Pine Ridge IHS scrutinized

PINE RIDGE, S.D. – Two weeks ago the Pine Ridge Indian Health Service Unit underwent a full survey conducted by the Centers for Medicare and Medicaid Services to determine if the hospital is meeting the minimum requirements needed to bill Medicaid and Medicare for services.

The CMS is responsible for maintaining oversight of compliance with the Medicare health and safety standards for laboratories, acute and continuing care providers.

The hospital in Pine Ridge has been under the close scrutiny of the Oglala Sioux Tribal Council for the past couple years, and is a victim of decades of underfunding by the federal government and could potentially lose the ability to charge third party insurers for the medical costs of patients if the findings of the survey determine that care at the hospital is not meeting CMS standards.

The hospital in Pine Ridge has run afoul of CMS before. In 2009 the hospital underwent a separate CMS review that came shortly after the hospital received a termination of payments warning (that was eventually retracted) for violations found by CMS.

A letter from CMS to then Service Unit Director Bill Pourier listed several violations at the facility including “Failure to adequately assess and monitor patients in a timely manner, inadequate communication of patient information/assessment data between providers and nurses to ensure safe and effective transition of patients to oncoming provider/nurse, and continuing medication errors and failure to ensure orders were legible and administered to right patient, right dose and right route.”

If the hospital lost the ability to bill third party insurance policies it could lose somewhere in the range of 25 to 30 million dollars a year in revenue and be forced to operate on funds allocated by Congress to IHS.

There has been no indication that the hospital has failed the survey and results of it have yet to be made public. The Rockville, Maryland offices of Indian Health Service did not provide a comment when asked by Native Sun News if there was a plan in place for the facility in Pine Ridge if the ability to bill was lost.

– Contact Brandon Ecoffey at This email address is being protected from spambots. You need JavaScript enabled to view it.

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