PROVIDENCE, R.I. (WPRI) — Another top doctor at Eleanor Slater Hospital is resigning and expressing concern that the state-run facility is unnecessarily warehousing some patients for financial gain, claiming his attempt to blow the whistle resulted in “retaliation and intolerable working conditions.”
Chief of Medical Services Dr. Andrew Stone, who has been raising concerns over patient care and billing practices for months, submitted his letter of resignation on Monday.
In the letter — obtained and independently verified by Target 12 — Stone said that while he remains committed to the population served at Eleanor Slater, he could no longer work at a hospital that “appears to be moving backwards.”
“The new stated direction appears to favor (again) the unnecessary institutionalization of people whose needs would be better and more appropriately served in alternative settings,” wrote Stone, who was hired in 2018.
Stone declined to comment when contacted Tuesday. A spokesperson for the hospital did not immediately respond to a request for comment. In his letter, Stone said he’s giving 30-days notice and his last day will be Nov. 3. His contract with the state is also set to expire at the end of November, Target 12 has confirmed.
Stone is among a group of Eleanor Slater employees who have repeatedly tried to convince lawmakers and state leaders that the hospital spent years keeping patients inside the long-term acute care hospital long after their needs could have been served at less restrictive health facilities, such as nursing homes.
The requirement to move patients to the least restrictive setting possible has been federal law for roughly a half-century. Stone along with others has accused past administrations of manipulating admissions and discharges over the years to ensure the hospital always has at least 50% medical patients.
By keeping more medical patients than psychiatric patients admitted at Eleanor Slater, the hospital avoids being designated an Institution for Mental Disease (IMD), allowing it to continue collecting tens of millions of dollars in annual federal funding.
The patient census requirement is often referred to as the “IMD mix,” with the goal being to keep the number of psychiatric patients below 50% of all Eleanor Slater patients. The state has breached that number at times in recent years, jeopardizing federal funding.
The federal money for medical patients helps offset the high costs associated with caring for psychiatric patients that are ordered into Eleanor Slater through the state’s courts system. Those so-called “forensic patients” do not qualify for any federal reimbursement.
Hospital leadership has repeatedly denied that the IMD mix has influenced operational strategies. But Stone suggested otherwise in his letter, citing a town hall-style meeting last week with Richard Charest, who leads the state agency that oversees Eleanor Slater.
Chartest “stated the hospital would be admitting more ‘medical’ patients and discharging more ‘psychiatric’ patients,” Stone wrote. “It appears that billing and not patient care is the driving force for who remains institutionalized and who is able to leave [Eleanor Slater], not the medical or psychiatric needs of the resident.”
Stone is the second high-ranking doctor to resign and speak out about what’s going on at the hospital in recent months. The hospital’s former chief medical officer, Dr. Brian Daly, penned a resignation letter with similar themes in July. Daly’s letter came three days after Gov. Dan McKee announced a leadership shakeup at Eleanor Slater.
“I have chosen to leave because I believe the state is intent on returning to practices that I believe are inappropriate and I feel have led to patient abuse,” Daly wrote at the time.
Daly and Stone clashed over the years with the hospital’s unions, whose leaders have argued management created a toxic workplace and were part of an effort to shutter the state-run facility’s Zambarano unit — a move proposed multiple times by Gov. Gina Raimondo’s administration.
At least two unions voted no confidence in their leadership.
The governor’s shakeup over the summer also came after Stone, Daly and others wrote letters to state leaders and testified multiple times during legislative hearings at the General Assembly. Stone claims the state retaliated against him because of those comments.
“My advocacy for the population we serve, and my whistleblowing activities have resulted in retaliation and intolerable working conditions,” he wrote. “The stripping of my duties as retribution makes it impossible to serve the residents of this hospital. Since this adverse environment has not improved, it is no longer sustainable personally or professionally for me to remain at Eleanor Slater Hospital.”