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IHS Closes Rosebud Emergency Room; Feds May Take Away Medicare Provider Status

The Rosebud Sioux Tribe has an emergency—no emergency room!

Ron Cornelius, area IHS director, to Pres. William Kindle, Rosebud Sioux Tribe, 2015.12.04.
Ron Cornelius, Great Plains Area IHS director, to Pres. William Kindle, Rosebud Sioux Tribe, 2015.12.04.

Great Plains Area Indian Health Service Director Ron Cornelius informed Rosebud Sioux Tribe President William Kindle yesterday that IHS is shutting down the emergency room at the IHS Rosebud Hospital indefinitely, effective as of today at 6 p.m. Patients around Rosebud needing emergency treatment will now have to go 40 miles to Valentine or 55 miles to Winner. The Rosebud hospital is still offering 24-hour urgent care.

The ER closure follows November 23 notice from the federal Centers for Medicare and Medicaid Division of intent to terminate CMS’s Medicare Provider agreement with the Rosebud IHS hospital for regulatory violations. The tribe responded Thursday with this press release:

Rosebud Sioux Tribe press release, 2015.12.03, p. 1.
Rosebud Sioux Tribe press release, 2015.12.03, p. 1.
Rosebud Sioux Tribe press release, 2015.12.03, p. 2.
Rosebud Sioux Tribe press release, 2015.12.03, p. 2.

Remember that Governor Daugaard wants to expand Medicaid under the Affordable Care Act by redirecting all Indian patients from state Medicaid providers to IHS providers. But it appears IHS lacks the funds to keep meet current health care needs on the Rosebud reservation.

President Kindle has called a special tribal council meeting today at 1 p.m. to discuss the ER closure.


  1. Lanny V Stricherz 2015-12-05 12:43

    Seems to me like I remember the same thing happening with the Yankton Sioux IHS at Wagner about ten years ago. Then because there were so many veterans there, and Senator Thune got the veterans healthcare to other communities besides where the VA hospitals were/are located, the Wagner IHS was changed to a VA outreach center with 24/7 services reinstated.

    Universal Single Payer Healthcare would eliminate the need for the IHS and the VA, with the exception of keeping a few VAs to deal with some of the most severe injuries and or mental health problems. It would also eliminate the need to reimburse those traveling for healthcare, for their travel expenses, as they would get healthcare at their home locality. It might also help to keep some of the smaller hospitals open and functioning the way they need, to give optimum healthcare.

  2. Porter Lansing 2015-12-05 13:22

    What do you suppose “regulatory violations” mean in this instance. Is it lack of Doctors? Lack of nurses and ancillary staff? Or is it that the paperwork isn’t getting processed properly?

  3. Nick Nemec 2015-12-06 07:53

    IHS has been chronically underfunded for years. This underfunding is the obvious fly in the ointment of Governor Daugaard’s proposal to expand Medicaid services in SD by requiring all Native medical services to be covered by IHS. I just don’t see Thune, Rounds and Noem convincing, or even trying to convince, their fellow GOP Congresscritters to increase IHS funding.

  4. Winston Smith 2015-12-06 12:19

    Well, good news. I am glad to see that IHS is leading the way in healthcare. Soon all of America will have the same quality health care as IHS.

    When the tragic and eventual single payer health care comes to the US every single facility will be as first class as IHS. If you want an example of government run health care look no further than IHS. Also the VA is not much better. More vets are dying for lack of care than before Obama fixed it.
    Regulatory violations usually mean process. Which usually comes down to paperwork.

  5. leslie 2015-12-06 13:45

    hmm. ihs is treating a friend w/ the most cutting edge care and science on the planet-google Feng Zhang lab @MIT.

  6. bearcreekbat 2015-12-06 13:51

    Winston, I don’t understand your analysis. I don’t see how IHS problems have anything to do with being a government program or a version of a single payer health care systems for Natives. Same with the VA.

    The problem appears to come from Republicans unwillingness to adequately fund both programs. No public program or private business can do very well without adequate funding. And adequate funding must come from fair taxation, which Republicans abhor, and by prioritizing funding for the IHS and VA, which Republicans refuse to do.

