Twelve Clans Unity Hospital Announces Inpatient Unit Opening

November 4, 2019

Winnebago, NE.-- Twelve Clans Unity Hospital announced today the opening of the Inpatient Services Unit for the hospital. Inpatient care has been unavailable since Indian Health Services (IHS) ceased its operation in the first quarter of 2018 due to the lack of staff and other issues related to IHS management of the hospital. Opening of the Inpatient Services Unit is a major step for the hospital toward achieving certification by the Centers for Medicare and Medicaid Services (CMS).

In July 2018, the Winnebago Tribe of Nebraska assumed management of the Omaha-Winnebago Hospital formerly operated by IHS, the federal government agency within the U.S. Department of Health and Human Services responsible for proving health care for Native Americans. The Tribe assumed management of the hospital through the IHS Tribal Self-Governance Program. As the first step in establishing a new health system for the Tribe, the hospital was renamed Twelve Clans Unity Hospital in honor of the twelve traditional clans of the Winnebago Tribe.

This was a significant move by the Tribe. Twelve Clans is the first hospital in the IHS Great Plains Region that has been converted to tribal management. There are 22 tribally managed hospitals and 24 IHS managed hospitals in the United States. Tribal hospital management is …”part of a growing trend in which tribes have declared themselves fed up with the federal government’s management of the health care system and are seizing control of troubled hospitals in the belief that they can do a better job of running them”, according to a New York Times article just published this October (Walker, 2019)*.

*Fed Up With Deaths, Native Americans Want to Run Their Own Healthcare”, Mark Walker, October 15, 2019, New York Times.

Following Indian Health Services departure last year, the Tribe began the long process of building new infrastructure, staffing, policies and procedures.

The new executive team is led by Danelle Smith, CEO, Winnebago Tribal member and attorney. The executive team was responsible for developing completely new Human Resources and Finance departments. This included developing policies not only for those departments but hospital-wide policies and procedures. “The very detailed and tedious work that needed to be done, while not exciting, was absolutely necessary to have a viable and functioning administration to operate all areas of the hospital. We are focused on working as quickly as possible to improve healthcare for our tribal members, gain CMS certification and continue our journey to provide outstanding healthcare for our tribal members and Native Americans throughout the region. We’re proud of the executive team, board and our staff for the hard work in making this last year successful and we look forward to the tremendous opportunities ahead”, stated Ms. Smith.

One of the other challenges has been the vacancy rate for key healthcare and administrative positions within the hospital. Nationwide, according to the New York Times article, 25% of all healthcare positions and in some cases up to 50% under Indian Health Services, have remained vacant.

For Twelve Clans, it was crucial to fill their positions with qualified and experienced providers, nursing and other staff. Prior to the Winnebago Tribe assuming management, the hospital had a 45% employment vacancy rate. As of November 2019, the hospital is now down to an 8% employment vacancy rate. While other areas of the country have had increasing problems with recruitment, the hospital in Winnebago is proud of the success they’ve had in hiring qualified personnel.

Other hospital accomplishments include the laboratory team being awarded a two-year term Certificate of Compliance under the Clinical Laboratory Improvement Amendments (CLIA) program for high complexity laboratory testing. The hospital’s eight-person laboratory team was surveyed on various practices, including but not limited to: instrumental validation and verification, standard operating procedures, personal documentation and education, and quality control. In addition to this certification, the Mammography Department at Twelve Clans Unity Hospital was also awarded a three-year term of accreditation in mammography as the result of a recent review by the American College of Radiology (ACR). A mammography exam, called a mammogram, is used to aid in the early detection and diagnosis of breast diseases in women. Twelve Clans Unity Hospital has the newest 3D Mammography imaging available. Both of these achievements mark important steps toward CMS certification.