Thursday, July 29, 2021

Pennsylvania Has Only 16 Public Nursing Homes Left

Cumberland County has decided to sell its nursing home to a private provider in a 2-1 vote. Once that sale is complete, there will be only 16 publicly-owned nursing homes left in Pennsylvania. This latest sale is discouraging to Council member John Cusick, He worries that the state association of counties, known as CCAP, is increasingly hesitant to lobby state officials on issues affecting nursing homes like "the need to increase Medicaid reimbursement rates and the proposed increase in the required nursing hours per resident by the state Department of Health." 

In Cumberland County, the sale was opposed by the Board's sole Democrat, Jean Foschi. The nursing home has been bleeding red ink for several years, but Foschi argued that Cumberland could use monies from the American Rescue Plan Act to keep the home afloat. 

Northampton County nursing home Gracedale has avoided red ink as a result of something called the IGT, or intergovernmental transfer.  Under this program, county-owned nursing homes pool monies, send it  in the state and get a matching federal grant, which then trickles back down to the counties. Gracedale has been receiving a substantial IGT since 2017

Gracedale is currently rated at two stars (below average) by Medicare, but Administrator Jennifer Stewart-King has told County Council that the ratings have been frozen as a result of the Covid pandemic It has received six infection control inspections over the past three  years with no citations. 

Staffing is an issue at Gracedale and other nursing homes in Pa. A state proposal that would mandate an increase in the time that staff must spend with residents each day has been condemned by the state's Health Care Association as "out of touch" and "unattainable."

As a member of County Council and as Executive, Lamont McClure has maintained that Northampton County has a "moral obligation" to support Gracedale. Voters overwhelmingly voted to keep the home a few years ago, when it was losing money. But if the IGT goes away and the county is required to recruit more staff, this moral obligation will become an increasing burden on taxpayers.  McClure has a moral obligation to them as well, which he often uses as an argument when employees seek higher wages. 


Anonymous said...

You and Stoffa still trying to dump the place?

Bernie O'Hare said...

No. First, the people voted overwhelmingly to keep it. Second, I believe I was wrong bc Gracedale employees really do care about the residents. If the county loses the IGT, however, it is going to start losing money. The people have made clear they are willing to contribute tax dollars to keep the home. There is a point at which such a decision could become untenable, but there should be a consensus on any decision to sell. We are far from that point right now.

Bernie O'Hare said...

"Stoffa had it right. How many lives would have been saved had our nursing home not fallen under Wolf's must admit policy during CoViD. Not very compassionate, huh? The dead can't vote though. They'll not be a problem anymore. They likely voted to keep Gracedale anyway. They didn't know they were pre-planning their funerals."

This is misinformation. Had Gracedale been sold to a private entity, Wolf's must admit policy would have resulted in more deaths. But as I have noted several times, Gracedale refused to admit residents with Covid unless and until they has two negative tests. Gracedale is the first or among the first home in the state to establish an isolation ward for those with Covid. It also brought in the national guard for testing and to help care for residents. The county did an excellent job responding to the pandemic, far better than the national or state government.

Anonymous said...

Now I understand the Northampton County Philosophy. If it costs the taxpayers money then SELL It. Every program the County has costs the taxpayers money. Does any of the HUMAN SERVICES PROGRAMS make money? Okay then, let's sell Children and Youth" or better yet Let's sell Mental Health and Mental Retardation and throw these people out in the street. I got it, in order to save the taxpayers money let's get rid of our JUDGES and their political hacks. Next, let's get rid of the County Prison. Just because something costs the taxpayers money doesn't mean we should get rid of it. ANYMORE brilliant ideas.
I don't hear any taxpayers complaining about funding Gracedale or the Prison.

Bernie O'Hare said...

