Gracedale By the Numbers

I've written three times about last week's Gracedale's Oversight Committee meeting. Continuum of Care Director Tom Carson has told NorCo Council established that an operational assessment they obtained in 2023 has been largely ignored by a former county executive who opposed it. We learned that the county's CNA training program was actually stopped by the state Department of Health. We also discovered that Gracedale, currently operating with a provisional II license, had two G-level deficiencies (actual harm) in September and failed to inform County Council. Most astonishingly, the very matter that led to an investigating grand jury had still been unresolved. There still is no formal protocol between Upper Nazareth police and Gracedale on 911 calls despite several attempts by the police to establish one. I'll finish my reporting about this meeting with some of the facts presented by Administrator Michelle Morton.

Employment Hires & Separations. - From January through August, Gracedale had 78 new hires, but lost 59. 

Open AFSCME positions (incorrectly spelled as AFCME) in Morton's report - In Dining, there are 43 positions, of which 23 are staffed. In Housekeeping, there are 54 staffed positions, of which 16 are open. In nursing there are openings for 319 CNAs, with only 69 positions staffed. There are 51 LPN positions staffed, with another 134 unfilled.  

Why did Executive Tara Zrinski raise the salaries of front-line workers before the nursing supervisors. She said the union actually asked her to raise the wages of nursing supervisors first. She added that the large number of open positions "will get better if you throw money at it." 

There are many dedicated employees, including 11 people with 30-35 years at the home. 

What about RNs? Morton failed to provide that information. 

Admissions. - Gracedale has had only 48 admissions this year through July. Over that same period, 56 residents have left. Average daily census dropped from 493 in January to 463 in August. 

Finances  - Gracedale is projected to lose about $2.3 million in 2026 according to one slide, but in another the loss is about $1 million. 

NorCo Council Needs to Adopt Rules Concerning Social Media Use

Northampton County employs a full-time communications director who periodically provides informational posts about what is happening in the county, like the need for a few more elections workers or drop box locations. But increasingly, the person paid by taxpayers is using a governmental social media platform to instead promote both the county executive as well as her agenda. This needs to change and the best way for that to happen is by having County Council adopt a social policy ordinance to prevent elected officials from self-promotion or advocacy on issues that have yet to be endorsed by the governing body. It should never be used to promote a private business. Both of these happened on Sunday. 

In a Facebook post, the "County of Northampton" on Sunday posted a message that promotes Executive Tara Zrinski's proposed tax hike with the argument that seniors and the disabled can apply to the state for a rebate. This leaves the realm of information and goes into advocacy to promote a tax hike that has yet to be adopted by the governing body. If the County Exec wishes to engage in advocacy or self-promotion, she should do so from her own Facebook page and use her own resources, not a communications director employed by the county. 

Even more disturbing than the position advocacy or self-promotion, the county's official Facebook page was also used to promote a real estate agent who could "help" you determine what your home is worth. This real estate agent then misrepresents that there is only one county hearing on Zrinski's proposed tax hike. "Just reach out to me, I'm your neighbor. .... If you're a homeowner in Northampton County, I'm here to help," says the real estate agent. 

There will actually be five budget hearings before adoption, rejection or amendment of the Proposed 2027 budget. They will happen on October 21, 2026, October 28, 2026, November 4, 2026, and November 18, 2026 and December 3, 2026. All the October and November meetings will be at 4:30 p.m. The December 3 meeting will start at 6:30 pm.

County Council's social media policy ordinance should bar the use of a government page from promoting elected officials or advocating issues that have yet to be decided by the governmental body. It should be used instead to share useful information about the county and its departments. 

Are We Going to Cheapen Humanity by Livestreaming Executions?

Though I'm an old fart who's seen many things, I've never actually witnessed the violent death of another human being. I've seen its immediate aftermath a few times. It stays with you forever. I remember going with my father for some reason to the south side Bethlehem home of a man who killed his son in a rage. Blood was everywhere, along with cockroaches crawling up and down walls and along the floor as women wailed. It stays with you. It changes you. It is why I believe most combat veterans are so unwilling to discuss their experience. It changes the murderer, too. I've seen it in their eyes, if I look long enough. The warm light of humanity flickers and then is gone. What's left is death.

As I'm sure most of you know, the US military plans to livestream the firing squad execution of a mass murderer who himself was an Army psychiatrist. DHS Secretary Markwayne Mullin defended this, saying it is a way to restore American values. I believe it erodes them and debases us, not just as Americans, but as human beings. 

Hopefully, President Donald Trump will stop this madness. I'm not holding my breath. 

