I published three stories on Thursday, all of which were related to Gracedale. One dealt with about half of the $5 million retention bonuses authorized by NorCo Council for Gracedale career service workers that was spent instead on operations. This happened without the assent of Council. Executive Lamont McClure told Council that even he was unaware of this until January of this year. A second story dealt with a daycare at the nursing home that was approved by County Council over three years ago but is still waiting for a state inspection and license. The third dealt with the agency nursing at the facility, which is somewhere between 70 and 80% of the staff. Council members want to know exactly how many agency nursing staffers are used there and what we've been paying them. I actually could have written more. Once again, the Controller's office was peppered with questions about the audit. And Council member John Brown has repeatedly claimed that finances there are a mess, and that the county is covering a deficit. This has been repeatedly denied by McClure and Fiscal Affairs Director Steve Barron with answers that make sense to me, but Brown has basically called them liars in his monotonal condescending style that would otherwise put you to sleep. Last night, Council was supposed to get answers to its questions with a presentation from Michelle Morton, Gracedale's new administrator. But it didn't happen. Instead, County Council listened for nearly an hour to a presentation from Battle Borne, leaving precious little time to discuss Gracedale before the Energy Committee was meeting. So most of Council's questions will have to wait until next month.
Council member Ron Heckman suggested that the next meeting of Council's Human Services Committee should be devoted exclusively to Gracedale. He recommended that all management staff should be present as well. "I'm very concerned about what's happened. I'm very concerned more so for the future."
Human Services Director Sue Wandalowski said that administrators have come up with a "strategic plan" for the home, and that will be provided next month.
Gracedale Administrator Michelle Morton started at the home in mid-March. She has over 40 years of experience in long-term care. Between January and May of this year, the nursing home has paid $9,102,000 for agency nursing staff. They worked 164,000 hours through June 6, which means the home is paying an average of least $55.50 an hour for outsiders.
Morton told Council that the home's nursing staff is 70-80% agency.
Although Morton's strategic plan will have to wait until next month, she said "we have already made a lot of progress moving forward. ... We have the right team in place."
Council member John Goffredo demurred. "From everything I'm hearing from people who have been there a long time, that's not the case." He noted that the home is only 25% staffed by actual employees. "We can't keep going at the rate we are. We're here to help but we need to be told realistically what's going on."
Two other Council members had a diametrically opposite view. Council member Jeff Warren thanked Morton for taking care of his mother in the rehab facility for the past two weeks when no other rehab facility would take her. Council member Kelly Keegan noted the home has improved in census, nursing care time, an increased rating and a decrease in overtime. She added that Gracedale cared for her grandmother once her funds were exhausted at other homes.
She questioned why, with all the improvements at Gracedale, half of Council continues to put out "an illusory truth effect", i.e. repeating the same false information until it is believed as true.
I am very dubious about Brown's claims, although even Executive Lamont McClure has agreed that discussions about the home's finances are always worthwhile. And there is no dispute that a home that is staffed largely by outsiders is unsustainable. And Ron Heckman is absolutely right to suggest that the county needs to plan long-term. While nursing homes like Gracedale are indispensable now, will they be needed in 50 years? Will any nursing homes be needed?
22 comments:
Very good question Bernie I suppose in the future we won’t need nursing homes because we will all voluntarily kill ourselves instead of being a burden on the tax base! That’s what we all really want right?
Two points first, using quotes from the article:
1). “…Nursing homes like Gracedale are indispensable now”? Really, yet 56 of 67 counties in the state are somehow able to function without a county nursing home. Perhaps there should be a report on that, but I suspect that might lead to a conclusion that a majority of the politicians don’t want.
2). “…administrators have come up with a "strategic plan" for the home, and that will be provided next month.”, and “… leaving precious little time to discuss Gracedale before the Energy Committee was meeting. So most of Council's questions will have to wait until next month.”
This is why county nursing homes are doomed to fail. Even if you have the best administrators (we don’t), the best Executive (we don’t) and the best council (we don’t), the system is set up to fail. It’s slow, inefficient and cumbersome. This makes it more expensive to run and ensures it will always lag behind a growing list of private homes.
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Instead of discussing staffing and exorcisms, the focus should be on 1) determining how many hundred NorCo residents the county has a “moral obligation” to care for; 2) determine how to identify and choose that number of Golden Ticket residents; and 3) how to meet their needs without clinging to a county-owned and operated nursing home model from the 1800’s.
I realize that’s a difficult reality for some to accept, but the fact remains that private homes are running circles around their government-run counterparts, and that’s not going to change.
If we have a “moral obligation” to a relative few county residents to PROVIDE care, shouldn’t we also have a “moral obligation” to provide the BEST care possible, even if that’s at private homes?
Right now, all we’re really doing is subsidizing the private homes by giving them a way to avoid taking those that can pay the least. If that means dividing the limited funds available and paying the private homes to each take a few residents that would have gone to Gracedale, so be it.
Again, most other counties are able to see their residents taken care of without having a county nursing home.
They're buying time and delaying while trying to get their stories straight because it's a big mess. Barron was always unfit for his position. The chickens of incompetence are coming home to roost. And Lamont is running away.
The Zapruder Study that the Commission commissioned found that the Commissioners constantly talking about Gracedale is one of the major problems at Gracedale. The Republicans are dying to sell it to a for profit corporation with the help of Lucille Vargo/Heffner.
