House Democrats RI nix have proposed $ 65 million Zambarano nursing home
PROVIDENCE, RI (WPRI) – Lawmakers in Rhode Island have rejected more than $ 65 million proposed for a new skilled nursing center at the Zambarano unit at Eleanor Slater Hospital, saying they will wait rather than the Governor Dan McKee unveils his future plans for the struggling health care system.
RI’s House finance committee on Thursday revealed its revised version of the proposed $ 13.1 billion state budget for fiscal year 2021-2022. The tax and spending plan, backed by House Democrats, includes McKee’s recently proposed amendment to close an existing $ 40 million budget hole in the hospital – a shortfall the governor blamed on his predecessor, Governor Gina Raimondo.
But lawmakers’ revised budget would also remove more than $ 65 million McKee proposed earlier this year to build the new nursing home to replace the hospital’s Zambarano unit in Burrillville.
“It is near and dear to our hearts,” Speaker of the House Joseph Shekarchi, a Democrat, said of Zambarano. “But he has yet to come up with a formal plan.”
After his initial proposal in March, McKee put his plan to restructure the hospital on hold, saying he needed to better understand many of the underlying issues first. He has since pledged to present a new plan to the General Assembly by the end of June, which Shekarchi said he would start evaluating at that time.
The state-run hospital system made headlines this year due to various controversies over its finances, staffing and operations. Rotary Attorney General Peter Neronha has launched an investigation into patient care and finances at Eleanor Slater. His investigation is one of at least five separate reviews currently underway there.
Earlier this week, the Joint Commission – a national healthcare accreditation agency – launched an unannounced review. The process typically takes place every three years, but it was delayed last fall due to the coronavirus pandemic. Accreditation is a critical condition for continuing to receive federal funding through the United States Centers for Medicare and Medicaid Services.
Rhode Island has not billed the federal government for hospital reimbursements for over 18 months. And state officials have struggled to determine if Eleanor Slater is in compliance with Medicaid regulations. The federal government is demanding that the long-term care hospital have more medical patients than psychiatric patients, a mix that the hospital has struggled to manage in recent years.
Earlier this year, the state said it could restart billing, announcing that it first planned to retroactively bill the federal government nearly $ 10 million back to last spring. But a later report came out showing that nearly 80% of patients were considered psychiatric, far exceeding the regulatory threshold of 50%.
Earlier this month, senior hospital officials told lawmakers the state has likely mistakenly counted psychiatric patients as medical patients for years in the hospital, raising broader questions about compliance.
This week, McKee’s office said the state had slashed its Medicaid claim to include only patients 65 and older, a group of nearly two dozen of the approximately 200 patients currently living in establishment.
At the same time, McKee’s aides said the state had hired a team from Butler Hospital to conduct an independent review of the number of beds occupied by patients with mental illness as a primary diagnosis.
The group – hired at an average hourly rate of $ 105 per person – will also look at how many people are receiving psychopharmacologic drugs to treat primary psychiatric illness, according to a contract reviewed by Target 12.
The contract – which is expected to run for the entire month – states that the total cost to the state will not exceed $ 60,000, unless otherwise changed.
In more than a year of financial turmoil at the hospital, lawmakers have become frustrated with the apparent inability of the Raimondo and McKee administrations to get the problem under control. Shekarchi paused on Thursday before saying he would pledge to allocate more funds to the hospital system this year.
“We may be back here in the fall,” he said. “When the governor publishes his plans, we will begin our review. ”