2 reservation hospitals now face funding-cutoff deadline
SIOUX FALLS (AP) -- A second troubled government-run hospital on a Native American reservation in South Dakota was given an extension Friday to reach an agreement with federal officials to make significant quality-of-care improvements in order to...
SIOUX FALLS (AP) - A second troubled government-run hospital on a Native American reservation in South Dakota was given an extension Friday to reach an agreement with federal officials to make significant quality-of-care improvements in order to avoid losing its Medicare and Medicaid funds.
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.
The CMS letter also noted that a Feb. 25 inspection found other deficiencies. Details won't be publicly available until later this month, but the letter showed the hospital was cited for violating policies regarding medical screenings during emergency cases and "anti-dumping" regulations that ensure individuals with emergency medical conditions are not denied essential life-saving services.
IHS, which provides free health care to enrolled members of Native American tribes, said it will work with CMS "as expeditiously as possible" to reach the agreement, it said in a statement Friday.
IHS has been severely underfunded and its facilities bill Medicare, Medicaid and private insurance for care given to patients who have that coverage. Statistics from a 2005 government study show that reimbursements constituted between 7 and 58 percent of some hospitals' direct medical care budgets, with the average being 39 percent.
At a public forum earlier this week in Sioux Falls, Smith told the tribal leaders and senior-level IHS officials in attendance that the agency intends to meet the April 29 deadline given to the hospital in Rosebud, which is about 95 miles east of Pine Ridge. In addition, the agency is accepting bids for a contract to manage the emergency rooms at hospitals on the Winnebago Reservation in Nebraska, Pine Ridge, and Rosebud.