At last week's Human Services meeting of Northampton County Council, Gracedale Administrator Jennifer Stewart warned that new minimum staffing requirements for nursing care are being pondered by the Centers for Medicare & Medicaid Services (CMS). If enacted, they will present challenges at a time when it's difficult to attract nurses.
Currently, the state requires nursing homes to provide 3.2 hours of nursing care per resident per day (PPD). The home can use CNA,s LPNs and RNs to meet that requirement.
Under the federal proposal, which Stewart says is already being challenged in the courts, the minimum PPD will be increased from 3.2 to 3.48. Although this might seem like a slight increase, the nursing care from LPNs is being reduced so that an hour of nursing care from a LPN will only count as 0.48 hours.
At the current census of 455 residents, Stewart said Gracedale can meet that higher standard. But the home is licensed for 688 beds, and will be unable to fill those beds at the higher PPD rate.
Council member John Brown asked Stewart to state the three biggest challenges at the nursing home. "Staffing, staffing and staffing," was her blunt reply. The facility still relies heavily on agency nurses to meet its staffing goals. She said there is a 70/30 ratio of agency to employee nursing, although that figure fluctuates.
Stewart also updated Council on the daycare. She expects the final furniture delivery to come in October and is "hopeful" that a licensed daycare can be up and running by early next year.
Theses new minimums are the least we can do for our most precious assets. The county is already outsourcing nursing staff at considerable cost. The county's position is clear: money is more important than care. This isn't difficult. Gracedale is not financially sustainable (as evidenced by its current outsourcing). It's being de-facto privatized without an official sale. Stoffa was correct, all along. He knew what was coming.
ReplyDeleteShould government be in this business? When Monroe County completes the sale of Pleasant Valley Manor there will be just 11/67 PA counties in the nursing homes business.Are 56/67 failing to meet some "moral obligation" to it's citizens?
ReplyDeleteJohn Brown wants to sell Gracedale. He and Lori Vargo Heffner have been meeting to discuss ways to accomplish this in the next Brown Administration.
ReplyDeleteWe need Brown back as Exec. He’ll raise taxes and gives COs and CNAs all the steps they didn’t get the first time he was in there.
ReplyDeleteThe COs would have had all their steps if they didnt arbitrate every contract offered by McClure
DeleteIt is amazing that Gracedale is still a county home that hasn’t required a county contribution since McClure has been Executive. That luck will probably run out, but it’s incredible Norco still owns it.
ReplyDeleteHe has used federal COViD funds to cover operating deficits. What's needed is a significant increase in the Medicaid reimbursement rate from the state.
DeleteStaffing staffing staffing means money money money, the county needs to save money (understandable) the workers need money, the issue is why would any cna,Lpn,rn work there when you can go to the major medical networks and get paid so much more? Gracedale will need a plan outside of the box to save it, something new or raise taxes
ReplyDelete"John Brown wants to sell Gracedale. He and Lori Vargo Heffner have been meeting to discuss ways to accomplish this in the next Brown Administration."
ReplyDeleteNo need to sell. It's being sold (aka privatized) day by day by the McClure administration. Their low-key, slow bleed is quite costly, though. Thus, their opposition to higher minimums. You're not paying attention to what's been well-documented on this blog.
Sell some of those licensed beds. Gracedale hasn’t had a full census in years. It’s that simple. Jen has been stating that she will fill those beds and she hasn’t. Why? Staffing yes but why is it that staffing has been such a problem? That’s the real issue. Retention has been poor even with recruitment. Where is that assistant administrator anyhow? It appears that job is posted yet again. .
ReplyDeleteNo one is buying the beds. That ship has sailed. But adjusting bed numbers to staffing of in house staff makes sense. Agency too high. Why is it that high? Significant risk to resident care
DeleteI have significant concerns of the 70/30 ration. Did u really mean. 70 percent agency? If so this is very dangerous for continuity of care
ReplyDelete70% agency.
DeleteThat is terrifying. A disaster waiting to happen
DeleteI'd rather see a smaller home with quality care. That is not sustainable
DeleteNow you're getting it. We were warned years ago.
DeleteIt is lucky Northampton County had so much federal money sent to them from
ReplyDeleteCovid. It allowed them to balance the books and afford to backfill all the things they spend money on. Now McClure can push his election ill-conceived tax cut.
It’s almost certain McClure will cut taxes in 2026.
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