONS THAT COVER THE WHOLE NAVAJO NATION WITH AN ESTIMATED POPULATION OF 280,000. IT SUPPORTS AND ASSISTS LOCAL COALITIONS WITH TECHNICAL ASSISTANCE IN PLANNING AND IDENTIFYING LOCAL HEALTH ISSUES, INCLUDING REDLAKE HEALTH COUNCIL, STEAMBOAT HEALTH COUNCIL AND REDLAKE YOUTH GROUP. IT PARTICIPATES IN AND SUPPORTS COALITION GROUPS IN THE FORMATION OF COMMUNITY IMPROVEMENT EVENTS; FORT-A TEAM AND NAVAJO NATION LOCAL GOVERNANCE CENTER. COMMUNITY HEALTH IMPROVEMENT ADVOCACY - THIS CAN BE HELD WITH SCHOOL, COMMUNITY, AND CHAPTER LEADERS TO MEET AND FACILITATE HEALTH ISSUES, POLICY DEVELOPMENT, COMMUNITY SHARING, AND OFFER A SENSE OF UNITY TO ADDRESS THE COMBATING ISSUES THAT NEED PROBLEM SOLVING, TEAM WORK, AND DISCUSSION TO MAKE CAMPAIGNING AND IMPACT EFFECTIVE. WORKFORCE DEVELOPMENT - PH NUTRITION SPONSORED A TIME MANAGEMENT CLASS FOR DCH AND OTHER TMC STAFF. IF ALL 37 PARTICIPANTS WERE ABLE TO INCREASE PRODUCTIVITY BY AS LITTLE AS 15 MINUTES PER WEEK, THE ADDED VALUE WOULD BE $12,000 OVER THE COURSE OF A YEAR. THE ORGANIZATION RECRUITS COMMUNITY MEMBERS TO PARTICIPATE IN COMMUNITY ADVOCACY TRAINING AND THE NAVAJO WELLNESS MODEL. IT PROVIDES TECHNICAL ASSISTANCE AND SUPPORT FOR THE DEVELOPMENT OF THE RESERVATION-WIDE JUNK FOOD TAXATION POLICY. IT ORGANIZES PUBLIC HEALTH COMMUNITY HEALTH PROGRAMS AIMED TO PREVENT CHRONIC DISEASES AND PROMOTE PHYSICAL ACTIVITY SUCH AS: JOURNEY TO WELLNESS SERIES TO INCLUDE WALKING TOGETHER FOR HEALTHIER NATIONS, JUST MOVE IT, AND TURKEY TROT. THE ORGANIZATION IMPLEMENTS A PERSONAL MOTIVATION PLAN FOR PHYSICAL ACTIVITY SUSTAINABILITY THROUGH INCENTIVE-BASED PROGRAM AND ORGANIZES COMMUNITY WELLNESS TEAM CONSISTING OF LOCAL TRIBAL AFFILIATIONS AND ORGANIZATIONS TO CARRY OUT PHYSICAL ACTIVITY PROGRAM AND EVENTS. OTHER - THE FACILITY PROVIDES FOR PHYSICAL ACTIVITY AND FITNESS INSTRUCTION WHICH IS MORE FREQUENTLY ACCESSIBLE TO THE COMMUNITY THROUGH OUT THE DAY. IT OFFERS EDUCATIONAL SESSIONS FOR ALL AGES, FREQUENT CLIENT CONSULTATION, AND AN ON-SITE OFFICE AREA FOR STAFF TO PROVIDE INSTRUCTION, DEMONSTRATION, CLIENT MONITORING, AND PROGRESS AND IMPACT DATA. THIS REINFORCES THE LIKELIHOOD THAT EACH CLIENT AND HIS/HER FAMILY WILL BE ABLE TO CHANGE THEIR BEHAVIOR SO AS TO REDUCE THEIR RISK OF LIVING AN UNHEALTHY LIFESTYLE. | ||
| PART III, LINE 8: USED COST ACCOUNTING METHODOLOGY; HAVE COST CENTERS SET UP TO CAPTURE COSTS AND REVENUES RELATED TO THOSE COST CENTERS. | ||
