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In resignation letter, Eleanor Slater Hospital leader says state’s practices have led to patient abuse

“I have chosen to leave because I believe the State is intent on returning to practices that I believe are inappropriate and I feel have led to patient abuse,” the chief medical officer of the Rhode Island’s state-run hospital says in his letter

The Eleanor Slater Hospital in Cranston, R.I.Lane Turner/Globe Staff

PROVIDENCE — The chief medical officer of the troubled Eleanor Slater Hospital said in a resignation letter submitted Thursday that he is leaving in protest and in fear of retaliation for speaking out.

“I have chosen to leave because I believe the State is intent on returning to practices that I believe are inappropriate and I feel have led to patient abuse,” Dr. Brian Daly wrote in his letter, which was submitted Thursday and obtained by the Globe.

A psychiatrist by training, Daly has been chief medical officer at Eleanor Slater Hospital and its parent agency, the Department of Behavioral Healthcare, Developmental Disabilities and Hospitals, since August 2018. He has become the target of criticism from unions representing workers there. For months, he has raised concerns that the hospital has been improperly billing the Medicaid program. He has also said the state is manipulating patient census counts to keep it on the right side of those Medicaid billing rules, all to the detriment of patients who shouldn’t spend decades institutionalized in a hospital.

“I believe that keeping patients in our current facilities … is a form of abuse,” Daly said.


The state-run Eleanor Slater Hospital system has campuses in Cranston and Burrillville. They care for patients who have a range of psychiatric and medical conditions, including patients who were court-ordered to obtain mental health treatment and those suffering the long-term effects of car crashes or drug overdoses.

The administration of Governor Dan McKee’s predecessor, Gina Raimondo, had proposed revamping the hospital system, building a new skilled nursing facility at the Burrillville site and closing two buildings at the Cranston site. Backlash from unions and local elected officials was swift. In the meantime, the state has been unable to bill the Medicaid program for months-long stretches because Eleanor Slater Hospital had more psychiatric than medical patients, a rule that’s intended to prevent hospitals from becoming warehouses for the mentally ill.


Daly said in his resignation letter that he has another job lined up for the fall. He was planning to stay at Eleanor Slater Hospital until late in the summer to help the hospital system deal with a review by the Joint Commission that cast a harsh light on the hospital’s facilities, he said. But after a colleague, Jennifer White, was placed on leave, Daly said he feared he was next, and decided to expedite his departure.

Daly also criticized the way the announcement of his job move was handled. He said he emailed Director Richard Charest Monday morning to say he was leaving. They had a pleasant conversation in-person, Daly said, and Daly asked for 24 hours to hold off on an announcement until he could notify colleagues, as well as an assurance that the state wouldn’t make it seem like he was “a head that rolled.”

“Yet within 5 hours neither was the case due to circumstances that remain unclear to me,” Daly wrote. “This obliges me to formally set the record straight now.”

Daly declined to comment for this story. But he makes the case in his letter that the Joint Commission report, which preliminarily denied accreditation to the hospital, cast a harsh light not on his leadership but on those higher up — namely, the state government’s own leaders. In fact, the clinical practices were a bright spot in the report, he said.


“Any effort to fault me or anyone else at the hospital for these things would be an effort to deflect blame downward,” Daly wrote. “That would represent the decades-long refusal to accept responsibility that has led to all of the problems now present at the hospital.”

Daly will continue to serve in his position until July 31, the state has previously said.

The state has never publicly said Daly was being forced to resign, and McKee said at a news conference Wednesday that he hadn’t asked Daly to resign. McKee also said the personnel move had nothing to do with billing practices. But the implication was clear: when asked about Daly and White, McKee responded: “I don’t think anybody has been trying to provide services that they weren’t trying to do their best, the problem is, their best wasn’t good enough.”

In his letter, Daly disagreed with the governor’s statement.

“Prior to Wednesday, June 30, 2021, and since I have been in state service, no one in a position to officially rate me had ever stated or implied my work was ‘not good enough.’ Quite the contrary, everyone who has reviewed me in any official capacity has rated my performance as exemplary.”

Brian Amaral can be reached at brian.amaral@globe.com. Follow him on Twitter @bamaral44.