Affinity Health Services, which already assists Gracedale in its preparation for annual inspections by the state Department of Health, was engaged by Northampton County Council in March to provide a performance audit at the county's nursing home. This included an off-site data analysis along with an om-site visit in May that included focus groups with staff from every shift.
Affinity's Exec VP, Candace McMullen, provided the bulk of a detailed analysis. But it could be summed up in her two-sentence answer to a question from Council member John Cusick. "The two biggest problems I think you have are wages are not competitive and you don't pay for experience. So your ability to recruit people is very limited."
In stark contrast to numerous complaints, the study found that Gracedale's management meets or exceeds expectations. So does its dietary and maintenance (housekeeping). It needs improvement in reducing nursing overtime, its five-star rating, its compensation package and environmental sciences.
McMullen lauded the home for a "true county home philosophy" to care for residents without regard to ability to pay. She noted a large number of residents (90%) have very limited resources.
Financially, Gracedale fares better than most county nursing homes They had negative margin of 3% in 2021 while Gracedale was 7% to the positive . In 2022, Gracedale had a negative margin of 1% , but nationwide, county nursing homes had a 4.8% loss. in 2022.
She was critical of the use of outside agency nurses to provide care. Gracedale's nursing employees was at the following level at the time of the study: 11 RNs, 46 LPNs and 85 CNAs. Outside agencies were as follows: 15 RNs, 34 LPNs and 30 CNAs. Over half of Gracedale's nursing care is provided by outside agencies.
The reason for this, according to McMullen is "very clear" - low wages. She provided data showing that the wages paid to nursing staff at Gracedale is considerably lower than that paid in this region and statewide. Outside agency nurses are paid 41% more than county employees
The argument has often been made that good county benefits are the trade off for low wages. While conceding that Northampton County has a "very robust benefit" plan that exceeds most others, but the workforce is less interested in benefits than it was in days past. "It's about paying your bills and having money in your pocket." ... "Whether it's right or wrong, it doesn't really matter. That's the reality."
Cusick also wanted to know why the county couldn't start an experienced nurse at a higher salary than a recent graduate. "You can, but because you have collective bargaining units, that's a bargainable [sic] issue."
It's a mystery to me why unions have failed to fight for higher wages or why they would oppose allowing an experienced nurse to start at a higher step.
In her discussion of Gracedale's average CMS rating of three of five stars, McMullen explained that what holds the home back is its one-star rating for "quality measures." This applies to the medical care afforded residents. She acknowledged that because Gracedale accepts residents with serious issues like dementia, it will be hard to improve that rating.
The study also encompassed the possibility of reducing 4-BR units to private or semi-private rooms. Under the current reimbursement structure, the home would lose money.
The union business agent works for McClure. McClure wants to cut the taxes again to ensure his re-election. The employees have no one trying to help them. That is part of the reason for the health center. It is big flashy and more public relations. People need pay. McClure is living in th past.
ReplyDeleteThis council spent almost $40,000 of taxpayer dollars to find out what they have been told numerous times over the years….that if you pay higher wages you get better people and secure better job longevity. The money is there..the IGT funding, if still in place, gives Gracedale a 2 million plus dollar fund that keeps it in the green and keeps the onus of raising taxes away from the taxpayers…..why aren’t they doing this?
ReplyDeleteShould have gotten rid of this burden on the taxpayers' years ago. mcculre couldn't lead ants to a picnic.
ReplyDeleteThis report called for the elimination of 15 janitors. The place will smell horrible.
ReplyDeleteThe benefits are over 50% of the compensation. Other County homes are 40. Cut benefits 10% and pay that money to workers ?
ReplyDeleteYou cite low wages but outstanding benefits. Can benefits be cut back in exchange for better wages, in order to hold steady on the profit/loss line? If bennies aren't important, trade them for wages and everyone wins. What is the overall hourly cost of an employee (wages and benefits combined) compared to other homes? That's key information a fair question. Any business person knows this number for their company and industry. Knowing this number allows for honest, apples-apples comparisons and sound financial decisions.
