CRANSTON, R.I. (WPRI) – Preliminary estimates suggest Eleanor Slater Hospital remains out of compliance with federal regulations tied to its patient mix, meaning the state will likely continue to miss out on tens of millions of dollars in federal support for at least another six months.

The R.I. Department of Behavioral Healthcare, Developmental Disabilities and Hospitals – which oversees Eleanor Slater – provided Target 12 with a preliminary estimate Friday showing psychiatric patients made up more than half – 55.5% – of the 207 people receiving treatment at the hospital as of Dec. 1.

The snapshot estimate – taken once every six months – is designed to help the state Medicaid office determine whether the hospital should be considered an Institution for Mental Diseases, or IMD, meaning in the simplest terms that it has more psychiatric patients than medical patients.

Based on the new estimates, Eleanor Slater would remain ineligible for federal funds under the law that was created in an attempt to discourage states from institutionalizing psychiatric patients in state-run facilities.

The hospital hasn’t been able to bill for the federal funds for months, as the patient mix was also out of whack the last time it was measured in May. And while BHDDH spokesperson Ryan Erickson said the current report wouldn’t be finalized until the state’s Medicaid office signs off on it, the agency has already examined any potential fallout financially.

“The state’s [current] budget assumed that federal billing in the current fiscal year would be limited, so this does not appear to materially change budget assumptions for the current year,” Erickson said.

The R.I. Executive Office of Health and Human Services, which oversees the state’s Medicaid office, declined to comment on the numbers. Spokesperson Ashley O’Shea said the office is “currently reviewing the data in accordance with the State and Federal regulators. Once that review is completed, EOHHS will release a final determination.”

The IMD designation has been a pain point for the state for decades, and it turned into a financial and regulatory headache beginning in 2019. A group of whistleblowers at the time raised concerns that the state wasn’t properly counting psychiatric patients and some people were being placed improperly in the long-term acute care hospital. The state stopped billing for federal reimbursements, costing upward of $60 million in general revenue the following year.

A Target 12 investigation last month detailed how the IMD mix has influenced decisions around admitting and discharging patients at the state-run facility for at least the past decade.

The hospital’s operational costs total upward of $500,0000 per patient per year, making the hospital a significant expense to the state — especially without federal support. The financial woes have been somewhat muted in recent years, however, because of the ongoing influx of federal COVID-19 pandemic relief money.

But R.I. Senate Oversight Chairman Sen. Louis DiPalma, who also serves on the Finance Committee, said the ongoing financial and regulatory issues at the hospital should not be ignored.

“Not addressing this is having an impact on us being able to do other kinds of investment across the state in the health and human services area,” DiPalma told Target 12 after reviewing the latest patient mix.

Eli Sherman ( is a Target 12 investigative reporter for 12 News. Connect with him on Twitter and on Facebook.