A late December Associated Press story by Regina Garcia Cano has Oglala Lakota Tribal Chairman, Scott Weston frustrated. Calling the tribe’s Pine Ridge Hospital “embattled,” Garcia Cano writes that the hospital “has again been found in violation of quality-of-care standards.”
Weston says the tribal council’s Health and Human Services Committee had already begun to address the problems identified by the Centers for Medicare and Medicaid Services (CMMS) inspectors and Indian Health Service before the story came out. Weston also said that newly installed hospital CEO Scott Meersman should be given time to make the needed changes.
In a December 16 press release, Indian Health Service announced that CMMS investigators found that the hospital’s emergency department had deficiencies that created an "immediate jeopardy" to patients. “Immediate jeopardy” implies that a hospital's practices have “caused or are likely to cause serious injury or death to a patient.”
Weston insists that the tribe, in consultation with IHS, immediately began seeking recommendations and remedies from the tribe upon hearing of the findings. Weston also noted that the AP story also quoted IHS about a plan of action that was being implemented. The December 16 IHS quote was: "For instance, Pine Ridge is implementing improvements to its medical provider credentialing and privileging process; improving its quality monitoring in the emergency department and implementing a clinical decision tool so medical providers have access to the most current standards of practice."
The tribal chairman did acknowledge that meeting the CMMS standards has been a challenge, but went on to say the AP story is not helpful in that it unduly raises concerns among the Lakota patients who use the hospital. Those concerns were initially raised last summer when surprise CMMS inspections in both the Rosebud and Pine Ridge hospitals revealed problems deemed “serious” and “failures” in both facilities emergency rooms. Rosebud’s emergency room was subsequently closed for several months, and a Pine Ridge Emergency Room closing was narrowly staved off by the hiring of a new staffing agency and promised remediation in practices.
Due to the nature of the patient population on both Rosebud and Pine Ridge, Indian Health Service’s permission to charge CMMS for care provided to their Medicare and Medicaid patients became problematic as a result of the inspection findings. Consequently, last spring IHS agreed to remediation agreements with CMMS.
Chairman Weston said the terms of those agreements called for “periodic inspection, which is what happened.” He also noted that those terms were also meant to show the tribes “what progress had been made, and what still needed to be done.”