Federally Operated Hospitals That Are So Bad, they Are Threatened With A Loss of Federal Funds

[Algernon Moncrieff]

SIOUX FALLS, S.D. (AP) - A troubled government-run hospital on the Pine Ridge Indian Reservation has been given a one-month extension to reach a significant improvement agreement with federal officials to avoid losing its Medicare and Medicaid funds.

The Centers for Medicare and Medicaid Services on Friday notified the hospital's administration of the funding cutoff extension.

The hospital administered by the Indian Health Service must reach the agreement by April 29 to enter a last-chance remediation program. If the agencies fail to reach an agreement, the hospital won't be allowed to bill the government for services provided to Medicare- and Medicaid-eligible patients after May 16.

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So let's be clear here: A hospital run by the federal government that serves some of the poorest people in America is going to lose its ability to bill the federally funded Medicare and Medicaid programs.

The Centers for Medicare and Medicaid Services notified the administration of the hospital on the Pine Ridge Indian Reservation about the extension a little more than a month after the hospital on the Rosebud Indian Reservation received the same extension. The latest notification comes days after the top officials at the Indian Health Service, which administers the hospitals, met with tribal leaders and pledged to improve the services provided at the facilities.

Both hospitals have an April 29 deadline to reach an agreement to enter what constitutes a last-chance remediation program. If not, the facilities won't be allowed to bill the government for services provided to Medicare- and Medicaid-eligible patients after May 16.

The purpose of the agreement for the Pine Ridge hospital would be "to effectively safeguard patient health and safety ... and effectively address underlying systemic problems" that have kept the hospital from achieving or sustaining compliance with regulations, according to the letter from CMS addressed to IHS's top leader, Mary Smith, and Sophia Conroy, the hospital's acting administrator.

The funding cutoff warning for the 45-bed Pine Ridge hospital comes after federal inspectors found serious deficiencies during an unannounced visit in October, including records from three of six sampled medical staffers who lacked appropriate permission to practice at that hospital; unlocked cupboards with syringes, needles and other equipment; and unsecured drugs and medical records.

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Optimists and skeptics sat down Tuesday with the new head of the Indian Health Service to hash out plans for improving care for Native Americans in Iowa, Nebraska, North Dakota and South Dakota.

At a tense two-and-a-half-hour meeting, IHS Principal Deputy Director Mary Smith outlined plans for short and long-term changes at IHS hospitals and clinics in the Great Plains region.

The visit follows a federal investigation into IHS hospitals in South Dakota that found poor sanitation and improper record-keeping and lead to the closure of the emergency room in Rosebud.

"Here we are in April and we're still on diversion," Evelyn Espinoza, Rosebud Sioux tribal health administrator, said of the Rosebud emergency room that has been closed for four months. "We have these people losing their lives. We have these children losing their parents."

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To borrow from Shakespeare, if you prick Native Americans, do they not bleed? Are they not human? As bad as things may be at VA hospitals, if they were as bad as these IHS Hospitals, there would be talk of impeachment. If a VA hospital hand washed surgical instruments for six months because a sterilizer was broken, there's be firings -- possibly prosecutions. Ask an Bernie Sanders supporter who has read my posts -- I don't know much; however, I know that cutting federal funds from a failing federal hospital isn't going to improve patient care.

[Hoyt]

1. Wow. Both IIHS and Medicare are under HHS. Maybe it's an attempt to get slashed budget

replenished or something. But dang, I hope there is some method to this madness.

[Algernon Moncrieff]

5. I fail to see how cutting a federal funding source will improve a federal hospital.

I get it with a private hospital -- improve or else. However, the IHS hospitals are it for these folks. There is no fall back plan.

[Hoyt]

8. If the GOPers don't budget enough for basic operations above revenue from payers, we

have a problem, just like VA, CDC, etc.

[Mike__M]

2. A decent nation

might devise a legal means of offering to set up an emergency military field hospital until the IHS gets its shit together. Congress has the constitutional authority to do it.

After four months without an emergency room, the Rosebud Sioux Tribe learned Thursday that the department will not likely re-open until summer.

Indian Health Service officials are struggling to recruit the minimum four doctors and a nurse practitioner needed to run the emergency department, IHS Principal Deputy Director Mary Smith told tribal members during a four-and-a-half hour meeting Thursday night.

Meanwhile, the toll on the community is dire, tribal members said, and it could worsen if the hospital can't correct dangerous deficiencies before the end of the month, when the hospital could lose its ability to bill to Medicare and Medicaid.

http://www.argusleader.com/story/news/2016/04/08/ihs-head-rosebud-er-unlikely-re-open-soon/82788252/

[Algernon Moncrieff]

3. Or just put military medical personnel into the ER until it's fixed

This is verging on "Doctors Without Borders" needs to step in.

[Mike__M]

4. Absolutely

How embarrassing is that.

[librechik]

6. we must shrink evil government down to the size where

we can drown it in a dirty hospital bedpan.

--Ronald Reagan

[Algernon Moncrieff]

7. I like your Dali sig-photo

While they might disagree on solutions, conservatives and liberals could travel together to Pine Ridge in SD or the Crow Agency in MT and agree that federal assistance to native Americans was an epic failure.