A 2023 Operational Assessment of Gracedale, Paid for By Taxpayers, Collected Dust for Three Years

Northampton County Council's Wednesday discussion with Continuum of Care Director Thomas Carson and Gracedale Administrator Michelle Morton included a detailed discussion of the 2023 Affinity operational assessment. at Gracedale. 

This report was ordered by a previous County Council over former Executive Lamont McClure's veto. Council thought it would be helpful to have some "outside lens" on Gracedale. Tara Zrinski, then a Council member, supported McClure's veto. 

This outside performance audit has pretty much been collecting dust since that time. After Michelle Morton was hired as Administrator in March 2025, it was never provided to her. She told County Council on November 9, 2025, that she had yet to see this report. When she testified before the Investigating Grand Jury on December 30, 2025, she still had failed to read it. 

Carson has. 

He told Council it produces a remarkably candid picture of the problems facing Gracedale. This raises questions about why many of the report's recommendations were not addressed sooner. Carson suggested Gracedale use the 2023 Affinity report as a blueprint and give current management time to implement its recommendations. He noted many of its findings and recommendations are the same issues he has been reporting to now County Executive Tara Zrinski.

Carson plans to meet with Gracedale's administration and nursing leadership and go through the Affinity report line by line to determine what needs to be done. "I'm not going to stand here before this committee and suggest everything is fine when the facts tell us otherwise," he declared. But he also stressed that Gracedale's problems are only a part of "the entire story." He has met employees who have devoted years and even decades to Gracedale and remain deeply committed to its residents.

Carson said employees want leadership that listens, communicates, holds people accountable and is present. His commitment to Council was straightforward: "I will tell you what I know, I will tell you what we are doing about it, and I will be accountable for the results."

Affinity findings that Gracedale had no referral tracking system, was poorly marketing itself and had no formal daily "standout" or shift-turnover meetings, have remained poorly addressed. But the most striking part of Carson's presentation involves employee morale.

The Affinity report said employees felt demoralized by negative media coverage and the frequent public discussion of Gracedale's problems. Carson said that finding remains relevant. He mentioned one employee had told him that she covers the Gracedale logo on her sweatshirt when leaving the facility because she is embarrassed to be identified with Gracedale.

WAGES AND AGENCY STAFFING

Affinity found that Gracedale's wages were noncompetitive. Three years later, that is still the case. Carson said some employees struggle to make ends meet, feel forgotten by the county, and many leave for higher-paying jobs. He described compensation as a "critical" problem.

Carson said the recent increase in nursing-supervisor pay was a step in the right direction and that paying all nursing staff more could result in the elimination of agency nursing. The Affinity report said Gracedale spent approximately $11.3 million on agency staffing in 2022. Now it's roughly twice that amount.

In one positive note, nine people were beginning new-hire orientation last week, the largest number Carson has seen since he arrived a few weeks ago. 

Only one is a nursing supervisor, but Carson "hopes" at least 90% of the supervisor positions are filled by the first quarter of 2027. 

WHY WAS THE 2023 REPORT SHELVED?

Council member Dave Holland asked Carson perhaps the most important question of the evening: Why was Council only discussing a taxpayer-funded 2023 report in October 2026 when it contained apparently relevant concerns?

Carson was unable to answer because he was not at Gracedale in 2023 and could only speculate that someone the report was unneeded.

AGENCY CONTRACT AND RATES

Council member Nadeem Qayyum had questions about the disparity between county and agency hourly rates.

Examples cited during the meeting included:

CNA: $17.88 county versus $36.40 agency.

LPN: $25.50 county versus $53.20 agency.

RN: $32.60 county versus $84 agency.

Morton acknowledged that agency rates are substantially higher.

THE CNA TRAINING PROGRAM WAS STOPPED BY DOH

Council member Lori Vargo Heffner asked what happened to a CNA training program that had once been used to recruit workers. Morton said originally that the program had been placed on hold because too many people were using it to obtain their CNA training and then leaving for jobs elsewhere. She later told the truth, admitting that the state DOH actually removed Gracedale's training certificate as a result of deficiencies, meaning the facility currently is unable to operate the CNA training program. 

Vargo Heffner asked whether Gracedale could require trainees to remain employed for a certain period or repay training costs if they leave. Morton said Pennsylvania law prevents the county from simply imposing such a requirement. She was asked to send the legal authority to Council's Solicitor for review. 

In effect, Gracedale was spending money and staff time training people who were not necessarily staying at Gracedale.

Morton also said Gracedale's population has changed. Whereas the facility had historically been more heavily geriatric, it now has many more residents with mental-health issues and associated behavioral challenges.

Management decided that staff-development resources would be better spent providing additional training to existing employees.

There was also a second problem: following an abuse incident last July, the Department of Health removed Gracedale's training certificate, meaning the facility currently cannot operate the CNA training program.

