SIOUX FALLS, S.D. (AP) – A new interim director has been assigned to the regional office responsible for federally administered hospitals that care for Native Americans in the Dakotas, Nebraska and Iowa weeks after inspectors found serious deficiencies at two health centers in the area.

Robert McSwain, the principal deputy director of the U.S. Department of Health and Human Services, announced the change in leadership Monday for the Indian Health Service’s Great Plains Area office, which provides health care services to about 122,000 Native Americans. In addition, a four-member team will focus on medical and quality assurance at the hospital on the Rosebud Indian Reservation in South Dakota, where inspectors found deficiencies in November so severe that its emergency department closed.

Rear Adm. Kevin Meeks will begin serving as the acting director on Monday, replacing Ron Cornelius, who had been in charge of the Aberdeen office since at least January 2012.

“(Meeks) consistently achieves outstanding results in carrying out the responsibility for the provision of comprehensive health care services to one of the largest and most diverse IHS service populations,” McSwain said in Monday’s letter to the tribes, which was first reported by the Argus Leader.

Meeks will inherit a troubled region as detailed in records recently obtained by The Associated Press.

Inspectors with the federal Centers for Medicare and Medicaid Services, commonly referred to as CMS, determined that failures at the Rosebud emergency room constituted an “immediate jeopardy” situation, a term used when a hospital’s actions – or lack thereof – have caused or are likely to cause serious injury, harm, impairment or death to a patient.

Those deficiencies included records for a patient with a history of untreated tuberculosis showing no infection control measures put in place while the person was treated; no documentation given about the tuberculosis when the patient was transferred to a different facility; and a patient having a heart attack was not treated until 90 minutes after she arrived.

An inspection at the hospital on the Pine Ridge Indian Reservation in South Dakota in October uncovered that staff members “would copy and paste information from old charts in current patient records” resulting in multiple errors in medical records. Also, a machine used to clean and sanitize dishware had been broken for three years.

Earlier in 2015, CMS inspectors also determined that deficiencies at a hospital in Winnebago, Nebraska, put patients in an “immediate jeopardy,” including a man who died of kidney failure.

The substandard care offered by some of the facilities that Meeks will oversee will be discussed Wednesday at a U.S. Senate Committee on Indian Affairs hearing. U.S. Sens. John Thune and Mike Rounds of South Dakota, Heidi Heitkamp of North Dakota and Al Franken of Minnesota requested the hearing.

“We are at a critical stage with Indian Health Service, particularly in the Great Plains Area,” Rounds said in a statement. “In many cases, IHS facilities are the only hospitals for miles. Adequate healthcare is a treaty responsibility of the federal government. Clearly, IHS is not meeting that obligation.”

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