The following is from a 10/22 letter to Gracedale Administrator Michelle Morton from the state DOH. Any plan of correction submitted by the county should include the termination of its administrator.
Representatives of the Division of Nursing Care Facilities conducted a Revisit and Abbreviated Survey on October 20, 2026 to determine if your facility meets the requirements to participate in the federal certification program. All references to regulatory requirements contained in this letter are found in Title 42 CFR Part 483, Subpart B, Requirements for Long Term Care, and the 28 Pa. Code.
Based on the findings of this revisit, it was determined that your facility failed to correct the identified deficiencies, whereas continuing and/or new areas of noncompliance with the following participating requirements were identified:
F580 42 CFR §483.10(g)(14) Notification of Changes-New
F689 42 CFR §483.25(d) Accidents – Continuing – D
State Tag 1040 Responsibility of Licensee – New
The enforcement cycle start date is 09/10/2026.
If you do not correct the cited deficiencies within 90 days from the enforcement cycle start date, the Centers for Medicare and Medicaid Services and the state Medicaid agency must deny payments for new admissions. A remedy of a civil money penalty and/or directed in-servicing may be imposed. Additionally, we will recommend that your provider agreement be terminated six months from the enforcement cycle start date. Remedies already imposed for this enforcement cycle remain in effect. [Emphasis added by blogger].
You must submit your plan of correction electronically. The deficiencies will be available for review and development of your plan of correction on October 23, 2026. This plan must be available for our review on the Department of Health Facility Site at https://sais.health.pa.gov/commonpoc/Login/Login.aspx, by November 1, 2026. If the deficiencies are not available on October 23, 2026, please notify the field office. Failure to submit an acceptable plan of correction within the required time frame may result in the recommendation of the imposition of additional remedies.
Your plan of correction must contain the following:
What corrective action(s) will be accomplished for those residents found to have been affected by the deficient practice?
How will you identify other residents having the potential to be affected by the same deficient practice and what corrective action will be taken?
What measures will be put into place or what system changes will you make to ensure that the deficient practice does not recur? How the corrective action will be monitored to ensure that the deficient practice will not recur; i.e., what quality assurance programs will be established?
Dates of when the corrective action will be completed.
If your plan of correction fails to contain these components for each deficiency cited, it will not be accepted. The specific target dates that you identify for your facility to achieve correction should reasonably reflect your facility's concern for the health and safety of your residents in relation to the deficiencies cited. If we conclude that your date of presumed compliance does not meet these criteria, it will not be accepted. The latest date identified for the completion of corrective actions will be accepted as the facility's allegation of compliance.
If we determine that subsequent to the date of presumed compliance identified by your facility that you have failed to achieve and maintain substantial compliance, additional remedies may be imposed.
Please note that this notice does not constitute formal notice of imposition of alternative remedies or termination of your provider agreement. Should the Centers for Medicare & Medicaid Services determine that termination or any other remedy is warranted, they will provide you with a separate formal notification of that determination.
The remainder of the letter provides informal dispute options.
It’s clear that , regardless of the many stated promises, ALL the new and existing management, including the council and executive, OWN the failures that were not addressed. This council and administration hold the life or death of the nursing home ,via their action or inaction ,in their hands.
ReplyDeleteSo this letter is regarding the survey in Sept. What about the DOH visit this week? What tag was Gracedale given? This should have been published already.
ReplyDeleteThe letter is the result og the 10/20 survey, not September
DeleteStart with firing the incompetent Administrator- this has gone on long enough!
ReplyDeleteAnd yet she apparently is still employed there. All of this was predictable but no one would listen.
ReplyDeleteI'm waiting to see what Tara has to say about this serious situation(if she even understands it). I wonder if Tom Carson and the QAPI person are "quick studies". I doubt they even understand how serious a situation this is but I guess ignorance is bliss.