UNANSWERED QUESTIONS 

Though Carson appeared sincere, he was hesitant and neither he nor Administrator Micheelle Morton were able to answer fully at least seven substantive questions or information requests.

1. How many Gracedale employees are covered by union contracts?

2. How many union positions are filled and how many are vacant?

3. How many employees are outside the union?

4. The biggest unanswered question was posed by Council member Jason Bouletter. How many county-employed nurses are required to operate a 450-bed Gracedale without agency nurses? - Both Carson and Morton looked like deer caught in the headlights when asked a pretty important financial and resident care question.

5. What were the exact dates of the three new Department of Health citations?

6. When will the agency contract receive a formal audit, and what would that audit show?

7. Why were the recommendations in the 2023 Affinity report not fully implemented before 2026?

There were also several questions that initially received incomplete answers and required Council members to press for clarification, particularly concerning agency staffing, the formal shift-change meetings and the CNA training program.

THE BIGGER ISSUE

The testimony creates an interesting paradox.

Carson and Morton both essentially agreed that the Affinity report identified legitimate problems. They also agreed that many of those problems are still relevant. What's troubling is that several problems identified in 2023 — referral tracking, marketing, employee morale, communication, accountability and staffing — remain issues three years later.

And the biggest unanswered question may be the one Carson was asked directly: Why did a taxpayer-funded report identifying these problems in 2023 apparently sit without being fully implemented until the current administration began addressing them?

Carson's answer was essentially that he was employed elsewhere and hence was unable to explain what happened. Morton's explanation was that current management independently identified many of the same issues and has been working on them since she arrived.

That leaves an important accountability question for County Council: Who was responsible for implementing the Affinity recommendations between 2023 and the arrival of the current Gracedale leadership, and why were so many of them still outstanding three years later?

Two words. Lamont McClure. He bristled at the notion of an operational assessment and simply ignored it. 

(More to come on Monday). 

Gracedale Still Has No Protocol with Upper Nazareth Police for 911 Calls

 On June 23, 2025, repeated calls to 911 occurred when Octavia Robinson, an agency nurse who was suffering some sort of mental health breakdown, decided to perform an exorcism on a resident (E.B.) by assaulting her. In addition to sticking fingers down E.B.'s throat and stuffing clothes and towels into E.B's mouth, Robinson was seen pounding E.B.'s back and chest with her fist, screaming that there was a demon inside E.B. This assault continued for 30 minutes before police responded. She was seriously injured and died shortly after the assault though her death was unrelated to the assault. 

In the 14 months that have passed since this incident, the county has yet to establish an official protocol with police concerning 911 calls and what is or is not an emergency. My understanding is that when receiving a 911 call, the dispatcher will first contact Gracedale to determine whether there is a real emergency. But no formal policy has been established, even after residents made multiple calls to 911 about a mentally ill nurse who was allegedly assaulting a resident. On June 23, three calls had to be made before a nursing supervisor got off her ass to check out the complaint. Then it was she who placed the fourth call. 

It is this incident, and an obvious breakdown in communications between Gracedale and Upper Nazareth police, that led District Attorney Steve Baratta to commence a Grand Jury investigation. You would think that something that sparked a grand jury investigation might induce Gracedale and county administrators to establish a formal policy. According to Upper Nazareth Tp Police Chief William Cope, he has reached out several times and has written to the county but has been ignored. 

At Wednesday's Gracedale Oversight Committee hearing, Continuum of Care Director Tom Carson told Council member Jason Boulette that he asked for a meeting but has received no response. 

But he only asked for a meeting this week. ... 14 months after an assault in which a resident could easily have been killed. 

Boulette told Carson that Chief Cope requested a meeting in June and after the Grand Jury report, releases a statement saying that he had followed up on that letter and had requested a meeting. 

"I've been in contact with him," said Boulette. "I know he's been reaching out and trying to get a meeting."

I don't know about you, but I am simply astonished that Gracedale has made no effort to establish a formal 911 protocol.  Administrator Michelle Morton should have been on top of this as soon as it became clear that three 911 calls were made before a nursing supervisor decided to do her job.

This is clear mismanagement, and it has continued until now. 

Third Suicide at NorCo Jail

In late June, I told you that there had been two suicides at NorCo jail within the span of 10 days. Executive Tara Zrinski has acknowledged a third suicide on September 23. 

Pedro Santiago-Espinosa, age 38, was described in an obituary as a "free spirit" and a Liberty High grad.  But he also had an extensive criminal history.  He had just finished an arson trial on September 21 and was found guilty in February of indecent assault. He had been sentenced to 5 1/2 to 11 years in state prison on that charge but was in NorCo's jail for the arson case. 

