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Nazareth, Pa., United States

Friday, March 16, 2018

Mattressgate

Lamont McClure addresses bedsores
at Gracedale 
Gracedale Nursing Home, which is owned by Northampton County, has been struggling with its Medicare rating for quality measures, which reflects the quality of care afforded to residents. It had dipped to one star, the lowest rating. It currently is at two stars, which is still considered below average. Every month, at the Human Services Committee, Gracedale Administrator Raymond Soto updates Council on measures being taken to improve resident care. But for the past two months, there's been an increase in the number of pressure ulcers, which are also called bedsores. Lori Vargo Heffner wanted to know why. Although no one can really be sure, this increase may be related to the $500,000 purchase of new mattresses. That took place under former Executive John Brown. Former Administrator Cathy Allen made the purchase, ignoring policies that had been put in place for testing.

Soto indicated that a number of factors can lead to bed sores, including failure to move residents and a diet that contains insufficient protein. But nursing staff is above the state average Heffner kept prodding Soto about other possible reasons until  Executive Lamont McClure provided his own explanation.

"I'm horrified by this," he said, noting that pressure ulcers have increased two months in a row. He agreed that there are several possible reasons. While "correlation is not causation," McClure believes the introduction of new mattresses last December may be one of those reasons. "We're going to get to the bottom of it," he promised. "We're all over it."

McClure added that another problem that has resulted from these new mattresses is that residents are falling out of bed. The mattresses are often improperly inflated by residents and they form domes, causing some of them to roll out of bed and onto the floor.

Cathy Allen, who had no nursing home experience, executed a half million dollar contract to purchase these mattresses.

Sherry Ficocelli
Soto explained that at the end of last year, he was told there would be new furniture. He said the mattresses were an afterthought. Cathy Allen told him she was going to get a "good deal" on new mattresses."There wasn't much input from any of us," he admitted  Soto said there is a policy that new equipment receive a 30-day trial in different areas. "We did not follow policy," he confessed. He said the trial was in one resident's room, and it involved Cathy Allen and the erstwhile Director of Nursing.

After the new mattresses were installed, he began receiving complaints. He spent the night at the facility after a snowstorm and tried one of the 309 new mattresses."It was like a rock," he complained. 

The company that resold the mattresses is checking each mattress and may retain staff on determining the pressure.

Materials Manager Sherry Ficocelli said that Cathy Allen never consulted with her concerning the new mattresses

"It sounds like they were knock offs from Dan's Mattress City," joked Ron Heckman.

Ficocelli said that Allen had overstepped her abilities."We were kind of told to keep out of it," she declared. "We didn't go through the proper trials ... . I was told not to, and keep my mouth shut."

"Say what?" said Heffner. "I don't think we heard what you just said."

"You did. I was told to keep my mouth shut," responded Ficocelli. She indicated it was Allen who muzzled her.

McClure said it is his hope that there are, in fact, several factors. He's also hopeful that better training will solve the problem.

There have been no serious injuries as a result of the falls.

"Keep us updated on Mattressgate," said Lori Vargo Heffner.

63 comments:

Anonymous said...

Say What?

Anonymous said...

Does anyone else smell something rotten?
The former administrator, who has financial problems, executes a half-million dollar contract, foregoing proper testing, telling others to keep their mouth shut, and claiming she got a great deal.
I'll bet she did.

Anonymous said...

Mattress buying is already a crap shoot. There is no “Menroni “ label and almost anyone that buys one gets some misrepresentation of information most any place they shop. So- no bid , so specs? No council people knew? How can this happen at $1,600 a piece?

Anonymous said...

Going to get to the bottom of the bed sore problem? hilarious

Anonymous said...

Who on current council approved Ms. Allen? They should resign immediately! This is the nonsense the previous administration and council advocated. Those who voted for her and are still on council, should resign for malfeasance of duty. Especially pocketbook Peg, who thinks taxpayer's money grows on trees. $500,000 is a healthy amount to squander away in a clandestine manner. I'd say sue her for fraud, but their are plenty of liens on her now.

Anonymous said...

Mattress mess is timely, but soon we will move on to SPRING.

Anonymous said...

Gracedale has been run very poorly for years and should be sold. With a brief period of exception, the home's ratings have been miserable for years through several administrations. John Stoffa was right to attempt to sell the place and deliver better patient care. Anyone who still supports county ownership of Gracedale values votes and political power over elderly care.