The years of work done by The Premier Nursing home management group, including Diem Freeman and David Holland, is now in jeapordy. Under Premier, Gracedale had achieved 5 star free deficiencies and was making 2.5 million in profit. Yet, no one chose to ask them for help ? Here’s a fact: once the license is lost, it can never be used or sold as a nursing home, and the building(s) will have to be repurposed. Dave Holland will be able to confirm what this executive and council failed to know.
ReplyDeleteAll true.
DeleteOh please… Premier cut positions
Delete…Premier kept the home in the black and 5 star rating deficiency free.
DeleteOnce the county took over it went downhill. If the licensing goes, the chances of any type of return on years of investment are slim to none.
Zrinski must resign.
DeletePremier tried to save Gracedale. The unions fought them every step of the way. Gracedale succeeded for a few years but went downhill when the Premier administrator who brought that success had had enough of it all. Gracedale’s loss. The unions also brought you McClure and now Tara. Wonder if she still thinks she can build Gracedale city? She’ll be lucky if the license stays intact. If only that decision was taken away from her. Will see.
DeletePositions need to be cut. Way to many people sitting around. Middle management & 1/2 the housekeepers can be let go.
DeleteWhoa the place is circling the drain.
ReplyDeleteYou rarely see a politician so readily Own the failures of her predecessor. Lamont sent the home down this path. Tara has fully assumed responsibility at this point. Gracedale needs help. There’s no evidence the county is able to run this operation without help. It’s insanity to continue down this path. Has Tara reached out to a management company yet? That’s the best option. If she is not willing to give it to a management company, has she at least reached out to other Nursing Home professionals in the area? Has she reached out to Bucks, Berks, or Lehigh County? Fellowship, Moravian, Country Meadows and others run great senior homes in the area and could offer professional advice. Does she have a relationship with Siegel to get over to Cedarbrook to see how they do things? Has she reached out to anybody? She probably has no clue that she’s on the precipice of disaster with the nursing home. She is about to completely lose All of Gracedale, but she instead proposes Unrealistic ideas for the future and creates made up positions that have nothing to do with improving resident care. If there’s not a professional consulting company tearing apart the operations of the facility by November 1 and giving immediate actionable advice, there’s a high probability the whole freaking thing crumbles.
ReplyDeleteTime to shut down this dump. There’s $12 million saved from the budget. Got that crybaby Fruit Loops. How many hours do you practice crying in the mirror, Zrinski.
ReplyDeleteDo you have ANY compassion for the residents who live there...shut down dump??? Do you work there or even been to Gracedale??? That is alot of people's home ASSHOLE
DeleteTY for saying this!! People just rip into Gracedale and disregard the PEOPLE who live there and rely on having some place to live as many have no visitors and no place else to go. The residents are PEOPLE .. human beings!
DeleteIt may be time to sell this sinking ship and if not fire mortin! I wonder how much money the county would save and could lower taxes for 2027 if there was no gracedale?
ReplyDeleteSell it now no more new taxes
ReplyDeleteThe Gracedale DOH response from committee head Kraft, caregiver Keegan, the new oversight guy Carson, and executive Tara should be very telling. How will they rationalize their lack of action over their years of involvement and oversight ofGracedale? How many innocent families and patients will now be caught up
ReplyDeleteIn the fallout from this real threat?
When egos and attitude hide problems behind narrative of false hope and lies, there is always collateral damage.
They should hang their heads in shame.
sell sell sell
ReplyDeleteWho is in the Department of Quality Care? It is obvious that Department head isn't doing their job.
ReplyDeleteQAPI is Shannon Aleman, Continuum of Care is Tom Carson. Both have degrees in Therapeutic Recreation. Gracedale is doomed.
