PROVIDENCE, R.I. (WPRI) — Rhode Island has submitted a corrective action plan to a national agency that is threatening to revoke the accreditation of Eleanor Slater Hospital, providing a window into how officials are responding to a scathing report that described the facility as a “dangerous environment.”
The R.I. Executive Office of Health and Human Services made the plan public Thursday, showing the state developed different strategies to address some of the problems raised by The Joint Commission, a national accrediting agency that reviewed the hospital last month.
“These documents show the significant progress that [state] staff have achieved in maintaining accreditation,” EOHHS spokesperson Kerri White said in a statement. “While more work remains, our staff have stepped up to ensure ESH is a safe place for its patients to heal and thrive.”
The Joint Commission’s review last month revealed dozens of health and safety issues at the state-run hospital, including five immediate threats to life, such as a dispute in which a patient was told to “go shoot yourself.”
Following the report, the state set up an interagency task force dubbed the “Tiger Team” to address many of the cited issues. The corrective action plan detailed a range of long-term and immediate fixes, including spending $200,000 in emergency funds to hire a contractor to repave the hospital’s Zambarano campus outside area in Burrillville to “make it safer for the patients to go out on the grounds.”
In the Joint Commission report, agency officials said a patient in a powered wheelchair was tipping over in the roadway when they arrived because the chair was “stuck in a rut on the shoulder of the road.”
“The four of us were able to free her and safely place her in the center of the roadway,” wrote the officials. “There was no staff outside monitoring the patient at the time.”
State officials for the past few weeks have scrambled to try and address some of the problems, which have clearly been festering for years at the hospital. The corrective action plan was accompanied by a separate document showing about 30 work orders had already been completed, including several related to the facility’s buildings — many of which The Joint Commission described as “decrepit.”
In the state’s plan, officials repeatedly cited $42 million appropriated in the state budget as the source of funding that would go toward fixing the many problems at the hospital. Gov. Dan McKee successfully lobbied the General Assembly to restore that funding after finding that the hospital was facing a multimillion-dollar operating budget hole inherited from the Raimondo administration.
“Governor [McKee] has provided commitment that the hospital [will] not be shutting down but will continue operations in the future,” state officials wrote in the plan. “Legislature has restored $42M for fiscal 2022 and allocated emergency funds to help with facility repair and maintenance.”
Target 12 has requested cost estimates and contract details.
One of the most damning items detailed in an overall scathing report involved an incident from May 2019 — on Mother’s Day — when a registered nurse determined they were short staffed and couldn’t send a patient upstairs for dinner. According to the report, the patient complained and the nurse became “aggressively defensive.”
“The exchange escalated and the hospital report alleges that the nurse said the patient should ‘go shoot yourself,’” according to the report.
In response, state officials said the nurse “did not follow the patient rights regulations,” which was used as the rationale to fire her. But the National Association of Government Employees, a union group representing the nurse, disputed the decision and an arbitrator “did not uphold the termination,” according to the corrective action plan.
To address the issue, the state said it is requiring all Eleanor Slater staff to complete training in “workplace violence, prevention of abuse and neglect, code of conduct and patient’s rights and responsibilities,” according to the report.
The Joint Commission reported the nurse is still employed at the hospital.
In another area of high concern, state officials acknowledged that non-safety officials were making safety-related decisions related to the hospital’s medical gas system. The Joint Commission cited that as an immediate threat to life, saying “there was no evidence that leadership had responded to multiple instances of process failures relating to patient and/or environmental safety.”
As state Sen. Jessica de la Cruz, R-North Smithfield, detailed in a Senate Oversight Committee hearing last month, safety officers raised the issue with the hospital’s chief operating officer, Christopher Feisthamel, in January 2020. But he largely dismissed the problem, citing time and cost.
“We don’t have the time to repair it and we don’t want to sink a bunch of money into an old building,” he wrote in an email at the time. “At one point, we were told that it would be about $1M to fix the system.”
In the corrective action report, state officials said executive leadership is rewriting agreements to ensure concerns are addressed rapidly, and that “the open issues are being fixed expeditiously.”
The Joint Commission has issued the hospital a preliminary denial of accreditation, but state officials hope the corrective action plan will help remedy that. The Joint Commission previously threatened to revoke the hospital’s accreditation in 2017, citing life and safety problems with the facilities including too many “ligature risks,” or areas that would make it easier for patients to commit suicide.
In addition to having trouble with accreditation, Eleanor Slater has been the focus of at least half a dozen outside reviews since 2019 — including at least three that are happening right now — as the hospital continues to make headlines for its money woes, toxic workplace and subpar building conditions.
R.I. Attorney General Peter Neronha has launched his own investigation into the hospital, as well.
McKee and Health and Human Services Secretary Womazetta Jones recently pushed out several high-ranking hospital officials, pointing to the Joint Commission report as evidence that the hospital hasn’t been run well. The officials had also been raising the alarm about improper Medicaid billing practices.
In the Joint Commission report, one employee was cited as claiming the only time state officials ever showed up to fix issues at the hospital was when the accrediting agency conducted its review every three years.
State officials nonetheless are hopeful the most recent response to the many long-term problems will be enough to save the hospital’s accreditation, a key requirement to receiving millions in federal funding.
“Accreditation could be restored shortly after the Joint Commission returns to Eleanor Slater Hospital to complete its ‘onsite validation survey,'” White said.
The next visit is expected to happen in late August, according to state officials.