N.M. detention center nurses raise concerns over low healthcare staffing

Toward the end of the year, the medical unit was so short staffed the jail stopped accepting people arrested by police


By Elise Kaplan
Albuquerque Journal

BERNALILLO COUNTY, N.M. — There was no on-site medical director and no doctor at the county jail and whole shifts went by without a mental health worker in the building. Around the end of the year, the facility's medical unit was so short staffed the jail stopped accepting people arrested by law enforcement for a period of time.

These are some of the allegations a nurse — who worked at the Metropolitan Detention Center for more than a decade — made in a declaration filed in federal court Jan. 6. The declaration is part of the McClendon lawsuit mandating reforms at the jail.

Nurse Taileigh Sanchez said the medical program began to decline after Centurion Health got the contract in mid 2018, and it only got worse since Centurion left and Corizon Health took over in mid October.

"In my experience, what is occurring now is the worst medical care has ever been at MDC," Sanchez wrote in the declaration. Sanchez has since left her job, stating in the declaration that even though she likes the work and has been employed there 11 years, she was resigning immediately "due to the safety concerns I have for our clientele and our staff."

"It is important for me to make this declaration because without change, I'm afraid something bad is going to happen," she wrote.

Bernalillo County Commission Chairwoman Adriann Barboa did not return multiple calls from the Journal. When the contract was approved, Barboa had said she was grateful for the thought that went into it and that new staff that would be coming in.

County officials directed all questions to Corizon.

Corizon officials would not do an interview with the Journal. Instead, Steven Tomlin, the senior vice president of business development, said in a statement that the company is in the process of overhauling standards and staff at MDC and wants to "dramatically improve the quality of care from what we inherited in the fall."

"But this takes time, and while disgruntled former employees who preferred the substandard status quo will surely make noise because we demand more quality from them, Corizon is committed to reform," Tomlin wrote. "The unfortunate reality is we're digging ourselves out of a deep hole to meet compliance standards, but it's a credit to Bernallilo County that they identified a need for change, and we're confident that working together, we will dramatically improve the quality of care at MDC."

Corizon did not address whether the report that there was no medical director and no doctor at the jail was accurate and instead said "all services continue to be provided to our patients, and critical roles are being performed by experienced interim staff where needed."

New provider

Health care at the county jail has been a topic of concern for attorneys and advocates for some time.

Centurion — the previous medical provider company — decided to terminate its contract more than a year early after county officials reportedly expressed concerns about staff vacancies and continuity of care. The announcement came not long after the Journal published an article detailing nine inmate deaths in a year.

In September, the Bernalillo County Commission approved a $64.9 million contract for jail medical services with Corizon. The company will be paid between $14 million and almost $16 million a year.

When the contract was approved, county officials said the agreement with Corizon Health would increase health care staffing at the jail and would include new positions, including seven certified medical assistants. The contract funds 105 medical staff positions, most of which were expected to be filled by those who were already working at the jail under Centurion. In emailed responses to the Journal, Corizon said it inherited 40 staff vacancies — "due in large part (to) a lack of recruiting by the previous contractor" — and 26 additional staff have since left.

The company added that it has made nearly two dozen new hires, including a new medical director and more than half a dozen members of a behavioral health team. Corizon said when it took over it discovered large backlogs in basic care, including physicals and dental exams and it has "either eliminated or dramatically cut down on all these backlogs, despite staffing issues."

'People are quitting every week'

Staffing levels of correctional officers at MDC have been described as dangerously low.

Inmates have been locked down for days at a time. Violence has broken out at the facility. In late October, investigators say an inmate killed his cellmate while one guard was responsible for watching two units.

As of November, there was about a 31.7% staff vacancy rate at the jail.

Now health care workers are speaking out about conditions there.

Nancy Simmons, an attorney representing plaintiffs in the McClendon lawsuit, said when she talks to experienced corrections nurses they appear more upset, sad and angry than ever.

"It's an extra concern that you have the number of personnel who are very, very concerned and are being in some ways treated as though they're the 'Debbie Downers' as opposed to trying to raise serious concerns," Simmons said. "I think that the people who are raising the concerns are very much speaking in good faith about what they're seeing, and they need to be listened to."

One health care worker told the Journal that a whole unit of inmates didn't receive medication one weekend because there wasn't enough security to escort a nurse around.

In her declaration, Sanchez said two months into the Corizon contract "people are quitting every week." She said the short staffing means there have been several times that a nurse is asked to fill multiple positions in one shift or had to work a position the nurse had not worked before, often without training.

"If a nurse is working Med 3 (intake) and detox, it is hard for them to do both jobs and puts patients at risk," Sanchez wrote. "If the Med 3 nurse is out on detox rounds, it means people are waiting for medical assessments and clearance before they can be admitted to the facility. Detox rounds are also very important and take a long time, usually hours."

"These are two huge and critical jobs. It is not safe for a nurse to try to cover both positions," she added.

Corizon said it has not terminated anyone for refusing to work a position they had not trained on, it does not expect anyone to work outside their scope of practice, and training is provided to all staff before they work in an area.

Seeking accountability

The attorneys representing the inmates in the McClendon lawsuit have been filing motions, asking for more oversight and for the county to give monthly reports.

In a motion filed in late December, the attorneys quoted a court-appointed expert who identified patients whose care was "substantially deficient" and who found "life-threatening" "lapses in medication continuity for patients on essential medications." The expert's report was filed in September, before Corizon took over.

The expert reportedly expressed concern about the transition to a new medical provider, especially since a new company brought a change in platform for electronic medical records. The Journal has requested a copy of the expert's report but has not yet received it.

Sanchez, in her declaration, said important patient information that was in the previous electronic record system did not show up in the new system.

Simmons said the attorneys are asking for more regular visits from the experts to provide more oversight. But ultimately, she said, the county runs the jail and it needs to take responsibility to ensure it's providing adequate medical care.

"The county knew that transition was coming up and so had a responsibility to oversee it," Simmons said. "What happened in terms of oversight isn't clear to us yet but it is clear that something went very haywire in the transition."

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