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DETROIT — Michigan State University's failure to detect and stop sexual assaults by now-imprisoned sports doctor Larry Nassar indicates a lack of institutional control, according to a U.S. Department of Education report.

The nearly 50-page program review report is dated Dec. 14, 2018, and was prepared by the Education Department's Federal Student Aid office. The Associated Press obtained a copy of the report from Michigan State via email on Wednesday.

The report accuses the East Lansing school of being out of compliance in areas under the Clery Act, which requires universities participating in student aid programs under Title IV to provide the campus community with information about public safety issues.

Hundreds of girls and women said Nassar sexually molested them while he worked for Michigan State and Indiana-based USA Gymnastics. Nassar, who admitted molesting some of the nation's top gymnasts for years under the guise of medical treatment, is now serving decades-long prison sentences for sexually assaulting patients and possessing child pornography.

Eleven girls and women who told university officials or campus security about the assaults are listed in the report.

The Spartan Stadium on the campus of Michigan State University in East Lansing, Michigan. Leon Halip / Getty Images file

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Unflattering to Michigan State, the report details what the school did — and didn't do — once they began complaining of being molested by Nassar during treatment for sports-related injuries.

It includes examples of incidents involving Nassar that never were officially lodged, documented or recorded.

"The university's persistent failure to take swift and decisive action to detect and stop Nassar's two-decade long predatory and abusive behavior indicates a lack of institutional control, especially in light of the credible information reported to institutional officials at several points over many years," the report stated. "This failure, alone, clearly demonstrates the institution's most serious administrative impairments."

Michigan State also failed to compile and disclose accurate and complete crime statistics because the statistics did not include sex crimes that Nassar committed during the years in which the statistics were reported.

"These violations date back to at least 1997, and involve victims, many of whom were minors at the time of the abuse, who reported these incidents to trusted adults, including coaches and athletic trainers," the report said.

The report also says no warnings were issued about 21 burglaries and other crimes from 2011 to 2016.

The review requires Michigan State to make changes that include providing complete and accurate crime statistics. The school also must conduct its own review of all Clery-reportable offenses and other incidents or events that may have constituted a dangerous condition reported from Jan. 1, 2011 to Dec. 31, 2017 to determine whether timely warnings or emergency notifications were required, and whether or not the university issued a warning or notice.

School spokeswoman Emily Guerrant said Wednesday that Michigan State is working on a written response to the report, which will be considered by the Education Department. That process could take several months to complete, Guerrant said.

"The university is committed to cooperating with the department and is carefully reviewing the preliminary findings," she added. "Our staff will continue to focus on making improvements to ensure accurate and transparent reporting on campus crime policy and statistics. It is our goal to be in full compliance with Clery Act requirements, which is one of the many ways we are working to strengthen campus safety."

Michigan State has been heavily criticized for its mishandling of past complaints against Nassar that allowed his abuse to continue and also for mismanaging the fallout. Three former employees, including former President Lou Anna Simon, are facing criminal charges.

Earlier this month, trustees forced out interim president John Engler who had announced he would step down after about a year on the job. A former Republican governor, Engler had been accused of making disparaging remarks about Nassar victims.

After Engler was hired by the board, Michigan State agreed to a $500 million settlement with 332 women and girls. Of that, $75 million will cover future claims.