Gracedale Warned Feds Will Deny Reimbusement Unless Deficiencies Are Corrected

The following is from a 10/22 letter to Gracedale Administrator Michelle Morton from the state DOH. Any plan of correction submitted by the county should include the termination of its administrator. 

Representatives of the Division of Nursing Care Facilities conducted a Revisit and Abbreviated Survey on October 20, 2026 to determine if your facility meets the requirements to participate in the federal certification program. All references to regulatory requirements contained in this letter are found in Title 42 CFR Part 483, Subpart B, Requirements for Long Term Care, and the 28 Pa. Code.

Based on the findings of this revisit, it was determined that your facility failed to correct the identified deficiencies, whereas continuing and/or new areas of noncompliance with the following participating requirements were identified:

F580 42 CFR §483.10(g)(14) Notification of Changes-New

F689 42 CFR §483.25(d) Accidents – Continuing – D

State Tag 1040 Responsibility of Licensee – New

The enforcement cycle start date is 09/10/2026.

If you do not correct the cited deficiencies within 90 days from the enforcement cycle start date, the Centers for Medicare and Medicaid Services and the state Medicaid agency must deny payments for new admissions. A remedy of a civil money penalty and/or directed in-servicing may be imposed. Additionally, we will recommend that your provider agreement be terminated six months from the enforcement cycle start date. Remedies already imposed for this enforcement cycle remain in effect. [Emphasis added by blogger].

You must submit your plan of correction electronically. The deficiencies will be available for review and development of your plan of correction on October 23, 2026. This plan must be available for our review on the Department of Health Facility Site at https://sais.health.pa.gov/commonpoc/Login/Login.aspx, by November 1, 2026. If the deficiencies are not available on October 23, 2026, please notify the field office. Failure to submit an acceptable plan of correction within the required time frame may result in the recommendation of the imposition of additional remedies.

Your plan of correction must contain the following:

What corrective action(s) will be accomplished for those residents found to have been affected by the deficient practice?

How will you identify other residents having the potential to be affected by the same deficient practice and what corrective action will be taken?

What measures will be put into place or what system changes will you make to ensure that the deficient practice does not recur? How the corrective action will be monitored to ensure that the deficient practice will not recur; i.e., what quality assurance programs will be established?

Dates of when the corrective action will be completed.

If your plan of correction fails to contain these components for each deficiency cited, it will not be accepted. The specific target dates that you identify for your facility to achieve correction should reasonably reflect your facility's concern for the health and safety of your residents in relation to the deficiencies cited. If we conclude that your date of presumed compliance does not meet these criteria, it will not be accepted. The latest date identified for the completion of corrective actions will be accepted as the facility's allegation of compliance.

If we determine that subsequent to the date of presumed compliance identified by your facility that you have failed to achieve and maintain substantial compliance, additional remedies may be imposed.

Please note that this notice does not constitute formal notice of imposition of alternative remedies or termination of your provider agreement. Should the Centers for Medicare & Medicaid Services determine that termination or any other remedy is warranted, they will provide you with a separate formal notification of that determination.

The remainder of the letter provides informal dispute options. 

Bob Brooks FRAUD Signs Blossom in Pa. 07 Congressional District

Along with chrysanthemums and marigolds, a batch of new political signs are blossoming throughout the Pa. 07 Congressional district. They are "Bob Brooks FRAUD" signs, some of which are planted next to Brooks' own signs. Paid for by the Ryan Mackenzie campaign, the signs contain the web address BobBrooksFraud.com. 

The webpage starts with "Meet the Real Bob Brooks", and asserts he has a "documented history of putting himself and his personal profit before others." It then goes on to list eight verifiable examples, including links

1. "Bob Brooks signed an agreement to pay his family for a property, lied about it in court, was found liable, and ordered to pay back over $130,000.

