Friday, March 05, 2021

NorCo Council Gets Exhaustive Report on Gracedale

Northampton County Council received an exhaustive report on how Gracedale is going at their Human Services meeting on Thursday night. They heard from Administrator Jennifer Stewart King as they do every month. In addition, Dr. Paige Van Wirt, who treats the residents, discussed the use of a new Covid treatment as well as the use of antipsychotic drugs.

Gracedale's Rating

Gracedale currently has a two-star (below average) rating from the Centers for Medicare and Medicaid Services. This is based on health inspections, staffing and the quality of resident care. Gracedale's rating for health inspections and staffing is three stars, which is considered average. But the quality of resident care is just one star, or much below average.

Over the past year, Gracedale has received four health citations, which is about half the state average. An infection control inspection, conducted in January, resulted in a no health deficiencies.  The quality of resident care is rated much below average because the home uses about 50% more antipsychotics than are seen in other Pennsylvania nursing homes. 

The Vacancy Problem

Gracedale has a vacancy problem, admitted Administrator Jennifer Stewart King.  This consists of 120 PT nurses vacancies, 110 FT nursess, 10 in dietary, 3 in laundry, 8 in housekeeping.

She indicated there are recruiting billboard along Rte 22 and 33, with more on the way. The county is also running recruiting commercials and is seeking new employees at numerous outlets. It has recently hired two Assistant Directors of Nursing and is offering 12-hour shifts on weekends.   

Council member John Cusick blamed the federal government. "It does make it a challenge to hire people because  the federal government keeps extending unemployment."

Cusick also complained about mandation, a county policy in which Gracedale emplyees can be forced to work overtime. He argued that employees have a "reasonable expectation that an excessive amount of mandation should be unnecessary." Stewart King countered that the county only mandates overtime when employees who are scheduled to work call off. 

In addition. Cuick was "disappointed" to learn that Gracedale Advisory Board's has failed to meet since the inception of the pandemic. The Advisory Board, which consists of numerous citizens, was created when county residents overwhelmingly voted to keep the nursing home.  "They could meet electronically," suggested Cusick.

Covid 

The average census in January was 527, which includes 22 new admissions. 

One resident is Covid-19 positive, with another five awaiting test results. 

There have been 419 total infections since Covid-19 first struck. The pandemic has claimed 97 lives at the nursing home. 

As a result of a vaccine clinic at the home, 87% of the residents and 48% of the staff and 21 volunteers have been fully inoculated. The facility maintains a Covid-19 ward for those who become infected. 

Antibodies and Psychotropic Drugs

Dr. Paige Van Wirt, who provides medical care for the residents, discussed a treatment option involving the use of monoclonal antibodies. She explained that these are synthetic antibodies that mimic actual antibodies. If given early, she indicated this treatment reduces spike proteins. She has administered this treatment to five residents. All recovered. She added the benefit is actually better for patients with co-morbidities like advanced age or obesity. 

She also discussed the use of antipsychotics at the home, stating that decisions concerning their use are totally under her control. She noted that other facilities can reject residents with behavioral issues, but Gracedale is a safety net that will take anyone, including residents who are already being treated with these drugs. She indicated that medical decision concerning their use is a "balancing act." She is governed by a desire  to reduce suffering. 

23 comments:

Anonymous said...

Who is the rep to the advisory board from Council? Did they respond to Cusick?

Anonymous said...

Cusick has a lot of complaints. Too bad he has no answers or solutions. His name should be Captain Obvious.

Anonymous said...

Cusick was one of the original dump Gracedale gang. He has no credibility.

Anonymous said...

I see the statistics on fully vaccinated staff at Gracedale. Did the state shift priorities and back off on offering sufficient supplies of vaccines and access to pharmacy programs to administer in nursing homes?

Bernie O'Hare said...

12:19, Heckman agreed with Cusick and vowed to look into why the advisory board is not meeting. No Council members are on this board.

Bernie O'Hare said...

"Cusick has a lot of complaints. Too bad he has no answers or solutions. His name should be Captain Obvious"

I believe his attempt to blame the staffing shortage on federal unemployment benefits was political, but the fact remains that there is a huge staffing shortage. This in turn leads to mandates. I appreciated hearing the different things the county is doing to attract people. The one thing not mentioned by anyone is paying this staff more money. The county is far too cheap and miserly when it comes to paying people. If I have to clean bedpans or wipe someone's ass, I think I'd want far more than the county currently pays CNAs. $15.36 per hour is too low. It should start at $20 per hour, which is being paid to cleaners at warehouses.

I am glad for Cusick's complaints. Not everyone on Council should be waving pom poms for McClure. He needs constructive criticism as well. It only makes the county better.

Bernie O'Hare said...

"I see the statistics on fully vaccinated staff at Gracedale. Did the state shift priorities and back off on offering sufficient supplies of vaccines and access to pharmacy programs to administer in nursing homes?"

I am sorry but fail to understand your question. Sorry.

Anonymous said...

"I believe his attempt to blame the staffing shortage on federal unemployment benefits was political ..."

Don't know Cusick or his political motivations, but my business remained open throughout with lots of orders and lots of work. Enhanced unemployment put a very sudden end to my ability to hire, as I began competing with federal unemployment. The feds were paying to watch Netflix, while I was offering to pay for actual work. I lost. My story repeats all over the country. Under threat of enhanced unemployment ending in July, I had a brief flurry of applications and resumes. Then it stopped again. I've increased wages by 12% in a year and still can't fill the shop. My wages are competitive enough to keep decades long employees. It's getting new ones off the couch that is a problem. My wage scale is considerably higher than what you've mentioned. But your point about wages is also dead on. Warehouses will pay $20/hr to start for pickers and packers.

