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Nazareth, Pa., United States

Monday, July 10, 2023

Gracedale Continues to Improve

Gracedale Administrator Jennifer Stewart-King updated Northampton County Council last week with very positive news about the county-owned nursing home. It underwent its annual survey by the state Department of Health (DOH) on June 6-8. Last year, DOH noted five deficiencies, which was below the state (8) and national (8.5) average. This year, things were even better, Health inspectors only found two problems. 

Stewart-King explained that one deficiency concerned a requirement that a resident be walked a certain number of feet per day. Though this was done and marked as done, staff neglected to record it in one instance. The second problem dealt with a doctor's order for a dressing on a resident's wound. The wound had actually healed but the order was still in place. Stewart-King said her staff should have asked to have the order discontinued.  

In conducting their survey, DOH inspectors examined 44 charts and spoke to residents and staff. The state website has a two-month lag in posting survey results, so are unavailable for public review.  In their exit interview, Stewart-King reports that inspectors "noticed a change over the past few years among staff and residents."  Some of them lauded the "positive teamwork attitude and happy residents."

That's certainly different from what is usually heard at election time. 

Stewart-King said she has one goal at Gracedale - to provide "the best life that our residents can have."  She is proud of her staff, acknowledging the work is demanding. "It's a tough job. You're taking care of someone's life. Sometimes it's rewarding and sometimes it's frustrating because people yell at you because they can't do anything. They come into a nursing home and sometimes it's their last place to go. They're frustrated. They've lost their independence. " 

As a result of this positive survey, Stewart-King predicts that Gracedale's Medicare rating will rise from its current 3 stars (average). It's current 4-star health inspection will go up to 5 (much above average). 

According to that most recent survey, Gracedale's staffing now is rated at 3 stars (average) .  

Stewart-King indicated the home is working on improving its low quality measures (1 star), which she attributes to sending residents to the hospital instead of providing care in-house. 

Gracedale's average census in May was 415. The current average census is 430. (There are 682 licensed beds). 

Its average nursing hours per resident per day (called PPD) is 3.3., above the 2.87 state minimum. Starting 7/1/24, the PPD minimum will be 3.2. 

She hired 20 workers in May, but lost 19. She is forced to use agency nurses to fill staff shortages and told Council that even hospitals are now losing nurses to agencies that pay high wages but provide no benefits. 

She also updated Council on the performance audit being performed by an independent agency. 

15 comments:

Anonymous said...

Cost per patient vs. other and average LTCFs? That's the story we apparently won't get here. Thanks.

Anonymous said...

When are you being admitted Bernie ? (Lol).

Anonymous said...

Recently, my wife and I went to Gracedale to visit a lifelong friend of ours. When we went to his floor, he was not in his room and the nurses at the nurse's station told us he was in the hospital. For privacy reasons they could not tell us why so when we got home, we called his wife to find out what his problems were that would require him to be hospitalized. She informed us that he was hospitalized for "treatment of infected bed sores". Three days later she informed us that he died from the infections. Will this be included in the State's Report?

Bernie O'Hare said...

"Cost per patient vs. other and average LTCFs? That's the story we apparently won't get here. Thanks."

Sorry this story fails to fit your narrative, but I don't know what you're talking about and doubt you do.

If your question relates to whether Gracedale breaks even, it does thanks to an annual IGT. It is something I have covered since 2017, when Gracedale first started coming out of the red. The county nursing home does not exist to turn a profit, but to serve as a safety net. Thanks to the annual IGT, it is fiscally stable. In addition, Gracedale was the beneficiary of ARPA funding, which was discussed here at length. I also cover and have written about Gracedale finances.

I write the good and the bad about Gracedale. I probably provide more details than you'll find anywhere else. Lately, the news is good. If the IGT stops, Gracedale might be in trouble. But there's no sign of that happening.

I was impressed by Jennifer Stewart-King. She strikes me as very dedicated. I could never do what she or her staff do. I am thankful for people like her and the people who work there.

Anonymous said...

Sorry, but anything below 4 for PPD is inadequate care. And any facility meeting our state standard still shortchanges those needing care. And residents without constant overviews by family/interested parties suffer. In The Morning Call today "The National Consumer Voice for Quality Long-Term Care...you want to be over 4.1 hours per day."

Bernie O'Hare said...

