Pallone Seeks Information on Quality of Care at Indian Health Services Facilities

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WASHINGTON, D.C. – Today, Energy and Commerce Ranking Member Frank Pallone, Jr. (D-NJ) sent letters to the Indian Health Service (IHS) and to the Centers for Medicare and Medicaid Services (CMS) requesting additional information on recent findings of grossly inadequate quality of care and services provided at IHS health facilities.

“I am writing regarding the series of recent problems leading to substandard care in the Great Plains Area of the Indian Health Service,” Pallone wrote in the letter to IHS. “According to the Centers for Medicare and Medicaid Services (CMS), problems at IHS hospitals have been so severe that they have resulted in multiple patient deaths.”

The quality of patient care at certain IHS facilities has been found to be so substandard that CMS has taken action against IHS hospitals in the Great Plains Area. Since July 2015, CMS has terminated the Winnebago’s IHS Hospital’s participation in Medicare and Medicaid and three other South Dakota IHS hospitals in Pine Ridge, Rapid City and Rosebud faced termination.

CMS found the Winnebago hospital out of compliance with Emergency Medical Treatment and Labor Act requirements that caused “immediate jeopardy” to patients. The deficiencies resulted in the death of one man and harm to at least nine other people. The Rosebud IHS Hospital was forced to temporarily close its emergency room when CMS declared it an “immediate jeopardy” situation due to broken sterilization equipment, an unattended delivery of a baby in a bathroom, and a patient having a heart attack who did not receive treatment for 90 minutes after arriving.

The letters request briefings from both IHS and CMS staff as soon as possible to provide additional information on questions including:

·         How do the number of violations at IHS facilities compare to the national average?

·         What specific steps have been or are being taken to remedy the situation at these hospitals and ensure safe care for patients? What specific resources are needed to get hospitals up to CMS standards?

·         What caused the failures that led inspectors to classify area hospitals as “immediate jeopardy” situations? What specific reasons led to staff utilizing unsafe practices such as copying information between patient charts and delays in repairs of sanitation equipment? 

  • Does the IHS have adequate resources to provide quality health care services in all IHS-operated health facilities?  If not, what funding level would ensure quality services could be provided across the IHS system?

The U.S. Department of Health and Human Services (HHS) and IHS have taken several steps aimed at improving the care provided by IHS in the Great Plains Area and at the hospitals in question. HHS Secretary Sylvia Burwell has announced the formation of an executive council on care quality that will be headed by Acting Deputy Secretary Mary Wakefield and will include leaders from a variety of HHS agencies.  The council will bring leaders together to create a rapid-response process that will facilitate the deployment of resources throughout HHS when urgent improvement is needed at an IHS facility. 

Pallone has been a longtime advocate for improved access to quality health care in Native American communities.  He led legislative efforts to pass the Indian Health Care Improvement Act, which was made permanent when President Obama signed the Affordable Care Act into law in 2010.

A copy of the letter to IHS is available here.

A copy of the letter to the CMS is available here.