PROVIDENCE, R.I. (WPRI) -- Thundermist Health Center won't miss payroll next week and is no longer facing imminent threat of closure after the health care provider successfully secured $9.5 million over the past few weeks from insurers, hospitals and state and federal taxpayers.

Thundermist, a Woonsocket-based federal health center that serves some of Rhode Island's poorest residents, has been facing a financial crisis that's put it at risk of going into receivership, laying off hundreds and ending care for 62,000 people.

But interim CEO Maria Montanaro, who was rehired to turn the nonprofit around, said outside entities have stepped up with loans, grants, advanced payments and public funds to help Thundermist "no longer be living paycheck-to-paycheck." Earlier this month, she had told Target 12 the nonprofit didn't have enough cash on hand to make payroll by next week.

"We are no longer at risk of closing," Montanaro said Friday, praising the different groups for stepping in to help them out of their immediate financial problems. She said they now have enough cash to ensure they can make payroll for at least the rest of their fiscal year, which ends next summer.

"The reason that the stakeholders have stepped up with a sense of urgency is because they understood that if we were to close, it would probably break the back of the primary care system for the state's most vulnerable people," she added.

Montanaro provided a breakdown of the fundraising efforts, including a combined $5.4 million from the state's four health insurance companies: Blue Cross & Blue Shield, Neighborhood Health Plan of Rhode Island, Tufts Health Plan and UnitedHealthcare. Montanero underscored that NHPRI was the first to step in.

"Without their early help, we would not have been open in September," she said. "They have been heroic."

Landmark Medical Center provided a $500,000 no-interest loan, while Care New England made a $250,000 no-interest loan and a $250,000 grant, according to Montanaro. And securing all those the funds has allowed Thundermist to tap into a risk-related restricted account inside the organization totaling $1 million.

The rest of the money is slated to come from taxpayer-funded entities, including $1.4 million from Thundermist's federal regulator, the Health Resources and Services Administration, which provides emergency funds to federal health centers in distress.

Gov. Dan McKee's administration is also using the Medicaid program to provide at least $1 million in "enhanced federal medical assistance percentage payments" -- known as e-FMAP payments -- "to help ensure continuity of operations."

"Thundermist, like all of the federally qualified health centers in the state, provides much needed care to some of our most vulnerable residents," state spokesperson Stephanie Menders said. "Given their current situation, our leadership team, with support from Governor McKee, felt it was critical to extend financial support at this time."

Montanaro said the state has agreed to pay Thundermist an additional $1 million in e-FMAP funds if the organization meets a series of conditions, including hiring an outside auditor to review its current budget and turnaround plan. Thundermist must also hire a firm to conduct a forensic audit of its past spending to examine how the nonprofit ended up in such a perilous financial situation.

Monatanaro said Thundermist is in the process of hiring those firms. The first audit is due in December, with the forensic expected to be done in March, she added. A final condition from the state was to ensure Thundermist's board "is fully able to provide the financial oversight that the organization needs," she said.

Montanaro has blamed former CEO Jeanne LaChance for the current financial situation. LaChance was fired this summer at the same time the nonprofit almost missed payroll, and Montanaro said earlier this month LaChance was negligent "for the performance of her responsibilities to both the board and the agency."

But Montanaro on Friday acknowledged the board didn't do a good enough job overseeing LaChance's leadership, adding that there will be some changes, along with an effort to bolster board membership from its current 13 members to something closer to the 25 members that's allowed under the organization's bylaws.

"As an organization, it needs improvement," she said, adding that she expects four new members to join the board in the coming months and for some of the existing members to resign.

"The board feels very accountable," she said.

Montanaro declined to provide any specific comments on whether any current employees were being held accountable for the organization's financial disarray. The nonprofit laid off 124 of its 907 employees last month, and Montanaro said there had been some "requested resignations."

"They have been requested," she said. "There will be other amounts of reorientation in administrative areas."

Internally, she said, Thundermist is also trying to bolster its revenue by having health providers increase the number of patients they see. Montanaro said the organization recently reopened services to new patients that had previously been closed.

The organization also overhauled its IT and payment systems, which she said has already improved how long it takes for the organization to receive payments. Montanaro announced the board has also hired back former CEO Chuck Jones, who's expected to take over for Montanaro -- who had been in semi-retirement -- by the beginning of January.

"It's still a very challenging environment, but we have the turnaround plan and the right people in place," she said. "It's a lot of work."

Montanaro said Thundermist will be able to pay back any borrowed money in part because Thundermist is due $10 million in employee retention tax credits from the federal government. She said Rhode Island U.S. Sens. Jack Reed and Sheldon Whitehouse helped her establish a director line with IRS officials, who confirmed the organization's application is now under consideration.

The American Rescue Plan Act program was temporarily halted last year due to high levels of fraudulent requests, and when it resumed earlier this year the IRS was dealing with a backlog of applications, Montanaro said.

"It's been almost a year," she said, adding she now expects the payment to come through in December.

While Montanaro celebrated having solved the imminent cash-flow crisis, she warned the organization is still suffering from an $800,000 monthly structural deficit. She's bullish they will continue to chip away at that hole, which is already down from $2 million.

But she warned no federal health care center will survive over the long term unless the state increases its Medicaid reimbursement rates. She said Thundermist has had a rate-increase request allowable under current law in front of state regulators since summer 2023.

Getting that approved will help Thundermist's structural deficit, she said, but she's adamant rates still need to go up for health centers to be sustained over the long-term.

"When every health center is being paid somewhere between 60% to 70% of their costs, they cannot survive," she said. "If we don't survive, the state's entire safety net for health care collapses."

The Medicaid reimbursement rate has long pitted health care officials against lawmakers, who are responsible for setting rates legislatively. House Speaker Joe Shekarchi has already said he expects a tight budget in the upcoming year, and he's wary about how many organizations have already come to him asking for more money.

Speaking at a Rhode Island Public Expenditure Council event Wednesday, Shekarchi warned he's unwilling to give Thundermist any extra money unless the nonprofit can clearly explain what happened.

"We need accountability," Shekarchi said. "We need to know what happened before we commit new money to an organization, or a department, or a community in distress."

Shekarchi and Montanaro met earlier this month, and a spokesperson said conversations between their staffs have continued since.

"They need to explain to us what went wrong, how they're going to fix it, is it fixed -- before they ask for new money," Shekarchi said.