Some Good News About Gracedale

Northampton County Executive Lamont McClure has always been a proponent of Gracedale, the County's nursing home. When he was still on County Council, he consistently argued there was a "moral obligation" to maintain the home, irrespective of whether it made or lost money. Voters agreed. In 2011, they voted by a 3-1 margin against plans to sell it. McClure made Gracedale a central theme of his Executive race as well. He exposed plans to relocate the jail there. Though he's been good to Gracedale, the nursing home has failed to repay the favor. A negative state health inspection report, released in January, revealed 11 deficiencies in patient care. Ratings plummeted to two stars, or below average. But he finally has some good news to report, and ironically, it comes from the state Department of Health.

When voters decided to keep Gracedale, former Executive John Stoffa and County Council decided that the facility needed a private management firm like Cedarbrook in Lehigh County. Premier Health Care Management was hired at a cost of about $500,000 a year. After doing a thorough assessment, Premier began making changes. The quality of care went up. The home went for two years in a row without a deficiency during the annual inspection. The Medicare ratings went up, too. The home was briefly at four stars. Moreover, a nursing home that was losing millions every year slowly became profitable. Even if you deduct a federal grant called the IGT transfer from the home, it still was in the black.

A large part of the reason for this is D Freeman, Premier's point man at Gracedale. During his time there, he got to know everyone. For some reason, McClure and some other Democrats had issues with Premier, but they were never really quantified in any meaningful way.

That changed when Freeman left Gracedale. His replacement, though affable, lacked Freeman's enthusiasm. The home remained profitable, but the quality of care began to suffer. The home dropped from four to two stars in Medicare's rating system. It was fined when a suicidal resident who was left alone attempted to kill herself. It was also repeatedly criticized over the use of psychotropic drugs, which have been called chemical restraints.

When McClure took office, he allowed Premiere to remain in place for a year before ending the county's contract. In hindsight, he has said that was a mistake. At the end of December, while Premier was still manager, a state inspection yielded 11 deficiencies directly related to resident care.

Anonymous commenters here have blamed McClure, claiming he hates old people and other nonsense. That is political garbage.

County Council and McClure have both also learned that medical records are kept on paper instead of electronically. The former Director of Nursing, in her year-old letter to Council, has said many of the problems there are decades in the making.

So that's the bad news. The good news is that the State Department of Health, the same agency that gave Gracedake a bad rating, has complimented Gracedale on its reduction of the use of psychotropic drugs.

“The current achievement of your staff is a reflection of the facility’s ability to empower residents to reach their highest practicable well-being,” the Department of Health noted in reference to Gracedale. The Pennsylvania Department of Health and the Division of Nursing Care Facilities (Division) has joined the National Partnership with the Centers for Medicare and Medicaid Services (CMS) to assist in the improvement of dementia care and reduction of antipsychotic drug use in nursing homes within the Commonwealth of Pennsylvania.

“We appreciate the recognition from the Department of Health on this issue,” says Lamont McClure. “When it comes to the care of our most vulnerable residents, it’s important that we are in line with current recommendations and research.”

In addition, the Department of Health requested that Gracedale share the lessons learned in achieving this goal in order to assist other nursing homes in accomplishing similar results.

T make clear his is a positive development, but the recent changes and negative survey make clear that thee is a need for separate Council oversight. Lori Vargo Heffner's Human Services Committee is simply overwhelmed by the numerous other Human Services agencies. They are important, too. There shoud be a separate Gracedale committe. Ideally, the person who should run it is a former Director of Human Services. That would be Council President Ron Heckman.