Rosebud Hospital’s Improvement Plan

By Vi Waln

The Rosebud Comprehensive Health Care Facility has been operating under an improvement plan for quite some time. This plan was put into place after the Centers for Medicare and Medicaid Services (CMS) found several questionable incidents or practices had happened at the hospital, some of which jeopardized the lives of patients. CMS conducts regular on-site visits to assess where the facility is in terms of their improvement plan.

The actions (or inaction) of medical and administrative staff at the Rosebud Hospital resulted in a 7 month diversion of our Emergency Department (ER). Our tribal citizens suffered because of the diversion of the ER to urgent care services from December 2015 through July 2016. In fact, during the diversion some of our relatives died while being transported to a facility where they could receive emergency treatment. Many people believe these deaths may have been prevented if the ER at Rosebud had remained open.

Our tribal council and tribal health officials worked very hard to get our ER reopened. The Indian Health Service (IHS) appointed several Commission Corp officials to key administrative positions on a temporary basis to deal with the CMS compliance issues. Consequently, there were positive and negative results from having temporary Commission Corp staff work on improving patient care at our hospital.

One positive result, of course, was the reopening of the ER last summer. Many tribal citizens have since visited the hospital to receive emergency care. Some patients received care at Rosebud’s ER while others were flown by airplane to larger facilities.

However, the re-opening of the ER has not been without a downside. For instance, there was visible tension between permanent hospital staff and the outside company that was contracted to run the Rosebud ER. Some permanent staff members displayed resentment toward the new employees appointed by the outside company to oversee Rosebud’s ER.

In addition, many of us have listened to talk about how much money this new company is spending to staff the ER. Yet, ER physicians, nurses and support staff must be paid what they are worth. When it comes to the health of our people, especially those needing immediate emergency care, there should be no concern about how much it costs.

More money often means more toys. That is, some of you who use the Rosebud Hospital may have noticed improvements in the form of new furniture or equipment. Remodeling of certain areas in the hospital was also done. For example, some of us wonder how much money was spent and if the quality of care we receive at the Rosebud Hospital was actually improved by remodeling the public restrooms. In any case, at least the water faucet in the ladies restroom no longer runs constantly.

Additional funding must be justified to the higher ups. The Commission Corp staff, no longer in charge at Rosebud, can justify the money they spent while there. That is, even though health care may not have improved for some patients, at least we got a new public restroom. The faucet that no longer runs constantly is justification for the money spent on “facility improvements.”

Consequently, some patients do receive excellent care during clinic or ER visits. For instance, I recently recovered from a serious illness. The medical provider I visited at the Rosebud Hospital ordered several tests to determine why I was sick. I was prescribed the proper medication to cure my illness. I do appreciate the hard working medical providers in our clinic.

Also, when our ER was diverted to urgent care, several of Rosebud’s tribal council members questioned the effectiveness of the key administrative staff initially responsible for ensuring our facility was in compliance with CMS regulations. Consequently, some of those staff members, who obviously didn’t work hard enough to ensure CMS compliance, have since been assigned to work in other facilities. This is why the Commission Corp personnel were brought in to oversee improvement efforts at the Rosebud Hospital.

Our tribal representatives are now working to contract the key administrative positions at the Rosebud Hospital. This will soon give our tribe a voice regarding the staff hired to correct on-going issues cited by CMS at our facility. In the meantime, the government is bringing back some of the same IHS employees to fill key administrative positions. If the tribal council representatives and tribal health officials are paying attention, they will see that some of the same players that didn’t contribute to any improvements are now back in the game at Rosebud.

We can’t afford to have our ER diverted again. The temporary duty assignment of employees, who were there before, may put the facility in jeopardy again. After all, those same employees were part of the reason for the Rosebud Hospital not being in compliance with CMS in the first place.

For the sake of all our tribal citizens and others seeking care at the Rosebud Hospital, let’s hope those same key administrative IHS employees don’t drop the ball again.

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