Corizon counters Idaho prison health care report
Published: May 12,2012
The national prison health care company Corizon says a scathing court-ordered report on the care provide at an Idaho prison is full of errors and that a review they commissioned themselves proves it.
But a close review of both reports show that they largely focused on different aspects of the health care system and that they noted some similar problems.
The medical care at the Idaho State Correctional Institution south of Boise is a major part of a long-running lawsuit brought by inmates against the state 30 years ago. Over the years the inmates won many of their claims, forcing the state to make changes to operations and procedures at the lock-up.
And a federal court has continued to oversee some aspects of the prison. Last year, U.S. District Judge B. Lynn Winmill appointed correctional health care expert Dr. Marc Stern to review the health care at the prison in hopes of finally bringing the lawsuit to a close.
Stern’s report found several problems. He said terminal and long-term care inmates sometimes went unfed and were left in soiled linens. The report also said nursing mistakes or failures were likely to have resulted in some deaths and one inmate wasn’t told for seven months that he probably had cancer.
The Brentwood, Tenn.-based Corizon, which provides medical care at the prison under a contract with the state, immediately took issue with Stern’s report. Corizon officials noted that the facility was accredited by the National Commission on Correctional Health Care, and the company announced it would pay for NCCHC to come out and review the prison’s health care system again.
Corizon announced May 10 the new NCCHC review found the health care system at the prison to be “sufficiently organized and in substantial compliance” with health service standards.
In a prepared statement, Corizon CEO Rich Hallworth said the NCCHC report was a “complete vindication” for the company.
“We are very pleased that the Special Master’s (Stern’s) report was proven to be fatally flawed and will never become an official finding of the court,” he said.
But the company isn’t a party to the lawsuit between inmates and the state and has no authority over whether Stern’s report is deemed an official finding. Corizon spokeswoman Courtney Eller acknowledged that would be up to the judge.
The NCCHC report found that many of Corizon’s policies and procedures at the Idaho prison meet national standards.
“It was evident that all inmates have access to health services and the system generally works well,” the review stated.
Still, the report mentioned some problems in record-keeping and the delivery of health care services and didn’t address some of the issues brought up in Stern’s report.
Of 42 records of “complicated” patient care reviewed by the NCCHC team, 23 were found to be satisfactory, according to the report. The rest had problems “ranging from minor to significant.”
The NCCHC report didn’t go into detail on the problems found, but the findings appeared to echo some of Stern’s findings.
“In our review we noted problems with the care provided to several chronic disease patients. These cases illustrate the need for closer monitoring by the medical director for both professional performance as well as continuity of chronic care,” the NCCHC review team wrote.
The NCCHC report found that Corizon had made some recent improvements to care at the prison, partly through the hiring of a new head physician and a new health services administrator. Stern also noted in his report that the company had shown some improvements during the period in which he reviewed care.
Some of the discrepancies in the reports may be from the different areas of emphasis focused on by the reviewers.
Ron Shanksy is an expert consultant in correctional health care who has served both as a special master for the courts and worked with the NCCHC to revise national standards and review prison facilities. While he’s not involved with the Idaho case, he says generally the two types of roles result in different types of reviews.
Special masters for the courts are usually asked to focus almost exclusively on clinical care and the medical outcome for patients. Reviews by NCCHC, meanwhile, typically have a greater emphasis on the structural elements that an organization needs to deliver good health care, he said.
In other words, a facility with poorly written policy can still deliver excellent care, and likewise a facility with policies and procedures that meet national standards can still make poor medical decisions, he said.
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