At yesterday's Human Services Committee meeting, Executive Lamont McClure reported on two matters that make the long-term viability of Gracedale, the county's nursing home, very questionable.
First, he noted that the state Department of Health told a state senate committee yesterday that it intends to require that nursing homes provide a minimum of 4.1 hours of nursing care daily for each resident. This is referred to as PPD. Last year, McClure actually testified against increasing it. Though this is completely inconsistent with providing adequate care to the elderly, McClure was concerned that such an increase would result in no care at all. Gracedale would undoubtedly be forced to close.
Second, McClure reported that AFSCME, the bargaining unit representing LPNs and CNs, has just rejected an offer of a 2 step salary increase and 2.5% over three years with no increase in health care costs. "I promise you money is not the issue at Gracedale," he insists. Council member Kerry Meyers agreed. "We're wearing what we got out," he said, in an inartful way of saying employees are burnt out/
I'd argue the reverse and that the increase offered is actually insulting and below the cost of inflation. Council member John Goffredo believes, like myself, that money is very much the issue. He noted that the hourly rate for an RN at Gracedale is about a third of what it is in the private sector.
McClure has previously argued that public facilities like Gracedale rely on Medicaid for most of its revenue, and this provides the lowest reimbursement. In other words, Gracedale would need a county taxpayer contribution to stay afloat if salaries increased.
Administrator Jennifer Stewart King told County Council that the census continues to drop. It was 468 in December and 454 in January. This is intentional. A lower census makes it more likely that the nursing home will meet the 2.7 hours of daily nursing care for each resident. But even with the reduction in resident numbers, Gracedale is still below that magic 2.7. It hovered between 2.45 and 2.6 in January.
Stewart King herself sounded a bit stressed. "For two years, we were hailed as heroes, and now we're not," she complained. She added it's impossible to plan long-term because of constant policy changes. One federal standard change might prohibit four residents in a room, which would require changes at the nursing home.
Cunty Council also discussed a salary, IT and Gracedale study. It appears to be unready to issue a Request for Proposals and Qualifications.
Council members John Brown and Kevin Lott were absent from the meeting.
12 comments:
Glad the conversation is being had. However need to correct or elaborate on a few items. The private sector is not keeping up with inflation either. Expecting over 12 percent in three years with the gift of same cost for benefits is a good deal today. A separate pay study could also be done and implemented in three years or before if the county desires. RN's in private sector may get higher salaries but Gracedale pays more than one third of other sites. Four bed rooms have been eliminated for years with any new construction and the county knew this was coming for years and did nothing to update environment or make a plan for this. The CMS and DOH staffing reg is ludicrous today as only a few homes would ever be able to meet a PPD of 4.1. Those that do will fail financially without more medicare and medicaid reimbursement. The unions have been demanding these staffing levels and the politicians will make it so on paper but few will be able to meet it. Policy changes now did not cause the lack of any planning by administration and county to deal with problems that we all knew were coming for a long time. To blame new regs is ridiculous. Administration has failed to prepare. Those who are succeeding planned long ago for what we are seeing now. These reg changes have been talked about for years. This is not new. I could write a book about CMS motive and lack of knowledge of the actual running of a nursing home but that's for another day. Gracedale is where it is today because those running the home have no clue how to be responsible knowledgeable leaders. The simple comment relating to heroes shows the focus is not on the residents and what's best for them. If you can't handle the pressure as a manager perhaps one should not be in the position. If Gracedale is to succeed it requires very knowledgeable skilled management to deal with the present situation
Your boy is in over his head at Gracedale. His pig headedness is keeping him from being open to any ideas but his own. If he would stop blaming everyone for his proble3ms and face them he might figure it put. Word is he even blames county council for talking about Gracedale.
He loved handing out his political millions to the business owners to raise his profile, he should consider helping Gracedale with more hiring staff instead of already signaling another tax cut next year. Reach out for help if he knows how to.
Keeping Gracedale open is unfair to everyone. Who exactly benefits by its continued operation? It was forced to stay open on a referendum during an off year primary. A tiny fraction of activists held the day and sentenced our elderly to substandard care, employees to substandard wages, and taxpayers to substandard government. If a referendum was held again today, the same heartless bastards would show up to deliver more misery to the county. Disgraceful and tragic. They'll blame the government for providing bad government and tell you more government is needed to fix the bad government they keep demanding.
It is very hard to suggest or even comment on improvements for Gracedale when no one shares all the facts. We all know the "STAFF Is UNDERPAID." Until you do a pay survey and make it public, there is no way to intelligently comment. Mr. McClure is known for screwing the employees/new hires/retirees/and other staff unless he is your friend. There are several of us who can't wait to retire and that will further the problem facing Gracedale. Here's something that we know and were told many times that applies to us as employees. The County has a formula by which they get reimbursed for costs at Gracedale. I don't know what that is but until we find out we can't intelligently address the cost of operating Gracedale. Let's say for example the cost (reimbursement) is 70%. That means if the County increases salaries for nurses by $2.00 it only cost the County an additional $.60 (sixty cents). It's a start. Do what's right for the backbone of Gracedale (the employees) and the rest May just take care of itself. Do the pay study
Shorty MIA? I'm shocked. Centralize the operation. I don't know the logistics out at the campus, however, they might want to fill the tower and close the other buildings maybe use them for other purposes . Save money on heating cooling maintenance.
He used it to get elected but it seems he wants to dump it like Stoffa. Refuses any construction, refuses any base pay increase, refuses raising bonuses, refuses usi8ng his massive surplus or even the American rescue millions he got on the Home.
He even refuses an independent county study. Yeah, he really wants to help the Home.
This is utter nonsense. 1) There are capitol projects at Gracedale every year, and this includes every year since McClure took office. 2) there have been base pay increases which resulted in two contracts at the home. 3) McClure used a substantial portion of both CARES act and American Rescue plan to pay for numerous things at the home and intends to continue.
Are salaries too low? Yes Should there be a pay study? yes. Should there be an operational assessment!’ Yes. But you utter what you yourself must know are lies and this is why no one can listen to disgruntled people.
The capitol projects are necessary for the functioning of the home. Every old building has capital funding each year. That's nothing extraordinary that's just necessary. Have you been to the home to see the three and four bed rooms? Especially in the old section that should have been closed years ago? At least other counties have built new or renovated homes. McClure did indeed get in his first time with promises to Gracedale employees. I know of many republican voters who voted for him for this reason. Politics. Use people to get in. Then he got rid of many people who knew Gracedale well because they were appointed and hired under executive Brown. McClure didn't believe he could trust those people because he didn't hire them. And look what's happened to the home since then. Politicians think because they have no commitment to what's right that others would betray them because that's what they do. he made a big mistake getting rid of many knowledgeable staff out of paranoia. Has he done some good in the county. Yes. But not for Gracedale.
Why is that lynch gets more response than the care of the elderly and those in need of care at Gracedale?
Where did the roughly 2.3 million dollars a year go that was supposedly dedicated to supporting Gracedale from the IGT funding program?
Mostly Medicaid reimbursement does not cover costs. That's why IGT funding is needed to reduce taxpayer contribution. Medicare pays more but hard to get a high Medicare level in an old outdated county home. The IGT is part of the budget for the nursing home not for extra projects
..if the IGT is part of the budget, and not line item dedicated for Gracedale, then it is being absorbed for use for other projects elsewhere
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