Anonymous said...

Despite the $750 incentive to get the vaccine. Healthcare workers have chosen to not take it. Unfortunate. Happening in many long term facilities.

peterjcochran said...

I m a registered volunteer at this facility. I would visit and eat lunch with veterans there. I have to submit what I observed. They were a bit understaffed , the folks that worked there were running hard. However all the veterans I visited were well cared for , I would ask questions about the food . The report was they liked it. I think this present county executive did make the right right decisions under extreme conditions..I’m as I declare,,I’m a hard R . This county executive did a great job under this pandemic with the largest facility of its kid in Pennsylvania.

peterjcochran said...

The employees need to be inoculated and because they are who they are ,they don’t ,L
lthey are lacking in judgment ,lThey should have first been educated in why. in 1919 that killed millions . I would walk through cemeteries in remote ares like Bradford and Tioga

County’s and see the whole family’s in a row buried . My father would say , they got caught by exposure to city people visiting .l
So get your inoculation .

Anonymous said...

Of course they have a hard time recruiting nursing personnel. The place is too big and it's a dump. The county should have sold it years ago when it had a chance.

Anonymous said...

6:27 With all due respect, you should be educated as to why as well. The reduction in infectious disease morbidity and mortality in this country was multifactorial and began way before "inoculations" took the forefront in this fight. How about we look at such now-routine activities as hand-washing. At one time, doctors did not wash their hands in the maternity wards when going from woman to woman....seems unthinkable now. How about pest control, antiseptics, sanitation/sanitary sewers, general hygiene practices, and the antibiotics? All of these things, along with vaccines, have contributed to why we won't have a repeat of 1919 my friend.

I would personally never tell anyone to inject themselves with something under emergency use authorization. There are all kinds of personal situations, all kinds of variables involved with this. You cannot paint it with a broad brush. My own mother decided to take the vaccine with a lot of pushing from her employer and has had long-lasting health issues (no, not a momentary sore arm or low-grade fever either).

Anonymous said...

There are many reasons why Northampton County doesn't have full employment at their Senior Care Facility (Gracedale). Most of it comes down to a decent wage scale and benefit package. When John Brown left office, he tried to cut taxes. Why? He realized that the new administration was going to have so much money that the new administration wouldn't have to raise taxes for eight years. (strictly a political move) Instead of correcting wage scales and benefit packages for employees, the McClure administration chose to continue the practice of the Brown Administration and balance budgets on the backs of their employees. How do you go from having a waiting list in the 90's for Gracedale admissions to shutting down nursing care floors at that facility with a shortage of nursing personnel to care for the reduced number of patients. The County no longer pays medical coverage for their retirees. That alone was a big factor in choosing to work at Gracedale as well as the Court House. I'm going to cut the list of recommendations for improving nursing quality at Gracedale short for now, but if you want to see why you have poor nursing care and why you no longer have a waiting list for admission to your facility, try talking with the people who experienced the identical circumstances in the 80's and 90's. One thing you don't want to do.....you don't want to keep screwing your dedicated nursing staff and employees the way this administration is doing.

Anonymous said...

Bernie, Ms. Hefner was the council person for the Gracedale Advisory Board for the past three years. Did she know what happened? Did she give any answers?

Bernie O'Hare said...

She said nothing. Heckman said he’d look into it. She would be the liaison not a member and likely does not know why there have been no meetings. I’d tend to agree that they should have been meeting at least electronically. Gracedale had a large number of deaths. If only for that reason, they should have met

Anonymous said...

Why no mention of Human Services Director, Wandalowski? What is she doing about the poor ratings at Gracedale as well as the employment problems? She should be shouldering some responsibility for these issues.

Anonymous said...

County benefits still beat hospitals and private sector. Few jobs offer lifetime health benefits anymore. To raise salaries they need to raise reimbursement at state and federal level.

Bernie O'Hare said...

6:43, Benefits begin to matter when someone is in his 40s or 50s. Before that, it's all about the money. People are not looking for jobs when they are in their 40s and 50s. They do so when young. You need to pay more. As I said, I would want more than $15 per hour to wipe someone's ass. Quit being so cheap already.

Bernie O'Hare said...

Why no mention of Human Services Director, Wandalowski?"

Oh I see an entitled caseworker from Children and Youth is commenting from her vacation home. Nice of you to drop by. Although Wandalowski runs Human Services, she has little to do with the day-to-day at the nursing home. You know this but want to smear her.

Anonymous said...

The Director of Human Services is ultimately responsible for their Department. You know this but want to deflect any responsibility form McClure and his Director. The reason the Advisory Board is not running should be answered by her or McClure. You will scream at everyone but them. If the Advisory Board is required it is the adminntrations job to answer for that. As McClure likes to tell everyone, he is in charge of the county. If he is not responsible for this Board then no-one is. He or Wandalowski dropped the ball accidently or on purpose. It is easier for you to attack someone else though, isn't it?

Anonymous said...

McClure's the Exec. He owns responsibility for Gracedale. Period. He could have raised a stink immediately. He didn't. He closed parks.

Anonymous said...

Bernie,

Does the following sentence translate to "hasn't met in a year?" Is this a clever way of informing the public it will be a year March 13th?

In addition. Cuick was "disappointed" to learn that Gracedale Advisory Board's has failed to meet since the inception of the pandemic