| PART III, LINE 9B: NO PROVISION INDICATED IN THE COLLECTION POLICY WHICH REFERENCES FINANCIAL ASSISTANCE. | ||
| ONE OR MORE HOSPITAL FACILITIES ARE NOT REQUIRED TO COMPLETE SCHEDULE H, PART V, SECTION B FOR THE 2010 TAX YEAR. FORT DEFIANCE INDIAN HOSPITAL BOARD HAS ELECTED NOT TO COMPLETE PART V, SECTION B, SO THEY CAN FAMILIARIZE THEMSELVES WITH THE INFORMATION REQUIRED AND TO REPORT COMPLETE AND ACCURATE INFORMATION ON SECTION B. | PURSUANT TO IRS ANNOUNCEMENT 2011-37, TAX-EXEMPT ORGANIZATIONS THAT OPERATE | FORM 990, SCH H, PART V, SECTION B |
| PART VI, LINE 2: THE COMMUNITY HEALTH DIVISON ASSESSES THE NEEDS OF THE COMMUNITY THE FDIHB SERVES VIA SURVEY, FACE TO FACE INTERVIEWS AND DATA COLLECTED AT VARIOUS COMMUNITY HEALTH EVENTS SUCH AS THE JUST MOVE IT AND PERSONAL WELLNESS PLAN SURVEYS CONDUCTED DURING THE JUST MOVE IT EVENTS IN THE SUMMER OF 2011.THE PLANNING OFFICE CONDUCTED A SURVEY WITH ALL THE CHAPTERS IN THE FALL OF 2011 TO ASSESS TELECOMMUNICATION NEEDS.THE PLANNING OFFICE CONDUCTED A COMMUNICATION NEEDS ASSESSMENT WITH THE HOSPITAL DEPARTMENTS IN THE FALL OF 2011.PHNS COLLABORATE WITH CHR'S WHO WORK IN COMMUNITY AND BASED ON THEIR FINDINGS WE PROVIDE HEALTH EDUCATION TOPICS.COORDINATED SCHOOL PROGRAM CONDUCTS SCHOOL HEALTH SURVEYS (NYRBS IN 2011) TO MEASURE YOUTH RISK BEHAVIORS AT SELECTED SCHOOLS. PRE- AND POST- FITNESSGRAM ASSESSMENTS ARE CONDUCTED TO INDICATE BMI MEASURES (OBESITY LEVELS) FOR ELEMENTARY-AGED CHILDREN IN SELECTED SCHOOLS. NAVAJO AREA HPDP ALSO SHARES COLLECTED CONGREGATE DATA WHICH ASSESS FAMILY CULTURAL AND HEALTH DATA EVERY YEAR A SURVEY IS SENT TO INDIVIDUAL NAVAJO HOUSEHOLD. CUSTOMER SERVICE SURVEYS ARE CONDUCTED AFTER COMMUNITY FITNESS EVENT SUCH AS JMI WTHN AND TURKEY TROT TO ASSESS CUSTOMER SATISFACTION AND THEIR EXPERIENCE WITH EACH EVENT. | ||
| PART VI, LINE 3: PATIENT REGISTRATION - PATIENT BENEFITS COORDINATOR EDUCATES THE COMMUNITY AND PATIENTS ON THE ELIGIBILITY FOR ALTERNATIVE RESOURCES (MEDICARE, MEDICAID,SCHIP,KIDSCARE,COMMERICAL PAYERS) | ||
| PART VI, LINE 4: FORT DEFIANCE INDIAN HOSPITAL BOARD, INC (FDIHB) IS LOCATED ON THE NAVAJO INDIAN RESERVATION AND IS ONE OF 8 HOSPITALS (SERVICE UNITS) THAT SERVICE THE RESERVATION. IN FY 2011, FDIHB HAD APPROXIMATELY 111,434 LIVING PATIENTS REGISTERED. IN 2011 THERE WERE 298,017 VISITS TO FDIHB'S ACTIVE CLINICS. THERE WERE 12,037 PATIENTS ENROLLED IN MEDICARE PART A AND 11,664 PATIENTS ENROLLED IN PART B AT THE END OF FY 2011. THERE WERE 3,322 PATIENTS ENROLLED IN MEDICARE PART D. THERE WERE ALSO 39,977 PATIENTS ENROLLED IN MEDICAID AND 18,297 PATIENTS WITH AN ACTIVE PRIVATE INSURANCE POLICY. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR LELAND LEONARD | |||||||||||||
