South Dakota hospital set to lose Medicare status

CMS has warned Pine Ridge (S.D.) Indian Health Service Hospital that its Medicare contract will be terminated May 16 unless the hospital enters a systems improvement agreement with CMS by the close of business April 29.

In an April 8 letter to the hospital, CMS said an Emergency Medical Treatment and Labor Act revisit survey conducted at the hospital February 25 revealed the facility was in violation of certain Medicare requirements, including anti-dumping provisions and appropriate medical screening examination policies.

Based on medical record review and staff interviews, CMS determined hospital staff failed to provide medical screening examinations that were appropriate to the presenting symptoms of six of 26 selected patients.

The facility originally had until February 17 to make improvements or it would lose its Medicare contract, but CMS offered the hospital three extensions. In its April 8 letter, CMS said it will offer no further extensions.

The Indian Health Service said it is meeting with CMS and the Oglala Sioux Tribe to discuss how to move forward. The IHS also said it is committed to making changes to ensure patients at Pine Ridge Hospital receive safe care.

"IHS' goal is to work with CMS as expeditiously as possible to reach agreement on a Systems Improvement Agreement that would further extend the date of the proposed termination while the Pine Ridge Hospital works to ensure quality healthcare," said IHS in a prepared statement.

Pine Ridge isn't the only IHS hospital that could lose Medicare funding. Rosebud (S.D.) Indian Health Service Hospital was set to lose its Medicare funding March 16, but CMS extended the termination date in early March. CMS granted an extension to explore a possible systems improvement agreement with the IHS.

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