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  • California State Prison,

    Los Angeles County

    Medical Inspection Results

    Cycle 5

    September 2017

    Roy W. Wesley

    Inspector General

    (Acting) Office of the Inspector General

  • Office of the Inspector General

    California State Prison,

    Los Angeles County

    Medical Inspection Results

    Cycle 5

    Roy W. Wesley

    Inspector General (Acting)

    Shaun R. Spillane

    Public Information Officer

    September 2017

  • California State Prison, Los Angeles County, Cycle 5 Medical Inspection Table of Contents

    Office of the Inspector General State of California

    TABLE OF CONTENTS

    Foreword .............................................................................................................................................. i

    Executive Summary ........................................................................................................................... iiiOverall Rating: Inadequate ............................................................................................................ iii

    Clinical Case Review and OIG Clinician Inspection Results .................................................vCompliance Testing Results.................................................................................................. viRecommendations ............................................................................................................... viiiPopulation-Based Metrics ................................................................................................... viii

    Introduction ......................................................................................................................................... 1

    About the Institution ........................................................................................................................ 1

    Objectives, Scope, and Methodology.................................................................................................. 3

    Case Reviews ................................................................................................................................... 4

    Patient Selection for Retrospective Case Reviews ................................................................. 4

    Benefits and Limitations of Targeted Subpopulation Review ............................................... 5

    Case Reviews Sampled .......................................................................................................... 5

    Compliance Testing ......................................................................................................................... 7

    Sampling Methods for Conducting Compliance Testing ....................................................... 7

    Scoring of Compliance Testing Results ................................................................................. 8

    Overall Quality Indicator Rating for Case Reviews and Compliance Testing ................................ 8

    Population-Based Metrics ................................................................................................................ 8

    Medical Inspection Results ................................................................................................................. 9

    Access to Care ................................................................................................................. 10 1

    Case Review Results ............................................................................................................ 10

    Compliance Testing Results................................................................................................. 13

    Diagnostic Services ......................................................................................................... 15 2

    Case Review Results ............................................................................................................ 15

    Compliance Testing Results................................................................................................. 18

    Emergency Services ........................................................................................................ 20 3

    Case Review Results ............................................................................................................ 20

    Health Information Management .................................................................................... 23 4

    Case Review Results ............................................................................................................ 23

    Compliance Testing Results................................................................................................. 25

    Health Care Environment ............................................................................................... 27 5

    Compliance Testing Results................................................................................................. 27

    Inter- and Intra-System Transfers ................................................................................... 30 6

    Case Review Results ............................................................................................................ 30

    Compliance Testing Results................................................................................................. 31

    Pharmacy and Medication Management ........................................................................ 33 7

    Case Review Results ............................................................................................................ 33

    Compliance Testing Results................................................................................................. 34

    Prenatal and Post-Delivery Services .............................................................................. 37 8

    file://///IGFS01/UNITS$/MIU/Cycle%205/I%20Inspections/06-LAC-17-0000099-HP/6%20Report%20Coordinator-Editor/A%20Draft%20Report%20Package/LAC%20DRAFT%20REPORT%20MASTER%20COPY%20FINAL%20(use%20for%20FINAL%20REPORT).docx%23_Toc492452576

  • California State Prison, Los Angeles County, Cycle 5 Medical Inspection Table of Contents

    Office of the Inspector General State of California

    Preventive Services ......................................................................................................... 38 9

    Compliance Testing Results................................................................................................. 38

    Quality of Nursing Performance ................................................................................... 40 10

    Case Review Results ............................................................................................................ 40

    Quality of Provider Performance .................................................................................. 44 11

    Case Review Results ............................................................................................................ 44

    Reception Center Arrivals ............................................................................................. 48 12

    Specialized Medical Housing ........................................................................................ 49 13

    Case Review Results ............................................................................................................ 49

    Compliance Testing Results................................................................................................. 50

    Specialty Services .......................................................................................................... 51 14

    Case Review Results ............................................................................................................ 51

    Compliance Testing Results................................................................................................. 53

    Administrative Operations (Secondary) ........................................................................ 55 15

    Compliance Testing Results................................................................................................. 55

    Recommendations ............................................................................................................................. 58

    Population-Based Metrics ................................................................................................................. 59

    Appendix A Compliance Test Results ......................................................................................... 62

    Appendix B Clinical Data ............................................................................................................ 75

    Appendix C Compliance Sampling Methodology ....................................................................... 79

    California Correctional Health Care Services Response ................................................................. 86

  • California State Prison, Los Angeles County, Cycle 5 Medical Inspection List of Tables and Figures

    Office of the Inspector General State of California

    LIST OF TABLES AND FIGURES

    LAC Executive Summary Table .........................................................................................................ivLAC Health Care Staffing Resources as of February 2017 ................................................................. 2

    LAC Master Registry Data as of February 13, 2017 ............................................................

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