Winnebago Indian Hospital

The Winnebago Tribe is in the process of taking over control of the embattled Omaha Winnebago Hospital in Winnebago.

JIM LEE, Sioux City (Iowa) Journal

WINNEBAGO — In a perfect world, the Winnebago Tribe would not be entering negotiations to take over control of the embattled Omaha Winnebago Hospital, Tribal Councilwoman Victoria Kitcheyan says.

Kitcheyan and other Winnebago authorities Tuesday pointed to the inability of the Indian Health Service, which provides federal health services to American Indians, to regain the Omaha Winnebago Hospital's Medicare contract after the contract's termination more than two years ago.

The Centers for Medicare & Medicaid Services had ceased the hospital's Medicare contract in July 2015, after IHS and hospital officials failed to correct deficiencies found by the agencies. Kitcheyan said since the hospital lost its Medicare contract, it has lost out on approximately $11 million in federal funding.

"In an ideal world, IHS would have corrected those deficiencies, restored that revenue, and we would have quality patient care," Kitcheyan said.

But a year went by, and confidence waned.

"Time and time again, their deadlines were passed," she said. "We have no more confidence left in IHS to correct the action plan and restore the certification."

About a year ago, the Winnebago Tribe began putting the pieces in place to prepare to enter negotiations to assume management. That included receiving a clean audit, building up the finance department, bringing on a chief financial officer and putting team members in place.

Then last week, the tribal council voted to initiate the self-governance process, meaning the tribe will soon ask IHS to begin negotiations for the tribal takeover of the federally operated health care facility. The tribe hopes to take over operations by July 1.

Located in Winnebago, the 13-bed facility provides free health care to a population of approximately 10,000 Native Americans enrolled as members of the Winnebago, Omaha, Santee Sioux and Ponca tribes, as well as others. It includes inpatient hospital care, a clinic, emergency services, a pharmacy, radiology and other support services.

"Our immediate goal is to stabilize the operation," Kitcheyan said. "For seven years, we haven't had a consistent leadership in that facility, and that has led to some of the dysfunction that permeates through the building."

In recent years, the hospital has been troubled by several incidents. The CMS released a report that identified a number of life-threatening deficiencies at the hospital, located about 20 miles south of Sioux City, Iowa. Critics have blamed problems at the hospital for multiple deaths and misdiagnosis of patients.

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