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Slater Hospital’s resigning top doctor claims state practices ‘led to patient abuse’

Target 12

PROVIDENCE, R.I. (WPRI) — Eleanor Slater Hospital chief medical officer Dr. Brian Daly told state leaders he’s resigning out of concern they are driving the hospital back toward old ways of operations that he claims have led to patient abuse.

The hospital’s top doctor submitted his letter of resignation Thursday, three days after Gov. Dan McKee’s office announced he would leave amid a leadership shakeup. He told state leaders he can no longer associate himself with a facility where the likelihood of an adverse event is “too high.”

“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 said, adding that keeping patients in a facility where a national accrediting agency just cited the hospital for five immediate threat-to-life violations “is a form of abuse.”

Daly is one of a handful of employees who has raised concerns for months about improper billing practices at the hospital, claiming Eleanor Slater doctors for years have been pressured by leadership to designate psychiatric patients as medical patients in order to remain eligible for tens of millions of dollars in federal funding each year.

In some cases, the approach has resulted in patients remaining in the hospital for years, even though they could have been discharged and received the same level of care in less restrictive settings, according to Daly’s testimony to lawmakers over the past two months.

In 2019, Rhode Island stopped billing Medicaid for reimbursements after similar concerns were raised. Billing has yet to resume, costing the state millions of dollars in services once covered by the federal government.

Earlier this year, McKee’s office announced it would restart billing, but again put the effort on hold after Daly and others voiced concerns that the problems had not been fixed.

“Our concerns are so significant that we cannot in good faith allow our licenses to be associated with that billing,” Daly wrote in an internal memo on May 5.

In his four-page resignation letter, independently obtained and verified by Target 12, Daly said he initially planned to remain at the hospital until starting a new position elsewhere in the fall.

But he decided to change course after hearing the state had placed the hospital’s former interim CEO, Jennifer White, on administrative leave. White had raised concerns about billing issues at the hospital for nearly two years.

Daly said he believes White was put on leave for “reasons related to intimidation and retaliation,” and he’s now planning to leave at the end of the month instead of the fall. (White declined to comment about the personnel move when contacted earlier this week.)

“I felt I had to expedite my departure,” he said, adding that his plans changed the day after he heard about White. “Quite frankly, I feared I would be next, and I now have reason to believe that this was indeed the plan.”

The letter, first reported by The Boston Globe, comes a day after McKee and his cabinet members released a 10-page report detailing many of the well-known issues currently plaguing the state-run hospital. His administration laid much of the responsibility at the feet of current leadership, reporting it had “lost the trust and confidence of staff, community, stakeholders and the General Assembly.”

The McKee administration initially refused to release Daly’s resignation letter, which didn’t actually get submitted until Thursday. State officials sent it to Target 12 after this story was published, and McKee through a spokesperson declined to comment on Daly’s claims.

On Wednesday, McKee said he didn’t ask for Daly’s resignation, which the doctor confirmed in his letter. When asked then why Daly was leaving, the governor told reporters to go ask him. Daly declined to comment when contacted Thursday, saying he didn’t know if he was allowed to speak to reporters, “despite the governor’s inviting people to ask me.”

Asked Wednesday about the perception that the state was pushing out the same people who have been blowing the whistle on potentially fraudulent billing practices, McKee said the Medicaid issue 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.

McKee also pointed to last week’s report by The Joint Commission that showed the hospital’s nearly 200 patients are currently living in a “dangerous environment.” The governor suggested the report showed the need for a change in leadership, which union groups have also been calling for in recent months.

In his letter, Daly pushed back on that idea, saying The Joint Commission report “was indeed a scathing indictment of the hospital facilities and the leadership above the hospital. Any effort to fault me or anyone else at the hospital for these things would be an effort to deflect blame downward. That would represent the decades-long refusal to accept responsibility that has led to all of the problems now present at the hospital.”

He cited the last time The Joint Commission visited the hospital in 2017, when it cited ligature risks in the facilities that make it easier for psychiatric patients to harm themselves. Daly noted that those issues — which long predated his time at the hospital — remain unfixed.

“Prior to Wednesday … and since I have been in state service, no one in a position to officially rate me had ever stated or implied my work was ‘not good enough,'” he said. “Quite the contrary, everyone who has reviewed me in my official capacity has rated my performance as exemplary.”

Daly expressed frustration with the way he’s been treated, saying, “I have many times hoped that I have been wrong about the things things I have uncovered and about the issues related to billing.”

“Indeed, it would have made my life much easier,” he wrote. “To this date, no one has approached me with any significant evidence to show me how and why I am wrong. And I have not yet been treated like a valuable employee who raised legitimate concerns.”

Eli Sherman (esherman@wpri.com) is an investigative reporter for WPRI 12. Connect with him on Twitter and on Facebook.

Copyright 2021 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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