ReplyDeleteGreat post. What’s the TOTAL compensation. Like others have posted, cut benefits and raise wages if that’s the issue.
DeleteAll McClure wants to do is cut taxes.
ReplyDeleteWay before McClure the County has tried and failed to up starting wages. Contracts are negotiated for the benefit of long time employees. They only care about hiring new employees right up to the time they might have to give something up.
ReplyDeleteCouncil’s report say’s employees don’t care about benefits. So cut benefits and pay more money.
ReplyDeleteCouncil should eliminate the 20 housekeepers it’s report calls for and give that money to nurses.
ReplyDeleteWho then will clean up after those nurses because they will not do it
DeleteSeems like Council is tired of paying for all those formers nurses aides for holding up a mop.
ReplyDeleteThe assessment done for Council says to cut housekeepers and laundry. The next recommendation will be to privatize the laundry.
ReplyDeleteLet’s see. Gracedale’s true mission is to care for the poor. They are living up to that mission. They rely a little to heavily on contract nurses and need to pay more to start and for experience. Is this really news to anyone ?
ReplyDeleteQuoting Anon 656am: "The benefits are over 50% of the compensation. Other County homes are 40. Cut benefits 10% and pay that money to workers?"
ReplyDeleteIf a robust benefit package is not important to workers, then why provide a robust benefit package and instead pass it through as higher wages.
Bingo.
"The assessment done for Council says to cut housekeepers and laundry. The next recommendation will be to privatize the laundry."
ReplyDeleteI had to go back and watch portions of the video. She seems to suggest that housekeeping might be a bit bloated, and does suggest cutting labor there and in laundry. But at the same time, she noted that Gracedale is remarkably clean. I can attest to this myself. During a recent visit there, I was very impressed by the cleanliness of the place. There were none of the smells I associate with nursing homes. It's an incredibly stupid suggestion. Gracedale has a problem with quality measures. That would be far worse if the place was filthy like Lehigh Valley Hospital. You don't screw with what works, and that is both housekeeping and laundry.
No shit
ReplyDeleteNot only should they get paid more, about $10 an hour more, there benefits need to be increased. They should get 16 holidays and 15 sick days off per year. These people are taking care of our parents and doing a great job. So let’s start treating them like they are professionals. They’re worth every Penney.
ReplyDelete"This council spent almost $40,000 of taxpayer dollars to find out what they have been told numerous times over the years….that if you pay higher wages you get better people and secure better job longevity. The money is there"
ReplyDeleteThe picture that some people have painted at Gracedale has been one of inept failure, from top to bottom. Council was getting a completely different picture from the administration. Who was right? It appears that Gracedale management was correct.
As for low wages, County Council has been saying for years that the pay everywhere is too low. It has been telling the Exec this for years. It ordered a pay study with him kicking and screaming against it.
The fault here lies with McClure and Council members Tara Zrinski and Kevin Lott, his rubber stamps.
Their intractability on the issue of paying a fair wage to the county worker is both inexcusable and hypocritical. They care more about the trade union workers, even for small contacts of $350,000, than they do for the people who actually work for the county.
It has been quite clear for some time that we don't pay enough. Now we have a report showing the stark disparity at Gracedale between wages paid there and elsewhere.
I really have to ask - where the hell have the unions been? I'm not being a smart ass, I really want to know why AFSCME and the steelworkers has dropped the ball so badly with respect to the salaries. Also, we know know that workers don't care about benefits. They want $. So it's probably time to consider scaling back benefits to make salaries far more competitive. This is completely antithetical to my own thinking, but I think it's time to accept that attitudes have changed markedly.
