In Pennsylvania, nearly all inmates serving life terms will die inside prison walls. The Laurel Highlands prison has a full-time hospice service, based in part on a hospice unit in California, which can care for seven inmates at a time. Medical staff are responsible for all the patients' healthcare, while inmates provide companionship and physical help such as lifting patients out of bed. Volunteer inmates visit patients several hours each week, playing games, helping them write letters and sometimes just keeping them company. Special arrangements are made so family members can visit and the prison ensures they'll have access when the patient is dying. Dedicated rooms for hospice are uncommon, so inmates at many facilities die in open wards and staff at some facilities lack expertise in pain and symptom management, said a nurse and hospice expert who has previously worked as a consultant for the department. Under the state's compassionate release rules, a sentencing judge has the power to release inmates only if they are near death, have a nursing or hospice facility that will take them and have shown that their needs aren't met in prison.