Bernie O'Hare said...

"Going to get to the bottom of the bed sore problem? hilarious"

Actually, there's nothing funny about the elderly suffering from bedsores. You may find it hilarious that the Exec is taking this matter very seriously, but people with family there find it refreshing.

Jody Smith said...
This comment has been removed by the author.
Anonymous said...

This situation is contemptible. Fortunately it has nothing to do with the running of Gracedale, despite those who continue to bash the facility and employees. No one in their right mind would allow a former secretary to make healthcare decisions. Imagine going to your family doctor and having the receptionist prescribe medications for you. Allowing the former county administrator to shut out healthcare professionals when purchasing essentials like mattresses is bordering on criminal negligence. Bad ratings will be erased once true health care professionals are given the ability to make proper decisons regarding care.

Bernie O'Hare said...

Jody Smith, I was just about to commend you for signing your name, and saw that you removed your comment.

Anonymous said...

Imagine what Gracedale would have become if Brown and his minions hadn't been shown the door. We wouldn't have heard about this fiasco if they hadn't been booted.

Anonymous said...

The staffing is the cause. 2 aides and 2 nurses for 50 bed units! The residents are not being changed out of wet/soiled diapers or repositioned much. How can they be if the staff is that limited?!?! Family complaints about staffing were not addressed. Gracedale RN complaints from unit nurses and administration nurses were not addressed let alone mentioned. Gracedale is losing long term nurses with 20 years experience because they pay their RNs approx $4-5/ hour less per hour than they can earn at an entry level nursing position elsewhere with far less roles to cover. Gracedale employees have an outrageous co-insurance cost of over $13,000 annually in addition to a high deductible. Who would go to work there if one can make more at the Amazon warehouse? The county will continue to lose qualified long term nurses if they don’t step up the pay scale for existing RNs and potential new hires.

Anonymous said...

That is the cause of bedsores- staffing. Obviously my county tax dollars do not pay to keep the place staffed. Why wouldn’t nurses complaints of being over worked and underpaid be addressed? What’s the salary comparison for nurses with this much experience state wide? Who were their complaints sent to and where are these sitting- on someone’s desk? Being ignored obviously.

Bernie O'Hare said...

Staffing was mentioned last night. But since staffing at Gracedale exceeds the state average, I question whether that is the reason.

Jeff Fox said...

I applaud Mr. McClure for his comments made during the Human Services Meeting last evening. I noticed and especially liked it, when partisanship began to raise its ugly head over, as Lori Vargo-Hefner referred to as "mattressgate", Mr. McClure stepped in and stopped it from going in that direction and said he was going to focus on fixing the problem(s) and would deal with whatever fallout comes from the obviously unacceptable situation. I have liked what I have seen and heard so far from this new administration. Of course, the honeymoon isn't over yet.

Bernie O'Hare said...

Jeff, There was no partisanship . Democrats and Republicans alike were equally appalled. The used of the word “mattressgate” by Lori was entirely appropriate and descriptive.. to be be fair, I’d want to hear from Brown and Allen before reaching any conclusion. But you apparently would prefer to brushthismatter under the rug. Now that’s partisan.

Anonymous said...

It’s definitely the reason. I see how hard the staff works. It barely exceeds state minimum. And would you really want to be here if your aide/nurse has to spend all of her/his time managing someone else’s behaviors rather than turning you or changing you?

Anonymous said...

Watched the webcast. It started out as a weird goofy Cathy Allen move and progressed to some shifty crap. At first it sounded like she stupidly bought them from some inferior joint and then it got real insider money moving. Can only imagine what will continue to uncovered about Brown and his rubber stamp council. Glad they are gone. Agree that any that approved that crazy Allen should resign.

Anonymous said...

Bernie, once all this was brought out did the new county council seem truly upset?

Bernie O'Hare said...

Absolutely.

Anonymous said...

This comes off as a cheap partisan shot at the past Admisntration. You are making it sound as though this is some criminal move. It is appalling that the democrats are doing this. Is this the game plan for the Admisntration and council to keep making political points at the expense of the Brown Admisntration. Stop this and do the job for the people.

Jeff Fox said...

