Rosebud Meets with top level Indian Health Officials

Mary Smith
Mary Smith, Principal Deputy Director of the Indian Health Service, was accompanied by a team of federal employees at the April 7 meeting with the Rosebud Sioux Tribe’s Health Board. Photo from

By Vi Waln

ROSEBUD – Members of the Rosebud Sioux Tribal Health Board recently spent over 4 hours discussing the future of the Rosebud Hospital with several officials from the Indian Health Service (IHS).


The Emergency Room at the Rosebud Hospital has been closed since December 5, 2015 after officials from the Centers for Medicaid and Medicare found at least 3 patients had been exposed to unsafe conditions. The 3 cases involved a cardiac patient, an OB patient and trauma on a pediatric patient.


“I want to say at the outset, the conditions at the hospital and what has happened with CMS are unacceptable. We are committed to making change and that’s why we’re here,” stated Mary Smith, Principal Deputy Director of the Indian Health Service. We have been working on the corrective action plan. We do want to open the Emergency Department as soon as possible. It is one of the highest priorities at IHS.”


“We want to open the emergency department when we have a full staff of physicians and nurses, when we are able to meet the CMS requirements and when we will be providing high quality patient care, that is our goal and you deserve no less. That’s why we’re here,” Smith continued.


“We are committed to opening the [Emergency Room] as soon as possible,” Smith told Health Board members. She was unable to give a definite date when the ER would be open. IHS has issued a request for proposals (RFP) to contract out and manage of the Emergency Departments at Rosebud, Pine Ridge and Winnebago. IHS hopes to award the contract in June.


Since the diversion took effect, patients needing care for serious conditions are transferred to off-reservation facilities. Many are taken directly by ambulance to hospitals in Winner, Martin or Valentine. The ER diversion has taken a toll on both the ambulance staff and vehicles.


“We ran 6 ambulances into the ground,” stated Willie Bear Shield, Chairman of the RST Health Board. “We need 2 handicap vans for transport. We still hold your agency for their word that all costs would be taken care of while we were in this immediate jeopardy status.”




The diversion of the emergency room came on the heels of a Notice of Intent to Terminate the Medicare Provider agreement, sent to the Rosebud Hospital from CMS last fall. CMS initially determined that the deficiencies identified in their recent survey were so serious that they constituted an immediate and serious threat to the health and safety of any individual who comes to the hospital to receive emergency services.


CMS subsequently granted at least 2 extensions to the Rosebud Hospital to correct deficiencies. The most recent extension was granted on March 4, 2016. The letter states in part “CMS therefore agrees to extend the termination date of the hospital’s Medicare Provider Agreement from March 16, 2016 to May 16, 2016. However, in the event that IHS and CMS are unable to agree on the terms of an SIA [Systems Improvement Agreement] for the Rosebud IHS Hospital and an SIA has not been signed by the close of business on April 29, 2016, CMS will offer no further extensions, and the Medicare Provider Agreement between CMS and the Rosebud IHS hospital will be terminated at the close of business on May 16, 2016.”

Published by Vi Waln


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