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.
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.