On January 30, 2003, about 0330 Alaska standard time, a Cessna 208B airplane, N1276P, sustained substantial damage when the airplane's tail impacted the ground during passenger loading at the Russian Mission Airport, Russian Mission, Alaska. The airplane was being operated as an instrument flight rules (IFR) medical patient transfer flight under Title 14, CFR Part 135, by Grant Aviation, Inc. of Anchorage, Alaska. The airline transport pilot, patient, and the three medical attendants were not injured. The intended destination was Bethel, Alaska. During a telephone conversation with the National Transportation Safety Board (NTSB) investigator-in-charge (IIC), on March 3, an FAA aviation safety inspector from the Anchorage Flight Standards District Office, said he was inspecting maintenance records at Grant Aviation, when he noticed a major airframe repair for unreported damage had been completed on the accident airplane. During a telephone conversation with the IIC on March 3, the director of operations for the operator said the accident pilot told him that he (the pilot) did not place the tail stand under the tail of the airplane while loading a medical patient at Russian Mission on the morning of the accident. The pilot told him the tail of the airplane went down on the tail tie down ring because too many people were in the aft section of the airplane while loading the patient. The pilot said it was dark, and he did not see the damage to the tail section, and flew the airplane to Bethel. In a telephone conversation with the IIC on March 5, a mechanic for the operator said the FS 427.88 bulkhead and tie down assembly were replaced due to the damage.