| 247939 | 0 | 0 | 0 | 0 | 0 | 14227 | 0 | 18940 | 0 | 281106 | 0 | 0 | 0 |
| VIVIAN SANTISTEVAN | |||||||||||||
| 188745 | 0 | 0 | 0 | 0 | 0 | 6607 | 0 | 14136 | 0 | 209488 | 0 | 0 | 0 |
| DR DAVID DOWNING | |||||||||||||
| 225027 | 0 | 0 | 0 | 0 | 0 | 13357 | 0 | 24112 | 0 | 262496 | 0 | 0 | 0 |
| TORI DAVIDSON | |||||||||||||
| 131866 | 0 | 0 | 0 | 0 | 0 | 8061 | 0 | 11877 | 0 | 151804 | 0 | 0 | 0 |
| DANIEL JOHNSON | |||||||||||||
| 270043 | 0 | 0 | 0 | 0 | 0 | 7986 | 0 | 9254 | 0 | 287283 | 0 | 0 | 0 |
| NAZHONE P YAZZIE | |||||||||||||
| 224848 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 4236 | 0 | 229084 | 0 | 0 | 0 |
| JOHN GARSON | |||||||||||||
| 261580 | 0 | 0 | 0 | 0 | 0 | 15958 | 0 | 4937 | 0 | 282475 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 4 | THE BOARD BYLAWS WERE REVISED ON 6/25/2011 WITH CHANGES TO THE FOLLOWING: DUTIES OF THE BOARD WERE ADDED TO INCLUDE OVERSIGHT OF WORK AND FINANCES OF THE HOSPITAL, APPOINT THE OFFICERS, APPROVE THE ANNUAL BUDGET, AND APPOINT AN AUDITOR TO THE CORPORATION. LANGUAGE WAS ADDED TO THE BYLAWS TO STAGGER THE TERMS OF BOARD MEMBERS AND COMPENSATION LANGUAGE WAS ADDED TO COMPENSATE BOARD MEMBERS FOR MEETINGS ATTENDED. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS REVIEWED BY THE CHIEF FINANCIAL OFFICER BEFORE IT IS FILED. | |
| THE COMPLIANCE COMMITTEE MONITORS AND ENFORCES THE CONFLICT OF INTEREST POLICY. BOARD MEMBERS, SENIOR LEADERS, DIRECTORS AND KEY EMPLOYEES MUST COMPLETE A CONFLICT OF INTEREST POLICY ANNUALLY. | FORM 990, PART VI, SECTION B, LINE 12C | |
| AN INDEPENDENT MANAGEMENT COMPANY UTILIZES SURVEYS AND COMPARATIVE DATA TO DETERMINE COMPENSATION FOR THE CEO, TOP MANAGEMENT OFFICIALS, OFFICERS AND KEY EMPLOYEES. | FORM 990, PART VI, SECTION B, LINE 15 | |
| THE FORM 990 AND FORM 1023 ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. | FORM 990, PART VI, SECTION C, LINE 18 | |
| THE AUDITED FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND ALL OTHER GOVERNING AND ORGANIZING DOCUMENTS ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. | FORM 990, PART VI, SECTION C, LINE 19 |