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The Penobscot Indian Nation Did Not Meet All Federal and Tribal Health and Safety Requirements

The Penobscot Indian Nation (Penobscot Nation) did not meet all Federal and Tribal health and safety requirements for the quality of health care at the Penobscot Nation Health Department (PNHD). Specifically, we found that PNHD did not have a physician who provided the medical direction for the health center and performed all of the required oversight duties, written patient care policies and procedures (including pain-management and opiate-dependency treatment and compliance monitoring), and other policies and procedures needed to comply with the requirements.

Because the Penobscot Nation did not provide adequate oversight and implement policies and procedures for its health center, PNHD did not meet all Federal and Tribal requirements, which increased the risk that (1) patients may not have always received quality health care, (2) PNHD may have hired unqualified medical providers and administrative staff, and (3) PNHD may have missed opportunities to improve its delivery of health care services.

We made several recommendations to the Penobscot Nation, including that it (1) ensures PNHD is under the medical direction of a physician who performs all of the required duties; (2) develops, approves, and implements written medical policies and procedures with the advice of the required group of professional medical staff; and (3) develops and implements policies and procedures to comply with health and safety requirements.

The Penobscot Nation concurred with our recommendations and described actions that it has taken or planned to take to address them.

Copies can also be obtained by contacting the Office of Public Affairs at

Download the complete report or the Report in Brief.

Office of Inspector General, U.S. Department of Health and Human Services | 330 Independence Avenue, SW, Washington, DC 20201