7:41, If a complaint was filed and the home is found to be at fault in any way, you can expect to see it noted by the state DOH. So far, six complaints have been reported to DOH this year, and none was substantiated. These do not appear until about two months after the investigation is complete. I am sorry that your friend passed away. Gracedale has a wound team that exists to address bed sores.

https://sais.health.pa.gov/commonpoc/Content/PublicWeb/ltc-survey.asp?facid=072802&page=1&name=NORTHAMPTON+COUNTY+HOME%2D+GRACEDALE&SurveyType=H&eventid=B6EJ11

Anonymous said...

Lipstick on a pig! The place is a depressing dinosaur. Sell it!

Bernie O'Hare said...

8:07, I looked and am unable to find a link to the Morning Call article you mention. I can tell you that Gracedale would love to have a higher PPD and strives to hire as many as it can. I am sure residents, staff and administration would like to be above 3.3. But here's the problem. You set the standard at 4.1 or some other high number, and all that does is ensure that only the wealthy will get nursing care. Gracedale and many other nursing homes will be forced to close, leaving many with no care at all. As I said, Gracedale is a safety net.

Anonymous said...

I’m hoping the performance audit is truthful and unbiased. A resident hospitalized and then dying from infected pressure ulcers screams resident neglect. Very sad. More fuzzy math - hired 20 in one month but 19 left. Hmm.

Bernie O'Hare said...

"I’m hoping the performance audit is truthful and unbiased. A resident hospitalized and then dying from infected pressure ulcers screams resident neglect. Very sad"

There's lots of "I don't knows." First, the comment is anonymous, which makes its credibility uncertain. Second, this person reports what she was told by the resident's widow. She might be mistaken or may have misunderstood. Third, how long was this person at Gracedale? Were the bedsores contracted at Gracedale or somewhere else? Fourth, was Gracedale negligent? If it was treating the bedsores and hospitalized the resident after they got worse or became infected, it's likely that reasonable care was exercised. It certainly does not scream resident neglect.

" More fuzzy math - hired 20 in one month but 19 left. Hmm"

There's no fuzzy math here. It's an honest report. It would be fuzzy if Stewart-King had noted the 20 hires without noting that 19 left.

Anonymous said...

I can see you are defensive of Gracedale but please understand that you are taking the side of administration when a resident possibly was neglected when you should stop and realize that this resident could be you. My fuzzy math comment simply notes that Gracedale is possibly recruiting but they are losing just about what they recruit. It’s clear that they are not retaining staff and that’s the bigger issue. If we don’t advocate for the resident, who will? You apparently believe less staffing is better in your support of a lower care ratio. I hope you never are on the receiving end of that, Bernie. Do you even know Jen Stewart-King?

Bernie O'Hare said...

5:26,the operative word is "possibly." Assuming that this resident even died from infected pressure ulcers, that's only possibly the result of neglect. It could very well be that due care was exercised. Your fuzzy math comment is absurd. Stewart King was being honest instead of hiding the facts and you criticize her. Your comment regarding retention is completely baseless. You don't know that based on one month's data. That is why an operational study is being done. I'd love to see more staffing, but what you are suggesting is turning people away completely. Where are they supposed to stay? I don't know the point of your question regarding Stewart-King. I do not know her and have only watched her for years. It took me tuime, but I believe she deeply cares about the residents./ I don't think you care at all. Your goal is to shut the place down.

Anonymous said...

My goal is for good care for the residents of Gracedale and a safe working environment for the staff. You?

Bernie O'Hare said...

I think not. I think your goal is no care for the residents and no staff. If Gracedale were required to have a higher ratio of nursing care, it would have to close. That would mean that many residents who receive care now would have nowhere else to go because no other facility will accept them. Many of them are suffering from dementia and Alzheimer's. You are quick to seize upon an infected bedsore to conclude, with no additional evidence, that Gracedale must have been negligent. That tells me your real goal you want it to fail. My goal is to report as accurately as I can what happens there, both the bad and the good. I have often reported negative news. When I report positive developments, people who want Gracedale to fail come on this blog and condemn the home. They and you want it to fail. So drop the pretense.

Bernie O'Hare said...

I think not. I think your goal is no care for the residents and no staff. If Gracedale were required to have a higher ratio of nursing care, it would have to close. That would mean that many residents who receive care now would have nowhere else to go because no other facility will accept them. Many of them are suffering from dementia and Alzheimer's. You are quick to seize upon an infected bedsore to conclude, with no additional evidence, that Gracedale must have been negligent. That tells me your real goal you want it to fail. My goal is to report as accurately as I can what happens there, both the bad and the good. I have often reported negative news. When I report positive developments, people who want Gracedale to fail come on this blog and condemn the home. They and you want it to fail. So drop the pretense.