Chapter 5 – Administrative

5.1.3 Medical Bed Management

• Policy

  • The California Department of Corrections and Rehabilitation (CDCR)/California Correctional Health Care Services (CCHCS) adopted a Medical Classification System (MCS) to serve as the process for considering medical factors in making patient placement decisions.

• Purpose

  • The Health Care Placement Oversight Program (HCPOP), in conjunction with CCHCS headquarters Utilization Management (UM), is responsible for providing management and oversight of institutional Specialized Medical Beds and for making patient placement decisions to ensure maximum and efficient bed utilization and to facilitate timely access to the continuity of care.  Specialized Medical beds are defined as Outpatient Housing Unit, Hospice, Correctional Treatment Center, Skilled Nursing Facility, and General Acute Care Hospital Beds.

• Local Level Placements and Discharges

  • Admissions and discharges can be made at the local level and shall be reported as they occur unless HCPOP/UM has placed a hold on the medical bed.  HCPOP/UM staff will review all admissions for appropriate level of care placement.

• Health Care Placement Oversight Program

  • Once HCPOP has placed a hold on a medical bed for an identified placement, the bed shall not be used without authorization from HCPOP. 

  • If an institution holding a bed requests to utilize a medical bed on which HCPOP has placed a hold, the institution shall provide the appropriate  documents (CDCR Form 128-C3, Medical Classification Chrono), CDCR Form 7410, Comprehensive Accommodation Chrono, and CDCR Form 1845, Disability Placement Program Verification) to HCPOP for review by UM to determine appropriate bed utilization.

  • As the availability of beds, programs, and other capacities change, the HCPOP staff will ensure the Medical Classification Matrix and the Medical Classification Matrix Database are updated as needed.  All updated information shall be disseminated to the field through the CDCR Division of Adult Institutions Population Management Unit.

• Medical Bed Placement/Weekends and Holidays

  • When institutional medical staff determines the need for an in-patient medical bed within their institution and one is not available, medical staff shall contact HCPOP to determine if the needed type of specialized medical bed is available at an alternate institution prior to placing/retaining a patient in a community hospital.

  • The need for a specialized medical bed may be for a medical admission, to clear a swing bed (a bed that can be used for either medical or mental health) for mental health, or to return a patient from a community hospital.

  • All transfers made during weekends/holidays are medical and return for short duration to avoid a hospital admission or delay in a community discharge.  The transferred patient shall be returned to the sending institution upon bed availability.

• Contact

  • For questions or clarification, please contact the Chief, Health Care Placement Oversight Program.

• Forms

  • CDCR Form 128-C3, Medical Classification Chrono

  • CDCR Form 1845, Disability Placement Program Verification

  • CDCR Form 7410, Comprehensive Accommodation Chrono

• References

  • Health Care Department Operations Manual, Chapter 1, Article 2, Section 1.2.15, Utilization Management Program

  • Health Care Department Operations Manual, Chapter 3, Article 1, Section 3.1.9, Health Care Transfer

  • Health Care Department Operations Manual, Chapter 1, Article 2, Section 1.2.14, Medical Classification System

• Revision History

  • Effective: 01/2012
    Reviewed: 08/2022