Medicare and Medicaid funding is on the line for Native American-run hospitals in Indian country after federal health care regulators this week cited a tribal facility for deficiencies in care to patients and poor administration. The Centers for Medicare and Medicaid Services — which administers health care programs for the needy, disabled and elderly — noted earlier this month that patients at Sioux San Hospital in Rapid City, South Dakota, are in "immediate jeopardy" of serious injury, harm, impairment or death, the Associated Press reported.
It's the third time in recent months that a South Dakota hospital serving Native Americans has been found to have serious deficiencies. Each of the facilities is run by the Indian Health Service, an ailing network of hospitals located on and off American-Indian reservations. Officials inspected the facility unannounced between May 10 and 12.
The network was established as part of the government's treaty with recognized sovereign tribes. But critics have claimed for years that the government is shirking its responsibility to American-Indian communities, as evidenced by the overall state of its health care facilities.
The CMS has given the Indian Health Service until June 15 to correct deficiencies at Sioux San Hospital, or it won't get reimbursed for the care given to Medicare and Medicaid patients.
Longstanding health disparities between American Indian populations and other ethnic groups have been a concern for decades, particularly among veterans. Tribal leaders and health care policy experts are calling on the United States to increase its commitment to providing care to tribal members, according to the AP.
Americans Indians and Alaska Natives account for 1.9 million of the more than 300 million American residents in the 2010 U.S. Census, but this demographic faces life threatening illnesses disproportionate to their share of the population. According to the most recent data from the Center for Disease Control and Prevention, 13% of American Indians were judged to have fair or poor health status, compared with 10% of the general population.
American-Indian families also account for an alarming number of sudden infant death syndrome cases, or SIDS; their rate is twice that of whites, according to the CDC. The CMS report on Sioux San Hospital highlights the case of a 6-month-old boy who was misdiagnosed at its emergency department in April after his mother complained her child was suffering from congestion, cough, runny nose and watery eyes, according to the AP. The care provider did not ask the boy's mother about his medical history, which included his being born prematurely and having respiratory distress. The boy had a seizure and was treated in an intensive care unit in another South Dakota facility.
"The hospital failed to provide a medical screening examination that was, within reasonable clinical confidence, sufficient to determine whether or not an Emergency Medical Condition existed," the CMS report stated.
Indian Health Services funding cutoff deadlines have also been issued to hospitals on the Pine Ridge and Rosebud Indian reservations in South Dakota, for substandard conditions, and at a facility on Nebraska's Winnebago reservation, within the last year. The hospital network said in a statement Monday it had already begun instituting changes that include "new leadership, expanded oversight, staff retraining and policy changes," the AP reported.