2. "Despite claiming to stand up for workers, Bob Brooks didn’t carry legally required workers’ compensation insurance for his own employees at the company he owns… for four years. That means Brooks pocketed the savings and his employees got stiffed."

3. "As a union president, Bob Brooks took big extra money for himself at the exact same time he cut the services he was supposed to provide to union members. Once again, more money for Brooks while others got denied."

4. "Bob Brooks lied on official government documents to get himself a $15,000 taxpayer-funded COVID grant. The penalty? Up to 5 years in jail and a $250,000 fine." (Blogger's Note, Brooks actually got $30,000 and appears to have lied twice on two separate applications.)

5. "If you want to know about Bob Brooks’ real character — or lack of it — imagine this: Bob Brooks called volunteer firefighters in our community “shitbags” and “scabs.” That’s people who volunteer to run into burning buildings for all of us."

6. "Bob Brooks has been credibly accused of racism for enforcing a “white-only” membership policy as the Steward (manager) of a local social club."

7. "Bob Brooks says he’ll ban stock trading in Congress. But in his own life Brooks is a millionaire who is getting richer from trading stocks — including in the mega-corporations he says he’s against."

8. "Bob Brooks likes to act like he’s a working-class everyman. The fact is he’s a longtime political insider and registered lobbyist who was hand-picked by the political bosses. Brooks even admits they “called me into a backroom meeting” to be their candidate."

DA Baratta Proposes Early Intercept Program at Jail

During last week's interview with NorCo DA Steve Baratta, he told me he had just completed and submitted a proposal for an early-intervention program at the jail. Tise program would use approximately $400,000 in opioid-related funding, not tax dollars.

Under this program, casweorkers will interview newly admitted inmates during classification to identify defendants whose criminal behavior is primarily the result of substance abuse or ongoing mental health problems.

For appropriate defendants present no public safety risks, Baratta wants to develop treatment plans and bring them before a judge for reconsideration of bail.

For peoplke who sit in jail with drug and mental health problems, and wait for six months to a year to get their case resolved, no one benefits from that," he remarked.

According to a 2018 assessment done by NorCo's health provider at the jail, 72% of inmates either are or were suffering a mental illness. A whopping 23% suffer from severe mental illness with current and acute symptoms.

That's what happens when you close state hospitals. Many of the people who belonged there end up at the jail or Gracedale.

When someone is jailed, the county bears the cost of housing and feeding an inmate. Moreover, incarcerated individuals are generally ineligible for Medicaid coverage, which means the county has to pay for medical expenses.

Baratta added that even though the jail is at half-capacity, it is "in turmoil because they can't manage their operations."They don't have enough corrections officers.

Lafayette Journalist Slams Gracedale Spending at NorCo Budget Hearing While DOH Pays Another Visit

Yesterday, NorCo Council conducted the first of four scheduled budget hearings to review Executive Tara Zrinski's proposed 43.5% tax hike next year. No amendments will be offered until next month, but it's pretty clear that Council is unhappy with Zrinski's spending plan. Several members of the public spoke in opposition as Jeff Ward reports in Lehigh Valley News Briefs. I was particularly struck by comments from Alexa Krabbe, a student journalist at The Lafayette. 

Lafayette's Landis Center provides Gracedale with student volunteers, but she reports that some have become wary as a result of patient safety and staffing issues that were never communicated to them.

We've heard numerous times from Executive Tara Zrinski and Council member Kelly Keegan that Gracedale must be great because they did such a good job of caring for their family members. But just as there is positive anecdotal evidence, there is also the negative. Krabbe stated, "One of the first things that I heard about Gracedale, when I got here, was never sent anybody that you care about to that home, because they will be subject to horrible treatment."

"One in 10 Americans over 60 years old is subject to abuse and mistreatment, and a nursing home that adds to that abuse is not useful in this county," she added. She argued that county tax dollars should be spent on things that actually benefit people.

