Overview
The Hampden County Sheriff’s Office (HCSO) should have provided physical examinations to all of its inmates who were committed to the facility for 30 days or more within 7 days of admission if their receiving screening was performed by a licensed practical nurse or within 14 days of admission if their receiving screening was performed by a registered nurse. From our sample of 60 inmates out of 3,608 inmates committed to HCSO’s facilities for more than 30 days, we found that 6 (10%) inmates did not receive physical examinations within the required timeframe. HCSO could not provide us with documented reasons (e.g., the inmate in question was at court or in the hospital) to justify why the physical examinations in question were not performed within the required timeframe. Out of the 6 inmates whose receiving screening was performed by licensed practical nurses, 2 received their physical examinations 12 to 15 days after their admission. The remaining 4 inmates had their receiving screenings performed by registered nurses and received their physical examinations 16 to 24 days after their admission.
We projected the test results from our sample of 60 inmates to the total population of 3,608 inmates committed to HCSO’s facilities for more than 30 days. Based on this calculation, we can project with a 95% confidence level that HCSO did not provide physical examinations as part of initial health assessments to at least 138 inmates committed to HCSO’s facilities for more than 30 days.
Because HCSO did not ensure that all inmates received physical examinations as part of their initial health assessments within the required timeframe, there is a higher risk that inmates’ medical issues were not identified and treated, ultimately affecting the health and safety of all HCSO inmates and staff members.
Authoritative Guidance
Section 932.07(1) of Title 103 of the Code of Massachusetts Regulations (CMR) states,
Each inmate committed to the facility [in this case, HCSO] for 30 days or more shall receive a thorough physical examination. Said examination shall take place no later than seven days after admission. This time frame may be extended to within 14 days of admission for cases in which the admission screening was completed by a physician, physician’s assistant or registered nurse.
HCSO’s “4.5.7—Health Care and Treatment” policy states,
Protocol 4: Health Assessment
A. Inmates receive initial and periodic health assessments in the facility. Each inmate committed to the facility for 30 days or more shall receive a complete health appraisal and examination no later than seven days after admission. This time frame may be extended to within 14 days of admission for cases in which the admission screening was completed by a physician, physician’s assistant or registered nurse ([Section 16 of Chapter 127 of the Massachusetts General Laws]).
Reasons for Issue
According to HCSO officials, there was a shortage of staff members available to perform physical examinations during part of the audit period.
Recommendations
- HCSO should establish monitoring controls to ensure that it completes all portions of the initial health assessment—especially the physical examination—on time.
- HCSO should ensure that its healthcare department has enough staff members to complete all portions of the initial health assessment—especially the physical examination—in the required timeframes.
Auditee’s Response
- Reports are now able to be monitored to ensure that all portions of the initial health assessment are completed within the required timeframe.
- The HCSO will and continues to actively search for qualified healthcare professionals in order to maintain appropriate staffing levels as determined by the Medical Director and Responsible Health Authority.
Auditor’s Reply
Based on its response, HCSO is taking measures to address our concerns regarding this matter. As part of our post-audit review process, we will follow up on this matter in approximately six months.
| Date published: | November 25, 2025 |
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