A new wing is under construction at the Oglala Lakota Nursing Home near Whiteclay, Nebraska. Photo by James Giago Davies / Native Sun News Today

Health | National

Native Sun News Today: Oglala Sioux Tribe expands nursing home

Friday, November 9, 2018

Pine Ridge nursing home builds new wing

Construction to be completed by the end of 2019
By James Giago Davies
Native Sun News Today Correspondent
nativesunnews.today

WHITE CLAY— As impressive as the Oglala Lakota Nursing Home south of White Clay already is, construction got underway this October on a 12-bed “memory unit” wing expansion, to provide Alzheimer’s and dementia patients with specialized service.

The Nursing Home Board met in mid-September to set the first wave of construction in motion. Richard Rangel handled the construction of the present facility, and his Rapid City based firm which also built the Rapid City Hospital, will handle the construction of the memory wing.

“The game plan is to get a floor slab completed by the first part of December,” Rangel said, “at worst by Christmas, and that way framing, which is a little less weather dependent, can begin in December. Generally, the rest of the design will be done for bidding by the first part of December that would be all the interior finishes, floors, windows, hardware, those sorts of things.”

The nature of the soil on the tribal land in Nebraska creates a special problem for Rangel: “One of the things that takes place before any of the concrete work, is something we call an ‘engineered fill.’ In this instance, the site had a very fine powdery type soil, and what we’re required to do by the testing company, the geo-tech company, we’re required to dig three feet deeper than where the footings are going to be. And then with controlled moisture, water, we have to back fill back up to where the bottom of the footings are going to be. This will stabilize your building walls so that you don’t have movement over the years. Same thing under the floor slab, we have to dig down three feet deeper and pack all that back in with water.”

The original design of the nursing home allowed for expansion, and the memory wing expansion will soon get the facility near its capacity. Ron Ross, who heads up a Native American Health Care Management consulting firm out of Lincoln, Nebraska, has been the indispensable cog that has driven the efforts to realize the nursing home. His company now manages the nursing home, is in charge of staffing, but also understands the relationship with the federal government necessary to fund the home. Board Director, Kathy Janis, has been working to realize the home for even longer. Fourteen years ago, she first approached the state of South Dakota with a nursing home proposal. She ran into a brick wall.

“The third time we went there,” Janis said, “the secretaries were the only ones came to meet with us. They said no there’s a moratorium on it, we walked out of there, got home, and they said, ‘We got land in Nebraska.’”

That is where Ross entered the picture. He understood how the system worked, and he knew exactly what was needed to make the nursing home a reality.

Mario Gonzalez is the tribal attorney that handled the legal aspect of the financing when the home was being built, with $13.5 million of funds from a Shakopee Mdewakanton Sioux Community loan, and $2.5 million from the tribe, and he now advises the nursing home board: “There’s a lot of teamwork that went into this, it isn’t just recent, it goes clear back. Kathy’s been involved for 14 years. Gary Russ played a very instrumental role, he doesn’t get enough credit, really a mover to keep things going.”

Russ was the tribal financial advisor, but his Nebraska state connections were vital in getting the political and logistical support to fund the nursing home. But Gonzalez gives high praise to Ross: “We couldn’t do this without him, because he’s got the understanding, expertise, to put all of this together.”

That understanding is based upon enhanced Medicaid payments, without which, the tribe could not afford the nursing home. “Financially the facility is fortunate that we have entered into a relationship with Indian Health Service,” Ross said, “which then has a relationship with the center for Medicare and Medicaid services. Tribal facilities that have a relationship with IHS enable them to access enhanced Medicaid rates, which, then in turn, pays for the operating costs of the building, nursing, housekeeping, administration, maintenance, all the operating costs, as well as the interest and the depreciation which makes the mortgage payment.”