"Here we are in April and we're still on diversion," Evelyn Espinoza, Rosebud Sioux tribal health administrator, said of the Rosebud emergency room that has been closed for four months. "We have these people losing their lives. We have these children losing their parents."

The Rosebud hospital closed its emergency room in December after CMS reports revealed employees at the facility hand washed surgical instruments for six months while a sterilizer was broken, didn't communicate that a patient had an untreated case of Tuberculosis and failed to monitor a patient who delivered a baby prematurely on a bathroom floor.

Staffing shortages also contributed to the temporary diversion of patients to the nearest emergency departments 45 and 55 miles away.