Northampton County Council's Wednesday discussion with Continuum of Care Director Thomas Carson and Gracedale Administrator Michelle Morton included a detailed discussion of the 2023 Affinity operational assessment. at Gracedale.
This report was ordered by a previous County Council over former Executive Lamont McClure's veto. Council thought it would be helpful to have some "outside lens" on Gracedale. Tara Zrinski, then a Council member, supported McClure's veto.
This outside performance audit has pretty much been collecting dust since that time. After Michelle Morton was hired as Administrator in March 2025, it was never provided to her. She told County Council on November 9, 2025, that she had yet to see this report. When she testified before the Investigating Grand Jury on December 30, 2025, she still had failed to read it.
Carson has.
He told Council it produces a remarkably candid picture of the problems facing Gracedale. This raises questions about why many of the report's recommendations were not addressed sooner. Carson suggested Gracedale use the 2023 Affinity report as a blueprint and give current management time to implement its recommendations. He noted many of its findings and recommendations are the same issues he has been reporting to now County Executive Tara Zrinski.
Carson plans to meet with Gracedale's administration and nursing leadership and go through the Affinity report line by line to determine what needs to be done. "I'm not going to stand here before this committee and suggest everything is fine when the facts tell us otherwise," he declared. But he also stressed that Gracedale's problems are only a part of "the entire story." He has met employees who have devoted years and even decades to Gracedale and remain deeply committed to its residents.
Carson said employees want leadership that listens, communicates, holds people accountable and is present. His commitment to Council was straightforward: "I will tell you what I know, I will tell you what we are doing about it, and I will be accountable for the results."
Affinity findings that Gracedale had no referral tracking system, was poorly marketing itself and had no formal daily "standout" or shift-turnover meetings, have remained poorly addressed. But the most striking part of Carson's presentation involves employee morale.
The Affinity report said employees felt demoralized by negative media coverage and the frequent public discussion of Gracedale's problems. Carson said that finding remains relevant. He mentioned one employee had told him that she covers the Gracedale logo on her sweatshirt when leaving the facility because she is embarrassed to be identified with Gracedale.
WAGES AND AGENCY STAFFING
Affinity found that Gracedale's wages were noncompetitive. Three years later, that is still the case. Carson said some employees struggle to make ends meet, feel forgotten by the county, and many leave for higher-paying jobs. He described compensation as a "critical" problem.
Carson said the recent increase in nursing-supervisor pay was a step in the right direction and that paying all nursing staff more could result in the elimination of agency nursing. The Affinity report said Gracedale spent approximately $11.3 million on agency staffing in 2022. Now it's roughly twice that amount.
In one positive note, nine people were beginning new-hire orientation last week, the largest number Carson has seen since he arrived a few weeks ago.
Only one is a nursing supervisor, but Carson "hopes" at least 90% of the supervisor positions are filled by the first quarter of 2027.
WHY WAS THE 2023 REPORT SHELVED?
Council member Dave Holland asked Carson perhaps the most important question of the evening: Why was Council only discussing a taxpayer-funded 2023 report in October 2026 when it contained apparently relevant concerns?
Carson was unable to answer because he was not at Gracedale in 2023 and could only speculate that someone the report was unneeded.
AGENCY CONTRACT AND RATES
Council member Nadeem Qayyum had questions about the disparity between county and agency hourly rates.
Examples cited during the meeting included:
CNA: $17.88 county versus $36.40 agency.
LPN: $25.50 county versus $53.20 agency.
RN: $32.60 county versus $84 agency.
Morton acknowledged that agency rates are substantially higher.
THE CNA TRAINING PROGRAM WAS STOPPED BY DOH
Council member Lori Vargo Heffner asked what happened to a CNA training program that had once been used to recruit workers. Morton said originally that the program had been placed on hold because too many people were using it to obtain their CNA training and then leaving for jobs elsewhere. She later told the truth, admitting that the state DOH actually removed Gracedale's training certificate as a result of deficiencies, meaning the facility currently is unable to operate the CNA training program.
Vargo Heffner asked whether Gracedale could require trainees to remain employed for a certain period or repay training costs if they leave. Morton said Pennsylvania law prevents the county from simply imposing such a requirement. She was asked to send the legal authority to Council's Solicitor for review.
In effect, Gracedale was spending money and staff time training people who were not necessarily staying at Gracedale.