I agree that all, including me, were appalled by what was disclosed. Lori Vargo Heffner smelled the red meat and Lamont McClure, to his credit, did not allow it to go in that direction. I certainly do not want to "brush this matter under the rug". It indeed should be addressed, and the chips shall fall where they may. I guess I interpreted things differently than you did. The kudos should go to Mr. McClure and to council, including Lori Vargo Hefner, for the questions and concern with the operation of Gracedale, which disclosed "mattressgate". We all should be appalled by and concerned with what was disclosed at the Human Services Committee meeting last evening.

Jeff Fox said...

Anonymous March 16, 2018 at 4:01 PM

"This comes off as a cheap partisan shot at the past Admisntration."

Unless you were at the meeting or watched the webcast, you would not be aware of what was said or disclosed at the meeting last evening. The "shot" is not cheap. What was disclosed should at least raise your eyebrows. Ignorance is bliss, I guess. Partisan politics are easy. Good and open government is not.

Resident of Allentown said...

I have a loved one who is bed ridden and the alternating air mat really seems to prevent the bed sores. When one broke down and I didn't replace it, thinking it might not be necessary, there were the beginning of pressure sores within a month. When it was replaced, they faded and did not come back. If the problem is the mattresses I would recommend fluctuating air mats be laid over the mattresses. The mats and compressors usually go for under a hundred dollars and they do work.

Anonymous said...

Sounds like Allen went to Fed Ed's school of money making. I got a good deal and keep your mouth shut. Sounds like money in the pocket to me. Bernie is there any recourse that Council can take against someone that is no longer in office. This should be investigated.

Anonymous said...

Bernie, could this be deemed as elder abuse. Than there is the question, did the bed sores cause any deaths due too infections in the bloodstream that could not be reversed?
That's a two question sentence.

Peter J.Cochran said...

This was once my -father- in laws big issue .Hemstreet always wanted to look after the elders. Welll ,it has appeared to have dissinigrated to something he never battled for. Too many residents are somebody’s mother from out of area . Too many have devolved grandma s estates and put them here and live in McMantions ,allowing us Dutchman to take her care at our expense all wilale that have a Lexis. The elected know it alls that are on council need to straighten this issue out ,or thay are negligent and should have their pay withheld.

Anonymous said...

Step up the pay for RNs??? Seriously?? The CNAs are the backbone of that facility and get paid shit and are the ones getting screwed all the time!! That place is a joke!!!!

Peter j. Cochran said...

The staff is most likely over worked at this point . We from our Amican Legion have visited in past and we never observed any infractions of care . The work load on the staff per patient seemed high and yet they were dealing with it. Commissioners - fix out of venue applications and you will fix a lot of our problems . Don’t admit somebody’s mother from ———— where ever it they did not live here 5 or 10 years . You guys are screwing us if you do ,but Bon-Ton Blam the staff . Blaim yourself .

Anonymous said...

Christ Almighty. What the hell are you going on about Pete. They are doing things as best they can. Don't be bashing people for things you don't know about.

Peter j. Cochran said...

Anon 7:05 I’m bashing Only council . Not one of them has spent 2 hours at Gracedale or knows what goes on there. With all the costs and the issues somebody from NoCo council should go over there and get ingrained. If this was the Marine Corps ,they would be FIred them for failure to lead.! With all the cost, the director should be dismissed and put in a prick like me to unscrew the place by leadership. .whatever has happened is not the employee s fault ,it is lack of leadership. So your council has only them to blaim .and —I Sign my name clearly.

Anonymous said...

No offense but a few of the people on council have spent numerous hours at Gracedale and I believe one of them was actually in charge of it once.

Anonymous said...

Kathy Allen thought she knew all right from the begining and she really didn't know her ass from a hole in the ground. She told many people to shut up at the County she was a very nasty person!

Anonymous said...

I’m sure the RNs should consult the aide and not the doctors before using their medical training and experience to implement life saving measures. If you look online, what Gracedale pays an aide is comparable to other nursing homes. What it pays it’s LPNs, RNs and administrative staff— not so much. Aides work damn hard. Nobody should ever say that. Nurses are just responsible for far more.

Anonymous said...

John Brown and the last Admin tried to set up Gracedale for failure to get the public to support their agenda of selling it to a private company. This greedy, corrupt admin did not follow protocols, withheld new employee applications to ensure poor staffing, offer unfair poor options to the Union contracts, HR was conducting illegally run investigations of employees, failed to permanently repair frequent water damage and leakage from rain in the Arcade (mold is a concern) where buckets are regularly set out, place false-half truth-twisted info to the media creating a poor outlook of Gracedale employees to support their (Admin) agenda to sell Gracedale. It all comes down to the almighty dollar. Brown didn't care about our hometown geriatrics or the staff that cares for them. We must take care of our own people. Don't judge Gracedale until you've volunteered or worked there.

