Case Study: Closure of the Rosebud Hospital Emergency Department

The Indian Health Service (IHS) provides comprehensive health services for approximately 2.2 million American Indians and Alaska Natives (AI/ANs). Ensuring that these services are both safe and accessible is critical to the well-being of AI/ANs. During a 7-month period, IHS discontinued emergency services at its Rosebud Hospital location. The closure of the Rosebud emergency department (ED) followed a notice of intent by the Centers for Medicare & Medicaid Services (CMS) to terminate Rosebud Hospital from the Medicare program. Representatives of the Rosebud Sioux Tribe raised concerns to OIG about the Rosebud ED closure and linked that closure to several patient deaths that occurred during ambulance transports to other facilities when emergency care was unavailable locally. In response to these concerns, we will examine factors considered and procedures involved in IHS's decisions to close and later reopen the Rosebud ED. We will also assess IHS's management, coordination, and communication related to the closure and will identify lessons learned that IHS could apply to similar situations in the future.

Announced or Revised	Agency	Title	Component	Report Number(s)	Expected Issue Date (FY)
Completed	Indian Health Services	Case Study: Closure of the Rosebud Hospital Emergency Department	Office of Evaluation and Inspections	OEI-06-17-00270	2019