WINNEBAGO, Neb. | 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 on 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, on Thursday, the tribal council voted to initiate the self-governance process, meaning the tribe will soon ask the Indian Health Service to begin negotiations for the tribal takeover of the federally operated health care facility in Winnebago.
Located in Winnebago, Nebraska, the 13-bed Omaha Winnebago Hospital 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.
The Winnebago Tribe has voted to pursue self-governance of the facility, which allows American Indian tribes to assume administration of federal programs. Kitcheyan said nearly 370 tribes have initiated such processes, and the Winnebago Tribe will be working with legal experts and consultants to ensure it navigates the process smoothly.
"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."
Tuesday, the council met with community members for a press conference to discuss the move. As a crowd of between 60 and 70 gathered, Kitcheyan and tribal council chairman Frank White fielded several concerns about the process and the funding.
One came from Omaha Tribal Council chairman Mike Wolfe, asking where his tribe's involvement would fall in.
"We have a partnership. We have a relationship. We have a commitment to each other," Wolfe said. "When are we going to get together and unite in this?"
White replied that the tribe has been in touch with the Omaha and that they hope to work together in the negotiations.
"We look forward to working cooperatively with the Omaha Nation, and I think your council shares the same concern we do," White said.
The Winnebago Tribe has eyed July 1, 2018 as the target date to assume management. Kitcheyan said the tribe will be simultaneously working to form a new Medicare contract with CMS. White said the council hopes to retain current employees and will prioritize the filling of several vacancies at the hospital as it can.
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. Critics have blamed problems at the hospital for multiple deaths and misdiagnosis of patients.
Trust in the hospital took another hit in August, after it was revealed that up to 35 podiatry patients may have been inadvertently infected with diseases including HIV and hepatitis because a podiatry instrument was not properly sterilized between procedures. The podiatrist responsible for the mistake was fired.
IHS officials have said improvements have been made at the hospital, where some top staff were replaced and day-to-day management of the emergency department was turned over to a private contractor based in Arizona.
White referred to the troubles at the hospital during Tuesdays' press conference, saying that in the end, what matters is the care of loved ones.
"The number one issue, the number one focus that we should have is the care of our relatives," he said. "That's what we're working towards. Right now Indian Health Services is not doing that."
The tribe plans to hold another public meeting Dec. 4 to address more community concerns.