Eleanor Slater Hospital has regained its full accreditation though its eligibility to collect federal Medicaid reimbursements remains uncertain.

The accreditation of the state-run system follows three separate unannounced surveys by the national nonprofit standard-setting body in July and August, The Joint Commission wrote to Slater’s chief executive officer, Richard Charest, in a Dec. 21 letter released by Governor Daniel J. McKee’s office. 

The approval comes six months after the hospital system received a preliminary denial of accreditation due to conditions that The Joint Commission said posed risk of an “immediate threat to health or safety.” The commission cited Slater for having a decrepit building, a long-standing medical-gas problem and a dispute in which a patient was told to “go shoot yourself.”

In September, Slater’s status was updated to accreditation pending a six-month follow-up survey.

Slater, which has campuses in Cranston and Burrillville, serves as Rhode Island’s hospital of last resort for patients with complex medical and psychiatric problems 

Slater is paid for primarily through Medicaid, the federal-state health insurance program for low-income and disabled residents. Federal laws prohibit long-term care facilities such as Slater to bill for Medicaid reimbursements if more than half of their patients have a primary psychiatric diagnosis, qualifying them as institutions of mental disease, or IMDs. 

Rhode Island has lost tens of millions in Medicaid funds during the last two years for periods when Slater reported that more than half of its patients were hospitalized due to psychiatric illnesses, which disqualified it for the federal reimbursements.  

So far this year, the state has collected about $47.6 million in federal Medicaid reimbursements for Slater, according to Randal Edgar, a spokesman for the state Department of Behavioral Healthcare, Developmental Disabilities and Hospitals. Some of the reimbursements, which date back to April of 2020, were for patients who are 65 and older, Edgar said, meaning they are Medicare eligible. 

As of Dec. 1, Slater reported that 55% of its patients had a primary psychiatric diagnosis, meaning that it would not qualify for Medicaid reimbursement, according to a draft report submitted to the state’s Executive Office of Health and Human Services. 

Last month, state officials announced plans to relicense part of Slater as a psychiatric facility for patients ordered by the court into treatment. The plan to spin off the Roosevelt Benton Center in Cranston as a psychiatric hospital is designed to reduce the psychiatric patient count at Slater so it can remain eligible for state Medicaid funding. 

Slater’s former chief medical officer is among a handful of employees who raised alarms about state leaders they say for years pressured doctors to label psychiatric patients as medical patients to remain eligible for Medicaid. The hospital is currently under investigation by the state Attorney General’s office for alleged Medicaid fraud related to its patient billing. 

This story has been updated.

Correction: The state resumed billing Medicaid for some Slater patients other than those 65 and older earlier this year. A previous version of this story incorrectly reported the time period during which the state had stopped billing Medicaid.

Health reporter Lynn Arditi can be reached at larditi@thepublicsradio.org. Follow her on Twitter @LynnArditi