As she spoke and Council listened, the state Department of Health was wrapping up yet another visit to the home. Hopefully, County Council will be told what's going on this time. From what I'm told, it's more bad news.

Details Emerge for Two of Three Deficiencies at Gracedale in September

Earlier this month, at the first-ever meeting of NorCo Council's Gracedale Oversight Committee, it was learned that the home, which is currently operating with a Provisional II license, was cited by the state Department of Health on September 10 and again on September 24 with three deficiencies. Two of these were "G" level deficiencies, meaning there was actual harm to a resident.

There was little detail about these violations at the meeting, but the September 10 deficiencies are now posted on the Department of Health website. 

The first violation involved a resident with dysphagia (difficulty swallowing), traumatic brain injury, and spastic hemiplegia (a neuromuscular condition that causes muscle tightness and involuntary contractions in the limbs and extremities on one side of the body resulting in muscles on one side of the body). He has a swallowing problem and was placed on a special diet of soft food. Direct supervision is required when he eats.

On August 28, he began choking on a meal that was supposed to be pureed. Although he was supposed to be under supervision while eating, another resident slipped him part of a sandwich without notice by a nurse. He began to choke and the Heimlich maneuver failed. The resident had to be laid on his side and was subject to back thrusts until he spit out pieces of the sandwich. He was rushed to the hospital, where it was determined that he had acute respiratory failure with hypoxia from aspiration pneumonia. He remained in the hospital for four days.

Gracedale's nursing director admitted that the facility failed to provide adequae supervision.

The second violation occurred on August 22, and involves a resident suffering from ALS. Her medical plan requires that a gait belt be used when she is walking or moving from his wheelchair to a bed. A nurse's aide was assisting this resident in getting from his wheelchair to his bed when the resident began to cry and fall down. The nurse's aide had failed to use the required gait belt, but had the presence of mind to lower herself to the floor with the resident to break the fall and reduce injury. There is no indication that the resident suffered any harm.

Although one of these incidents is a "G" level deficiency, I'd agree that they pale in comparison to some of the other deficiencies found at Gracedale since Michelle Morton has been its Administrator. But deficiencies are still deficiencies, and even Executive Tara Zrinski concedes that the home will be in Provisional status a bit longer than had been hoped.

The details of the third incident are still unavailable for public review.

According to the CMS website, there is no indication that Gracedale was fined over either of these incidents.

Baratta Warns About NVE, a Disturbing New Form of Online Child Exploitation

During last week's interview with NorCo DA Steve Baratta, he warned of a new trend in crime called Nihilistic Violent Extremism (NVE), associated with online networks such as 764. Baratta said his office has encountered several cases involving the online grooming and exploitation of minors. Perpetrators, frequently young males, will manipulate teenage girls into self-harm, sexual exploitation and other disturbing conduct.

He described a recent investigation involving a juvenile male who allegedly persuaded a girl to cut herself, collect her blood, mix it with water and use it to paint a so-called blood wall containing images and slogans.

The girl recorded the activity and transmitted it electronically. The material was intercepted, allowing authorities to identify the juvenile male. Unfortuantely, at the time of the interview, investigators had yet to locate the girl and provide appropriate services.

In December or January, Baratta will begin training local police departments and school districts about this emerging threat, with the help of federal authorities. He wants to educate police, school personnel and children about online grooming, coercion and exploitation.

NorCo Council President Ken Kraft Unilaterally Decides to Stop Executive Reports

NorCo's Home Rule Charter specifically provides that County Council can require periodic reports from the Executive branch. Ron Angle, when he was Council President, suggested to fellow Council members many moons ago that it would be good for them, the administration and the public they serve, to provide an opportunity at every meeting for the county's top official to tell us what's going on. Council agreed. And so, the county executive report was born. It became a feature of every County Council meeting agenda. Until now. County Council President Ken Kraft has unilaterally decided to remove this feature from county council agendas

This tradition lasted through several Executives, starting with John Stoffa. Sometimes they had a lot to say. On other occasions, nothing at all.vs. 

