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Dr. Leland Leonard has initiated an incredible concept of utilizing 100% Navajo services. He has given our firm to demonstrate our quality products and service.

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Annualreport121411 d

  1. 1. ANNUAL REPORTTSÉHOOTSOOÍM e d i c a l C e n t e r 2011
  2. 2. MISSION STATEMENT Providing Superior and Compassionate healthcare to ourcommunity by raising the level of health,hózhó, and quality of life.Table of ContentsChief Executive Officer’s Message............1Board of Directors..................................2Organization History..............................4Our Services...........................................5A Model of Best Practice.........................6Patient Centered Model..........................7FY 2010 - Financial Summary..................8FY 2010 - Expenditures/Revenues...........9Our Elders............................................11Telehealth...........................................11
  3. 3. T S É H O O T S O O Í M E D I C A L C E N T E R • 2 0 1 0 A N N U A L R E P O R TChief ExecutiveAOfficer’s MessageGreetings dóó Yá’át’ééh Naat áaníi!As the Chief Executive Officer (CEO) I am honored to provide the 2011 Annual Reportincluding the 2010 Fiscal Report to the Fort Defiance Indian Hospital Board of Directors(FDIHB). We hope this information will clarify and serve as a reference of the overalloperations of Tséhootsooí Medical Center (TMC) and Nahat’á Dziil Health Center(NDZHC). The mission of FDIHB is to provide superior and compassionate healthcare toour community by raising the level of health, hózhó and quality of life. A Strategic Planwas completed in February 2011, the goals, objectives, evaluation format and funds wereidentified to assure superior and compassionate health care. The leadership team supportsthe need to fully embrace hózhó embedded health care services in all operations. We willcontinue to collaborate with the Navajo Nation, Indian Health Services, the states ofArizona and New Mexico and other affiliates to secure resources needed to provide superiorhealth care. The Center for Medicare and Medicaid Services (CMS) monitors health carecompliance for TMC and NDZHC; we anticipate a monitoring visit at any time. The FDIHB 2010 operating budget exceeds $100 million; this included salaries,employee benefits, professional services, supplies, contract health services, utilities, traveland other. The Revenues are generated from net patient service revenue, Title I, TribalGrant Funds, and other revenues. Our first audit, as a non-profit 638 entity was conductedby Moss Adams Certified Public Accountants. The audit was classified as “Unqualified”which means there were no findings. The total number of patients served in 2010 is approximately 32,000. Currently,there are approximately 900 FDIHB employees. On March 28, 2010 the FDIHB officially became a 638 certified health care facility.Since that time the administration has diligently worked on making the transition fromIndian Health Service (IHS) to a corporate status with a focus on employee transition. The FDIHB administration continues to identify and address the medical needsof our patients from the 16 chapters and others who use TMC and NDZHC. I applaud theentire FDIHB staff for their services as they go above and beyond to serve all patients. Dr. Leland Leonard, I am committed to building elite health care services using the PL 93-638, Indian Chief Executive OfficerSelf Determination and Education Assistance Act. I sincerely believe that we have qualified Tséhootsooí Medical Centerand competent staff who consistently promote the mission of FDIHB. We will continueto provide superior and compassionate health care to our community byraising the level of health, hózhó and quality of life. Please contact me if you have any questions, I can be contactedat 928-729-8000.Sincerely,Dr. Leland LeonardChief Executive Officer 1
  4. 4. T S É H O O T S O O Í M E D I C A L C E N T E R • 2 0 1 0 A N N U A L R E P O R T Board of Directors ROY DEMPSEY, LELAND ANTHONY, LORRAINE NELSON, Vice Chairman Treasurer SecretaryCaleb Roanhorse,Board President,Fort Defiance Indian HospitalBoard, Inc. MARTIN ASHLEY, Jerry Freddie, TIM GOODLUCK, Board Member Board Member Board Member Elmer Milford, DR. RAYMOND REID, Board Member Board Member 2 1
