Cases of measles — a highly contagious virus that spreads in close quarters — cropped up in two centers for unauthorized immigrants in Arizona and Texas last month.
The centers are almost 1,000 miles apart, yet they have one thing in common: They are operated by CoreCivic. The publicly traded detention company has secured contracts worth hundreds of millions of dollars since President Trump took office last year, but it has a checkered track record of providing medical care to the people in its facilities.
In recent years, it has been accused of falsifying records to disguise unsafe conditions, failing to provide lifesaving medications, and being slow to take critically ill people to the hospital, according to court records, government audits, sworn declarations and interviews with lawyers and people who were detained.
CoreCivic disputes those accusations and says it provides quality medical care at Central Arizona Florence Correctional Center in Florence and at the Dilley Immigration Processing Center in Texas. Health officials said this week that the spread of measles was limited and appears to have stopped.
But aside from the outbreaks, more than a dozen detainees and immigration lawyers in both states detailed unsanitary conditions and lax care.
They described hourslong waits to see a nurse, only to be turned away and told they were not sick enough to receive care. People with injuries often wait days or weeks to receive X-rays, diabetes patients lack regular access to insulin and people hoping to see outside specialists such as cancer doctors or dentists are frequently denied, many of the detainees and their lawyers said. Those lucky enough to see a doctor and get prescription drugs sometimes must wait days or weeks before the medication arrives, they said.
Illnesses spread rapidly throughout the facilities, the detainees and their lawyers said, accelerated by sleeping quarters that are often cramped and communal bathrooms that are often filthy. Two families and one immigration lawyer said in interviews that when several children fell ill with stomach ailments at Dilley, CoreCivic’s medical staff refused to treat them unless they had already vomited at least eight times.
Last month, an 18-month-old at Dilley was taken to a regional children’s hospital with dangerously low blood-oxygen levels after her parents had begged for weeks for someone at the facility to address her illness, the parents said in an emergency petition for her release. A 35-year-old woman released last week said medical staff initially refused to see her after she began hemorrhaging profusely, soaking through six sanitary pads in an hour; she was ultimately taken to a hospital. And last summer, a 32-year-old man died at the Florence center after being detained at the facility for roughly three weeks. The man had been detained even though he was seriously ill with diabetes and had recently been hospitalized with dangerously high blood sugar.
The federal government issues national standards that require that detainees receive access to appropriate medical, dental and mental health care, including emergency services. But an influx of detainees under Mr. Trump has aggravated the problems with medical care in CoreCivic’s facilities, legal records, inspection documents and interviews show.
In a statement Thursday, a spokesman for CoreCivic, Steven Owen, said that “nothing matters more to CoreCivic than the health and safety of the people in our care.” He noted that its facilities routinely pass government inspections, and said the reports of substandard care “simply do not reflect the hard work our staff does every day to help people in our facilities get the care they need.” He said children who have gastrointestinal symptoms such as vomiting are evaluated and given appropriate medical care.
A Department of Homeland Security spokesperson said that immigrants are in detention by “choice,” because they are allowed to exit if they agree to voluntarily leave the country. The Trump administration has been offering $2,600 and a free flight to people who do so. Detainees receive comprehensive medical care from the moment they enter custody, the spokesperson said. “This is the best health care that many aliens have received in their entire lives.”
Founded as the Corrections Corporation of America in 1983, CoreCivic was one of the first for-profit prison companies in the country. In 2016, it changed its name as it pivoted away from prisons. On Thursday, CoreCivic executives told investors that 23 percent of Immigration and Customs Enforcement detainees are in facilities run by the company, and that ICE is the company’s largest customer.
The Trump administration’s push to arrest and deport millions of people is reshaping the makeup of the country’s more than 200 immigration detention facilities. The detainee population ballooned to about 68,000 people in early February, compared with about 40,000 one year ago, according to ICE.
The surge includes more people with chronic diseases, as well as pregnant women and older people who need intensive, round-the-clock care, according to interviews with detainees, their lawyers and Congressional reports. More than a dozen pregnant women were being housed in a facility in Basile, La., when Senate staff visited last spring, according to a subsequent report. For decades, including during Mr. Trump’s first term, many immigrants facing deportation were not put in detention but allowed to live in their communities until their cases were resolved.
“We are seeing a dramatic increase in people who are being detained despite serious medical conditions,” said Laura St. John, the legal director of the Florence Immigrant and Refugee Rights Project, a group that represents people in detention. Ms. St. John said one of their clients was being treated for cancer when he was detained, and “he is far from the only one.”
Complaints about medical care at CoreCivic facilities predate the second Trump administration.
In 2016, a measles outbreak at a CoreCivic detention center in Eloy, Ariz., infected 31 people. Many workers were not vaccinated, health officials said, and nine employees got sick.
In 2022, the Department of Homeland Security’s inspector general found “critical staffing shortages” at a CoreCivic facility in Torrance, N.M., and recommended that all detainees be removed immediately. That never happened. Last February, lawyers representing whistle-blowers who had worked at the facility told Congress that the company had “grossly mismanaged” its medical operations.
