The sound of coworkers crying. Sprinting to stabbings and hangings. The hiss of an empty oxygen tank. The inevitable loss of life. These are the memories of Jose Vallejo from his time in an Arizona prison.
Vallejo worked for Corizon Health in the Arizona Department of Corrections for two years from December 2016 to December 2018. He alleges the company, is violating state regulations, purposefully misleading state auditors, and putting patient lives at risk.
The state announced recently that Corizon will be replaced with a new private health care vendor in July.
U.S. District Judge Roslyn Silver, overseeing the Parsons v. Ryan prison health care settlement, recently appointed an independent expert to review the entire Arizona prison health care system after similar allegations were made by previous whistleblowers.
Vallejo read their accounts and came to KJZZ with his own story, after he says his concerns fell on deaf ears at Corizon and the Department of Corrections.
Vallejo is no stranger to the correctional world. He has worked as a correctional officer and a police officer, as well as a correctional nurse. For the past two years, he was employed as a licensed vocational nurse at the Arizona State Prison Complex – Eyman in Florence.
Much of his time was spent working in the SMU-1 unit, where some of the most seriously mentally ill patients in the state prison system are housed.
Vallejo worked as an hourly employee for Corizon Health, logging 12-hour shifts, four or five days a week. His duties included distributing medicine and providing health care to thousands of patients. He estimates he was putting in between 120 and 150 hours every two weeks at the prison.
“It’s mentally exhausting — emotionally — physically,” he recalled in a recent interview at his home. “We have to stop what we’re doing to respond to emergencies. We have inmate stabbings, inmate hangings. It takes a toll. It really does.”
Lack Of Staffing, Training
When Vallejo first started at Eyman, he said he was forced to hit the ground running. Instead of the two weeks of training he was promised, “I literally got two days of training, and I was thrown into working nights by myself.”
He says his previous work experience helped steel him against the pressure, but other nurses were simply not prepared.
“There’s RNs there that don’t even know how to start an IV,” Vallejo said. “There are nurses that can’t operate an oxygen tank. A lot of them have no type of training. They’re book-smart, but when it comes to a hands-on situation, they have no idea what’s going on.”
Vallejo says the lack of training provided by Corizon sets nurses up for failure.
An independent expert hired by Magistrate Judge David Duncan in 2018 to review Corizon’s staffing woes found that “recruitment and retention are an ongoing issue, resulting in staff being stretched too thin to provide coverage.”
Vallejo said not much has changed. He says he and his colleagues were run ragged.
“You have nurses crying in the middle of their shift — it’s horrible,” he said.
Despite Corizon’s contract with the state guaranteeing 90 percent staffing fulfillment, Vallejo claims his unit was usually only 50 percent staffed with health care personnel.
He says the turnover was like nothing he has ever seen.
“Corizon is just hiring bodies, trying to get their numbers up,” he said.
Vallejo kept internal employee logs that he claims show several units at the Eyman prison were continually understaffed.
Editor’s Note: KJZZ reports that the Arizona Department of Corrections (ADC) did not respond to multiple requests for comment regarding the accusations contained in this article. Corizon Health spokesperson Martha Harbin said Jose Vallejo was “terminated from his position for failure to perform required duties” but provided no other response to his allegations.
Vallejo says a registered nurse should have been at the prison complex at all times, but often there was no one working with that level of certification. Many times, he says, licensed vocational nurses were forced to make decisions that should have been handled by someone with more experience.
“We’re making a call that someone else should be making,” Vallejo said. “We’re making calls that someone with more education should be doing.”
Vallejo says this led to many dangerous situations.
*“We’re putting people’s lives on the line,” he said. “When we’re passing medications to so many inmates, it creates room for medication errors.”
Vallejo says this included inadvertently giving inmates the wrong medication, “which can ultimately kill them, depending on what you’re giving them. I mean you have blood pressure medications, heart medications – critical stuff.”
Vallejo says inmates with chronic illnesses suffered the most.
“There was a lot of times, due to lack of staff, that diabetic inmates weren’t getting their insulin until 9 or 10 o’clock in the morning,” Vallejo said. “That’s pretty dangerous considering we turn around and give it to them again at 3 p.m.
