Since the pandemic, Gracedale has been suffering from a perfect storm of resident deaths, staffing shortages, declining census and funding shortfalls that could have sunk the home but for the infusion of cash from the American Rescue Plan Act. The county-owned nursing home is struggling valiantly to remain a last refuge for older (and even younger) people with nowhere else to go. Despite some negative comments on this blog, it has great support from the community. No one in or running for county office supports privatization, despite what you may hear on the campaign trail. There can be no dispute, however, that the current model is unsustainable because it relies too heavily on outside agency nursing care. A strategic plan to change that is far less Icarian than I would have expected. The American Rescue Plan and Cares Acts certainly helped Gracedale. But what about the recently enacted One Big Beautiful Bill Act (OBBBA)? Is it good or bad for nursing homes? I believe it's mostly bad and base this conclusion on reports from Skilled Nursing News and the AARP
1) It delays minimum staffing standards until 2034. - In 2024, the Biden administration finalized rules that would require nursing homes to provide 3.48 hours of nursing care to residents each day. While this delay has been blasted because it obviously reduces skilled nursing care, it's incredibly stupid to impose such a requirement when nursing homes face unprecedented staffing shortages. This gives Gracedale and other LTCFs a bit of breathing room.
2) It reduces retroactive Medicaid coverage. - Most residents at Gracedale have Medicare, but that only provides coverage for 100 days. To cover the cost, residents must also apply for Medicaid coverage. Under the OBBBA, Medicaid will cover medical expenses incurred for two months after they applied. Previously, there was a three-month window. Since residents at homes like Gracedale lack the financial means to pay these costs, the home would be forced to eat these costs itself, and that's expensive.
3) Home equity limit changes. - Under Pa. law, a person can apply for Medicaid, but the value of his primary residence is exempt it is worth $730,000 or less. The OBBBA increases that exemption to $1 million with no adjustments for inflation. While this might seem beneficial, it is likely to reduce the pool of people eligible for Medicaid as home values increase.
4) Dual Enrollment Changes for Medicaid and Medicare Delayed Until 2034. - Most Gracedale residents have both Medicare and Medicaid, but getting them enrolled in both programs successfully has been challenging. Under the Biden administration, two separate rules were adopted to simplify the process. The OBBBA delays implementation of these new rules until 2034, and this is estimated to reduce te number of "dual-eligible" residents by 1.3 million people.
Northampton politicians screwed that place up years ago now you are trying to blame Trump You are one pitiful person.
ReplyDeleteExcuse me, but I have pointed out numerous problems at Gracedale over the past several days that have nothing to do with OBBBA. But yes, the OBBBA will have a mostly negative impact. I have pointed to the changes. You could argue that two months of retroactivity is enough. You could argue that $1 million home equity is plenty or even too high. I have no idea how you can justify the attempt to simplify dual enrollment, but perhaps you can.
DeleteTypical democrat a very deranged person trying to blame the great President Trump for the failures of democratic people over many years of failed policies of democrats. Face facts the Democrats on any level of government are failures and very evil people.
ReplyDeleteAs a Democrat I take offense. What failed policies? Social Security, Medicare, Medicaid. I disagree with many Republican policies but I don’t believe they are “evil” people.
DeleteIt is clear anything Trump does is consider Bad by the democrats as a result the democrats are on the verge of a total collapse of their faired party.
ReplyDeleteI see nothing here that would help to determine whether or not Gracedale should be sold.
ReplyDeleteWhy is Icarian a word, but Dedalian isn't?
ReplyDeleteIt is, lol, but is spelled "daedalian." For those of you who wonder what the hell we are talking about, Icarus was the ambitious soul who was punished by the gods for flying too close to the sun. Daedalus was Icarus' father and was an inventor
DeleteI confused my Dedaluses.
DeleteUnfunded mandates are killers. Also, being $37 trillion in debt is a killer. It's been in all the papers. We should redirect the money we spend on so-called sex change surgeries and stop spending on wars - like Ukraine, that you stupidly and cruelly championed on this blog, while never calling for peace talks. Do you still support that budget-breaking bloodbath? That dough would have paid for a lot of senior care. Maybe Zelenski can lend our seniors some money.
ReplyDeleteYour rant has nothing to do with Gracedale, and oh, by the way, OBBBA adds $3 trillion to the defecit that concerns you so much.
DeleteOBBBA adds 3 trillion if you use a 1.7% GDP growth. We’re running at 3% right now. CBO is low balling growth.
