Charging
1 Are appointment list forwarded daily to inmate banking? [HSTM Chapter 5, Section 8.0]
2 Are staffing trained on charging procedures?
3 Does appointment sheets reflect if there is a charge or no charge?
4 Are inmates signing the health appointment logs?
5 Does a review of appointment logs and medical encounters reflect appropriate charges?
Diagnostic Services
1 Does the responsible health authority maintain documentation that on-site diagnostics services
are certified or licensed (and posted)? [NCCHC Standard P-D-04]
2 Is there a procedure manual if a facility provides on-site diagnostic services including protocols for
calibration of testing devices (available to staff)? [NCCHC Standard P-D-04]
3 Do facilities with full-time health staff have multiple-test dip-stick urinalysis, finger-stick glucose
tests, peak flow meters, stool blood-testing material, and if applicable, pregnancy tests? (Post
orders for these tests?) [NCCHC Standard P-D-04]
4 Are laboratory tubes checked monthly for expiration?
5 Does radiology regularly monitor levels of exposure through dosimeters? [NCCHC Standard P-D04]
Hospital Specialty Care
1 Does each community hospital or off-site specialty service used have a written agreement that
outlines terms of care to be provided?
[NCCHC Standard P-D-05]
2 Do agreements with outside providers or off-site facilities require that a summary of treatment
provided and any follow-up instructions (this follow up information is to accompany the inmate upon
return to the facility)? [NCCHC Standard P-D-05]
3 Does the inmate get transferred to the hospital or clinic with a summary of the health record?
Emergency Services
1 Is an emergency/after hours on-call physician, mental health, dental roster available to nursing
staff? [P-E-08]
2 Are emergency drugs, supplies, and medical equipment regularly maintained (is there proof of
routine monthly inventory of Man-down Bag and no expired supplies)? [P-E-08]
3 Is (are) an AED(s) available, checked for fully functioning batteries and new pads? Is the location
clearly marked or known? [P-E-08]
4 Are nurses familiar with off site emergency transport procedures? [P-E-08]
5 Are there "Emergency Nursing Proctocols" in place and utilized?
6 Is the facility using a Medical Appointment List Form marked "ER" for inmates brought to health
unit to be seen as an emergency? [P-E-08]
Continuity of Care During Incarceration
1 Are ordered tests or specialty consultations completed in a timely manner and there is evidence
in the record of ordering clinicians review of the results?
2 When an inmate returns from hospitalization, does the physician see the patient, review the
discharge orders, and issue follow-up orders as clinically indicated?
3 Do clinicians use diagnostic and treatment results to modify treatment plans as appropriate?
4 Are individual treatment plans used to guide treatment for episodes of illness? Does the format
include, at a minimum, the frequency follow-up for medical and diagnostic testing and therapeutic
regimens and when appropriate, instructions about diet, exercise, adaptation tot he correctional
environment and medication?
PRR ADC00177