Giovanni, Brown and Goffredo are playing politics with the nursing home. They did it in the last election and got thumped. They have changed tactics however. Last time they said they’d do a better job running it. The voters went 🤣 Now they are lying about the finances of the home. The truth is it probably needs about a half a mil dedicated increase like Stauffer did for open stuff.
John Brown is flat out lying. He has tried for years to get rid of Gracedale and this is his last at bat to do it. This county is too smart to ever elect him again. Especially after his childish tantrums with voting no on multiple items that would only benefit the residents. His lone no votes were pathetic and made him look like a spoiled brat.
It is obvious he is making all of this political and what is good for the goose is good for the gander! Council should hold him responsible for his accusations and projections. He was the worst County Executive and he is proving to be one of the worst Commissioner. Get rid of him! He sucks!
Save Gracedale for the good of this county!!!
The plan for the future is simple - Dump Gracedale
McClures plan is smoke and mirrors
McClure can't even run a nursing home, why would we want him in congress?
McClure and Barrons answers “make sense.” That’s all well and fine to someone like you who has been a supporter of them. Me, I like hard data and the use of evidence based practices. Just because a politician says something doesn’t make it true, show me data. As far as Keegan and Warren, if they had their way the government would be running EVERYTHING. No matter what is going on at the nursing home they’ll continue to support it, everything is political to them.
Brown is right to question and imply they are lying. If it's government-run entity, be it on the federal, municipal, or county level, and whatever it is, assume it's running a deficit.
County Council should just jettison Gracedale. It's only adding to the things they can bungle. But, I guess on the plus side, it's always good blogger fodder.
Five 1:1 residents. The administrator conveniently blamed the physicians. 1:1 is a temporary intervention that apparently for which this new team has no game plan. Other facilities screen their potential residents to be certain they can take care of them. Not apparently the case at Gracedale. Sue is dreaming and so is Kellie if they think that star rating will persist after the most recent horrific documented resident abuse. My money is on Goffredo first and then Brown to have the true story about Gracedale revealed soon.
No, I am suggesting that Gracedale will evolve. It was originally the county's poor house for over 100 years before becoming a nursing home. It evolved. I am suggesting that the need for a nursing home will change over time, especially as our demographics change and we boomers die off. There is a real push for people to age in place, where they seem happier. There is little dignity in being packed four to a room. I am glad it is there and respect the dedicated workers there who do things I could never do. But people don't want to be there.
If you deride the performance audit so much, why are you embracing its conclusions? The Affinity performance review does not really say that a public nursing home should have no public oversight. That's ridiculous, although it's certainly true that a public institution of any kind should get more scrutiny than a private institution precisely because it is public and is publicly funded. If you don't like that, sell the home. If you don't like public scrutiny of government operations, I would argue that's a reason for even more scrutiny.
What the Affinity report did note is that the home needs to pay more. "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."
The study also recommended getting rid of 4-persons to a room, but the county believes that is financially unfeasible.
https://lehighvalleyramblings.blogspot.com/2023/09/gracedale-operational-assessment.html
1:36, You have valid points. Government is slow, inefficient and cumbersome. But these are not "golden ticket" residents. Far from it.
I like hard data, too. I agree that Gracedale finances need a big review. But hard facts are that the county has a very high bond rating, always receives unqualified audits and is financially very sound. I think Brown is meretricious and fails to mention that Gracedale really should be operating on a complete accrual accounting basis bc cash accounting never takes into account the receivables that are sometimes received many months after the expense is incurred. Gracedale is not losing money, but that could change bc of reductions in the intergovernmental transfer, reductions in reimbursements and the expense of agency nursing. That needs to be watched carefully. As counties get out of the nursing home business, the lobby for public nursing homes is diminishing as well.
I believe zGoffredo has valid concerns about agency nursing and agree the CMS rating is going to drop as a result of the resident abuse.
Gracedale accepts residents based on need not income or insurance. Have someone requiring heavy care or the assistance of more than one person without sufficient assets may not be attractive to private nursing homes. Sell Gracedale and private nursing homes will continue to use there admission criteria and life long tax paying residents of Northampton County may find themselves a hundred miles from home in a nursing home. Gracedale is a fine facility that provides quality care.
It might also be good to know a breakdown of the ages of residents along with the number of residents with those “mental health “ diagnoses. Intermixing those residents with our frail elderly is never a good idea and there are documented cases to prove it.
All good points. I voted to sell Gracedale way back when, but the people spoke and wanted to keep it. Now, I would just like to see it run as efficiently as possible while providing good care. It doesn’t seem like it’s being managed very well.
Pipe down Kelly let the adults in the room figure it out.
That sounds great to age in place but also very expensive. Are we using our own funds to age in place. After GenX, millennials and especially GenZ are on track to have far less purchasing power than boomers. And worse yet they have worse investment opportunities compared to the current boomers. No company funded pensions or stock market booms over 50 years. I could bore everyone with economics but it would be wasting everyone’s time. The reality is very likely that with people living longer and the economic reality these boomers are going to be the best off at that age. GenX millennials and GenZ when they get there in 50 years are very unlikely to have this level of money. That’s just the state of American economics where all wealth added goes to the richest. This Country is run by the rich and for the rich, and unfortunately things like Gracedale will get sold to for profits thanks to scumbags like John Brown. This isn’t about republicans vs democrats its about doing the right thing and taking care of every American. But neither party is capable of that anymore they cater to the rich and work to divide us because if we were united they’d be in trouble.
TDLR: it’s going to get so much worse
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