A street view of the Winnebago Hospital on the Winnebago Reservation in Nebraska. Image: Google Maps
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Indian Health Service hires contractor to run emergency rooms





A third party will take over operations at three emergency rooms in Nebraska and South Dakota, the Indian Health Service announced on Tuesday.

AB Staffing Solutions will provide staffing, operations support and management services at the Winnebago Service Unit, the Rosebud Service Unit and the Pine Ridge Service Unit for one year. But the deal could be extended for a total of five years at a cost of $60 million, the IHS said.

"This new contract underscores the IHS commitment to pursuing creative new solutions that ensure high quality care for our patients, who are our top priority,” Mary Smith, the acting director of the IHS, said in a press release. “The new contract will benefit IHS patients and providers by ensuring a 24-hour Emergency Department at IHS Rosebud Hospital and two others. IHS recognizes that high quality emergency room services are critical to communities.”

The contract will not lead to the immediate reopening of the emergency room at the Rosebud Hospital, which serves the Rosebud Sioux Tribe in South Dakota. But it's part of a process laid out by a systems improvement agreement that the IHS signed in an attempt to resolve the shutdown.

Since the emergency room closed in December, six members of the tribe have died while being transported to urgent care centers up to 55 miles away. The tribe has filed a lawsuit in hopes of getting it reopened.

The contract also does not address a funding situation that affects the Winnebago Hospital in Nebraska, which serves the Omaha Tribe and the Winnebago Tribe. The Centers for Medicaid and Medicare Service terminated certification to the facility last summer, meaning it cannot bill Medicaid and Medicare for patient care.

The IHS has not entered into any agreements to address the situation at the Winnebago. The Rosebud and Pine Ridge agreements were signed to prevent the CMS from terminating certification at those two facilities.

The awarding of the contract appears to answer at least one question raised by key lawmakers. They had asked how much it might cost to execute the Rosebud and Pine Ridge agreements.

Nebraska and South Dakota are part of the Great Plains Area, a troubled region of the IHS that has faced numerous management, staffing and quality of care issues.

Get the Story:
Feds hire contractor to run ERs at hospitals on reservations (AP 5/17)
Rosebud ER Remains Closed (KEVN 5/17)
Private contractor to manage tribal hospital in Winnebago (The Sioux City Journal 5/18)

Government Accountability Office Report:
INDIAN HEALTH SERVICE: Actions Needed to Improve Oversight of Patient Wait Times (April 29, 2016)

Senate Committee on Indian Affairs Report:
In Critical Condition: The urgent need to reform the Indian Health Service’s Aberdeen Area (December 2010)

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