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- UNCLASSIFIEDILAW ENFORCEMENT SENSITIVE (When Completed) <br />How many suicidal prisoners were placed in restrictive housing during the rating period? <br />Prisoner Death <br />Does the facility have procedures to respond to a prisoner's death? <br />CYes CNo <br />Does the facility immediately notify the USMS in the event of a USMS prisoner death? <br />CYes CNo <br />Does the facility review each prisoner death? <br />CYes CNo <br />lnfectious Disease <br />Does the facility have policy or procedures to address the management and reporting of infectious and communicable <br />diseases? <br />CYes CNo <br />Does the plan include: <br />HIV? <br />Tuberculosis? <br />Hepatitis? <br />lnfluenza? <br />Chlamydia? <br />COVID? <br />Ebola? <br />HPV? <br />Salmonella? <br />Scabies? <br />Zika? <br />E. coli? <br />Chicken Pox? <br />C Yes <br />(^ Yes <br />C Yes <br />C Yes <br />C Yes <br />C Yes <br />C Yes <br />C Yes <br />C Yes <br />C Yes <br />C Yes <br />C Yes <br />C Yes <br />CNo <br />CNo <br />CNo <br />CNo <br />CNo <br />CNo <br />CNo <br />CNo <br />CNo <br />CNo <br />CNo <br />CNo <br />CNo <br />Does the facility have an infectious and communicable disease policy or procedures to: <br />lnclude identify prisoners with infectious and communicable diseases? C yes <br />Treat prisoners with infectious and communicable diseases? C yes <br />Quarantine prisoners with infectious and communicable diseases? C yes <br />Does the facility report all cases of infectious and communicable diseases to the USMS? <br />CYes CNo <br />CNo <br />CNo <br />CNo <br />Does the facility maintain adequate PPE for all staff in the event of a pandemic? <br />CYes CNo <br />NOTICE: This document is intended FoR oFFlclAL usE ONLY and may contain LAW ENFoRcEMENT sENSrTtvE oR coNFtDENTtAL information <br />whiah is for the sole use of the intended recipient(s). Any unauthorlzed review, use, disclosure, or distribulion is prohibited. lf you are not the intended <br />recipient, please conlact the sender and destroy all copies of lhis document. Any Protected Health lnformation contained in lhis document is to be used <br />only lo aid in providing healthcare services to federal prlsoners. Any other use is a violation of Federal HIPAA Law and/or the Privacy Act and will be <br />reporled as such. <br />UNCLASSIFIED//LAW ENFORCEMENT SENSITIVE (When Completed) <br />Page 11 of 22 <br />Form USM-218 <br />Rev, 07/21