  5. 5. T S É H O O T S O O Í M E D I C A L C E N T E R • 2 0 1 0 A N N U A L R E P O R T1 health 3
  6. 6. T S É H O O T S O O Í M E D I C A L C E N T E R • 2 0 1 0 A N N U A L R E P O R T T Organization History 1851 The history of healthcare in the Fort Defiance area stems back to the mid 1800’s whenU.S. Calvary built a fort and the federal government was establishing military forts and placing physicians at thosenamed it Fort Defiance forts. The first Fort Defiance Indian Hospital was built in 1912. The hospital was under 1897 - 1929 the control of the Bureau of Indian Affairs until 1955 when Congress transferred theFederal Government employees Indian Health Program to the Indian Health Service department within the U.S. Publicfield matrons to raise living Health Service. This facility was located in the same vicinity as the original Fort Defiancestandards, improve hygiene and military perform preventative health By 1965 the Fort Defiance Indian Hospital, operated by the Indian Healthmeasures. Service (IHS), became an accredited hospital. 1908 - 1914 In the early 1980s, a grassroots effort kicked off the planning stages to requestFederal Gov. built four hospitals. a new IHS facility. The group known as the Fort Defiance Hospital Steering Committee 1955 was composed of community members and elected community leaders, along with theCongress transfers Indian Health Navajo Nation Division of Health and the Navajo Area Indian Health Service. TheProgram to US Public Health efforts of the committee paid off with the allocation of funds to construct a new hospital.Service. In August 2002 the new 54 bed; 24,000 square foot hospital opened for business. 1965 Since that time, the hospital continued its growth and acquired the Nahat’aFort Defiance Indian Hospital Dziil Health Center in Sanders, Arizona. It also initiated efforts to become one of severalbecomes an accredited hospital. self-determined PL 93-638 hospital organizations on the Navajo Nation. The ‘638 status gives the community control of the management and operation of the facility. 1980s On March 28, 2010 the hospital won approval and officially became the fourth ‘638 Community members beginpetitioning for a new hospital on the Navajo Nation and no longer under the control of the Indian Healthfacility. Service. The FDIHB, Inc. Board of Directors voted unanimously on April 15, 2011, 2001 to change its name to the Tséhootsooí Medical Center and commissioned a new logo.Construction of new facilitybegins. Today FDIHB, Inc. is the parent to Tséhootsooí Medical Center and the Nahat’a Dziil Health Center. 2002Doors open for business. Legal Entity 2004 The Fort Defiance Indian Hospital Board, Inc. is incorporated under the Navajo NationNon-profit status by the Internal Corporation Code, and Arizona Corporation Commission as a 501(c)(3) nonprofitRevenue Service corporation. The Internal Revenue Service has also certified FDIHB, Inc. as a nonprofit 2004 entity638-Contract is completed. Organization Summary The Fort Defiance Indian Hospital Board, Inc. (FDIHB, Inc.) is a tribally chartered, 501(c)(3) nonprofit healthcare organization that operates and manages the Tséhootsooí Medical Center (TMC) and the Nahat’a Dziil Health Center (NDZHC). FDIHB, Inc. is certified by the Center for Medicare & Medicaid Services (CMS) to offer a wide range of acute and ambulatory care services to patients. The two facilities provide healthcare services to an estimated 32,000 people; a majority of whom are members of the Navajo Nation and reside within 16 Navajo communities in the Fort Defiance service area. TMC is a 240,000 square feet facility which is located at the Northwest corner of Navajo Route 7 and Navajo Route 12 in Fort Defiance, Arizona. TMC is a 56 bed inpatient and outpatient facility with a 24-hour Emergency Room and NDZHC is located off Interstate 40 and State Highway 191 in Sanders, Arizona. NDZHC provides 4 1 basic outpatient services in a family practice atmosphere with a small lab, a pharmacy, and four exam rooms. It is open Monday through Friday from 8:00 am to 5:00 pm.
