We discuss the consistency of a recently proposed class of theories described by an arbitrary function of the Ricci scalar, the trace of the energy-momentum tensor and the contraction of the Ricci tensor with the energy-momentum tensor. We briefly discuss the limitations of including the energy-momentum tensor in the action, as it is a non fundamental quantity, but a quantity that should be derived from the action. The fact that theories containing non-linear contractions of the Ricci tensor usually leads to the presence of pathologies associated with higher-order equations of motion will be shown to constrain the stability of this class of theories. We provide a general framework and show that the conformal and non-minimal couplings to the matter fields usually lead to higher-order equations of motion. In order to illustrate such limitations we explicitly study the cases of a canonical scalar field, a K-essence field and a massive vector field. Whereas for the scalar field cases it is possible to find healthy theories, for the vector field case the presence of instabilities is unavoidable.