The union is right there they tried last contract for a 5 dollar raise Lamont and his people would not even listen to that
DeleteWe should make the wealthy pay their fair share of taxes and then the county workers would get paid their fair share, about 25% increase and better retirement.
ReplyDelete"Not only should they get paid more, about $10 an hour more, there benefits need to be increased. They should get 16 holidays and 15 sick days off per year. These people are taking care of our parents and doing a great job. So let’s start treating them like they are professionals. They’re worth every Penney."
ReplyDeleteThat would be wonderful, but there is a responsibility to the taxpayers AND RESIDENTS as well. It's ridiculous to suggest you are taking care of anyone if you are absent over a month per year. But it might be possible if you'd give up medical care and a pension. The $11 disparity exists only with RNs.
9/11 should be a Federal Holiday !
DeleteThe United States spends more on health care than any other high-income country but still has the lowest life expectancy at birth and the highest rate of people with multiple chronic diseases, according to a new report from The Commonwealth Fund, an independent research group.Jan 31, 2023. Time for Universal Healthcare and higher wages!!!
ReplyDeleteGee, wages are too low. So what’s causing this? INFLATION, that’s what. Then what causes inflation? GOVERNMENT decision-making. Could be wasteful spending, printing too much money, giving away too much money to other nations.
ReplyDeleteSo, the easy answer? RAISE wages!
Raise wages without changing your government’s behavior? OK, then. A temporary fix. Your increased buying power will be met with merchants increasing prices. You get nowhere. Wash, rinse, and repeat. Enjoy your $10 Big Macs.
No. Corporate greed causes inflation because of the need to pay dividends to shareholders.
DeleteGovernments don’t control the cost of goods and services.
I am no economist and am hardly in a position to discuss the causes of inflation. According to Kinesis, there are five main causes for inflation: 1) demand-pull, when consumer demand for a product exceeds supply; 2) cost-push, when the cost of production increases; 3) increased money supply, which is caused by low interest and stimulation packages; 4) currency devaluation, when the value of the dollar decreases in comparison to other global currencies; and 5) government policies and regulations, which can be stimulus or subsidies. https://kinesis.money/blog/what-are-five-causes-of-inflation/
ReplyDeleteMy own amateurish take on this is that both corporate greed and government are guilty.
This is a worldwide problem, and the pandemic and war in Ukraine are additional factors.
The pandemic caused dome serious supply chain issues, even before the pandemic. This created shortages, and prices began to increase. Corresponding to the lockdowns was the great resignation. This resulted in an increased cost of labor and drove up prices even more. Then the government enacted the CARES Act and America Rescue Plan Act, which poured all kinds of money into consumers, and this increased demand for consumer products and drove up prices. The war in Ukraine reduced our energy supply and this in turn drove up prices.
Is the government at fault? Yes. Is corporate greed at fault? Yes. Are we pigs who consume too much? Absolutely.
Bernie, you wrote about "environmental sciences." For a nursing home, what are environmental sciences? I am not familiar with that term. Thanks. JJ
ReplyDeleteThis comment has been removed by a blog administrator.
ReplyDeleteI give corporations a little more leeway than most. People incorporate to protect their personal assets from loss due to mistakes made by corporate GOVERNMENT decisions. Incorporated, or not, the goal of every marketing enterprise is to make a profit. That is, cover one’s expenses, and then make money over and above.
ReplyDeleteIt’s not so much greed, as it is staying in business and possibly growing, too. Increased costs to the business (materials, labor, energy, insurance, etc.) must be covered. Sometimes, executives COULD reduce the number of people they hire, or they COULD raise the price of their product. Either way, workers lose. All workers, unemployed and those still working, require more money to keep pace.
Pay employees more and you increase the company’s cost of doing business. In turn, prices for goods and services rises for EVERYONE. Typically, employees think if only THEY can be paid more, THEY will be fine. NOT HAPPENING! Whatever wage increase they realize will soon be eaten-up by paying more for what the still want to consume. It’s an endless loop.
