The chief of medical services at Eleanor Slater Hospital has resigned, charging administrators of the state-run facility with prioritizing billing over medical necessity when deciding who is hospitalized.
Dr. Andrew C. Stone, who has publicly testified about his concerns before state lawmakers, said that rather than working towards meeting the needs of patients “the direction of the hospital appears to be moving backwards,’’ according to a copy of his Oct. 4 resignation letter obtained by The Public’s Radio.
Stone said that during a Sep. 29 meeting with Eleanor Slater employees a top administrator said that the hospital planned to admit more medical patients and discharge more psychiatric patients to “reset” the patient mix by Dec. 1, the next review of the patient census. That review will determine if the hospital qualifies for federal Medicaid reimbursement. “It appears that billing and not patient care is the driving force for who remains institutionalized and who is able to leave ESH,” Stone said in the letter, “not the medical or psychiatric needs of the resident.”
Stone declined to comment Tuesday night. A spokesman for the agency that oversees the hospital confirmed that Stone still works at the hospital but has submitted a letter of resignation. Stone’s contract is scheduled to expire at the end of November.
Responding to Stone’s statements about the hospital’s prioritizing billing over medical necessity, Randy Edgar, a spokesman for the state Department of Behavioral Healthcare, Developmental Disabilities and Hospitals (BHDDH) said in an email, “The approach the hospital is taking regarding admissions, discharges and the IMD (institutions for mental disease) mix is consistent with recent independent evaluations.’’
Stone, who was hired in 2018, said in his resignation letter that he has faced retaliation for acting as a whistleblower, which he said has resulted in “intolerable working conditions.’’ Stone said in his letter that he is giving his 30-day notice and that his last day of work will be Nov. 3.
Stone was among a group of employees who testified last spring about problems at the hospital during legislative hearings at the General Assembly and is the second top doctor to resign from Eleanor Slater.
In July, Dr. Brian P. Daly, the hospital’s chief medical officer, resigned citing fear of retaliation. Daly and another top administrator, Jennifer White, accused the state of manipulating admissions and discharges to keep the number of psychiatric patients below 50% to remain eligible for federal Medicaid reimbursements. White was placed on administrative leave in June, and resigned in July.
A review of the hospital’s billing practices requested by Gov. Dan McKee’s administration found that the state-run hospital was in compliance with Medicaid rules except for a period in May 2021, due to its high proportion of psychiatric patients.
Eleanor Slater, which has campuses in Burrillville and Cranston, serves as Rhode Island’s hospital of last resort for patients with complex medical and psychiatric needs. The hospital is paid primarily through Medicaid, the federal-state health insurance program for low-income and disabled residents.
Eleanor Slater has also come under scrutiny from The Joint Commission, a national nonprofit that accredits hospitals. The hospital was issued a preliminary denial of accreditation in mid-June, after The Joint Commission found conditions at Eleanor Slater posed risk of an “immediate threat to health or safety.” Last month, Eleanor Slater moved one step closer to regaining its full accreditation after a follow-up survey reported improvements.
Health reporter Lynn Arditi can be reached at larditi@thepublicsradio.org. Follow her on Twitter @LynnArditi