DeleteLike "Skilled Nursing News" and "AARP" don't have their own agendas and are basically working on behest of the Huge Profit-Seeking Private Conglomerates, rather in service to individual care facilities.
ReplyDeleteOf course they have agendas. AARP advocates for seniors and Skilled Nursing advocates for nurses. Neither advocate for "huge profit-seeking private conglomerates." I have cited sources that advocate for the elderly and the people who care for them. They provided the best and actually one of the fewest breakdowns that actually discuss the impact of OBBBA on nursing homes. And I chose to use summaries that discuss the actual passed law as opposed to iterations before enactment. There are also breakdowns from several elder law firms that I chose not to use although they are pretty good.
DeleteCould someone tell me how many people who earn under the limit for Medicaid live in $1,000,000 homes? Am I supposed to feel sorry for them, Bernie?
ReplyDeleteThat is a fair point and I could understand why this seems reasonable. But let's say a husband goes into a nursing home but his wife lives in a house bought for about $200k and worth $730,000 at this time. It will be worth $1 million pretty quickly bc housing inflation is quite high. The Act does not adjust for inflation, meaning the wife will have to move. Maybe you think she should. I don't.
DeleteBut half of the home’s value is the husband’s. He’s on unit going to be living there. The wife could take out a reverse mortgage to pay for the husband’s care.
DeleteWhy should it fall on NorCo taxpayers to pay the bill?
I believe a home is protected for spouse in pennsylvania. You can't make them move out
DeleteHaving experienced this with a parent, when the patient dies the home is sold and the nursing home recoups the money owed. If the spouse is still living the home when the patient dies, the spouse may be permitted to continue to live in the home until death at which point the house must be be sold to pay the medical bills. If the home is not sold the new owner (even if an adult child of the original owner inherited it) is responsible to repay the nursing home bill, and often has to sell the home to pay the bill. I Don't jump to conclusions without knowing the rules or the facts. This only applies to nursing homes that take medicaid patients.
DeleteNORCO could always pass a Logan's Run law.
ReplyDeleteTrump must be doing something right. The inflation numbers came out better than expected and you post this. On Biden's watch inflation reached record numbers so why didn't he do what Trump did to fix it? Just like the border why didn't he do what Trump did to fix it? Why didn't he get companies like Apple to invest money? Either he is stupid or he didn't want to fix any of these things. But hey lets cherrypick from a bill. Curious if you posted anything about the Inflation Reduction Act that didn't reduce inflation.
ReplyDeleteBernie, at this point you’re making yourself look silly. If I were you, I would delete this post because it’s mostly inaccurate. The bill had no impact whatsoever for long-term care facilities in the state of Pennsylvania.
ReplyDeleteThis post is completely accurate. If anything, I did not do enough. You can't scream "fake news" just bc you dislike what you read.
Delete3 of your 4 points are inaccurate. Only point 1 is accurate and is obviously beneficial for Gracedale. Point 2 reflects your lack of understanding of the nursing home industry. The 2 months are immaterial if the MA application is submitted timely and the county assistance office is not completely broken. Most residents do NOT get 100 days of Medicare first. A resident admitting from home gets no medicare day cover on admission. 90% of residents coming from the hospital get a few weeks of medicare coverage based on medical necessity. Only highly complex residents get more than a month of coverage. It is all based on medical necessity, in which only in a relatively few cases may exhaust the full 100 day benefit. Point 3 is theoretical and largely nonsense that MA residents have million dollar houses. Point 4 is completely speculative, and the Biden administration did not simplify any process to assist our citizens in applying for medicaid or medicare. You have zero subject matter knowledge, other than hanging out in the gracedale stairwells. If you are getting your info from your Norco insiders, consider the source… the source that admits to having almost a year of account receivables. Yikes.
DeleteWait. Bernie write something that blames Trump for my screw ups at gracedale. So I can use it when I run for congress.
ReplyDeleteIs that what the message read from Lamont
Dysfunctional norco needs to quit playing kick the can. Sell the white elephant.
ReplyDeleteGracedale like all nursing homes have issues. Gracedale has a long history of accepting residents no matter how much care they need. I have not been to Gracedale for several years but was always impressed with the care and how clean the facility was. Sell it and when someone you know requires heavy care and no local facility accepts for that reason, you will understand the true value of Gracedale. Northampton County is one of the few counties left that understands that. The federal government making care harder is just another problem for all nursing homes
DeleteTrump is doing a lot of things right but the left and the democrats including Bernie must hate America because Trump is surely make it much better.