Kraft has the authority as Council President to preside at meetings. By tradition, Council Presidents also set agendas and appoint county council committees. But he has no actual authority to make appointments or set agendas. He is little more than a first among equals. 

After she became Executive, Zrinski took the opportunity to deliver informative reports about what was going on in different county departments. Anyone with an actual interest in county government, instead of county politics, would find these useful. Not Kraft. He preferred that we know as little as possible, and pressured Zrinski to speed things up. When I complained, it was played off as a running joke. 

Not anymore. 

Although Zrinski has continued to provide these updates, she has also spent perhaps a bit more time than she should talking about herself. That's who she is, and she is far from the first politician to have a massive ego. During her report at last week's meeting, she went too far. She directly confronted several audience members who are understandably critical of her planned 43.5% tax hike. She also got emotional and had to choke back tears during the remainder of her report. 

It made her and County Council look bad.  

Kraft seized on that poor display to make a change. In an email sent to County Council members on Friday that has Lamont McClure's fingerprints all over it, Kraft made the unilateral decision to remove the Executive Report from future County Council agendas. "The objective is not to restrict questions or diminish accountability; it is to eliminate an unnecessary standing agenda item while preserving every Commissioner’s ability to obtain the information needed to perform their duties."

This is nonsense. When the county executive exercises the option of reporting on what is happening throughout different departments, she is providing accountability and transparency that also reaches members of the public who have no ability to ask questions of obtain this information any other way. 

This also enables both Council and the public to evaluate the kind of person who is speaking. Is she informative? Knowledgeable about county operations? A little too juvenile? Or instead, is she too pompous? Is she sincere? 

Kraft lacks the authority to do what he did. He is depriving both fellow Council members and the public from an opportunity to see their Exec in action and judge for themselves.  If he hates the idea that it adds 15 minutes to a meeting, he should resign. Hopefully County Council will reverse him at their next meeting. 

Let me tell what I've learned about watching and listening to her. She is working hard and grows more and more familiar with each department. She is a bit too jocular and laughs at the strangest times with very odd facial expressions. She talks a bit too much about herself. But she also has a deep desire to make the county a better place, is empathetic and is certainly sincere. 

We learn a lot from watching the Execs. What did I learn? John Stoffa displayed a deep sense of personal integrity combined with a wry humor. Brown was very knowledgeable about finance but had no empathy and hated saying more than was necessary. McClure by far was the most brilliant of the Execs and was often responsive to members of both Council and the public. He often would focus on one or two matters and sometimes used the Exec report to honor people. He was the first Exec to recognize that this report was a very useful too that combined good politics with good governance. Zrinski should have the same opportunity as other Execs.  

NorCo DA Steve Baratta Concerned About Three Suicides at Jail

During my interview with NorCo DA Steve Baratta last week, he expressed particular concern about the jail. That facility has experienced three inmate suicides in approximately three months, including two in one week. "And they don't call us," noted Baratta. "They don't call Easton police. They don't even call the coroner [except for the last suicide]. They just clean them up, call the EMT and make them go to the hospital with the dead body. And that's how we find out about it." He indicated that law enforcement should alwayus be summoned to investigate and make sure no crimes were committed. "It's part of transparency in government."

He believes part of the problem is the result of a critical shortage of corrections officers. The county has only been able to fill about half of these m[ositions, which leads to mandated overtinme, 16-hour shifts and exhausted guards.

He believes Executive Tara Zrinski is well aware of the problem.

Baratta believes that Zrinski took office with "rose-colored glasses," but is beginning to understand "how overwelming some of the issues are right now."

He acknowledged that the county is at a "low point right now", but adds that Zrinski understands that, and we'll see."

He believes Zrinski was getting bad advice from former Exec Lamont McClure. "I believe he was motivated to have her undertake his problems and shield himself from criticism because once she understands the problem and acts, people turn away from the last administration and say 'Well, now it's your problem, get it done.'"

