As I told you last week, Northampton County's Gracedale nursing home now has a Provisional II license. It previously had a Provisional I license. In early May, Executive Tara Zrinski said the home did very well in its annual survey, but the downgrade from Provisional I to Provisional II indicates that the facility is in worse shape now than it has ever been.
Although Zrinski has previously stated that she is happy with Administrator Michelle Morton, the state Department of Health has had to visit the home 27 times since she has been there. Gracedale has been cited eight times since her arrival last year (six times last year and twice this year). The home has been repeatedly cited for elopements (escapes) and a failure to meet minimum staffing requirements.
next to its name to warn potential residents and their families about the possibility of abuse. The home has operated with a Provisional license since February.
All of this, not some of it, has happened during Morton's tenure. And that's understandable. She's had 23 different jobs since 1983. Her background is therapeutic recreation, not nursing or nursing homes.
In her Exec report last week, Zrinski tried to downplay the problems, stating that they were caused by being too lax in admitting people. I'll agree that is likely one of the causes. Sure, Gracedale should be a sanctuary for the indigent, but should decline residents who are violent to other residents and to staff. But that is only one of the causes.
Administration is another. The sheer number of visits from the DOH alone indicate that people (staff, residents or both) are unhappy with Michelle Morton, the current Administrator. The decline in the home's ratings, the citations, and the downgrade to a Provisional I and then a Provisional II license have all happened under her watch. I have no doubt she could succeed in some role, but not as Gracedale's administrator.
A third root cause of Gracedale's problems is its heavy reliance on agency nursing. These are nurses brought in from outside agencies. They are paid far more than regular staffers, which obviously causes resentment. And since they come and go as they please, they are unable to build up the relationships with residents that regular staff have.
A final problem, quite frankly, is politics. The continuum of care positions that Zrinski sought and got are political hires who come and go with the exec. They should have the protection of either career service or a contract. When he was first elected Exec, one of the first things Lamont McClure did was fire the Director of Nursing, Her position was career service, but she must have been probationary, or he'd be unable to axe her. Here's what she wrote in 2018:
"Gracedale has been neglected for years. Not just the last four years but for many decades. The outdated and appalling status of the living conditions for the residents of Gracedale actually brought me to tears the first time I saw the cinder block walls and furniture obviously from decades ago. The resident mattresses had not been replaced for years (actually no one could tell me when) leading to resident skin pressure injury. An assessment revealed these mattresses were no longer offering any pressure reduction. The mechanical lifts recently assessed found 22 lifts were in poor condition. The most vulnerable of our population have been ignored and the taxpayers should be appalled as I was. However, my goal was to work to improve the conditions and the mattresses have been replaced, some furniture has begun to be purchased and the next step was to begin mechanical lift replacement. The ultimate goal being to develop a purchasing replacement plan yearly to assure that this would never happen again.
"I knew the position would be a challenge, and I happen to love a challenge that works to improve the lives of residents in long term care. So imagine my response in early December when I received a letter from the new county executive- elect that stated “this past November our voters spoke loudly and issued a mandate for change.” It went on to say “ I write at this time to inform you that you will not be re-appointed to your position in the new administration” and “your last day of employment with the County of Northampton will be January 1, 2018.”
I believe this nurse was canned because she was chosen by the John Brown administration.
In her report to County Council last week, Zrinski stated that the downgrade to Provisional II occurred because of yet another resident elopement as well as a resident who brought contraband (I'm told it was a K-Bar knife) into the facility. These matters do not yet appear on the DOH deficiency site, but I suspect we'll be seeing them soon. An alarm actually went off during one of Zrinski's visits. "I assure you that person did not get away," she declared.
As NorCo Council member Dave Holland stated last week, a provisional license means that the state DOH can do a number of things. They can stop new admissions. They can stop Medicaid reimbursements. They can take over the facility with their own managers.
How common is a provisional license in Pennsylvania? I decided to check.
According to the DOH nursing home facility webpage, there are 661 nursing homes in Pennsylvania. Gracedale is the only one operating with a Provisional II license.
Of 417 for-profit nursing homes, four are operating with Provisional I licenses: Emerald Nursing and Rehabilitation (Elizabethtown); Kadima Rehabilitation and Nursing (Palmyra Pa); Rochester Residence and Care Center (Rochester); and Wecare at South Hills (Canonsburg) Provisional I.
Of 223 NonProfit Facilities, all have regular licenses.
Of 14 county-owned facilities, only Gracedale has a Provisional license
Of 7 State-owned facilities for veterans, all have regular licenses.
Another point made by Zrinski during her Exec report is that for-profit homes are less likely to accept Medicaid. Northampton County has 11 nursing homes. All but 1 accept Medicaid.
In other words, Gracedale's performance really sucks. Thanks for letting us know how badly, relative to its peers.
ReplyDeleteStop the madness. Hire a professional company to manage the Home. County owns it but the management group runs it. McClure played union politics when he dumped the company. This has gone on long enough. Stop playing these games with people's lives. Not every resident is related to a politician.
ReplyDeleteThese council people can't think for themselves, and they have no real depth of knowledge. Neither McClure nor Zirinsky know what the Hell they are doing. Since it is Medicaid money, maybe the feds should be brought in on this. No more syrupy sweet stories, do something other than just rubberstamp. Kraft, Warren, Keegan and Bolete are hacks who have no clue of their authority bring in a professional review firm by ordinance!
All the signs and red flags were ignored by this council and administration. Failure to look into , or even consider a professional outside nursing home management group,
ReplyDeletenow exemplifies the ineptness and procrastination of these elected officials. Dismissing David Holland’s honest assessment and refusing to acknowledge fact it cannot responsibly and
adequately operate a nursing home will surely impact
the families, patients, and personnel at Gracedale. Shame on this council, administration, and Executive for their inability to recognize and their inadequate response to the obvious need for help.