GOVERNMENT decision-making, political and non-elected, creates inflation. FIX GOVERNMENT every chance you get.
Stop with the hogwash. Capitalism destroyed this country because it’s in its nature to be greedy and exploit employees. Shareholders and wealthy investors demand companies to make unattainable profit margins so in turn these companies are forced to either raise prices, cut quality of goods and services or lay off employees. Stop being such corporate boot-lickers and defending these billionaires because everyone reading this blog is poor and you’ll never be one of them so support a system that has never worked for the working class. Revolt.
DeleteAOC is that you?
Delete@11:35
DeleteIgnorant bootlicker who lives in a echo-chamber called the Lehigh valley and probably doesn’t have a passport, is that you?
I deleted 12:55 bc it suggests violence.
ReplyDeleteJJ Cordi, I honestly do not know what she was talking about at that point, and it was never clarified.
ReplyDelete1:23, Your view reflects a simple-minded approach to a problem that is far more nuanced. This is not WWE.
ReplyDeleteThe only cause of system wide inflation is money supply, since what is inflating is that which must be purchased with money. There aren't multiple factors, just money. We printed $4 trillion new dollar bills that were backed by the same US balance sheet. That means each new dollar, as well as all the existing dollars, became worth a little bit less. When your dollar is worth a little bit less, it will take more of them to buy the same stuff. That's called inflation. Economists on both sides of the aisle agreed that too much stimulus would risk inflation. We overdid it. And here we are.
ReplyDeleteNever in its history did Gracedale have a staffing shortage such as what has been seen by the facility over the last 5 plus years. So - let’s ask why. It’s not only wages since there was a time when there was a waiting list for residents to get into Gracedale and it was considered an accomplishment to obtain a position there. Usually it’s the administration that’s the issue when hiring and retention are a problem . (remember the nurses who were fired for not taking the vaccine?) A one star rating for resident care and a 90%census of residents with few resources equals problems that have few solutions. Yes, update the facility (make those 4 bed rooms into 2 bedrooms with a bathroom in each one). Doing that will decrease the census and allow the county to sell those Medicaid licenses. Where is the dignity in those units with one centralized area for bathing and bathroom use for numerous residents? That basically means the Main Building beds are obsolete and the space should be utilized or rented for something else. Boom - just could have saved $40,000.
ReplyDeleteOne should not forget that the Gracedale liaison (Vargo Heffner) was to have been giving updates
ReplyDeleteto council on an ongoing basis and yet, not once did she acknowledge or pursue better wages or
Push for wage reviews to stop Gracedale employees from exiting or seeking other employment. She, and this and other councils for years have known about salary concerns and
Yet nothing is still being offered as a remedy.
I wish the county would get out of the nursing home game.
ReplyDelete"Never in its history did Gracedale have a staffing shortage such as what has been seen by the facility over the last 5 plus years. So - let’s ask why. It’s not only wages since there was a time when there was a waiting list for residents to get into Gracedale and it was considered an accomplishment to obtain a position there. Usually it’s the administration that’s the issue when hiring and retention are a problem . (remember the nurses who were fired for not taking the vaccine?) A one star rating for resident care and a 90%census of residents with few resources equals problems that have few solutions. Yes, update the facility (make those 4 bed rooms into 2 bedrooms with a bathroom in each one)"
ReplyDeleteThe staffing shortage goes back at least to the John Brown era, if not before. McClure told Brown that there were several hundred vacancies at Gracedale when Brown was Exec, and offered to show Brown the data when Brown denied it. This shortage corresponds with my recollection, along with staffing shortages nearly everywhere under Brown.
When McClure took over, one of the first things he did was to start hiring there. He also replaced Premier, the privatized Administrator, with Jennifer Stewart, a county employee. I thought this was a mistake bc of all the experience Premier has, but Stewart has really proven herself. I was wrong and McClure was right. What I like most about her is that she came up from the bottom and is completely service oriented, doing a job most of us could never do. That has at times included changing bedpans.