Baratta believes that Zrinski was led to believe that the county's financial problems were manageable, but no longer has that view.

Congressional Candidate Bob Brooks Cancels Only Debate ith Incumbent Ryan Mackenzie

Bob Brooks, the Democratic nominee in the race for the Pa.-07 Congressional seat, has canceled his one and only debate with incumbent Republican Ryan Mackenzie. 

During the primary, Brooks received no accolades for his rhetorical skills. Mackenzie, on the other hand, did well in debates with former Congress member Susan Wild. 

The Brooks' campaign decided to drop out as a result of criticism over stealing from his own family, cheating his workers by paying no workmen's compensation insurance and lying on two separate applications for $30,000 in federally funded COVID grants. Brooks has issued a "cease and desist" letter to Mackenzie, which is probably sitting in a trash can right now. 

I suspect there would be two good reasons for Brooks to refuse to debate.

One, he is so far ahead in polling that it makes little sense for him to give any visibility to his opponent. Given that Mackenzie is an incumbent Congressman whose campaign is well-funded, he's already visible.

Two, Brooks will do very poorly. That's the more likely explanation. This is a guy who basically cheated his own family and lied about a judgment they obtained against him when he applied for COVID money. That's pretty sleazy. 

I also am disappointed that anyone who believes in our democratic republic would refuse to let the people see him for what he is, bad or good. 

Zrinski's Proposed 43.5% Tax Hike a Factor in Emrick-Warren State House Race

NorCo Exec Tara Zrinski's proposed 43.5% property tax hike has worked its way into the state house race between incumbent Joe Emrick and challenger Jeff Warren. While I would expect Warren to be part of a blue wave that sweeps Republicans out of office in this year's local races and midterms, Zrinski's unpopular proposal could cost him the election.

Warren, along with Ken Kraft and Kelly Keegan, have thus far been Zrinski's loyal lapdogs, as they were for former Exec Lamont McClure. But loyalty in politics can be very short-lived if it has political consequences. But he now claims that "she blind-sided the community, and she blind-sided county leadership as well, without seeking input or working towards solutions before announcing it."

Zrinski, in fact, has told County Council repeatedly that the tax man cometh. She has also hinted that a reassessment is needed.  

Warren has previously stated that he would be very troubled by a county council that provides "oversight," although they, and not Zrinski, are actually the governing body. 

What has happened is precisely what can be expected when Council members like Warren abdicate their responsibility. His failure to provide that oversight is precisely why Zrinski, and McClure before her, felt they could operate with impunity. 

Warren has said on his Facebook page that he opposes Zrinski's 43% tax hike. "When Executive Zrinski brushes this off as just $25 more a month, it does show how out of touch she is with household budgets."

There have been 30 mailers in this state house race, and most are garbage. But this one will hurt. 

Former NorCo Exec Defends His No-Tax-Hike Budgets, Justifies Kicking Can Down the Road

As most of you know, NorCo Exec Tara Zrinski has proposed raising property taxes by 43.5%. County Council will never agree. Even her closest allies there have distanced themselves from a very unpopular spending plan. At last week's Council meeting, she nearly broke down in tears as she tried to justify it to an unpersuadable public. Partisan Republicans are opposed to any hike at all, even if it means drastic cuts in services. But more open-minded Republicans and many others would agree with her goals. Employees are paid far too little, and that needs to change, especially in the county's 24/7 operations. The county needs to keep its retirement accounts funded. Its rainy-day fund is depleted. Necessary repairs to county infrastructure have been deferred. Even the county's commitment to open space to the tune of $3 million a year was shortchanged in the last budget. Without naming names, Zrinski has laid the blame for this financial morass on former Executive Lamont McClure. In a recent Facebook post, he explains why he never sought and actually reduced taxes.  I'll post what he says, and tomorrow, I'll give you the perspective of District Attorney Steve Baratta and his fractious relationship with McClure

