All About Gracedale

Tara Zrinski is in her fifth week as NorCo Executive and is already dealing with a full-blown crisis aka Gracedale. She had barely taken office when she learned that the nursing home's license had been reduced from regular to provisional. That's when she also learned of federal fines amounting to $80,550. At last night's meeting of Northampton County Council, she went into great detail on steps she is taking to improve what was once hailed as the "jewel of the county." It has since become a millstone around the necks of county executives. She also advised Council that, at least in the short term, "it is likely that the county is going to have to support Gracedale out of the general fund."

Here's what she's doing in the short term.

First, she is meeting on a regular basis with the Director of Human Services and Gracedale's Administrator, and will receive a written report every two weeks about what is happening. To the extent that she can supply Council with copies of these reports without violating privacy laws, she will do so. 

Second, the Administrator will be required to attend quality assurance committee meetings to ensure that it is held accountable for plans of correction that address deficiencies found by the state Department of Health and to exercise oversight before quality issues become deficiencies. 

 

Third, she is evaluating whether the right people are in the right positions. She will delve deeper into the vetting of nurse services, contractors, and their staff as well as on-site training and the scheduling of nurse staff. 

Fourth, both she and representatives of her office will make unannounced visits to Gracedale. 

Fifth, she wants Gracedale's Human Resource representative to provide a report on the frequency, quality, and utilization of staff evaluations. "This is something that I did in the controller's office. I believe that you have to evaluate staff. I believe that if they are not performing the duties that they are obligated to do in their contracts, that we will be putting people on performance improvement plans. We will be holding people accountable for the actions at Gracedal. "

Sixth, she will begin the process of retraining new and existing employees. 

Seventh, "we're getting a cat, right?"

She has three long-range goals. She wants to make the home financially sustainable, provide a higher quality of care and make it more attractive to residents, families and referral sources. 

To accomplish these goals, she wants to do the following. 

First, she wants to create a quasi cabinet level position just for Gracedale and take the home out of the hands of Director of Human Services Sue Wandalowski, who has enough on her plate

Second, she wants to convert Gracedale's advisory board into an actual task force. It's unclear what they would actually be tasked to do, other than raising money via grants and donations to a 501c3.

Third, she thinks the home can be reimagined to provide more health services like the dialysis it currently offers. She thinks that could be accomplished by partnering with other health networks.

Fourth, she believes the aging home is in dire need of capital improvements, noting that the practice of housing four residents in one room is outdated and needs to change. 

Fifth, Gracedale needs its own financial overseer..

Sixth, she like to make the daycare at the home available to other count employees.

She also would like County Council to do the following:

First, tour the home.

Second, adopt a resolution against cuts to Medicare and medical assistance payments to nursing homes and for increases in Medicare and medical assistance reimbursement to nursing homes, especially county run homes, whose census is almost all medical assistance. 

Third, pass a resolution to state and federal officials for capital improvement funds, similar to the capital improvement funds established for school districts, for county owned nursing homes. 

Following her presentation, she asked for an executive session to discuss personnel measures taken to address some of the eight citations that have plagued the home since March. 

I will have more about Gracedale on Monday to explain why its license is provisional, which was explained by Council member Dave Holland.