Skip to main content
U.S. flag

An official website of the United States government

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

The Passamaquoddy Tribe's Pleasant Point Health Center Did Not Always Meet Federal and Tribal Health and Safety Requirements

Issued on  | Posted on  | Report number: A-01-17-01500

The Passamaquoddy Tribe at Pleasant Point did not always meet Federal and Tribal health and safety requirements for the quality of care at the Pleasant Point Health Center (PPHC). Specifically, we found that PPHC did not always have a physician who provided medical direction for the health center, clear lines of authority and responsibility between medical and administrative decision-making, medical policies and procedures (including pain-management treatment prioritization for opioid prescription and compliance monitoring), and other policies and procedures needed to comply with the requirements.

Because the Passamaquoddy Tribe at Pleasant Point did not provide adequate oversight and implement policies and procedures for its health center, PPHC did not always meet Federal and Tribal requirements, which increased the risk that patients did not always receive quality health care and PPHC may hire unqualified medical providers and administrative staff.

We made several recommendations to the Passamaquoddy Tribe at Pleasant Point, including that it (1) ensures PPHC is under the medical direction of a physician, (2) establishes clear lines of authority and responsibility between medical and administrative decision-making, and (3) develops and implements medical policies and procedures to comply with health and safety requirements.

In written comments on our draft report, the Passamaquoddy Tribe at Pleasant Point concurred with our recommendations and described actions that it has taken or planned to take to address them.

18-A-01-139.01 to CMS - Closed Implemented
Closed on 12/16/2024
We recommend that the Passamaquoddy Tribe at Pleasant Point ensures PPHC is under the medical direction of a physician, in accordance with Federal and Tribal requirements.

18-A-01-139.02 to IHS - Closed Implemented
Closed on 07/30/2018
We recommend that the Passamaquoddy Tribe at Pleasant Point establishes clear lines of authority between the health directorÆs administrative duties and the medical staffÆs duties to provide care by defining job responsibilities as well as policies and procedures that ensure medical complaints are resolved by staff with the appropriate clinical training who can assess and evaluate patient-care decisions and patient-care decisions are prioritized with appropriate input from medical staff during periods of limited funding.

18-A-01-139.03 to CMS - Closed Implemented
Closed on 12/16/2024
We recommend that the Passamaquoddy Tribe at Pleasant Point develop, approve, and implement with the advice of the required group of professional medical staff written medical policies and procedures that include pain-management treatment prioritization requirements for opioid prescription and compliance monitoring and requirements for timely completion, signature, and review of patient health records.

18-A-01-139.04 to CMS - Open Unimplemented
Update expected on 04/30/2025
We recommend that the Passamaquoddy Tribe at Pleasant Point conduct annual program evaluations in accordance with Federal requirements.

18-A-01-139.05 to IHS - Closed Implemented
Closed on 02/10/2022
We recommend that the Passamaquoddy Tribe at Pleasant Point implement Federal and Tribal preemployment screening controls for employees who have not been fully screened prior to employment and for new staff hired at PPHC, including the performance of fingerprinting and FBI background checks for all staff currently working with Indian children.

18-A-01-139.06 to CMS - Closed Implemented
Closed on 11/08/2022
We recommend that the Passamaquoddy Tribe at Pleasant Point provide a safe, clean, and accessible environment with a preventative maintenance program for the facility and medical equipment for the provision of health care.

View in Recommendation Tracker