The recent news that my successor as County Executive has proposed raising real estate property taxes an astonishing 43% has caused a furor. It’s also raised several questions in the minds of citizens about the decisions we made over the last 8 years. In this and other mediums, I will try and answer the most common and salient questions I get asked. The first one I will tackle is why didn’t we incrementally raise taxes over the years to avoid a huge increase in one year ? (This is long and you may need to take a nap while reading, and if you’re not from Northampton County, you may want to use it to combat insomnia, but here we go.)

First, I disagree that a 43% increase this year is necessary or warranted. But, that’s a different post. I’m only going to discuss the 7 no tax increase budgets in this post as the 2022 tax cut deserves its own treatment.

Second, the last 8 years were dominated by the COVID-19 Global Pandemic. The economy was crushed when the Country shut down, and after the attempts at rescuing the economy supercharged inflation it would have been economically counterproductive and overly burdensome to place an additional property tax obligation on our taxpayers.

Third, in order to attempt to rescue the economy the Congress, during the first Trump Administration passed The Cares Act, and during the Biden Administration it passed The American Rescue Plan. Northampton County directly received $63,000,000.00 from these two Acts of Congress. Gracedale received many millions more directly as did Emergency Management and the Area Agency on Aging. Northampton County received tens of millions of dollars in aid and it would have been immoral to raise taxes while that money was coming into the coffers. (An approximate total of 90 million dollars.)

Fourth, when I took office, Northampton County was normally keeping surpluses of 60-100 million dollars per year. There was no need to raise taxes just to keep citizens money sitting in our bank accounts. I’ll talk more about this when I discuss the 2022 tax cut. Fifth, philosophically during my time on County Council and as County Executive, I came to view the real estate property tax as regressive. This is ironic in that when the property tax was conceived it was the ultimate progressive tax, however, after WWII and the GI Bill, home ownership was democratized and now the people being asked to bear a great burden are middle class seniors on a fixed income.

Sixth, while I’m a Democrat, I also found myself in the context of the property tax, and the way Northampton County had budgeted for so long, to be an avowed tax cutter. While on County Council I tried to cut the millage rate 5 or 6 times, and by now you know what I did in 2022. Seventh, I ran in 2017 for County Executive promising not to raise property taxes, and I won convincingly. When I ran for re-election in 2021, I promised not to raise property taxes. I kept my promises to people of Northampton County.

Eighth, during all 8 of our years we never had to cut any core or vital services such that we would have needed a tax increase. In fact, we expanded services.

Ninth, the politics of taxes are very tricky anywhere, but especially for Democrats in one of the most Purple counties in the Country. I was personally involved in two elections where we wrested control from the Republicans, and both times it was because they had raised taxes. The first time was in 2005 when we took the County Council majority as the Republicans raised taxes 64%. The second was when I defeated John Brown in 2017 after he and his Republican Council majority raised taxes by 1 mil.

Tenth, I take full responsibility for the 8 budgets that I proposed and passed. I’m quite proud of my record, but it’s worth noting that our 9 member County Council is the Governing Body of Northampton County. Only County Council can establish the millage rate. At any time, during those 8 budgets, any 6 members of County Council could have raised taxes “incrementally.” They would have needed 6 because I would have vetoed it, but I digress. Only once during the 11th hour of the 8th budget did any member [former Council member Ron Heckman] propose raising taxes even 1 mil. That motion died for failure of a second.

In his 10-point manifesto, McClure fails to address the poor morale and turnover, his refusal to fully fund open space and the sub-par salaries paid to county employees. Whether he likes it or not, he certainly appears to have balanced budgets on the backs of county workers. His philosophical objection to property tax is no justification for treating workers like shit. 

Zrinski has clearly gone too far, but her goal of providing a decent wage is something that must be pursued.