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IHS awards contract to temporarily staff and operate Emergency Departments at 3 hospitals

Patients to benefit from increased number of Emergency Department health care providers at these IHS facilities in South Dakota and Nebraska

The Indian Health Service today awarded a contract with a ceiling of $60 million in total for up to 5 years to AB Staffing Solutions, LLC, to provide a temporary surge in Emergency Department staffing, operations support and management services at three hospitals: Rosebud Hospital and Pine Ridge Hospital in South Dakota and Omaha Winnebago Hospital in Nebraska. IHS is using short-term funding to provide health care in these hospital emergency rooms while IHS reviews the administrative and clinical operations of its facilities across the region to develop long-term solutions.

“This new contract underscores the IHS commitment to pursuing creative new solutions that ensure high quality care for our patients, who are our top priority,” said Mary Smith, principal deputy director of the IHS. “The new contract will benefit IHS patients and providers by ensuring a 24-hour Emergency Department at IHS Rosebud Hospital and two others. IHS recognizes that high quality emergency room services are critical to communities.”

This limited-term contract will support IHS at a first step in staffing the Emergency Department at Rosebud Hospital. Insufficient staffing contributed to some patients on Rosebud reservation being diverted to other facilities for care. Urgent care services and other inpatient and outpatient hospital services at Rosebud have remained continuously available.

The contract has a base period of one year, with four option years that IHS could choose to execute, meaning that it could extend up to five years in total.

As part of IHS’s commitment to quality care throughout these hospitals, IHS staff serving in these Emergency Departments will be assigned to other departments, enabling IHS to decrease overall patient wait times and offer more services at night and on weekends. At Pine Ridge IHS Hospital, for example, at least 21 nurses and 10 medical support assistants currently serving in the Emergency Department will be shifted to other hospital outpatient clinics. With these staffing changes, Pine Ridge IHS Hospital will offer -- for the first time -- services on Saturday, with clinics running from noon to midnight. The hours of the existing Sunday clinic at Pine Ridge IHS Hospital will also be expanded by seven hours beyond the current hours and will now run from noon to midnight, as well. At Omaha Winnebago IHS Hospital a doctor, nurses and a medical support assistant will also be assigned to other departments to improve services and decrease patient wait times. A schedule of expanded clinic hours at that facility is not yet available.

While IHS has often contracted with health professionals to address staffing challenges in the past, the contract announced today requires the vendor to provide all appropriate department management as well as clinical staffing. The contractor will provide a physician to serve as the full time Director of each Emergency Department and other management services. It is estimated that approximately half of U.S. emergency departments utilize contracted physician practice management.

On April 30, IHS signed Systems Improvement Agreements with the Centers for Medicare & Medicaid Services, another part of the U.S. government, which requires that in the short-term IHS obtain the services of an Emergency Department medical group contractor for Pine Ridge Hospital and for Rosebud Hospital. The Systems Improvement Agreements strengthen the foundation for immediate and long-term quality improvements at Pine Ridge and Rosebud Hospitals.

In addition to efforts to add contract staff in Emergency Departments, IHS has a number of ongoing efforts to improve staffing across the IHS system. Last week, IHS requested proposals for enhanced telehealth services in the Great Plains enabling more clinical appointments to be provided remotely. Additionally, IHS has eliminated a number of administrative impediments to health professional staff recruitment across the IHS system, including securing approval to offer additional relocation benefits for qualified job candidates as well as more pay for some health providers so that salaries at IHS are more competitive. For example, IHS has established a new Title 38 special salary pay table for Certified Registered Nurse Anesthetists, which allows for more competitive salaries for this critical nursing specialty.

IHS, in conjunction with the Centers for Medicare & Medicaid Services, announced on May 13 an additional partnership to strengthen the quality of care, with IHS hospitals receiving assistance from a CMS-supported Hospital Engagement Network.

The IHS Great Plains Area serves 130,000 patients in Iowa, Nebraska, South Dakota and North Dakota by operating 16 federal government facilities and funding the operations of 17 tribally operated health facilities. Review the IHS Principal Deputy Director’s recent briefing on Great Plains Area operations.

The IHS, an agency in the U.S. Department of Health and Human Services, provides a comprehensive health service delivery system for approximately 2.2 million American Indians and Alaska Natives.