Most of the human services programs, along with the courts and the jails and elections, are core county functions. Counties are mandated to provide these services, and much of it is reimbursed. A nursing home is not a core county function, which is why only 16 are left. I am by no means suggesting the home be sold. I believe the people have spoken. Moreover, I am very impressed by the care residents receive. But if the county has to raise taxes every year bc of the nursing home, it will have to revisit the issue. I do not see that happening so long as the IGT remains. Calm down.

Anonymous said...

" This latest sale is discouraging to Council member John Cusick"

Ummm... Wasn't it John Cusick who led the charge to sell Gracedale just a few years ago? I love how now all the sudden he's concerned.

Bernie O'Hare said...

The move to sell Gracedale was led by John Stoffa, Ron Angle and myself. I doubt any of us would support a sale now. I know I would be opposed. Those who support Gracedale should certainly be concerned about the sale of a public nursing home. We should be concerned about Medicaid and Medicare rates as well as the push to mandate more nursing hours. We should be concerned that the IGT remains. John Cusick is doing nothing more than his job. He watches the tax dollars and is bothered that CCAP is going to stop lobbying for nursing homes as the number of public nursing homes dwindle. Shouldn't that bother us all? I realize he plays for a different team than you, but we work better when we work together.

Anonymous said...

I've always appreciated the support for county homes. Not only do they have to be fiscally responsible they also most importantly need to provide the highest level of care to those they serve. We support a county home but can not continue to support a home that is not providing the care those residents deserve. A county run home needs dedicated knowledgeable caring people in top management who advocate for their staff and residents. It's not just a job. It's a mission and a position of service that unfortunately is not present. Not being honest to the public of the true situation at Gracedale is unacceptable. It's not about making it all sound perfect. It's about identifying what is wrong and development of plans to improve. It's not about keeping a position by saying what people tell you to. It's about caring enough to share the truth so it can be improved.

Anonymous said...

There is no law marking community and economic development a core county responsibility. Over the past 20 years it has become a goody bag for county executives to hand out checks and get photo ops.

Before you cut out Gracedale you can cut this unnecessary patronage factory drain on county taxpayers.

Bernie O'Hare said...

I completely agree that economic development is far from a county function. We already have a nonprofit (LVEDC) to whom we contribute hotel taxes for that very purpose, so it is redundant. We also have a nonprofit (CACLV) for community development, and I'm sure this outfit would gladly absorb our community development. But then we lose control. I am sure whatever we gave to CACLV for community development would go to Allentown instead of Easton or the suffering boroughs. There are always complaints about what we give to LVEDC.

Here's why we keep DCDC. Through HUD, we get block grants every yeaR, and the county DCED does a great job of analyzing where the need is and how the resources should be allocated. The county DCED also serves as the lead agency with hotel tax grants and gaming grants. It provides the administration for the GPA and IDA.

So basically, we use the county DCED to perform county functions even though economic development is NOT (nor should it be) a core county function. I honestly think we need to stay out of business bc government officials have no real understanding of how business works.

But I'd keep them both.

If you're asking which matters more, it's Gracedale, of course. The county nursing home is an invaluable safety net. I believe it is managed well and it receives a lot of oversight.
I am concerned that, as the number of counties involved grow smaller, our voice will diminish in Harrisburg.

Anonymous said...

When Mike Wilt left PACAH and country homes privatized the county voice for advocacy at the state and federal level for nursing homes diminished. What we are left with are politicians who pretend to care but won't ruffle any feathers at CMS or DOH for fear of loosing their position to hear changes first. Mike didn't care about making friends and was never arrogant. He fought for the residents in the homes. It has not been the same since he left. The voice has already diminished as you fear.

Anonymous said...

County economic development. 10% substance,90% bullshot. One maybe two people needed to do the job the county must do, the rest is PR. They analyze their buddies and always have. Fiscal does most of the lifting with grants. If ED went away no one but the bloodsucking insiders and patronage hogs would notice. Rather spend a million to really help people than spend a nickel on that worthless insider agency that was created by an unscrupulous political consultant.

Tine for a charter review and clean up some of this mess.