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

Submitting OIG:

Department of Health & Human Services OIG

Report Description:

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.

Date Issued:

Monday, November 26, 2018

Agency Reviewed / Investigated:

Department of Health & Human Services

Submitting OIG-Specific Report Number:

A-01-17-01502

Component, if applicable:

Indian Health Service

External entity, if applicable:

Penobscot Indian Nation

Location(s):

Agency-Wide

Type of Report:

Audit

View Document:

Attachment	Size
11701502.pdf	2.12 MB

Additional Details Link:

https://oig.hhs.gov/oas/reports/region1/11701502.asp

Recommendation Number	Recommendation Status	Significant Recommendation
265977	Open	No
(1) We recommend that the Penobscot Nation ensure that PNHD is under the medical direction of a physician who performs all of the duties required in the job description and in accordance with Federal and Tribal requirements.
265978	Open	No
(2) We recommend that the Penobscot Nation develop, approve, and implement written medical policies and procedures, with the advice of the required group of professional medical staff, 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.
265979	Open	No
(3) We recommend that the Penobscot Nation conduct annual program evaluations in accordance with Federal requirements, review the results of the program evaluations, and take corrective actions as appropriate.
265980	Open	No
We recommend that Penobscot Nation implement Federal and Tribal preemployment screening controls for employees who have not been fully screened prior to employment and for new staff hired at PNHD, including the performance of fingerprinting and FBI background checks for all staff currently working with Indian children, and maintain complete employee personnel files that include current licensing information when applicable.
265981	Open	No
We recommend that the Penobscot Nation establish a preventative maintenance program for the facility and medical equipment to ensure that it provides a safe, clean, and accessible environment.
265982	Open	No
(6) We recommend that Penobscot Nation work with the Penobscot Nation’s Tribal government to ensure that its emergency preparedness program is reviewed, updated, and tested annually, in accordance with Federal requirements, and review and update PNHD’s standard operating procedures in accordance with Tribal requirements.

Recommendation Number

Recommendation Status

Significant Recommendation

Additional Details

265977

Open

(1) We recommend that the Penobscot Nation ensure that PNHD is under the medical direction of a physician who performs all of the duties required in the job description and in accordance with Federal and Tribal requirements.

265978

Open

(2) We recommend that the Penobscot Nation develop, approve, and implement written medical policies and procedures, with the advice of the required group of professional medical staff, 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.

265979

Open