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Nazareth, Pa., United States

Monday, March 20, 2017

Pain Management and Psychotropic Drugs at Gracedale

Seth Vaughn 
Contrary to what Executive John Brown stated in his annual "State of the County" Address at Hotel Bethlehem, Medicare's actual rating at Gracedale is just three stars. One of the most troubling aspects of this rating is for "quality measures," which measures things like the use of psychotropic drugs, pain management, bed sores and infections. Gracedale has just one star in this category, which is considered "much below average."  This black eye has been ignored by Seth Vaughn's Human Services Committee, but was one of the first things Pete Melan noted in announcing his candidacy for a seat on County Council. "We should not only focus on revenue and expenses but want families to place their loved ones in a safe and comforting environment and maintain a home away from home feeling," he said.

Guess what? Seth Vaughn's Committee finally addressed these lousy ratings at their meeting last week. Before things got underway, Mat Benol and Vaughn spoke on a hot mike about where to send someone who needs medical care. They also spoke about an email that court administrator Jermaine Greene had sent about the Grace Packer case, with what Benol called "canned responses." Ken Kraft told Vaughn he was lucky I wasn't there, and Vaughn snapped. "I couldn't care less what he says."

Once the meeting finally started, Vaughn asked about Gracedale's terrible rating on quality measures. Administrator Raymond Soto said the nursing home is working with Kendal Outreach to reduce both pain and the psychotropic medications.

Nothing on h Kendal Outreach's webpage even mentions the use of these drugs.

The reality is that most nursing homes, including Gracedale, improperly use psychotropic drugs. At Gracedale, one of every four residents receives antipsychotic medications, and 35% of the facility's population are on anxiety or hypnotic drugs.

A 2011 study determined that 88% of Medicare claims for antipsychotics prescribed in nursing homes were for treating symptoms of dementia even though the drugs have never been approved for dementia. Federal law prohibits the use of psychoactive drugs when they are just for the convenience of staff. It's called a "chemical restraint." There has to be a documented medical need for the drugs. These are considered "chemical restraints."

In addition to the overuse of drugs, Gracedale gets a low score on quality measures for pain management. Soto stated that there is a "pain committee," but it is a subjective matter.

Council was much more concerned about overtime,and devotedmost of the meeting to that discussion.  In February, overtime for LPNs was up 24%. For CNAs, it was up 31%.

Soto pointed to one resident who requires one-on-one nursing care, 24 hours a day. He tried to ship her to NJ, but she is not Medicaid eligible under Jersey law. Once she is, she will be sent off. No one on Council seemed troubled in the slightest by this insensitivity to a fellow human being. They were focused on cost. "Are you saying that one person drive 1,000 hours of overtime?" demanded Glenn Geissinger. Soto responded that five people get one-to-one, but only one gets it a full 24/7.

Matt Dietz complained that Council voted on changes to bring OT down."When is that going to happen?" he wondered. Now Administrator Cathy Allen jumped up to say that the county is building up its staff of per diem RNs.

Soto also noted that the nursing home received a deficiency in February because a psychiatrist made a mistake in ordering drugs.

In other Gracedale business, Human Services Director Allison Frantz reported two pieces of good news.

First, here will be an intergovernmental transfer again this year. That's what helped Gracedale return a slight profit last year.

Second, the VA has conducted an onsite inspection of the facility for residents,and the county is waiting for a contract.

She had nothing to report about the Packer case, but spoke highly of foster parents. "They do the work of angels,." she said.

If Grace Packer were still alive, she might disagree with that assessment.


Anonymous said...

If this place was under private control it would be run better and have a higher rating. Rid the rest of us that didn't steal our parents assets and stick them in that hell hole and cry when the thought of them having to actually care for and pay for our parents well being. Its time to drain the NC swamp too and rid of of this hell hole both for the patients and the taxpayers. called Gracedale-

Anonymous said...

Overmedicating in Nursing Himes is a nationwide issue. The idea that this is a "Gracedale" issue alone is asinine. Inspections are not perfect. It might be that some homes are more deceptive and secretive, it may be that Gracedale is more open and honest. Possibly Doctors are more lenient in scripts in some homes.

The problem is that the ever increasing numbers of senior citizens needing skilled care is increasing at a rapid pace. The statistics point to ever increasing numbers of dementia and Alzheimer related health issue. Many homes are not prepared ort ready for this onslaught.

Sadly, instead of intelligently addressing the issue. The "dump Gracedale" folks are still pedaling their poison. They want to crunch the numbers since they have never given up on dumping the Nursing Home.

The Republicans have key players in place and are planning one electing more of them. Many folks are beginning to realize that Gracedale is in danger not from inspectors but from those who have an agenda to see it sold off. This will be a major campaign issue.

Bernie O'Hare said...

Given that Gracedale has only one star for quality measures, this certainly is a Gracedale issue. I consider it far more important than a one-month increase in overtime. The attitude of both Administration and council is reflected by their attempt to ship out a resident who is no longer cost effective.

Anonymous said...

Rid the citizens of this white elephant and the unions it supports.

Anonymous said...

Fake News!

Bernie O'Hare said...

What is written here is 100% accurate. You can watch the video of the meeting if you think anything from there is misrepresented. I also have links to all my assertions about quality measures and the use of drugs at Gracedale. Council was far more concerned about OT than the quality of care.

Anonymous said...

As a public institution Gracedale will have this type of information reported on and discussed over and over again. This is a real problem that exists in all Nursing homes private and Public, if you don't think so you have your heads up your asses.

Anonymous said...

Is Vaughn catching a quick nap?

Bernie O'Hare said...

Bad picture.