Anonymous said...

Amen

Anonymous said...

Follow the money! The vendor likely kicked back some serious dough to Allen. Many Brown contracts we're highly dubious. Like C3. Those transactions should be investigated. Morganelli should charge a grand jury with examining the Brown administration's procurement practices. Allen was a tax cheat, and violated travel expense policies. She has no moral compass. Turn over some rocks. She will be exposed for the crook she is.

Bernie O'Hare said...

" Lori Vargo Heffner smelled the red meat and Lamont McClure, to his credit, did not allow it to go in that direction."

Jeff, McClure most definitely wanted it going in that direction.That's why he had the Materials Manager there. He cut things off when Zrinski started talking about going after people bc that's premature. I doubt that Allen was trying to benefit personally, but she is unqualified. This is why I opposed her as Administrator. Telling the materials manager to keep quiet does make me suspicious. But I'd want to hear from her before forming any conclusions.

Bernie O'Hare said...

Peter,several council members visit Gracedale routinely. But I don't expect them to micromanage mattress purchases. I do expect them to confirm competent people.

Bernie O'Hare said...

5:57, I am unable to answer your question. I have heard no reports of any deaths indirectly caused by bedsores, but do not know. I tend to think something like that would have been discussed. I doubt this rises to the level of elder abuse or neglect, but any inspector who saw this would ding Gracedale and another star would go down the tube.

Bernie O'Hare said...

Resident of Allentown, I really appreciate your comment. It appears that Gracedale employees are very interested in this matter, and I am sure they will read what you say with great interest. These people really care about the residents and want the incidence of bedsores to go down, not up.

Anonymous said...

Morganelli is a nice man. However, he has no backbone in addressing political corruption in any meaningful way. He has demonstrated this over and over. Do not forget, ultimately, he is a politician. For a politician to investigate and prosecute their own would be like the state police investigating and prosecuting their own. Never going happen. Hypocrisy at its best.

Anonymous said...

I watched the video of the meeting and I got the impression that this information of the mattress purchase by Allen had to be made public in a manner that would inform, but not accuse anyone of criminality. It highlighted the fact that Allen was unqualified for her position, policy was not followed, and strong-arming others ("keep your mouth shut") contributed to the problem.
McClure made it clear that the mattresses may not be the sole reason for the increase in bed sores, but they could be a large part of the problem. It may also be that more training is needed for proper inflation.
Even if it turns out that the mattresses were a quality purchase and it is simply a matter of improving training on inflation, one thing should be changed...
Purchase contracts over certain amount (whatever County Council deems appropriate) should be reviewed and approved by Council.
I think a $500,000 purchase, decided by one individual, is a disaster waiting happen. If it turns out it didn't happen this time, it could still happen in the future - and will it be more than a half-million?

Peter J.Cochran said...

Ok, Bernie, I had mentioned that we never observed any infractions in earlier post. It is stated on this blog that council members visit the facility. Could be we see nothing in short time one might visit? To know the dynamics of a group any group ,one must be able to spend time and learn ,observe and then blend in to some degree. Nobody see s the inside of any facility with a walk though. Like anyone of us would go to work and know what problems may exist ,but not a guest that walks though. I have in the past 3 years spent lots of time with elderly folks in several nursing facilities . When your sitting there with your own relatives and you think they’re in real need of attention - guess what happens next ? So some of the poor residents there have few people that ever visit? I’m sympathetic toward elders more after having been though some of their issues of need,and standards of care.

Jeff Fox said...

Bernie, I think we may have differing notions of what I meant by the terms "red meat" and "direction". Other than that, we're on the same page regarding this "matressgate" issue. I think your claws are sharper than mine. Just be careful when you take pictures!

Anonymous said...

People use this and other things to attack Gracedale. This is nonsense. Bedsores are a problem at EVERY nursing home. Gracedale is public so these things are made public. Private homes can cover this up. Inspections are at times planned and they work around them.

Stop bashing Gracedale or using this as an excuse for youir plans to dump Gracedale. People made it clear to both Stoffa and Brwon that their stu[id plans to profit off the elderly poor wre not going to work. VContinue to fix th eprobmens. Stop bashing Gracedale.

