Update: IHS submits plan for hospital in 'immediate jeopardy'

Two federal agencies have reached an accord to maintain a key federal funding source for a government hospital found to be in "immediate jeopardy" this week.

An Indian Health Service spokeswoman said Saturday morning that the agency had submitted a plan of correction for the Rapid City - Sioux San IHS hospital which was approved by the Centers for Medicare and Medicaid Services (CMS) Friday.

Details of the plan were not immediately released Saturday.

CMS agents earlier this month found that the hospital's patients were misdiagnosed or not treated in the facility's emergency department. Steven Chickering, a CMS regional administrator, in a letter to the hospital's administrator called the deficiencies reported "so serious that they constitute an immediate and serious threat to the health and safety of any individual who comes to your hospital to receive services."

IHS overhaul:Sen. John Thune bill meant to increase transparency and accountability

Nine of 32 patients in sample cases reviewed weren't given appropriate medical screening examinations when they arrived at the hospital's emergency department, the report found. Some left the facility to get better care elsewhere, and others had to return on multiple occasions before being admitted to another facility.

CMS agents set a five-day deadline for IHS to submit a plan of correction and to begin correcting problems before the proposed June 15 cut off date. At that point, they said, the agency would terminate Medicare funding if IHS couldn't comply with CMS health care standards.

By submitting the plan of correction, IHS at least temporarily avoided the threat of losing Medicare billing access at the hospital.

An IHS spokeswoman said Saturday that the agency is working aggressively to correct the deficiencies at the hospital. In the meantime, the hospital remains open and patients continue to receive care in all service areas.

Thomas Poor Bear, Oglala Sioux Tribe vice president, said the facility had provided inadequate health care for as long as he could remember. He said he was glad CMS was pushing IHS to improve the conditions at the facility.

"Health care is always important and I don't think we've been getting quality health care from IHS," Poor Bear said.

Two other hospitals in Pine Ridge and Rosebud were flagged last fall for fatally flawed health care. Agents reported that employees at the Rosebud facility hand-washed surgical instruments for six months while a sterilizer was broken, didn't communicate that a patient had an untreated case of tuberculosis and failed to monitor a patient who delivered a baby prematurely on a bathroom floor. The hospital's emergency room was closed in December as a result of those reports.

Patients have since been diverted to the nearest emergency rooms 44 miles and 55 miles away. Six people have died in the back of ambulances in transit to those facilities.

IHS contracted with a private group to take over the emergency rooms in those hospitals as well as at another ailing IHS hospital in Winnebago, Neb. They're also looking to contract for additional services, at least on a short-term basis.

And the agency's failings have entered the state's political sphere recently as Sen. John Thune and Rep. Kristi Noem have brought legislation aimed at overhauling the IHS. Their Democratic challengers questioned whether the two were spurred to action because it's an election year.

IHS Principal Deputy Director Mary Smith, who has inherited substantial difficulties in her first three months in the position, said the agency is committed to improving IHS health care in the region and failings in the past are "unacceptable." Smith has said she will work with haste in the next few months to improve health care options at the state's IHS facilities.

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- This story was updated from an earlier version to reflect that IHS and CMS have agreed on a plan of correction for the Rapid City - Sioux San IHS hospital. The agencies didn't immediately announce or confirm the agreement Friday afternoon.