DAVID K. DUNCAN, Magistrate Judge.
After more than three years, it is clear to the Court that Defendants are unable or unwilling to meet several of the Stipulation's requirements. Defendants have submitted, and the Court has adopted, multiple remediation plans. (Docs. 1619, 2030) Defendants have revised and re-revised these remediation plans and yet, pockets of non-compliance persist. For example, PM 42 at Eyman has been non-compliant since April 2017 and Defendants have stopped proposing substantive revisions to their remediation plan. (Docs. 2801-1 at 83-85; 2807 at 68) Similarly, PM 39 at Lewis has been non-compliant for eight of the last 12 months and Defendants most recent plan is that they "will continue to utilize the same corrective action plan as set forth in the [previous] update." (Doc. 2874-1 at 79-80)
For other performance measure/locations, Defendants have not even attempted a substantive remedial measure and have simply informed the Court that a new hire will solve the problem. For example, PM 50 at Tucson has been non-compliant for 11 of the last 13 months. Defendants informed the Court on May 9, 2018, that "A new clinical coordinator has been hired and is currently in the process of on-boarding. Effects of this action should be reflected in the May audit." (Doc. 2803-1 at 5) At the Status Hearing, Counsel could not address basic issues and had no information about how hiring one new person could constitute a remediation plan or would solve the previous year's non-compliance. (Doc. 2807 at 165-166) Accordingly, the Court ordered a remediation plan. (Doc. 2810) In response, Defendants responded with an explanation of the hiring history of the clinical coordinator position. (Doc. 2858-1 at 2) However, when Defendants had the position filled, PM 50/Tucson was non-compliant so it is unclear to the Court, and Defendants do not explain, why refilling the position will solve the underlying problem(s) and create compliance.
In another example, PM 19 at Lewis has been non-compliant for at least 13 consecutive months. Defendants submitted a corrective action plan on May 9, 2018, that stated "A new DON [Director of Nursing] started March 12 and, upon arrival, began addressing medication administration issues. . . . Due to the large number of staff that will need to be trained on the new plan, full plan development and implementation will not be accomplished until July 2018." (Doc. 2801-1 at 39) This means that for the previous year, Defendants did not attempt to create a solution.
The Court further notes that the show cause hearing did not result in full compliance with the subset of PM/locations targeted by the OSC. Moreover, the OSC only covered some of the failing PM/locations and, in the year since the OSC was first raised, other PM/locations have been consistently non-compliant. For example, PM 42 at Florence has been non-compliant for 12 of the last 13 months, PM 42 at Lewis has been non-compliant for 8 of the last 10 months, PM 44 at Florence has been non-compliant for the last three months, PM 52 at Tucson has been non-compliant for 8 of the last 10 months, and PM 67 has been non-compliant for 10 of the last 12 months. (Doc. 2801-1 at 86, 88, 93, 162, 183) It appears that Peter has, in fact, been robbed to pay Paul.
Defendants have professed that they welcome ideas from Plaintiffs. (Doc. 2071 at 137-138) To the extent that this knowledge-sharing has occurred, it has not produced compliance. Based on Defendants' representations to the Court and the monthly CGAR reports, it appears that Defendants do not have additional ideas or resources that they can rely upon to obtain compliance with the Stipulation. As a result, the Court has determined that it is not efficacious to require Defendants to submit yet another revised remediation plan. (Doc. 1185 at ¶ 36)
"The ongoing, intractable nature of this litigation affords the district court considerable discretion in fashioning relief." Armstrong v. Brown, 768 F.3d 975, 986 (9th Cir. 2014). Accordingly, as part of the Court's remedial authority under the Stipulation (Doc. 1185 ¶ 36), the Court will require Defendants to hire outside experts who can perform the analysis necessary to understand why deficiencies persist and to opine as to the policies and procedures necessary to compel compliance with the Stipulation.