As usual, you miss the bigger picture.
ReplyDeleteThis is actually brilliant marketing by Zrinski.
Now she can honestly claim that under her leadership, she’s put Gracedale in a class of its own!
Everyone (but Panto and Zrinski) are well aware that Gracedale is a disgraceful worst-in-the-state failure. Nobody wants to admit the truth: Ron Angle was right, all along. Now, NorCo is abusing the elderly to make a political point. A compassionate county executive and council would sell the place this afternoon and not a minute later. Our county hates its elderly. That's fact supported by evidence.
ReplyDeleteTZ just got caught with her pants down and for the county and gracedale it is not a pretty picture. Only 6 months in and no one believes her smoke and mirrors anymore. ZERO credibility. On the other hand, council, as usual is the blind leading the blind.
ReplyDeleteThis is a sexist comment
DeleteI ve said this many times in the past--they need to sell this place before its gonna cost the county many dollars to bring it up to where it needs to be. And i mean many dollars that the county does not have which would be a large tax increase to accomplish.
ReplyDeleteWhy is it that not one of you who say the home should be sold is willing to ID yourself?
DeleteI have been following this blog for well over a decade. One continuing theme has been the disgrace of how gracedale has been handled. Has NORCO no shame?
ReplyDeleteTime to clean house! Vote them out. Tara needs a flashlight to find the front door. Incompetent.
ReplyDeleteThis situation appears to be out of control, but yet we keep throwing money at the situation, creating very high paying (unnecessary jobs) but yet nothing improves and very little questions are asked. McClure, Tara, Warren and Kraft and the ones who keep pushing this failing agenda. County council needs to wake up and listen to holland and stop being rubber stamps and do what’s right. It does sound like the DOH needs to come in take over for the best interest of the residents.
ReplyDeleteThe administration on council are doubling/tripling down on McClure's mismanagement. It's a crime against the county's elderly.
ReplyDeleteMonth after month the public was told that everything was fine. You had people writing in this blog that this was not correct. I wonder if that knife was discovered during the admissions inventory of belongings and the resident was allowed to keep it because of “residents’ rights “ or because it was missed during the inventory by staff. Another elopement? No surprise there. Wow - guess Tara single handedly stopped the most recent elopement. Will wait to see what the report indicates when it’s posted on the state site. Great investigative work, Bernie.It’s a sad reveal about Gracedale!
ReplyDeleteNorthampton County is well known for its poor treatment of their employees. AND yes, I know you don't like to hear the rhetoric, but it all starts with wages. You get what you pay for. Start at the top. Start with the leadership and yes, take a careful look at the philosophies of the County Executives and the County Councils/Commissioners. What are /were their priorities? Obviously Gracedale wasn't one of them. They even tried to sell it at one time. Then look how they treated their employees. Cutting wages and benefits and cutting staff. In an attempt to make themselves look good they sacrifice the welfare of those most dependent on them for funding the necessities to function properly as a "nursing facility" and a government addressing the needs of our community. Take a look at who started this mess. It didn't just start.
ReplyDeleteThis writer is 100%:correct. Lamont, Brown and now Tara have destroyed this county. It all comes down to staffing in the county. And the only reason for the staffing issues is wages. There are major issues in all county departments. JJC ,Gracedale, as you have wrote, and the jail. This is Lamonts fault and the county should hold him 100% responsible. He made his great stands by about not raising taxes, but he did by not paying county employees livable wages. Well not you are getting
DeleteI worked 28 years for the County. When Holland was running Gracedale it was doing well. Go back to private running it. Gracedale at one time was the Jewel of The County! One problem is they never updated the place when Gracedale was making money the County Executives used the profits from Gracedale for other of their projects. I worked in Maintenace and became a Supervisor there in Maintenace this is how I know no modernization was ever done. Come on Council and Tara lets get the ball rolling on improvements
ReplyDeleteHey Roger. Good to hear from you.
DeleteThank you for your honest details, Roger. Tara, unfortunately, doesn’t seem to care what anyone other than her current circle think and believe. If she won’t listen to the man you referenced when he’s trying to help now as a commissioner, Gracedale is doomed.
DeleteIt's more like the cubic zirconia of the county.
DeleteRoger is correct. When Gracedale made $, that was used to fund other county departments.
DeleteWhat office will Tara run for next?
ReplyDeleteWhy are deputy sheriffs posted at Gracedale and the elopements keep happening. Seems like someone has their head in the phone just like when I went to vote. Barney Fyfe was more competent.
ReplyDeleteAppears Life Safety inspections were May 11-12, 2026. Deficiencies noted, Bernie. Located on same state site. Did Tara mention them?
ReplyDeleteFace facts and sell it before you get a huge lawsuit against the county from Gracedale residents and/or their families.
ReplyDeleteTo those who think you can go back to a time when it was properly run, let it go. Everything is different from what it was in the past. The state doesn’t reimburse as much because most other counties have sold their home off.
There is no going back to the good old days when having a county-owned home made sense.
Morton needs to be fired and Fruit Loops Zrinski proves she’s incompetent and Koo Koo Keagan proves she’s incompetent as a council member and nurse as she praised the fine workers of Gracedale. Credit Holland for trying to make council and Fruit Loops how severe of a problem Gracedale has. Time to sell. Get over it. Zrinski clown talking is BS. This proves whatever she says, investigate because she lies.
ReplyDeleteWhy should she not praise the 99% of workers who are doing a outstanding job? please explain this to me?
DeleteShe does at nearly every meeting. .
Delete