Once the pandemic hit, wit COVID racing thru the home and a lockdown in place, many employees began to quit. It's true that the Gracedale rating dropped, but that was a function of a transition to a new system of transmitting data to the feds. There was a delay, and the default rating of one star was imposed. This problem was fixed and the home is now three stars, a position it has maintained for nearly two years.
The vaccine requirement is not something that the county imposed. It was imposed by the feds on all nursing homes. If the county refused to vaccinate its staff, its reimbursement would be zero.
As has already been explained, updating the facility to reduce the four BR units would be cost prohibitive at this time.
THIS
ReplyDeleteOne should not forget that the Gracedale liaison (Vargo Heffner) was to have been giving updates
to council on an ongoing basis and yet, not once did she acknowledge or pursue better wages or
Push for wage reviews to stop Gracedale employees from exiting
"One should not forget that the Gracedale liaison (Vargo Heffner) was to have been giving updates to council on an ongoing basis and yet, not once did she acknowledge or pursue better wages or Push for wage reviews to stop Gracedale employees from exiting or seeking other employment. She, and this and other councils for years have known about salary concerns and
ReplyDeleteYet nothing is still being offered as a remedy."
LVH has held nearly monthly meeting that include updates on Gracedale. he was the driving force behind the push for a performance review as well as the pay study. The purpose of both is to quantify those salary concerns so that the staff at the home is compensated properly. While she sometimes gets lost in the weeds, I think she has done a good job with Gracedale. I know of no one in the Executive or legislative branch thqat wants Gracedale to fail.
To clarify the staffing vacancies over the years. The position compliment was the original problem and no one wanted to fix it as it would result in more benefit positions . I would think this still remains and hope the 40000$ consultant addressed the compliment of fulltime part time and per diem positions to cover the vacancy factor which includes generous paid holidays personal days and vacation and sick days. That's were this all started. The large number of open positions were part time and per diem positions that years ago no one wanted . The union objected to any changes and the county didn't want to pay more full time benefits. So the alleged 100's of positions didn't even cover the shifts. It still required overtime. Staff also could take vacation on the weekends which is honestly unheard of in the private sector. As far as I know that still stands today. This is a complex problem that no one wanted to fix and here we are years later with the same problem . It's of course worse as COVID further impacted staffing as did warehouses offering non skilled staff 25$ hour to start. Hard to compete with that. Consultants often tell you where they think you should cut staff. Housekeeping often a target. It's important to remember housekeeping are also available to let nursing know of residents needs or if they are in trouble . They are valuable members of a team. Having said all of that I hate to say this but years of poor management of this home will result in more taxpayer dollars being needed. Many homes have gone private. Cost of updating gracedale is now probably prohibitive
ReplyDelete10:25, You make some valid points. I believe the county has eliminated most of the large number of positions that are no longer needed. You are correct when you offer this as a possible explanation for some of the numerous vacancies under Brown. Housekeeping is a very poor target.
ReplyDeleteThe wages there are horrible. As are all wages for all union employees at the county. The county has made its " gentleman agreement " on the backs of the union employees. If you're wondering what the gentleman agreement is watch the 2023 budget report on YouTube. 40 to 50 million extra!!
ReplyDeleteTo the people that ask about the CBAs. The county doesn't negotiate at contract talks. Walks in put an offer on the table and walks away. And all afscme wants is to settle and get it over so they get paid Tosti and Lamont have it worked out before they even sit down. Afscme works for union dues not thier members. I saw Irwin shaking chucky hand Thursday county council meeting. The way this county treats its union employees he should have never offered his hand. This administration was there fighting for union contractors because it is a nice election contribution at election time. Screw gracedale and the rest of county union employees. Hypocrites all of them.
By the way get the national guard ready for the jail Lamont it is coming