ReplyDeleteBrainwashed people need to be deprogrammed. It's a slow process, but I do see this happening. Just hit them with facts they can't disprove by mere name calling
DeleteThe irony of the right supporting all of these medicaid cuts and cuts to funding of health care is that primarily the boomer demographic, which primarily voted for Trump, is the demographic that will need these services the most.
ReplyDeleteOnce again, Medicaid is NOT being cut! Total payments made by Medicaid are being reduced by removing not eligible, illegal recipients. Also by catching Medicaid fraudsters all throughout the distribution system.
DeleteActually percentage wise Harris won the 65 plus crowd narrowly.
DeleteNursing homes like medicaid and Medicare have been in financial trouble before this bill. A portion of the bill is to get people off medicaid to fund the legal seniors care. You can't look at the bill individually you must see it in it's entirety. Your point about staffing is true. Can't increase numbers now when no one can meet them. That just look good on paper. As for homes unfortunately people play the game to protect their savings for their children so find ways to go on medicaid so they don't have to pay. But we all pay for that. If you own a million dollar home chances are you have some money. Spouses are no longer required to sell their home for care. Most people apply for medicaid as they enter a nursing home if eligible which gives time for it to kick in. Of course it does need to apply now within 2 months after the 100 days already covered by Medicare. Lastly I don't know the effect of the dual eligible with this change but it has been done for years successfully albeit challenging and in over 30 years I never saw a problem. Not sure who came up with numbers to be affected .
ReplyDeleteYou're a professional complainer. What abilities and opportunities did you waste that require you to live in subsidized housing? Are you planning to go to Gracedale and occupy a bed that taxpayers will finance? You have a law degree. Why is anyone on the hook for any part of your survival? You're taking from those who truly need it. Disgraceful.
ReplyDeleteGo away, Tricia.
DeleteBernie you are part of the liberal media you voted for Biden the media in America today is anti-America and you are part of it I quess as a disbarred lawyer you must be a very bitter person.
ReplyDeleteAlthough I mostly do t agree with Bernie and he can be quite blunt he also provides a service e informing us. We all have a history and we are all far from perfect. Don't attack a person for their beliefs. No one should
DeleteNo one currently receiving Medicaid legally is having their benefits cut! The goal is to remove those cheating the system, making the funds for legal recipients greater.
ReplyDeletePeople are living too long with little to no quality of life. They are warehoused like sick sheep by the tens of millions all across the country.
ReplyDeleteWhen they exhaust their assets, the taxpayer is on the hook.
This is the problem.
I have an idea on how to fix this issue. We disconnect the phone line to the facility, wait a few months, and boom! No more problem!
ReplyDeletePlease correct your false fabrication that gracedale and other nursing homes are experiencing staffing shortages. A refusal to hire is not a staffing shortage. A refusal to hire is the well known tactic statewide and nationwide to present false propaganda to the public that there is a shortage of staff. Nothing could be further from the truth.
ReplyDeleteThe truth is found and explained in numerous publications, journals, Facebook groups, statistics and human resource files which dictate that the market is oversaturated with nurses. Market oversaturation has bred unsafe and undesirable working environments, simply because employers can replace a nurse in 10 minutues or less. This has given the Healthcare i dustry the ability to run wild and roughshod placing profit over patients in all facilities. It has nothing to do with a lack of nurses but everything to do with self inflicted horrendous working environments that most people reject after a few short weeks on the job. A suitable analogy would be an equally false shortage of teachers. In reality, there are plenty, but few hired due to budget constraints. Large teacher to student ratios and dwindling resources cause high turnover in some places. Get your facts straight before spewing nonsense.
Please correct your poor grammar. A "false fabrication" is truth. And yes, there is a nationwide staffing shortage for nursing care. They would not hire you bc you are a lunatic.
DeleteJust some of hundreds that dispel your intentional misrepresentation of the truth. No nursing shortage...https://www.statnews.com/2023/10/16/nursing-shortage-us-hospitals-unions/
ReplyDeletehttps://www.thenation.com/article/archive/health-care-medicare-nurses/
https://www.westmonroe.com/insights/healthcare-needs-a-clinical-workforce-paradigm-shift
https://ldi.upenn.edu/our-work/research-updates/sorting-out-fact-and-fiction-of-a-national-nursing-shortage/
Yes, who would choose changing diapers and wiping others behinds over just sitting around bilking actual working stiffs by receiving government welfare and other free services? The difference in net spendable dollars not that great.
DeleteThese post prove crazy people exist! There is most definitely a nursing shortage...fact! Dear heavens.
ReplyDelete