NORTH PROVIDENCE, R.I. — From the outside, Our Lady of Fatima Hospital looks pristine. The grounds are neatly manicured, with white, religious statues and crosses and an unassuming brick building.
But the inside of this for-profit, safety net hospital owned by Prospect Medical Holdings is riddled with hazards, including bedbug infestations, cockroaches, mice, and other problems that put patients at “immediate” risk, according to court documents obtained by the Globe.
Buttons that are supposed to monitor radiation exposure were not functioning properly, mold is visible, and leaking ceilings and pipes have caused slip and fall hazards, according to a letter OSHA penned to the hospital in November 2023.
Roger Williams Medical Center in Providence, which is also owned by Prospect Medical Holdings, is facing similar problems. Though the emergency room was renovated in 2019 as part of a $15.1 million project and the building’s exterior looks impressive, during a visit earlier this year accreditors with the Joint Commission found brown water flowing from an eye wash device, “black substances” on the walls, improper sterilization, and problems with staff administering anesthesia, the court documents show.
“The conditions at these hospitals ... are completely unacceptable and a direct result of Prospect’s lack of investment in these facilities. Our members see it on a daily basis,” said Brad Dufault, a spokesman for United Nurses & Allied Professionals, which represents workers at both facilities.
The two hospitals treat a large number of patients from low-income and underserved communities who rely on Medicaid. On June 12, state Superior Court Judge Brian Stern released a 45-page decision ordering Prospect to pay $17 million in unpaid bills within 10 days, following a lawsuit filed against the Los Angeles-based hospital owner by Rhode Island Attorney General Peter F. Neronha. At the time, Neronha outlined a series of violations in a 106-page petition that he said raised “significant concerns” about the financial viability of Roger Williams Medical Center and Our Lady of Fatima Hospital. The hospitals currently owe $24 million to vendors, and have had to cancel surgeries for lack of adequate supplies.
Prospect has “created a situation of great urgency” at the hospitals, Stern wrote in his decision.
“Not only are the hospitals scrambling to obtain supplies day to day,” wrote Stern. “But other areas of the hospital are falling into disrepair.”
In an email to the Globe on June 13, Otis Brown, a spokesman for Fatima and Roger Williams hospitals, said “all of the deficiencies” detailed in the court documents made public by Stern’s decision “have been corrected promptly.” When asked if that included financial deficiencies, Brown did not immediately respond. He also did not respond to the Globe’s requests for comment on the judge’s order to pay $17 million within 10 days.
Gary Hopkins of Blanco + Hopkins & Associates LLC, a California public affairs firm that regularly represents Prospect, also did not respond to the Globe’s request for comment
Brown said the two hospitals “remain in compliance” with the Rhode Island Department of Health. Joseph Wendelken, a spokesman for the department, told the Globe the facilities have “submitted a plan of correction.”
Earlier this year, Joint Commission staff members visited Fatima Hospital, a 312-bed acute care facility in North Providence that first opened in 1954. They noted improper sterilization techniques, unsecured medications and supplies, and a lack of competency assessments for nurses administering sedation and performing blood-glucose testing, according to court documents. They also found expired medications and expired filters on osmosis devices that could lead them to stop filtering effectively and even release contaminants like bacteria back into the water.
In March, federal inspectors found that Fatima Hospital failed to report a patient’s death that was associated with the use of restraints to the Centers for Medicare & Medicaid Services, which is required by law no later than the close of business on the next business day. The patient, who was seen in the emergency department on Jan. 26, was placed in four restraints after attempting to jump off the bed, spit, and scratch staff. Within an hour, the patient was found unresponsive and “had a cardiac arrest while in restraints,” according to an inspection report obtained by the Globe.
At Roger Williams Medical Center, a 220-bed acute care hospital in Providence founded in 1922 and historically known for its cancer care, employees failed to wear personal protective equipment for hazardous medications like chemotherapy, and failed to properly record vital signs during blood transfusions. Discharge instructions also were issued to some patients in the wrong language, Stern wrote in his decision.
In late March, inspectors with the Rhode Island Department of Health conducted a complaint investigation survey at Roger Williams and found that the condition of the hospital posed “immediate jeopardy” to the health and safety of patients. Inspectors found “extensive” water leaks in “multiple areas of the hospital,” including through the ceiling and into a light fixture with live electrical wires. Waste baskets were placed around the building to collect water, including in operating room suites, and blankets were used to sop up puddles.
Several months earlier, an investigation by the state health department found that Prospect collected all revenue from Fatima Hospital and Roger Williams Medical Center every day andgave the hospitals a smaller “operating allowance” once a week. In a 2023 compliance order, the Department of Health said Prospect underfunded the two hospitals to such an extent that it impacted operations.
The scrutiny over the hospitals’ operations comes as Prospect has been trying to sell several of the 17 hospitals it owns in five states. The Centurion Foundation, an Atlanta-based private nonprofit, is attempting to buy the two in Rhode Island. Together, the Roger Williams and Fatima hospitals employ about 2,800 people and care for thousands of patients each year.
The attorney general has said Prospect uses the Rhode Island hospitals “as a private bank” and treats accounts payable “as a credit facility loan.” The attorney general could reject the sale to Centurion, approve it, or approve it with hefty conditions to which current hospital executives and Centurion would have to agree.
Prospect’s lawyers have previously warned that if the judge attempted to force Prospect to pay the hospitals’ bills, Prospect could have the hospitals file bankruptcy or even close them. Prospect’s executives have made such threats before, as recently as 2021 while in a dispute with Neronha over its ownership structure.
If Prospect fails to comply with the court order to pay the $17.3 million, “we will pursue all available and appropriate remedies,” attorney general spokesman Timothy Rondeau told the Globe in an email on June 13.
Alexa Gagosz can be reached at alexa.gagosz@globe.com. Follow her @alexagagosz and on Instagram @AlexaGagosz.