Regional Health Rapid City Hospital is now shipping its garbage more than 300 miles away to Nebraska.

The South Dakota Department of Environment and Natural Resources said the city's hospital is first sending its non-medical waste garbage to a transfer station in Wall and then to J Bar J Landfill in Ogallala, Nebraska — a 303-mile journey.

The hospital made the change after the Journal reported April 30 that the city landfill had seen repeated violations of its policy regarding the disposal of infectious medical waste and as a result was routinely calling the hospital to pick up red bags designated for infectious waste or transparent bags reserved for other garbage that contained infectious waste, which is considered a health hazard for city employees.

"We only saw a load of two in early May," Darrell Shoemaker, spokesperson for the city, said. "And there has been nothing since."

Five days later after the Journal story, Regional Health's now-interim Chief Executive Officer Paulette Davidson announced a new off-site "sorting facility" in a video posted to Facebook. A statement from the company six weeks later said, "The steps we have taken have ensured that we are meeting all city, state and federal standards."

The statement did not say, however, that off-site meant out of state.

Stericycle, which is in Denver, remains the hauler for the hospital's medical waste. But Regional's other garbage is being redirected to the landfill in Nebraska. The waste stream takes a circuitous route — first transported on Kieffer trucks to a transfer station in Wall and then on a semi-trailer to the largest landfill in western Nebraska

"That's one of the longer hauls I've heard of," said Erik Waiss, environmental assistance coordinator with the Nebraska Department of Environmental Quality. "I know they (J Bar J) receives loads from quite a distance away, like Colorado or maybe Kansas, but I was pretty sure it wasn't coming all the way from South Dakota."

A supervisor with J Bar J Landfill confirmed the facility receives loads from Wall. The site strictly prohibits any infectious waste from entering the facility.

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"It's been looked at three times by the time it reaches us," supervisor Will McKnight said. "No hazardous waste is accepted here."

What prompted the change has not been disclosed by Regional. The health-care provider issued a statement in response to a Journal inquiry that says they "have partnered with a facility that meets our waste-disposal needs that is cost-effective and environmentally sound." A question about any additional costs accrued by Regional in transporting the garbage more than 300 miles was not answered.

Bypassing the local landfill to ship garbage out of state is an unusual move relative to other hospitals in South Dakota. At the two largest health-care providers in Sioux Falls, throwing a coffee cup or napkin into the waste receptacle in a patient room or waiting area means the trash lands in the local landfill. Spokespersons for both Sanford Health and Avera Health said that while medical waste is sent by specialized waste disposers, the hospital's garbage is taken by private haulers to nearby landfills. 

Neither the city nor the state would speculate why Regional has decided to make the move. The company has publicly committed to comply with regulations for waste disposal. Moreover, there doesn't appear to be any greater leniency in Nebraska regarding the disposal of medical waste than in South Dakota.

"They've got pretty stringent laws, actually," McKnight said of Nebraska waste rules.

As in South Dakota, a landfill in Nebraska can lose its state-issued permit for violating environmental and waste-disposal regulations.

Beginning in 2016, health regulators with South Dakota documented instances when bone spurs, bloody gauze and catheter tubes, fatty tissue and urine containers landed in the Rapid City landfill. The instances of non-compliance were filed with the Centers of Medicare and Medicaid Services and reported earlier this year.

Investigators visited the hospital in early May and found the health center in compliance with all relevant regulations. No state law requires a generator to deposit waste in state.

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Contact Christopher Vondracek at Christopher.Vondracek@rapidcityjournal.com.

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