Holland on What a Provisional II License Means at Gracedale

Dave Holland, a nurse practitioner and nursing professor at East Stroudsburg University, was also an administrator at Gracedale and at Monroe County's nursing home. He knows about medical care. He also knows about nursing homes. Last year, Northampton County voters fortunately elected him to an at-large seat on Northampton County Council. Since that time, his insights and attempts to provide advice about the home have been strangely ignored by Executive Tara Zrinski, who prefers listening to an administrator whose background is therapeutic recreation. While she does zumba classes, the home is clearly and objectively declining. It was placed in a Provisional I license last year. Despite claims that things were improving, the state Department of Health has downgraded Gracedale's license to Provisional II.  

When did this happen? When was Administrator Morton informed? When was Executive Zrinski informed? We do not have the answers to these questions, but the public itself was in the dark until earlier this week. 

The most important question is what does a Provisional II license mean? Despite attempts by Council President Ken Kraft to muzzle Holland at last night's meeting, he explained in very clear terms precisely what options are now available to the state Department of Health, and it's pretty bad. Here's what Holland said: 

If we don't resolve our noncompliance status, we're not going to have to worry about the continuum of care because we won't be able to have the license to do so.

So what do I mean by that?

So, in a provisional license status, every day that goes by that we're not in compliance, there are remedies that are available to the Department of Health, which they have not instituted yet, but they certainly could at any day.

That includes denial of new admissions to the facility.

If we're denied admissions to the facility, we're not allowed to carry out the mission of Gracedale, which I'm going to read to you.

Gracedale is a skilled nursing facility that serves the medically challenged and financially indigent residents of Northampton County and surrounding communities. The mission of the facility is to rehabilitate its residents to their highest practical level of medical, social, and psychosocial well-being.

If we get into a situation because of noncompliance, fair or not, that's the situation we're in from the Department of Health.

We're not gonna' be able to meet that mission because we may be denied admission at some point.

Second to that, the other option is to deny payment.

And again, we will not be able to comply with our mission to the residents of Northampton County if we're going to be denied payment for Medicaid or Medicaid residents.

There's a process where the agreement to provide payment for Medicare Medicaid can start, they can start that process to nullify and separate from that agreement based on noncompliance.

So the other options are temporary management.

If we don't get into compliance within a certain period of time, they can basically deem we are no longer capable of managing it ourselves and institute temporary management.