Delete729 - if that is true, that is astoundingly stupid and Gracedale may not survive past Tara’s term. I’m sure those two individuals are great Therapeutic recreation specialists, but this type of work is completely outside of that professional wheelhouse. That profession has very little knowledge on Nursing Home quality assurance In terms of clinical or operational areas. That profession knows how to engage the residents in activities. They have no knowledge on what to do when you’re staring down a G or an IJ, or how to avoid it in the first place. This is a failure by Tara. Gracedale is a worthy endeavor and should last another hundred years, but creating two positions and filling them with unrelated professions is a complete waste of taxpayer money. It’s malpractice by the governing body, whether it is a Governing body of a county home or private home. This is a disaster and she needs to seek outside help. Her administration cannot operate a 700 bed senior home and be responsible for lives.
DeleteThese two key positions should have been filled with qualified staff. Having a QAPI without knowledgeable RN is just incompetence. It set them up to fail
DeleteMichelle Mortin resigned now we need to get someone in there to turn it around ..
ReplyDeleteIf this is true they need a qualified NHA willing to stand up and be listened to. This home needs a major overhaul and the county executive uf she wants it to succeed needs to allow the person or management company do what needs to be done. First is census..close wings .get rid of agency.
DeleteA question that has been asked quite a few times, but never really gets answered: After 9 years as the Director of Human Services why does Sue Wandalowski continually escape any blame for Gracedale?
ReplyDeleteWindowloski was in charge of the home and failed. Now she has 1/2 of a job, same salary and gets to continue terrorising DSH staff with no concequnces. Thats on Tara.
DeleteDo you mean who is the QAPI director? A new employee who is not a RN. That’ s why NorCo is in the predicament it’s in. They hire to fill spots with those who are not qualified.
ReplyDeleteWell, that’s consistent with electing people who are not qualified.
DeleteYes - they changed the QAPI job description so it didn’t have to be filled by an RN. It was stupid then and is stupid now.
DeleteAgree, why does Wandelowski evade questioning and responsibility
ReplyDeleteWhy isn't the Director of Nursing and her assistants also being looked into? The deficiencies have been Nursing related, where is the accountability? Or, due to the turnover, maybe there is no mentorship. If there was a consulting firm like premier, there would be someone to ask questions and to review policies. It is sad that a once 5 star facility has come to this.
ReplyDeleteWhat went wrong over the past 10 years or so? Initially, it started with Lamont, he let James Irwin tell him how to run Gracedale and who to run the nursing department by firing Janet Harrison, a very qualified, experienced DON, who had been the DON for Cedarbrook and also worked for the DOH. But she didn't play nice with Irwin from AFSCME and wanted to make some needed changes. So, Lonny had to keep union promises, fired her and put a string of incompetent DONs to run one of the largest long term care nursing departments in the state. On top of that, he got rid of Premier to save the county around one million a year. However, in the long run we all know Premier had Gracedale in the black or made the county money most years they were contracted. Once Premier left, and another LTC inexperienced DON (but sure of herself and loved to delegate) was in place. Under her morale declined and her nursing administrative staff left and again inexperienced nurses replaced them . Then came COVID, mandatory vaccines, mandatory overtime and burnout. If you were able to retire, you did. Many left, eventhough, they spent many years caring for residents they knew as their second families. Many found jobs that paid more. Private homes pay more. Non union places do not have to negotiate, when they need help, they pay more money, give bonuses. They don't give a 2% raise a year and have a union tell their membership it is a great contract. And Finally, NOW WE HAVE NO CHOICE BUT TO FILL ALL THOSE VACANT POSITIONS WITH AGENCY. THEY DO NOT CARE. THEY DO NO NOT FOLLOW THE RESIDENTS PLAN OF CARE, THEY HAVE NOTHING INVESTED IN THE RESIDENTS OR GRACEDALE. THEY ARE NOT HELD ACCOUNTABLE FOR ANYTHING THAT GOES WRONG..
ReplyDeleteHOW DO FIX IT? Bring back a company like Premier. Pay employees what they are worth. Hold people accountable (top to bottom). Maybe reach out to long tram employees or retirees who have/had great input and experience in making Gracedale what it once was.
This County is falling from grace. What a shame.
ReplyDelete