Morton also said Gracedale's population has changed. Whereas the facility had historically been more heavily geriatric, it now has many more residents with mental-health issues and associated behavioral challenges.
Management decided that staff-development resources would be better spent providing additional training to existing employees.
There was also a second problem: following an abuse incident last July, the Department of Health removed Gracedale's training certificate, meaning the facility currently cannot operate the CNA training program.
UNANSWERED QUESTIONS
Though Carson appeared sincere, he was hesitant and neither he nor Administrator Micheelle Morton were able to answer fully at least seven substantive questions or information requests.
1. How many Gracedale employees are covered by union contracts?
2. How many union positions are filled and how many are vacant?
3. How many employees are outside the union?
4. The biggest unanswered question was posed by Council member Jason Bouletter. How many county-employed nurses are required to operate a 450-bed Gracedale without agency nurses? - Both Carson and Morton looked like deer caught in the headlights when asked a pretty important financial and resident care question.
5. What were the exact dates of the three new Department of Health citations?
6. When will the agency contract receive a formal audit, and what would that audit show?
7. Why were the recommendations in the 2023 Affinity report not fully implemented before 2026?
There were also several questions that initially received incomplete answers and required Council members to press for clarification, particularly concerning agency staffing, the formal shift-change meetings and the CNA training program.
THE BIGGER ISSUE
The testimony creates an interesting paradox.
Carson and Morton both essentially agreed that the Affinity report identified legitimate problems. They also agreed that many of those problems are still relevant. What's troubling is that several problems identified in 2023 — referral tracking, marketing, employee morale, communication, accountability and staffing — remain issues three years later.
And the biggest unanswered question may be the one Carson was asked directly: Why did a taxpayer-funded report identifying these problems in 2023 apparently sit without being fully implemented until the current administration began addressing them?
Carson's answer was essentially that he was employed elsewhere and hence was unable to explain what happened. Morton's explanation was that current management independently identified many of the same issues and has been working on them since she arrived.
That leaves an important accountability question for County Council: Who was responsible for implementing the Affinity recommendations between 2023 and the arrival of the current Gracedale leadership, and why were so many of them still outstanding three years later?
Two words. Lamont McClure. He bristled at the notion of an operational assessment and simply ignored it.
(More to come on Monday).
Check out Human Services Committee meeting July 6, 2023 at the 16 min. mark.
ReplyDeleteIncompetent management. Every department in Gracedale is a mess. It’s a “fly by the wind” management group. No leadership. Nursing admin is a joke. People put in those positions with no qualifications. 1 is a brand new RN. Why?
ReplyDeletewell, this will only get uglier...
ReplyDeleteI tried to watch this meeting but I gave up. It was not a presentation but a grab bag of stray thoughts.
ReplyDeleteFrom the Executive Summary of the Affinity Report: “Through Quarter 1 2023, occupancy has averaged 85% of active bed capacity and is consistent with 2022 performance. Staffing challenges have necessitated the closure of four resident units. The COVID-19 pandemic not only deepened nursing home’s occupancy challenges but increased the strain on an already stressed labor pool.”
ReplyDeleteIf you don’t know what your numbers are and should be where do you begin budgeting? This administration has not fixed 1 thing yet. How long have they been in command? Morton 2 yrs? She had a problem with Jen Stewart and the QAPI person. They knew more than she did. Why not tap into that knowledge instead of being an asshole towards them. They don’t know how to fix it.
ReplyDelete“Compared to its County Homes and regional nursing home’s peers, Gracedale performs above average in operating margin performance based on 2021 accepted cost report data. The operating margins reflected above include all IGT funds, PRF, and COVID - Relief subsidies received in that fiscal year. We included them here to ensure an equitable comparison. Of the seventeen county homes included in the comparison, only seven had a positive operating margins.” Affinity Report pg. 9
ReplyDeleteOn pages 66 & 67 of the Affinity Report, there are 4 “Recommendations” made regarding “Compensation.” All four Affinity “Recommendations” were implemented via a Memorandum of Understanding with the nursing employees represented by AFSCME and approved by a previous County Council subsequent to the issuance of the Report. The Agreement allowed paying more to new hires with experience, implemented a new pay scale for wage adjustment based on prior/job position experience, and raised the pay of all current employees.
