PROVIDENCE, R.I. (WPRI) — State leaders on Wednesday unveiled an internal review of Eleanor Slater Hospital, revealing little new information about the many problems plaguing the facility but laying much of the blame at the feet of its current leadership.
Gov. Dan McKee and members of his cabinet released the much-anticipated 10-page report during a news conference. It cites the state-run hospital for a lack of leadership, problems with “threatening behavior, bullying and retaliation,” and an overall “entrenched culture saturated in singular objectives.”
At McKee’s request, the 60-day review was led by Health and Human Services Secretary Womazetta Jones, who offered a series of short- and medium-term recommendations, including an overhaul of the leadership team to “allow for true organizational culture change.”
“Current leadership team has lost the trust and confidence of staff, community, stakeholders and the General Assembly,” wrote Jones, who has had oversight of the agency that runs the hospital since she was first appointed in 2019.
Ahead of the report’s release, McKee announced Monday the hospital’s former interim CEO, Jennifer White, has been put on administrative leave with pay. His office also announced Chief Medical Officer Dr. Brian Daly has submitted his resignation, although the state has so far refused to release his resignation letter. During the news conference, McKee suggested it was submitted as a letter or text message.
The two hospital executives were highly unpopular among union groups and had raised concerns about improper billing of Medicaid, claiming the practice had been going on for many years to ensure a steady stream of federal funding.
“Our concerns are so significant that we cannot in good faith allow our licenses to be associated with that billing,” Daly wrote in a May 5 internal memo obtained and independently verified by Target 12.
Asked whether those people are now out because they raised concerns about the billing practices, McKee said that wasn’t the main reason, but it did factor into the decision.
“The decisions that we’re making are not based on the Medicaid issue, but they are a factor,” he said. “You need to make sure that you’re operating properly and that — if we’re entitled to get federal funding, we’re going to get it.”
The explanation comes at the same time a state-hired team from Butler Hospital is still conducting a separate review of billing practices at Eleanor Slater to try to determine whether the claims of improper billing are accurate. That review has not yet been completed.
While not identifying anybody by name, Jones said she experienced “resistance” from some members of hospital leadership when it came to gathering information for her review. In some cases, Jones said she found out about issues only when they came to light through public-records requests made by people outside government.
“Those reports were not known to me and my office,” she said.
Some of those people continue to work at the hospital, she added, suggesting more changes in personnel could be coming in the future. Following the news conference, McKee received praise from J. Michael Downey, president of the AFSCME RI Council 94 union, which represents a large portion of the employees at the hospital’s Cranston facilities.
“For months Council 94 has raised concerns about the Eleanor Slater Hospital/BHDDH Management Team and the ill-conceived plan proposed by the previous administration,” he said in a statement. “We appreciate Governor McKee’s and Secretariat Jones’s efforts and emphasis on rebuilding bridges between management, patients, residents, their families, and front-line direct care workers.”
“As the new plan is fleshed out we hope that it will strengthen the Regan & Benton Hospital Buildings, RICLAS group homes, and allow our members to keep providing critical services as they have done throughout the pandemic,” Downey added.
In her review, Jones called for a halt to the previous plan laid out for Eleanor Slater, a move McKee already signaled two months ago. But later in the report, Jones recommended that the hospital’s Benton unit in Cranston be licensed as a standalone psychiatric hospital. She also recommended closing its Adolph Meyer unit and suggested a “new” building might be built at Zambarano in Burrillville.
All three of those ideas were major elements of the original proposal that came out from the former Gov. Gina Raimondo administration, and were included in McKee’s initial budget plan sent to the General Assembly in March.
“There’s elements of that original plan that are going to be in the long-term strategy,” McKee conceded, adding that it was unrealistic to achieve them in the original timeframe laid out by the Raimondo administration. The decision to halt the plans contributed to a $40 million hole in the budget year ending Wednesday, which legislative leaders closed in the budget passed last week.
Jones also pointed to some differences between the plans. She said the old one aimed to close the hospital’s Regan unit, which is no longer part of the latest recommendations.
Jones also said they are going to try and figure out whether the hospital campuses could operate under separate licenses, recommending the state hire a consultant “with extensive knowledge and patient care and licensure” to do the work.
When asked if the hospital — currently the subject of multiple reviews and scores of past consultant reports — needed yet another consultant to come in, Jones quickly pointed out that it would only be one.
“The previous plan didn’t talk about what a quote-unquote ‘new building’ could be, but this one is talking about how do we explore not only what it could be, but also, should we or could we repurpose [Zambarano] if we did a new building,” Jones said. “Also, do we need to look at a new building, or could we retrofit Zam. There were items that were brought from that proposal, but there are stark differences that are even within the recommendations that are provided.”
McKee said the public should expect more concrete action plans based on Jones’s recommendations to come out in the coming weeks in the form of additional reports. On Tuesday, McKee suggested he might use money from the American Rescue Plan Act to stabilize Eleanor Slater, which he’s characterized as a top priority for the state.
Rep. David Place, a Burrillville Republican and strong proponent of Zambarano as a health facility and local job center, said Jones’s report validates many of his concerns. It “sets a foundation for proper standards of care for patients residing in Eleanor Slater hospitals going forward,” he said.
“We amplified the astonishing issues at Eleanor Slater Hospital brought to our attention by family members, patients and staff, including the shadow close; the culture of intimidation by leadership; maintenance failures; the need for multiple licenses and hospital level of care; dysfunctional management and rogue operations,” Place said in a statement.
“Governor McKee inherited compounded issues at Eleanor Slater Hospital from multiple administrations,” Place continued. “He has an opportunity to leave a lasting legacy for Rhode Island’s most vulnerable through an exhaustive reorganization and revitalization of one of the state’s greatest resources.”
Jones has technically had Eleanor Slater under her portfolio as health and human services secretary since she was appointed by Raimondo in 2019. But the secretary rejected the idea that she shared any of the responsibility for the ongoing debacle there.
“I do not believe that I shoulder the responsibility,” Jones said.
When asked why, McKee jumped in to defend Jones, saying there were no clear guidelines about who was in charge of what under Raimondo, and saying that’s now changed under his leadership.
“She thought she had oversight of multiple directors, but that wasn’t the case,” McKee said, before adding that he thinks everyone in state government shares some responsibility.