According to a report by medical receiver Clark Kelso, healthcare within California's 34 prisons continues to improve, however problems persist in contract prisons where the state pays to house its overflow inmate population. Four of the seven prisons in Kern and San Bernardino counties are owned by the GEO Group; three are owned by small communities. The worst problems were at GEO's women's prison in McFarland. According to Kelso's report, inmates there went without a physician for a month. The report cites all seven contract prisons for a "lack of accountability" and failure to employ qualified physicians to meet their state requirements to have doctors available at least five days a week. As a result, Kelso said, inmates with health problems have had to be returned to state-operated prisons for their care. Medical care at the state's own prisons continue to improve, Kelso's report notes, and his office is now preparing to return healthcare management to the state, one prison at a time. The independent Office of Inspector General in April deemed inmate care at Folsom State Prison adequate, positioning it for final review by Kelso's office and a return to state control.