ReplyDeleteStoffa is rolling over in his grave. "Nobody listens to me!!!!"
ReplyDeleteMcClure was only interested in making himself look good for his congressional run. He needs to go.
ReplyDeleteAt first I thought the people calling for McClure to be prohibited from being solicitor were just being petty. But really, the more we find out the more my views are changing. I’m not so sure the county should be paying him a salary for anything.
Delete
ReplyDeleteCarson said employees want leadership that listens, communicates, holds people accountable and is present. Common denominator here? Sue wandalowski. Ask the same question to DHS staff and you will get the exact same response. She was responsible for addressing the report. She didn’t.
Bingo! Yet Tara kept both her and McClure on the payroll.
DeleteWandalowski somehow skirts responsibility for all the deficiencies and failure to follow the recommendations of the report. Its Good staff is seeing the culprit. She has been mean to staff and threatening. She has told them not to speak to council. Council members used to walk into human services and get greeted with a cup of coffee and conversarion. Not anymore! She is responsible for the morale problems everywhere and its a big hole to dig out of and staff would really like a new leader. But exec doesn't listen.
DeleteShe had to keep McCluless on board, since he's solely responsible for her becoming Executive! Jobs are handed out like candy, like Boulette's wife getting handed a job in the Controllers office immediately after the election. This County is a laughing stock, and needs real leadership.
DeleteAnother wasted salary. You could pay 3 CNAs for what Sue makes. Nobody would even know that she’s gone. What exactly does she do?
ReplyDeleteAlmost all of the recommendations made were already in the process of happening or did happen after the issuance of the report. But, the Report did sit on the shelf and “gather dust” in one important way - Lamont McClure was never going to spend the money to reduce the number of beds in the rooms. It was by far the most important, and costliest recommendation Affinity made, and he wasn’t going to spend the money to do it.
ReplyDeleteAnd look at what it cost the home in agency and license. Wrong decision
DeleteIt’s “Scorched Earth Policy”.
ReplyDeleteThe report did not become a plan of action because it would have led to a tax increase, and the same commenters who are personally attacking various individuals...and their ilk...would have howled at the necessary tax increase and called for McClure and any member of Council that voted for it to be punished at the ballot box. And, that's how it works, especially in this political environment. And, taxes would have gone up if Giovanni had won....but the crowd here would have blamed McClure. But they'd still complain about their taxes, and might well take it out on Council anyway.
ReplyDeleteTime to get rid of Gracedale Government cannot run it properly.
ReplyDeleteTime to get rid of dysfunctional council and executive.
DeleteThe reason reports like this are not addressed is usually financial. Watch what you ask for when you get a report. Those reports are pretty standard. I've seen many and they all say basically the same thing. McClure was aware of what was needed when he entered office. He dealt with it by getting rid of those who brought it to his attention. There is nothing new in 2023 that wasn't an existing problem except covid effects that made staffing worse. The residents have included behavior mental issues for years. This is also not new. It all can be sol v ed they just have to be willing and knowledgeable. But continuing this path of agency will not improve the care. With the benefits they also dont need to match agency salaries .lastly most staff are union and frankly that is a large part of the problem.
ReplyDeleteIs there an answer coming from anyone, in the near future, to salvage the licensing to keep the lights on??
ReplyDeleteYou've finally taken off your blinders and are seeing the REAL McCluless- arrogant and petty. It's no wonder he got destroyed in the primary by Crooksy Brooksy.
ReplyDeleteThe problem with employment in all areas of Northampton County government is very simple to resolve.........pay competitive wages and a lot of your problems will go away. Training,,,,,,get good instructors to train your people in areas that are deficient. Leadership.....get rid of your losers.
ReplyDeleteThe problem is the County is being led by losers- we haven't had a decent Executive in years!
DeleteTZ was in government when all this was happening. She can no longer hide by saying she wasn’t.
ReplyDeleteShe is a coward and has not done her homework on how to fix the licensing issue. Her, Kraft, and Keegan’s egos won’t let them tap into Dave Holland’s suggestions, or even call Premier Nursing home management. They are naive to think they alone can fix this. Gracedale and the county’s fiscal failure they will own.
I don’t understand why they don’t just invite McClure to answer questions about it. I happen to know he regularly is in contact with multiple Commissioners. I’m sure he’d be happy to answer there questions.
ReplyDelete