OIG identifies care quality issues plaguing Indian Health Service hospitals


Hospitals serving American Indian reservations face difficulties recruiting and keeping quality staff members, upgrading technology and offering needed resources, according to a new report.

The Department of Health and Human Development’s Office of Inspector General released two reports Friday detailing the longstanding problems plaguing Indian Health Service (IHS) hospitals. OIG noted in one report that IHS hospitals, despite treating a growing number of patients, are unable to provide needed care for particularly complex patient conditions, and there is also limited access to specialists. IHS facilities also frequently rely on "acting" staff members, as leadership cannot recruit and retain staff.

“The dependence on ‘acting’ personnel and contracted providers to fill vacancies sometimes creates instability in IHS hospitals and weakens the continuity of care provided to patients,” the OIG concluded.

Outdated equipment and a lack of needed resources can lead to care outages, the OIG, found.

Earlier this year, a column in The Wall Street Journal likened the struggles to the Department of Veterans’ Affairs ongoing issues, FierceHealthcare previously reported. Poor facilities and a lack of resources hurt both systems, according to the editorial, and both offer dated treatment technologies.

Another similarity, according to the column? A lack of oversight and accountability. In its second report, the OIG noted that IHS hospitals have “performed limited oversight” on care quality and complying with Medicare Hospital Conditions of Participation. The health system, according to the OIG, relies on Area Offices to conduct such reviews, but these offices receive limited care quality data. Compliance reviews are infrequent, according to the report, and the monitoring offices are often short-staffed, further reducing the amount of oversight.

The Office of the Inspector General recommended that IHS conduct a needs assessment and, with its new executive council, identify new and more innovative strategies for improving care quality and oversight. It also suggested that the agency identify better performance metrics and invest time in training staff on them.