RI state hospital gets 90 days to fix problems that put patients in 'immediate jeopardy'

PROVIDENCE – The McKee administration has been given an additional 90 days by the federal government to address recurring problems at the state hospital that have placed patients in "immediate jeopardy."

At stake are millions of dollars in potential federal reimbursement for patient care at the Eleanor Slater Hospital from Medicare and possibly Medicaid.

The state's so-called "last resort" hospital has about 200 patients on two campuses, in Cranston and Burrillville. 

Report:Lapses at state hospital reached 'level of immediate jeopardy'

Eleanor Slater Hospital 'plans for correction'

In a letter obtained by The Journal, the federal Centers for Medicare & Medicaid Services on May 17 advised the state it had received acceptable "plans for correction" for the many deficiencies it cited in a sharply critical report in January.

"However, on March 3, 2022," the letter said, state Health Department inspectors "completed an unannounced onsite complaint investigation ... of your hospital and identified additional non-compliance [of] the following Medicare conditions of participation .... patients rights...nursing services."

On April 2, a state health department team completed another "unannounced onsite complaint in investigation ... of your hospital and identified additional non-compliance."

"In addition," the letter said, the "non-compliance was of such a nature that it reached the level of immediate jeopardy" to patients which, though later resolved, has left the hospital once again in limbo.

The details of the incidents that prompted the two unannounced visits are not disclosed in the letter.

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CMS report findings

CMS initially gave the hospital an April 14 deadline to fix – or present an acceptable plan for fixing – the many problems cited in its unreleased January statement of findings.

Among the findings cited in the report obtained independently by The Journal: 

• "The hospital failed to complete the required observation/safety checks for 17 patients."

• "The hospital failed to provide the necessary supervision to maintain safety."

• "The hospital failed to ... monitor patients placed in restraint devices to ensure their physical and psychological needs were met."

• Even more basically, "the hospital failed to demonstrate adherence to nationally recognized infection prevention and control guidelines, as well as to best practices for the prevention of transmission of the SARS-CoV-2, 2019 Novel Coronavirus as evidenced by failure to complete COVID-19 screening protocols upon entry to 2 of 4 hospital buildings."

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In its May 17 letter to Richard Charest, director of the state agency that runs the hospital, the CMS gave the state an additional 90 days "to regain substantial compliance" with the requirements for the hospital to qualify for Medicare payments..

The new deadline is Aug. 15.

Late Thursday, the state Department of Behavioral Healthcare, Developmental Disabilities and Hospitals provided a copy of the letter, the approved plans of correction and this statement:

"CMS’s approval of the three [earlier] plans of correction indicates that the agency is satisfied with ESH’s plan ... Eleanor Slater Hospital continues to make progress, as evidenced by CMS’ approval of three plans of correction, and the remaining issues raised by CMS are being addressed."