“CoreCivic leadership chronically maintained severe understaffing at the medical, dental and mental health units at Torrance, jeopardizing patient health and safety,” according to the letter the lawyers wrote to Congress. The whistle-blowers also claimed that the company had falsified records to make it look as if they were complying with safety standards.
Mr. Owen said that ICE had disputed the inspector general’s findings from 2022, and he noted that since then, the facility has “not been cited for any deficiencies in care.”
A nurse at another CoreCivic facility in San Diego has raised similar claims. In February 2024, the nurse sued CoreCivic for wrongful termination. In her lawsuit, she claimed that she had faced retaliation after raising alarms about medical care. She accused the company of operating with skeletal staffing — sometimes just two nurses for 1,500 detainees — that led one man to develop a dangerous infection and another to go into multiple organ failure. The lawsuit was settled confidentially. Mr. Owen, the spokesman for CoreCivic, denied that the nurse was fired because she raised concerns about medical care.
Family members and a local Democratic state representative have raised questions about the death in August of Lorenzo Antonio Batrez Vargas, a 32-year-old man who died in CoreCivic’s Florence facility. Mr. Vargas had multiple health problems, including diabetes, elevated blood sugar and a foot wound, and contracted Covid while he was in the detention center, according to an initial ICE summary of his death. Mr. Vargas was found unresponsive and was later pronounced dead. The summary details how medical staff checked Mr. Vargas’s blood sugar levels on multiple occasions until he was isolated with Covid. There is no mention of those checks continuing after that. The D.H.S. spokesperson said Mr. Vargas was provided with proper medical care, and said the cause of death was still being investigated.
In a GoFundMe page to raise money for funeral expenses, Mr. Vargas’s family described his death as a “tragedy compounded by the circumstances under which he died; alone, likely from complications of Covid-19, and without the medical attention he deserved.” The family declined to comment.
Mr. Owen, the spokesman for CoreCivic, referred comment on individual detainees’ cases to ICE. He said all detainees can sign up for medical or mental health care. Emergency care is always available, he said, and the company coordinates access to outside specialists and hospitals.
Mr. Trump’s immigration crackdown has been good for CoreCivic, which has opened a number of detention facilities in the past year. One of those is at a former state prison about 75 miles from Bakersfield, Calif., which started taking detainees last summer.
Just months later, lawyers with the American Civil Liberties Union brought a class-action lawsuit against ICE on behalf of sick immigrants at the facility. The lawyers said that detainees were denied insulin, cancer treatment and heart medications. The company has said the facility will bring in revenue of $130 million a year. Earlier this week, a judge ruled that ICE must install a monitor at the facility and provide “timely access to prescribed medications.”
At Dilley, which is about 70 miles south of San Antonio, immigration lawyers have logged more than 1,000 complaints of poor medical care since the facility was reopened by the Trump administration last April, according to Faisal Al-Juburi, the co-chief executive at the Refugee and Immigrant Center for Education and Legal Services, or Raices, which represents immigrant and refugee families in Texas.
As of January, more than 1,200 people were detained at Dilley, according to ICE.
Elora Mukherjee, an immigration lawyer who represents families at Dilley, said her clients are constantly sick. “They are coughing, they have fevers, they are not feeling well.”
One mother and father from Russia, who have been at Dilley since October, said in a sworn declaration and in an interview that when they arrived, their 11-year-old daughter had an earache, but the medical staff did a cursory examination and dismissed them. They returned repeatedly as their daughter developed a fever of 104 degrees, only to be told her problems were caused by allergies, they said. She was eventually given ear drops and antibiotics, but she lost some of her hearing and was still in pain as her family noticed pus coming from her ear. As of last week, her hearing had still not fully returned, they said.
The mother, whose name is Oksana, said that patients at Dilley who need medicine often must wait in long lines, outside in the evening. One worker mocked the children crying in line, she said. Oksana and other detainees spoke on the condition that their last names be withheld because they were afraid of retaliation.
In other cases, families reported that staff downplayed their concerns until they became medical emergencies. In January, 18-month-old Amalia developed a fever that lasted for nearly 19 days and lost two pounds, according to a medical review provided by her lawyer. She spent several days in the hospital and was diagnosed with Covid, pneumonia and other infections. The D.H.S. spokesperson said that Amalia received “proper medical care.”
Anastasia, the 35-year-old mother whose hemorrhaging led her to bleed through six sanitary pads, said she was eventually taken to a hospital after pleading with staff and after they demanded proof, and she complied by showing them her bloody pads. She was prescribed medication that took weeks to arrive, and said the bleeding continued.
Late last week, she and her family were released after spending more than 120 days at Dilley. Days later, CoreCivic reported its fourth-quarter earnings: Revenue from ICE more than doubled, and the company’s chief executive boasted that 2026 was already shaping up “to be another year of strong growth.”
Edgar Sandoval and Albert Sun contributed reporting and Susan Beachy contributed research.
Katie Thomas is an investigative health care reporter at The Times.
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