Newly disclosed documents reveal state hospital closing plan, neglect

Dec 28, 2023

PROVIDENCE — A consultant hired by the former Raimondo administration recommended in no uncertain terms in October 2019 the closure of the state-run Zambarano hospital in Burrillville, according to a newly disclosed document.

In a long-withheld Oct. 31, 2019, report to the state agency that oversees the hospital, the Alvarez & Marsal consulting firm wrote: "Assume closure of Zambarano Campus, transitioning those patients to Nursing Homes (and other various levels of care)."

Zambarano is one of the two hospital campuses under the umbrella of the state-run Eleanor Slater Hospital (ESH) for patients with serious psychiatric and medical disorders resulting, in some cases, from gunshot wounds and automobile accidents.

More:10 things to know about the Eleanor Slater Hospital controversy

"This scenario assumes an 18-month plan, but we recognize that this timeline is heavily dependent on available and/or new capacity and should be reassessed as progress is made,'' Alvarez & Marsal wrote.

The consultant's report also presaged what happened over the next year and a half as the Raimondo administration suspended efforts to collect an estimated $60 million to $70 million in federal Medicaid reimnbursement dollars:

"Scenario 1 assumes that ESH is not currently billing for Medicaid and will not do so in the future as it transitions to an in-patient psychiatric hospital. ... Federal match is captured for patients transitioning into community-based settings and Nursing Homes."

The Department of Behavioral Healthcare, Developmental Disabilities and Hospitals did not respond Friday to questions about this newly released consultant's report, which is dated almost a year before state legislators were briefed on possible cost-saving options.

But spokesman Randal Edgar noted in an email that the 2019 report was "followed by a more in-depth review by Alvarez & Marsal in 2020,'' and "plans put forth by the previous administration following the second report have been put on hold."

But House Oversight Committee Chairwoman Patricia Serpa told The Providence Journal that Antonio Afonso, a top aide to new Gov. Dan McKee, told lawmakers on a walk-through of Zambarano on Thursday that: "We have received and reviewed the A & M report ... and I can tell you: It is unacceptable.'

"And as far as this facility closing, his words were, It's not going to happen. He said that in a roomful of people."

(The McKee administration has not yet commented on this account.)

A second newly released document indicates neglect of some basic maintenance at the hospital, during a period when Kathryn Power, the previous director of the agency that oversees the hospital, denied the plans to close the hospital.

Her agency — now under the helm of state Health and Human Services Secretary Womazetta Jones — also withheld access to the initial Alvarez & Marsal report until Friday.

The two newly public documents shed light on what was happening behind the scenes while the administrators of the hospital embarked on a campaign to discharge patients — many of whom had lived at the hospital for a decade or more — as part of a still-unapproved cost-cutting and downsizing plan.

On Friday, the McKee administration belatedly made public the previously requested findings of a Feb. 22 inspection by the state fire marshal's office of the buildings on the Burrillville campus of the Eleanor Slater Hospital.

The report lists 112 "violations" which administration spokesman Brian Hodge characterized this way:

''Based on a thorough inspection, the Office of the State Fire Marshal believes there is no imminent threat to the patients or employees of the facility at this time. [While] the inspection did discover items that needed immediate attention, those were quickly remedied. All other violations pose no immediate threat.

"The number of violations found is reflective of the size of the facility and it is not uncommon for a facility of this size to have a correspondingly high number of violations."

The findings ranged from apparent neglect to design flaws: accumulated lint behind the dryer in the washroom, inadequate venting and cleaning of the exhaust system in the kitchen. and inaction on door-hardware problems identified a year earlier.

A sampling of some of the others:

"The two built-in phone booths provided with folding doors lack sprinkler protection. ... Closet in room 2-13 has coats hanging from sprinkler piping."

"Waste cooking oil is being stored in a container in the loading dock area that was not listed for the purpose of storing cooking oil and was not equipped with normal vents nor emergency relief vents."

"The dishwasher is located in a wet area. All electrical outlets in this area lack Ground Fault Circuit-Interrupter Protection."

"The system smoke detector near room 2-4 is hanging from its circuit conductors."

"The basement has a pit 30" deep containing mechanical equipment. This pit lacks guards preventing injury of persons from falling during normal use of the building."

And this: "It is unknown if the building's fire protection is designed to properly protect the fire hazards associated with the kitchen industrial oven."

Only one of the findings was deemed serious enough to temporarily relocate oxygen-dependent patients from the hospital while repairs were made. All but one — who chose to stay on the Cranston campus of the hospital — have since returned.

The finding — first "communicated" on Feb. 22 and listed as resolved by March 22: "Oxygen zone isolation valves on North 1, South 1, North 2, Northeast 2, South 2, North 3, Center 3, South 3 are leaking. Oxygen and vacuum piping are painted and not properly labeled."

The report references "inspection documents from William G. Frank Medical Gas & Consulting, LLC dated January 22-23, 2020,'' but does not say what they revealed.

On April 1, The Journal asked the administration for "any reports, including maintenance reports, documenting problems with the 'Med Gas' system at the state-run Zambarano hospital."

A spokesman for the Department of Administration denied that the state's property management division had any earlier reports about the leaky valves.