Gracedale Had Two Serious Deficiencies in September and Failed to Notify NorCo Council

The long-awaited first-ever meeting of the Gracedale Oversight Committee was finally conducted yesterday afternoon. Though there are only four members, all of  NorCo Council, with the exception of Jeff Warren, were present. This heavy attendance is what'll happen when an Executive proposes a 43.5% tax hike and wants $12 million to go to Gracedale. 

Chair Kelly Keegan, who voted against establishing a Gracedale Oversight Committee, explained yesterday why she waited so long to call a meeting. She said she wanted to give Tom Carson, the newly appointed Director of the newly created Continuum of Care department, some time to familiarize himself with his new role. She said she'd take responsibility for the delay, and I can accept her reasoning after watching him yesterday. I'd say he even needs more time.

It was a very lengthy meeting and I will provide more detail in a separate post. But for now, I want to focus on two September inspections that resulted in G-level deficiencies — a classification described as involving actual harm to a resident. We'll learn more about them when the state Department of Health (DOH) posts its surveys. There was also a third, less serious, deficiency.

At a meeting in early February, Council member Dave Holland requested that County Council be immediately notified whenever DOH visits Gracedale because there is a 41-day lag between when a visit occurs and when it is posted online. He was assured that Council would be notified, but that never happened. 

Holland: "So you're telling me you had a survey on September 10 and there was a G?

Administrator Michelle Morton: "Correct."

Holland: "That's the first time this County Council is hearing that. Does anyone else have that information?"

Morton: "I believe that was sent in." 

Holland: "I'm telling you No. Whose responsibility is it to notify this Council when we have surveys because that did not happen? Anybody in the room? Anybody? Whose responsibility is it to do that?"

At this point, Executive Tara Zrinski said that function would have been up to the Human Services Director but now belongs to Carson. She apologized that she failed to make that duty clear to him.

This communication failure is significant because Gracedale remains on a Provisional II license. Pennsylvania records identify Gracedale as operating under that provisional status, following deficiencies that resulted in the downgrade.

As miffed as he was about the failure to notify Council of two serious deficiencies, Holland said the more serious issue was the new G-level deficiencies and what it could mean for Gracedale's provisional license. He had been encouraged that Gracedale might be moving toward getting out of provisional status, but that new G-level deficiencies could make that more difficult.

Zrinski acknowledged that losing the license was theoretically possible but argued that the latest incident was different from previous problems and that the appropriate response was to correct the problems rather than assume the facility would fail. "We are not going to lose this license," she flatly insisted. She said remained optimistic.

Council member Theresa Fadem was less optimistic. "I support optimism, but what's going to happen if we lose this license? Why are we being asked to fund another $12 million? I don't understand what is going on here. We're throwing money at a problem and we could just lose Gracedale. What is happening"

Zrinski rejected the notion that the county was simply "throwing $12 million" at Gracedale. She said the $12 million represents a budgeted county contribution based on what the county wants Gracedale to become, rather than what the facility looks like today.

She downplayed the G-level deficiencies saying "they are not as horrific as you think. We are not going to lose this license." She argued Gracedale only gets more attention because of a critical Grand Jury report. She also blamed agency nurses, claiming, "We need our eyes on people. That's how things like this happen."

Fadem remained unpersuaded. "How do we expect to attract more people to Gracedale when we keep doing the same thing over and over again and expect different results? Isn't that what somebody called the definition of insanity?"

Zrinski: "I do understand the definition of insanity." She then went on to say that other nursing homes have problems, too, referring to an incident at Moravian Hall Square. But Fadem noted that Gracedale, unlike Moravian Hall Square, is a publicly run facility. Zrinski then said she is putting out fires daily.

Council member Keegan, who is a nurse, told Zrinski that she would be sure to keep her eyes on patients with histories of problems. She said she wants to hear that every single employee is staring at the residents to ensure they don't fall, they don't choke or have other issues that can be prevented. Zrinski sarcastically suggested bubble wrap, but no one laughed "We want to hear that employees are taking extra care because this is serious," said Keegan.

Zrinski then got emotional. "Things can happen in a second. And when they do, you think, 'I should have been watching." And you blame yourself. You can't think that all of us sitting here today haven't thought, 'Damn it. We failed again.' because we do. That goes through our heads. And we're trying so hard. This is not easy."

She then returned to her seat.

This emotional exchange indicates that Gracedale's problems are beginning to take a toll on Zrinski, who does seem intent on keeping a poor administrator and unwilling to look into other publicly run nursing homes. 

The next Gracedale Oversight Committee will be December 2 at 4 pm.

I will report on other aspects of the meeting tomorrow.