“So they’re not even hitting their peak when we’re turning around and giving them more.”
In addition to serving thousands of patients’ daily needs, Vallejo says there were constant emergencies.
He claims during one shift he worked in early November, there were 28 Incident Command System (ICS) responses. An ICS is an emergency situation at the prison requiring an all-hands-on-deck type of response from health care providers and Department of Corrections staff.
“It was everything from inmates cutting themselves to cell extractions to chest pains,” he said.
Vallejo said the health care staff wasn’t alone in dealing with staffing shortages.
“The Department of Corrections staff is hurting just as much as we are,” he said.
“There [are] times when you have one correctional officer running an entire wing of several hundred inmates. So you don’t even have eyes on you like you’re supposed to 24/7.”
Vallejo says one night at SMU-1, the inmates set the building on fire.
“We had fire trucks out there, ambulances sending people to the hospital.”
He claims several patients and Department of Corrections staff were injured. He says the inmates were rebelling because they had not been receiving their medication.
“They warned us that they were going to go off,” Vallejo said. “But nobody listened, and they ended up setting the unit on fire.”
Vallejo says despite the short staffing, nurses were expected to perform the work required of a full roster of employees. He claims Corizon supervisors repeatedly ordered him and his colleagues to improperly distribute medicine to patients.
“She wanted one of us to pop ’em, while the other two went and handed them out,” he said.
Vallejo says instructing one nurse to “pop” pills from their blister packs while directing another nurse to distribute them is against guidelines established by the state board of nursing.
“We told her we weren’t going to do it. It’s illegal. We can’t pass medicines that somebody else has poured. But they didn’t care.”
Empty Oxygen Tanks, Broken EKG Machines
Vallejo alleges a lack of resources contributed to a dangerously deficient level of care.
“We have cancer patients not getting cancer treatment like they should be,” he said. “There are follow-ups by providers that aren’t happening. They’re just being overlooked.”
Dr. Jan Watson, who also formerly worked for Corizon as a health care provider at the Eyman prison, made similar accusations about poor access to specialty care to KJZZ in December 2017.
“I had one male patient that was so bloated he looked like he was nine months’ pregnant,” Vallejo said. “He was jaundiced so badly, he had pretty much yellowish skin.”
Vallejo says he fought with administrators for three months before they agreed to send the patient to another facility that could provide proper care.
“He should have had a lot better care,” Vallejo said. “He needed dialysis. He needed different types of CAT scans and we just weren’t equipped to handle that.”
Vallejo says he treated another patient whose blood platelet levels were dropping rapidly. He says he asked administrators for help with the patient for a year before it was discovered he had developed cancer.
“There was a time when we had an emergency and we didn’t even have working oxygen tanks that were full — they were all empty,” he said. “Other times, we’re having to run to another unit on the other side of the complex to get an EKG machine because ours isn’t working.”
Vallejo says “man down” situations were a constant occurrence. But a specific bag, reserved for such emergencies, was never properly maintained.
“People would break the secure tags on ‘man down bags’ to get supplies in an emergency and then wouldn’t replace them,” he said. “You have things in there that are expired and don’t even belong in there.”
DOC Monitoring Bureau
The Arizona Department of Corrections created a monitoring bureau “to follow the medical care and treatment of inmates” after the state privatized prison health care in 2012. The bureau performs audits on the health care facilities at state-run prisons, currently operated by Corizon Health.
Vallejo claims he witnessed and took part in numerous practices, directed by Corizon Health administrators, that were conducted to deceive the state monitoring bureau and avoid potential fines.
“When it’s time for audits, Corizon administrators will ask us to make sure all the books are signed and tell us to ‘fill in the blanks,’” Vallejo said. He says there are several logs maintained by Corizon for monitoring things like narcotics inventories and temperatures in the inmates’ cells.
“Our narcotic books are supposed to be signed every shift,” he said. “All the temperatures are supposed to be within normal limits.” But these books, he said, were often left blank.
“I’ve been asked to fill in the blanks on multiple occasions,” Vallejo said. “Narcotics are supposed to be counted and signed for at the beginning of the shift and at the end of the shift. But there’s a lot of times where they aren’t. So two or three months later, they’ll ask whoever is around to sign off on the books, so they’re not getting dinged for it.”