  7. 7. T S É H O O T S O O Í M E D I C A L C E N T E R • 2 0 1 0 A N N U A L R E P O R TOur ServicesInpatient services include the following: Outpatient services include the following:• Adolescent Care Unit • Obstetrical e Unit (OBU) • Radiology Department • Adult Medicine Clinic • Counseling Services • Office of Traditional (ACU) • Sterile Processing • Physical Therapy (PT) (AMC) • Emergency Department Services• Inpatient Social Services Department • Inpatient Pharmacy • Pediatric Clinic (Peds) • Home Based Care (Elder • Outpatient Pharmacy• Intensive Care Unit (ICU) • Multi-Service Unity • Dietary • Women’s Health Clinic Care, Hospice, Palliative • Orthopedics (WHC) Service) • Podiatry• OR/Post Anesthesia Care • Respiratory Therapy (RT) • Medical Records • Diabetes Program • Health Promotion and • Surgical Clinic Unit (OR/PACU) • Laboratory Department • Dental Clinic Disease Prevention • Physical Therapy • Optometry Clinic • Public Health Nutrition • Radiology • Ear, Nose, Throat (ENT) • Wellness Center • Respiratory Therapy Clinic • Behavioral • Specialty Care Clinic Health/ • Social Services Mental Health • Public Health NursingCompassionate 5 1
  8. 8. T S É H O O T S O O Í M E D I C A L C E N T E R • 2 0 1 0 A N N U A L R E P O R TA Modelof BestPracticeThe Navajo Area Indian Health Servicesrecognizes Fort Defiance Indian HospitalBoard, Inc.’s Tséhootsooí Medical Center asa leader in immunizing children. NAIHS saysTMC’s Pediatric Clinic is “one service unit thathas had consistently high immunization rates.”The Navajo Area consists of 13 healthcarefacilities. For the past three years, TséhootsooíMedical Center demonstrated “Best Practice”when it comes to getting children immunized.Best Practices recognized include:1. Assignment of nursing staff member as an Immunization Manager • The Immunization Manager works with clinical staff to orients them on proper reporting. • Develops policies for immunization at all clinical opportunities/reduction of missed opportunities • Educates on the true reasons or factors that parents/guardians may not want their child immunized • Establishes a clinic “culture” of immunizations at any clinic visit regardless of Purpose of Visit. • Works with Public Health Nurse staff to assist with finding families not accessing the clinic for care and determining if they are getting care elsewhere • Interface with parents by contacting parents by phone or letter when children are delinquent in their immunizations. • Improving the reliability and accuracy of the data reporting system for active patients Life2. Active management of the childhoodpopulation using the data reporting systemtools to • track delinquent children and notify parents of deficient immunizations • inactivate children no longer in the service unit to give more accurate statistics about immunizations. 6 1
  9. 9. T S É H O O T S O O Í M E D I C A L C E N T E R • 2 0 1 0 A N N U A L R E P O R TPatient Centered ModelHTHospital leadership and administration have embraced a patientcentered model of providing care. This model is grounded in Dinéphilosophy of using a holistic and balanced approach in providingquality healthcare to achieve Hózhó, and wellness.IMPROVING PATIENT CARETséhootsooí Medical Center is taking a proactive role to ensurethat each patient receives the best health care. The customer serviceand quality of service are improving through the Quality Assessment and PerformanceImprovement plans, policies, and procedures. TMC is implementing the Improved PatientCare model which focuses on the Plan, Do, Study, Act process in determining challengesand identifying ways to improve deficiencies. This process has led to improved care. In theEmergency Department a Performance Improvement project led to a dramatic decrease inthe “Left Without Being Seen” rate and patients’ wait times have decreased. 7 1
  10. 10. T S É H O O T S O O Í M E D I C A L C E N T E R • 2 0 1 0 A N N U A L R E P O R T FY 2010 Financial Summary (Data from Audited FY 2010 Financial Statements – March 28, 2010 to September 30, 2010) 2010 EXPENDITURES EXPENDITURES Salaries $ 26,332,481. Professional Services $ 8,721,00. Supplies $ 4,928,685. Contract Health Services $ 3,529,610. Employee Benefits $ 3,235,078. Utilities $ 737,956. Travel $ 607,315. Other $ 1,576,825. TOTAL $ 49,669,550. 2010 REVENUES Net Patient Service Revenue $ 28,672,731. Title 1 $ 24,551,861. Tribal Grant Funds $ 200,409. Other Revenue $ 690,570, TOTAL $ 54,115,571. Expenditures as a Percent of Revenues: 91.8% +$4,446,021 Fiscal Year 2010 FISCAL YEAR 2010 Net Income Revenues FDIHB Benchmark Profit Margin - 4,483,594.00 54,115,571.00 8.29% 11.42% Net Income/Revenues Labor Net Oper Revs Total labor costs - 29,587,559.00 53,224,592.00 55.55% 41.26% Net Operating Revenues Oper Income Revenues Total Operating Profit 4,446,021.00 54,115,571.00 8.22% 9.60% Margin = Operating/ Revenues Curr Assets Curr Liab Working Capital = 53,604,371.00 4,983,380.00 48,620,941.00 Current Assets - Liabilities81 Reference: Becker’s Hospital Review,
