BOP Program Statement 6270.02 § 2

The OMDT considers the following issues, in addition to other clinical factors, when designating

inmates for medical, surgical, or psychiatric care.

a. Length of Hospital Stay. Acute care requiring hospitalization of the inmate will usually be

provided in a community hospital near the institution. Most institutions will be able to locally

manage hospitalizations between seven and 14 days for acute medical care or surgical procedures

followed by one to three post-operation appointments.

b. Follow-Up Care. Requests for Care 3 and Care 4 transfers should only be submitted when

the inmate is stable for transport. OMDT will not routinely process or authorize transfer for

inmates who have not been approved for discharge/transfer from a community hospital or when

appropriate testing/reports are not completed. However, inmates requiring ongoing inpatient care

or intensive follow-up care may be considered for MRC transfer. Additional factors include:

 prognosis for continued long-term treatment and rehabilitation

 local institution resources to provide the necessary nursing care

 cases requiring long-term skilled nursing care

 overriding case management and/or security needs for the transfer

c. Available Community Resources. OMDT will determine if there are sufficient community

resources to handle a specific inmate or medical condition. If the community resources are not

available, re-designation may be considered.

d. Institution (non-MRC) Medical and Mental Health Resources. Each institution’s Health

Services Administrator (HSA) will maintain an EMS-A206.060, Medical Resources Directory

(MRD) listing the availability of specialized medical and mental health services on-site, such as

dialysis, blood transfusions, wound care, intravenous antibiotics, Residential Drug Abuse

Treatment Program (RDAP), and physical therapy. A link to the MRD is available on the OMDT

Section, HSD page on the Bureau’s intranet site. Institutions will provide this MRD to OMDT

and update this directory at least quarterly and/or as changes in staffing patterns or the

availability of community medical and mental health resources occur.

6270.02 5/7/2026 PROPERTY OF US GOVERNMENT 3

 MRD changes will be reported on the applicable form and forwarded as an email

attachment to OMDT/Medical Designations email box quarterly.

e. MRC Medical and Mental Health Resources. Each MRC HSA will maintain a Medical

Resources Directory (MRC/MRD) listing the availability of specialized medical and mental

health services on-site, such as dialysis, blood transfusions, wound care, intravenous antibiotics,

Residential Drug Abuse Treatment Program (RDAP), and physical therapy. Each MRC will

utilize the specialized MRC/MRD Excel template to ensure accurate and up-to-date information

regarding MRC services. This template will be available on the Utilization Review Section, HSD

page on the Bureau’s intranet site. MRCs will update this directory at least quarterly and/or as

changes in staffing patterns or the availability of community medical and mental health resources

occur

 MRC/MRD changes will be reported on the applicable template and forwarded as an

email attachment to the Utilization Management email box quarterly.

f. Co-morbidities. The mere presence of multiple chronic medical conditions is not sufficient

to justify an MRC transfer. When making a referral, the primary diagnosis and reason for referral

(e.g. surgery, chemotherapy, comfort care) should be identified.

g. Custodial and/or Case Management Requests. When there are specific custodial or case

management reasons for transferring an inmate with medical problems (e.g. Central Inmate

Monitoring (CIM) considerations, court-ordered evaluation or treatment, mandatory participation

in non-medical programs), the circumstances must be documented in the re-designation request

and supporting documentation, such as Special Investigative Services (SIS) reports must be

attached to the re-designation (770) or treatment complete (413) request.

h. MRC On-Site Treatment Availability. If a major medical treatment or procedure can be

performed internally at an MRC but would have to be done externally at the referring institution,

a re-designation will be considered.

i. Medical Furloughs. Institutions may consider medical furloughs consistent with Program

Statement Inmate Furloughs.