Vallejo says there was a specific room at his unit where his supervisors would pile up the books full of empty blanks and a Corizon administrator would order Vallejo and his colleagues to fill them in.
“If a state auditor shows up, they’ll call every unit and let them know they’re there and instruct the nurses to make sure everything is signed out, make sure everything is out of sight, and make sure everything is ‘tidy,’” Vallejo said.
Vallejo admits to improperly signing several of the narcotic books under order from his supervisors.
“It sucks because they’re putting us in a predicament where either we sign it — or if we don’t — we’d end up getting some sort of retaliation.”
Vallejo says he is certain that Corizon administrators knew when the audits were coming, and prepared for them. “They know before they show up. So they try to start fixing everything and hide what they can,” he said.
“Every nurse that works there has been told at one point or another to fill in a blank, or sign something off, or back-date something, or chart on something that they might not even have been there to chart on,” Vallejo said. “It’s common practice.”
Vallejo claims that in addition to falsely signing forms and backdating patient visits that didn’t occur, Corizon administrators ordered nurses to hide expired medicines from the state auditors.
Expired Meds Hidden From Auditors
“We were asked to make sure expired medications were out of sight so the auditor doesn’t see them,” he said.
“We had medications in the med room that should have been discontinued,” he said.
“When they find out the auditors are coming, they’ll go and stick the expired meds in the pharmacy room and pretty much just lock them up until the auditors are gone. And once they leave, they’ll bring them back out.”
Vallejo says when clinics at the prison would run out of medications, which he says occurred frequently, Corizon administrators would instruct nurses to give patients the expired medications.
Vallejo said he expressed his concerns about all of these allegations to the Corizon Health facility administrator, assistant administrator, assistant directors of nursing and the regional director of nursing. He claims nothing happened in response.
Vallejo saved emails from his superiors that show they were aware of the staffing shortages and the impact it was having on patient care.
Vallejo says he asked Arizona Department of Corrections officials for help as well, to no avail.
“Anytime we try to go to ADC, they have us go up our chain of command at Corizon,” he said. “It got the the point where I started telling inmates to write grievances because we weren’t getting anywhere with management.”
In November 2018, Vallejo and his colleagues sent emails to Corizon Health administrators describing how dire the staffing situation had become.
Vallejo says two weeks after the November email to supervisors stating the nurses would no longer distribute medicines without proper staffing, he was told by his supervisors they were going to report him for abandoning his patients. Vallejo says on Dec. 3, 2018, ADC officers escorted him from the property at Eyman.
‘I Hope Somebody Opens Their Eyes’
Days later, Vallejo contacted KJZZ to tell his story.
“I just hope somebody opens their eyes,” Vallejo said. “I hope something is done about it, because there is a lot of potential there. You have a lot of great nurses there, but we don’t have the resources or the help that we need.”
“Nothing is being done,” Vallejo said, “and nothing will be done unless it’s brought to the light. The only route that anyone can take now is bringing it out to where people can read about it and taxpayers can know what they’re paying for.”
Vallejo believes if Corizon would fill the contracted health care positions and provide better training for new employees, turnover would decrease and the quality of patient care would improve dramatically.
He says he’s heard from former coworkers since his departure who were told by Corizon administrators that if they took a stand like Vallejo did, they would face the same fate.
Vallejo says he continues to worry about the patients he left behind at Eyman.
“They are not asking for anything out of the norm,” he said. “They’re just asking for the medications they need. They’re asking to be seen when they’re supposed to be seen. They’re asking for simple stuff. It’s not anything drastic, just basic necessities that we don’t have the resources for.”
“Somebody needs to do something,” Vallejo said, “or else more patients are going to die.”
The Arizona Department of Corrections recently announced it has selected a new health care vendor, Centurion Managed Care, to take over the state prison health care contract from Corizon Health on July 1, 2019.
Jimmy Jenkins, a staff reporter for KJZZ, Arizona Public Radio, is a 2018 John Jay Justice Reporting Fellow. A fuller version of his reporting, as well as links to his broadcasts, are available here.