  7. Porter Lansing 2015-12-06 14:14

    Winston is exposing an example of classic conservative “negativity bias”. Psychologists have proven that it’s easier for the brain to choose a negative response to a new idea than engage a few rusty brain cells and think of a way to make it work. In short … lazy thinking.
    A proper example of governmental healthcare is Medicare and it’s step-child Medicaid. Administration costs are low and patient satisfaction is very high. If not handcuffed by Bush’s ban on negotiating drug prices (soon to be lifted) Medicare would be even better, Winston. Aren’t you on Medicare, sir?

  8. jerry 2015-12-06 15:39

    Winston has his medicare and is just full of fear as he watches way to much Fox. They tell him that Obama screwed up the VA and Winston sucks that up like a Hoover. Winston, the fact is President Obama has done so much to help the VA it is amazing. Go up to Fort Meade, just outside of Sturgis, South Dakota and see the new wing that is being added there. What built that and what has helped the VA immensely is the fact that it has had more funds put into its budget. It is still not fully funded but it has come a long way in the last 7 years.

    The IHS has suffered the lack of funding since it was formed. The tragedy is that veterans are nationwide and they are seen by the public so they know the situation. The media reported on the shortcomings at Walter Reed and the veterans got recognized right away. Natives are not so fortunate and they are also not so fortunate on where they live. These remote areas are just not the kind of places doctors and professionals want to go and on top of that when there is not the funding needed to do simple stuff. The congress needs to act and stop sending money to places like Israel, that does not need it, and start sending it to places in Indian Country that desperately need the money.

  9. Winston Smith 2015-12-06 15:58

    Sorry, I am not drinking the kool-aid. The VA is not fixed.

    New York Post
    Star Tribune
    Washington Post

    I realize that you can say FOX News and feel good about yourselves. The VA is still broke. It has been broken for DECADES. And no Obama did not break it. He has promised to solve and failed to do so. He has made the problem worse as all politicians do.

    Are there are bright spots in the VA system. Of course there are. On a whole it is in shambles.

    Medicare and Medicaid are running out of money like crazy. People that I know seem ok as a better than nothing option. Obamacare has skyrocketed out of control on pricing. The only way Medicare works well is with supplemental insurance.

    The problem is I I am a student of history and if history has shown us one thing, just one thing: governments should not be trusted. In the United States it does not matter who is controlling it.

    You want an option that is positive? I will give you one that has not been tried since prior to WWII. Free markets. Not government controlled regulating things like crazy. Actual true free markets. WWII started the whole insurance paid for by the employer by wage controls. Then the government had to fix the insurance problem. Everytime the government fixes, whether democrat or republican the results are the same. It is worse for the consumer.

    The IHS is the example number one of what is wrong with government. I have no expectation that the three federal representatives will do or can (realistically) do anything to fix IHS.

  10. bearcreekbat 2015-12-06 16:51

    Winston, are you, as a student of history, aware that the United States Constitution is the basis for the “government” you do not trust? The founders created this untrustworthy “government” that is the American government, and you choose to denigrate that? And you talk about drinking kool aid. . . .

    As for me, I adore our American government, warts and all. It has given so many people opportunities for a good life, and it has tried to care for the aged and infirm among us. It has defended us from foreign enemies and has provided educational opportunities for our children.

    I do nor understand why people like you and our current crop of Republican presidential candidates have decided you want our government destroyed. If you are successful in bringing about your desired anarchy, then you will need all the guns you can get as the government that has protected you your entire life will be gone. Good luck with that!

  11. jerry 2015-12-06 18:10

    No Winston, I did not say that the VA was fixed. What I said was that President Obama has done some amazing things to improve the VA as it now stands. I am a disabled veteran that has been in the VA system since 1971. I have seen many things in those years, but I also have never seen the improvement that I have seen in the last 7 years. My son was wounded in Iraq and is disabled from TBI, I monitor his healthcare as well as my own, his is no more second rate that the great care that I receive. Keep in mind that when President Obama took office in 2008, we had already been sending causalities from all our wars that started in 2003. That was 5 years Winston. Obama had an already under funded VA system that was then taxed with the burden of yet another set of wars.

    The congress was in his hands for a matter of weeks before the mid terms that changed it all. If you want to be a conservative and bitch and moan about the black dude, fine. But if you want answers to all of those articles, ask Jihadi John or EB Rounds or how about NOem, she voted 50 plus times to screw up the ACA with the only results being from the other Right Wing terrorist outfit the NFIB.