Bernie O'Hare said...

Every nursing home, public or private is rated publicly. All the inspection records are public. Gracedale has had a problem with quality measures,and rather than seep it under the rug, it should and is being addressed publicly. The best way to ensure that Gracedale gets sold is by covering things up or telling people to keep their mouths shut. McClure is the last person on earth who would want to sell Gracedale. But he and most of the people who work there would want to do everything in their power to look out for the residents.

Anonymous said...

Private Homes and their association know how to grease the wheels. Gracedale is held to a higher standard. Especially since so many elected officials want to see it sold. It is part of the plan they have for years. I am thankful for some intelligent people who can see behind the plot to make a quick nickel off of the poor.

Anonymous said...

Taking advantage of the disadvantaged ultimately ripping off the federal government under the guise of LLC/LLP!

Anonymous said...

McClure may have bed sores from sleeping in and not going for a walk ! šŸ˜ƒ

Peter J.Cochran said...

Gracedale May have worked well once upon a time ,when we wanted to take care of elderly indigent. But people that came here from out of state have figured out how to put grandma away and keep her money too and the county never reacted to the issue properly . That’s one big issue . Competition in the market place , Other facilities pay more and working conditions may be better. ,that’s my un scientific opion only. But what ever the issues are an employee should not work this type of occupation unless they have compassion,and understanding of geriatrics. They should not be hired because they need a job! There are some real fine personal working there and some others that need to get a job at a car wash.

Anonymous said...

Bottom line. Some people who work there should not be working there. If patients must be turned every few hours to prevent bedsores, make the people responsible to do their job. If a patient is required to receive meds at a certain make the staff responsible so it happens. If a patient is on a special diet, the staff should be held responsible that a special diet is delivered. When patients run out of oxygen for hours at a time, the staff must be held responsible that the oxygen bottles are replaced in a timely manner before they run out. When patients lose personal items, the staff should be held responsible to find those items. Let's tell the entire story. Yes there are good people working at Gracedale, but you must investigate and remove those who are un responsible.

Jeff Fox said...

Both NorCo and Gracedale administration seem to be addressing the issue of bedsores. Those who matter are not bashing the employees of Gracedale. The more concerning issue, in the context of governance, is the way in which the purchase of mattresses was conducted. Unless one was either at the Human Services meeting, or watched the webcast, one would not know what was discussed. There was obviously an issue which goes deeper than bedsores.

Anonymous said...

Who was responsible for eliminating the restorative aide department? Who was responsible for eliminating the wound care treatment team? That is where and when these problems manifested themselves, and became exacerbated

Anonymous said...

12:19 pm it was Brown who got rid of those departments

Anonymous said...

One way or other it’s not. Employee fault on what goes on it the Ship Captain s fault .peiod!

Anonymous said...

The nurses and aides provide the best care they can with the amount of staff they have. Let me see you take care of 15 people yourself on day shift and 25 people on middle shift. Plus dealing with behaviors from residents and families while trying to take care of this many people. I wish you luck.

Anonymous said...

I slept on one of those mattresses. Wasn’t bad at all. I was not catapulted out of bed nor did I develop any pressure sores anywhere. Pressure area etiology is multifactorial. Feel free to google what that means.

Anonymous said...

This situation is a complex problem. Who wants to have a job, where no one gets better, every patient is on a down hill slope. It must be depressing to be there. It really takes a special person to do this kind of work. Those people need and deserve all the support they can get.

Anonymous said...

The Brown/Allen legacy..scum!

Anonymous said...

RNs are paper pushers at Gracedale. Most of them don't even provide hands on care. Jobs where they can go and make $4-$5 more to start also have alot more job duties. The LPNs and the CNAs are the backbone of resident care. If anyone should make more money its them!

Anonymous said...

"Prevention of Bedsores at Gracedale Equation" (my opinion):
* Responsible/mature employees ONLY should apply
*The increasing need of "direct-care aides" for the residents is obvious (i.e. toileting, bathing, re-positioning, ect.) Employees suffer "burning out". RN's and LPN's have their own important positions to maintain, therefore unable to maintain direct care.
* More supervision might be beneficial to ensure tasks are completed.
* Increasing quality of care may decrease skin breakdown! A resident resting on a floor mat (if he/she chooses to do so) most likely will not suffer a "bed sore" if cared for in a timely fashion.