An aerial view of the Omaha Winnebago Hospital, an Indian Health Service facility on the Winnebago Reservation in Nebraska. Image: Google Earth

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Embattled Indian Health Service hospital in Nebraska losing top executive again

Wednesday, June 14, 2017

One of the worst-performing hospitals in Indian Country is losing its top executive barely six months into the job.

Gary Wabaunsee, a citizen of Seneca-Cayuga Tribe, was hired in December to make crucial improvements at the Omaha Winnebago Hospital in Nebraska. But he's leaving at the end of next week for unrelated family reasons.

His departure represents a major setback because the hospital needs a management team in place before it can be certified by the Centers for Medicare and Medicaid Services. The facility was terminated in the summer of 2015 due to serious lapses in patient care and it seems there's no light at the end of the tunnel.

“Two years later and we are still without that certification,” Victoria Kitcheyan, the treasurer for the Winnebago Tribe, told the Senate Committee on Indian Affairs at a hearing on Tuesday. “Month after month, re-certification is delayed due to lack of resources and key staff vacancies.”

Chris Buchanan, a citizen of the Seminole Nation who serves as the “acting” director of the Indian Health Service, acknowledged the delays in seeking to regain certification at the hospital. He said the loss of Wabaunsee represents a "challenge" going forward.

“We want to apply for that certification when it's safe to do so,” Buchanan told the committee as he declined to offer a timeline for getting the facility, which also serves the Omaha Tribe, back on track.

Indianz.Com on SoundCloud: Senate Committee on Indian Affairs Legislative Hearing June 13, 2017

Without certification, the already underfunded hospital is unable to collect revenues from patients whose services might otherwise be paid through Medicare and Medicaid. That makes it even harder to address quality of care issues.

“If these facilities are in a status where they don't get those funds, that hurts their ability to offer health care to a significant degree,” said Sen. Tom Udall (D-New Mexico), the vice chairman of the committee.

In 2015 and 2016, a record four facilities in the Great Plains Area, a region that includes Nebraska and South Dakota, either lost certification or were threatened with losing that status. Only the Omaha Winnebago remains in limbo.

The problems in the Great Plains were among the many issues highlighted during the hearing, which was called to take testimony on S.1250, the Restoring Accountability in the Indian Health Service Act. The bill seeks to address long-standing management, hiring and other issues at the IHS.

“We can do better in providing health care for Native communities,” said Sen. John Hoeven (R-North Dakota), the chairman of the committee and one of the co-sponsors of S.1250.

Sen. John Thune on YouTube: Thune Discusses IHS Accountability Bill at Indian Affairs Committee Hearing

But the Omaha Winnebago Hospital is just a symptom of a larger problem, another witness told the committee. Max Stier, the president of the Partnership for Public Service, said the IHS as a whole suffers from an accountability issue.

“There's no question that it's critical to get full-time leadership at IHS,” Stier testified.

President Donald Trump has yet to nominate someone to serve as the agency's director, nearly six months after taking office.

“I have no doubt that Buchanan is terrific,” Stier added, “but the reality is when you are in an 'acting' status, it's impossible to really do the job in the same way.”

In a sign of Buchanan's restricted role, he did not outright say whether the Trump administration supports or opposes S.1250. He only offered to provide “technical assistance” to the committee as the measure moves forward.

“It's long past time to address the problems with IHS. They've been identified time and time again,” said Sen. John Thune (R-South Dakota), another co-sponsor of the bill. “Our tribes just deserve better than the status quo.”

Senate Committee on Indian Affairs Notice:
Legislative Hearing to Receive Testimony on the Following bills: S. 1250, S. 1275 (June 13, 2017)