    IHS has nothing to do with the VA and yet a lot to do with the VA. There are a lot of Native veterans that are being cared for in both places. There are a lot of Native veterans with PTSD that has been masked for years under the cloud of alcohol abuse just like non Indians. As Native veterans served mostly in the combat arms portion of the military in the Marines as well as the Army, they came back with the same issues. We are all the same, brothers from different times. Maybe you should have gone to know that feeling and to know what the VA has done to help.

    Keep in fear Winston, keep watching Fox and buy some more guns damnit. That will make you feel good as you think of filling sandbags in your dreams to protect you. Remember though, they can tunnel in on you, toss in a satchel charge and all of the sudden, a smoked Winston.

  12. leslie 2015-12-06 18:28

    winston the WaPo article is dated 6.23.14 and you shouldn’t be reading the Post if you expect reliability

  13. jerry 2015-12-06 19:31

    Sequestration is same as genocide in Indian Country. It has the same effects, to either kill you slowly or kill you with haste. It makes Jihadi John, Rounds and NOem all support and love this sequestration which proves their unwavering support of what another Republican said in 1886.
    “I suppose I should be ashamed to say that I take the Western view of the Indian. I don’t go so far as to think that the only good Indians are dead Indians, but I believe nine out of every ten are, and I shouldn’t like to inquire too closely into the case of the tenth.” These words were spoken by Theodore Roosevelt less than 15 years before he became President of the United States.

  14. Lanny V Stricherz 2015-12-06 19:34

    Jerry, thanks for some great posts, but particularly the one describing your service and that of your son. I will never understand how a person like Winston, who probably is like Bush and Cheney and never served but has the cajones to not to want to fully fund veterans healthcare.

    We have needed mandatory funding of the VA for many years, not just fully funding to what the VA asks for. If the VA were mandatorily funded, we would not be seeing 23 veterans a day committing suicide because they would be getting the mental health help that they need. It was estimated that by the end of 2008, fully a quarter of a million veterans of the Iraq Afghanistan wars were suffering from PTSD, and that number has grown exponentially since then. For anyone reading this that does not understand what mandatory funding means, it is a blank check to pay whatever it takes to care for those returning from war.

    If we ever have the courage to do that, perhaps, we will see the true cost of war and we won’t be starting a new war every other year.

  15. leslie 2015-12-06 19:39

    wow, i guess pennington county AND custer county residents who allow their elected officials to vote down the Harney name change, DO have reason to fear this spreading. time to replace teddy with franklin’s bust on the mountain.

  16. Winston Smith 2015-12-06 20:08

    Funny thing is we are on the same side in a way. IHS sucks. And the government sucks at doing it. I do not own weapons and have not fired or held a weapon since my last night of guard duty while in the Army. I do not have a television so I find it difficult to watch Fox News. I primarily read overseas press about the United States.

    I love my country. I love the United States Constitution. I dislike what the United States Government has turned into. As a whole you should distrust governments. The history of the world is that of despotic and tyrannical governments. The US has been the one exception to that rule. One of the things I learned studying the Soviet Union is the government is much different than the people.

    Do I blame the “BLACK MAN” in office. No more than I blamed the white man who preceded him. And the white man who preceded him and the white man before him, which is when I started paying attention to Washington DC. So by my count I blame the white men 3to1.

    As you will recall Democrat party had full control of the government for two full years, not weeks. Well, I guess 104 weeks. You will also notice that while NOem has voted “50 times” to change Obamacare she has not managed to do so. The only person to change Obamacare is Obama. According to Forbes there have been 54 changes. Some of those were done by SCOTUS. The majority of the changes were done by Obama.

    As someone is a vet and who volunteers at the VA, I would not consider myself a hater of vets. I hate what has happened to them.

    Jerry, I am not sure why they would want to tunnel in on me.

  17. jerry 2015-12-06 20:44

    Thank you for volunteering Winston. You probably do not use the VA because of your income. A lot of veterans are in different classes with those that are service connected being priority and the rest following in different categories of need.

    Your arguments though follow through on the the lying rhetoric of the Senate leader Turtle man regarding the 2 year or in your case, 104 weeks. It was in fact 72 days.

    The NFIB killed the Medicaid Expansion when they bought it to the Supremes. Each business that proudly has one of these stickers on their doors, kills innocent working people.