  11. 11. Salaries $ 26,332,481 Net Patient Service Revenue $ 28,672,731 Professional ServicesE D I C A L$ C E N T E R • 2 0 1 0 T S É H O O T S O O Í M 8,721,600 A N N U A L TitleP1 O R T R E $ 24,551,861 Supplies $ 4,928,685 Tribal Grant Funds $ 200,409 Contract Health Services $ 3,529,610 Other Revenue $ 690,570 Employee Benefits $ 3,235,078 TOTAL $ 54,115,571 FY 2010 Utilities Travel $ $ 737,956 607,315 Expenditures as a Percent of Revenues Expenditures/Revenues Other $ 1,576,825 TOTAL $ 49,669,550 *Numbers are from FY2010 audited financial statements 91.8% + $ 4,446,021 (Data from Audited FY 2010 Financial Statements – March 28, 2010 to September 30, 2010) Expenditures EXPENDITURES Revenues Travel, $607,315 Other Utilities, Revenue, Other, Tribal Grant $737,956 Hospital Board, Inc.Employee * $1,576,825 Funds, $200,409 $690,570 Contract Benefits, 2010 Revenues Health $3,235,078 Services,32,481 Net Patient Service Revenue $3,529,610 $ 28,672,73121,600 Title 1 $ 24,551,86128,685 Tribal Grant Funds $ 200,40929,610 Other Revenue $ 690,570 Title 1, Net Patient35,078 TOTAL Supplies, $ 54,115,571 $24,551,861 , Service Salaries, 45% Revenue,37,956 $4,928,685 $26,332,481 , $28,672,731 ,07,315 Expenditures as a Percent of Revenues 53% 53%76,825 91.8% , Professional69,550 Services,statements $8,721,600 + $ 4,446,021 18%res Revenues revenues Other Other, Tribal Grant Revenue,1,576,825 Funds, $690,570 $200,409 Title 1, Net Patient $24,551,861 , Service Salaries, 45% Revenue, $26,332,481 , $28,672,731 , 53% 53% 9 1
  12. 12. T S É H O O T S O O Í M E TD SI É H O O CT ES N TO EÍ R M • E D2 I0 C1 A0 L A C NE NN UT AE LR R• E 2 0 1R 0 C A L O P O T A N N U A L R E P O R T10 Superior 1
  13. 13. T S É H O O T S O O Í M E D I C A L C E N T E R • 2 0 1 0 A N N U A L R E P O R TTOur EldersThe Tséhootsooí Medical Center’s Home Based Care Clinic is acomprehensive elder care services that includes medical, psychosocial,nursing, dental, rehabilitative, behavioral health and spirituality.The services are provided by an interdisciplinary team of medicalprofessionals who make home visits and/or treat the elders and/or patientsat the clinic. The Home Based Care Clinic is recognized internationallyfor breaking cultural barriers in preparing Navajo elders with end of lifecare. The Home Based Care established pathways to implement anddevelop traditional and culturally sensitive for elders and patients withchronic and long term health care needs. The clinic honors and respectsIthe elders’ and patients’ wishes for comfort care and quality of life inthe last days of their lives. Support for community based resourcesfor in-home and personal care services are identified, established andimplemented in partnership with the Arizona and New Mexico LongTerm Care Services.TELEHEALTHIn partnership with the University of New Mexico, Fort Defiance IndianHospital Board, Inc. ventures into the world of Telehealth, which is usingelectronic information and telecommunication technology to deliverhealth care, health information, and health education, from a distance.This innovative and technical endeavor allows Tséhootsooí MedicalCenter and Náhátá Dzííl Health Center to deliver healthcare servicesto the most remote communities within our service area. Navajo NationChapters within our service area will play a key role in this groundbreakingproject. We anticipate providing technology equipment to some of theNavajo Nation Chapters within our service area so our patients willreceive their health care at the Chapter buildings. 11 1
  14. 14. T S É H O O T S O O Í M E D I C A L C E N T E R • 2 0 1 1 A N N U A L R E P O R T TMC’s Pediatric Clinic staff promote literacyStaffgatherin thehospitalrotundafor ageneralstaffmeeting TMC Dancers promote healthy and active lifestyles Weekly Cultural sessions Hózhó in the hospital’s Hogan draws big crowds 12
  15. 15. T S É H O O T S O O Í M E D I C A L C E N T E R • 2 0 1 0 T S A NHN O O LT S EOP O ÍR T M E D I C A L C E N T E R É UA R O Leadership Council Dr. David Downing, Tori Davidson, Rachel Sorrell, Chief Medical Officer Chief Nurse Executive Interim Chief Financial Officer Dr. Janet Slowman-Chee, Vivian Santistevan, Valonia Hardy, Chief Planning Officer Chief Human Resources Officer Chief Community Health Officer Dr. J ulianna Reece Ahehee. EEN, A AHAST JAMESCIT Control Nurse ionTESHINA CODY, cer TMC Infect Control OffiTM C Infection 1
  16. 16. T S É H O O T S O O Í M E D I C A L C E N T E R • 2 0 1 0 A N N U A L R E P O R T TSÉHOOTSOOÍ M e d i c a l C e n t e rTSÉHOOTSOOÍ Medical CenterP. O. Box 649 / Hwy. 12 7Fort Defiance, Arizona 86504Office: 928-729-8000 1