    Your republican congress and its position on sequestration has raided the VA, almost destroyed the economy and is killing Indians in a way that has not been done since the first violations of the Fort Laramie Treaty.

  18. Winston Smith 2015-12-06 20:56

    I am not a republican. I am registered Democrat who is far more libertarian than anything.

    The sequestration was allegedly Obama’s idea and he went along with it. Is there no blame to given to the one person who could have stopped it?

    So the only democrats have control of the senate is when they have a filibuster proof majority. So, then, by the same logic the republicans are not in control now?

  19. jerry 2015-12-06 21:10

    Right and I look just like Brad Pitt. Party registration is such a farce anymore, nothing matters in that regard. I am a registered Independent that votes for anyone but Thune and anyone but Rounds and anyone but NOem. You are welcome to figure what side of the fence I am on. You are speaking Fox points so I know that you get your info from the right wing. You are full of fear as that is what is controlling your love for the republican party now. They will break your heart while they steal the metal from your teeth.

    Sequestration was the wet dream of John Boner to keep the government open. You do remember the republican party shut it down, correct? The Turtle man put the senate in such a way that nothing would pass that President Obama put in for vote unless it could gain the 60 vote majority. Kevin Drum describes sequestration from the begining in the mid 1980’s until this steaming pile of crap came about.

    No one is in control of the congress except for the lobbyists that are paid by those that are trying to steal your Medicare and your Social Security. I would tell you that it would be in your best interests to heed that last sentence, but you will not. Too bad that your heart is not in the fight for your well being and that of the country’s.

  20. jerry 2015-12-06 21:47

    The race powder keg that the republican party’s bosses are trying like hell to ignite. Listen to your candidates for the presidency. The most incredible group of racists this country has had to listen to ever. When you add fascism into the mix, it gets even more treasonous.

    We see it hear and we hear it directly from the governor of our state. The dog whistle racial divide that he continues to bleat with the latest being on Medicaid. People are not being served and their issues are not being addressed by this current and past republican control of all things state government. They and the congressional representatives are not only complacent in South Dakota’s dysfunction, but that of the nation itself.

  21. Lanny V Stricherz 2015-12-06 22:34

    Jerry, you are so right. If the things that are happening here in SD and in our nation were to happen and so blatantly in “our face,” in a third wold country, there would be open armed revolt. But we have so much, and have become so complacent, that we could give a crap if our government is mistreating any of our citizens, again, such as the Native Americans, the veterans, the teachers and our children, and then any one who has not been fortunate enough to be on the gravy train.

  22. bearcreekbat 2015-12-07 10:16

    Winston, if you really love our Constitution and our American government you might consider appreciating the good in it rather than asserting no government, which by definition includes our very own Constitutional government, can be trusted.

    How do you think it looks to other anti-government individuals, including those with too many guns and too much hate, to hear people like you affirm their view that the government is evil and untrustworthy? Don’t you even wonder whether your anti-government rants encourage violence against our friends, family and neighbors who are employed by our government, such as the folks helping people with disabilities in California?

    If you truly love America and our Constitution, then wouldn’t it make sense to stop dissing our government as a whole? I would encourage you to identify particular policies that you think should be changed, or identify particular individuals in our government that ought to be challenged. But to assert all government is untrustworthy does nothing more than foster anger and distrust of everything we stand for.

  23. caheidelberger Post author | 2015-12-07 16:30

    Winston, if IHS isn’t working, we don’t get to shift the blame to “government.” In a democracy, the government is us. Government failure is our failure. If Indians aren’t getting the health care we are bound by treaty to provide, then we, including those of us participating in this conversation, are to blame. No one is an innocent bystander in democracy. If anything, in a democracy, bystanders are more likely guilty…. of standing by instead of acting.

    Make IHS the agency in charge of coordinating a national single-payer system (not my first policy choice, but for the sake of argument…), and you can bet 230 million American voters and their elected Congresspeople won’t let that program go underfunded for long.

  24. MD 2015-12-07 20:58

    This is yet another example of the tragedy of the way we have treated our indigenous people. It is time to step up, own our failings, and honor our promises. The more we continue with the current system, the more drawn out the trail of tears is. It is economically and ethically irresponsible to continue to let these issues fester.

    Steve Hickey had the best idea, its time for a truth and reconciliation commission – to admit where we have failed and create a national dialogue on how to fix it. We are all guilty, the blood is on our hands.

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