At last night's NorCo Council meeting, an uncharacteristically somber Exec Tara Zrinski informed the Board that Gracedale's nursing home license has been downgraded from Provisional II to Provisional III as a result of deficiencies at the home on September 10 and 24. But she also indicated that she finally gets it and will seek a management consultant to help turn things around. She added that she has also shared a draft of her strategic plan for Gracedale with Council member Dave Holland. She has asked him to keep it to himself.
According to Zrinski, a nursing home with a Provisional III license can be fined at different rates. Centers for Medicare and Medicaid Services (CMS) has fined the county $16,350 for the September 10 deficiency. This is in addition to $144,328 in fines assessed since Michelle Morton has been running the facility.
Morton is resigning as Administrator, and Zrinski now concedes that "some of [her] reactions to the surveyors may have not been in our best interests. Zrinski is alluding to a previous attitude of defensiveness. "That's not what surveyors want to her," she acknowledged. They want to hear that we identify the issue, will not dismiss it and that we will ensure that it does not happen again in the future. She conceded that past practice has been to appeal deficiencies, "to no avail."
Zrinski also prepared a distributed a handout on what happens to a nursing home with a provisional license. "I'm not emailing you this information because I kind of don't want Bernie to get it," she stated. "But I know he will."
A handout at a public meeting of Northampton County Council is certainly something to which the public is entitled. But I already know what happens when a nursing home is downgraded a provisional license, which is a temporary license that lasts six months and can only be renewed three times.
According to the Pa Code, a nursing home with a Provisional III license can operate despite serious deficiencies. It must follow a corrective plan and timetable with the state DOH. Failure to correct can result in closure or the loss of the license. But Zrinski told Council last night that the "likelihood that Gracedale will close is very low."
On the bright side, Zrinski told County Council that Gracedale recently underwent its annual survey and did well. An email from Continuum of Care Director Tom Carson said there were five deficiencies, which he said is below the state average.
UPDATEd 2 PM - In a news release issued late this morning, the county denies Gracedale is closing (No one has suggested it is). In addition to what she told County Council last night, Zrinski states that "[c]orrecting individual findings is not enough. We must also examine the systems that allowed additional problems to occur and intend to hire a consultant to review policies, procedures, and resident care plans, strengthen our corrective actions, and help demonstrate lasting compliance. Our priority remains the safety and well-being of every resident.”
UPDATED 2:15 PM: Pa. DOH posts September 24 Deficiency - Nurse's Aide Accidentally Broke Resident's Foot. - The September 24 deficiency flagged by the state department of health has now been posted online. It is a "G" level deficiency, meaning one that resulted in actual harm to a resident.
According to a Nurse Aide Kardex (a concise, quick-reference worksheet that summarizes each patient’s essential care information in one place) a resident at Gracedale was non ambulatory and needed assistance of two staff members when getting in and out of a wheelchair. A nurse's aide who failed to read the Kardex and who did not even know what a Kardex moved a resident from the toilet to a wheelchair, and in the process that resident's foot was fractured. This aide was supposed to have had a shadow day with another aide, but there is no evidence that happened. The resident stated that the nurse's aide let her slide down causing her leg to get twisted. She further stated that more than one staff usually assisted her; but at that time, only one staff member assisted with the transfer.
According to DOH, the facility's negligence resulted in a serious injury to a resident.
Provisional III. Jesus H it’s gone from bad to really bad to off the rails!!
ReplyDeleteOver $150,000 in CMS fines, and
ReplyDeleteLicense downgraded, again, and now, 6 months later, she is asking David Holland for help!
The clock is ticking on her job performance as executive, and her ability to get the problems at Gracedale solved and presented to the DOH in proper fashion.
Wonder what her contingency plans are if all fails?
Doing well in an annual survey is “zero” deficiencies, Mr. Carson. So now we have hired two new people plus we are getting a management consultant? Geez - hate to say that I told you so but this was very predictable given the pattern of what has been happening (or not happening) there. Now we playing secret games with David Holland (the oversight committee doesn’t get to see it?)Will have to watch the video of this meeting to see if Tara dressed in black and used her contrite voice. Gracedale is in terrible trouble. Sad.
ReplyDeleteNot surprised at all. Keeping the same co -Administrator, Director of Nursing, two assistant directors of nursing and risk manager is going to continue being more of the same at Gracedale. Until they are all removed Tara is never going to be able to have a chance of keeping Gracedale under county control. They are still trying to cover things up and are so out of touch and tone deaf. Maybe to be in their position you have to be in order to keep their high paying jobs. Not sure I could sleep at night. I just thought most people that work in nursing homes or with elderly do because they want to help others and less fortunate.
ReplyDeleteRisk manager should go back to being a supervisor.
DeleteHopefully this strategic plan includes directly speaking to every single Gracedale front line worker to find out from them what's working and what's not working. Part of solving this problem is recognizing that it's the staff who can help. No not agency staff or administrators or agency supervisors. Talk to everyone. Nursing, dietary, housekeeping, maintenance, social workers, activities etc. Even speak to the physical and speech therapists. Because even though they're not county employees, they interact with practically everyone and see a lot of what's happening at Gracedale.
ReplyDeleteI think that all County departments front line workers should be asked to speak anonymously about the job and working conditions, or at least without management being able to identify them. This is the only way to really see what is going on there.
DeleteWow. This is frightening. Sounds like admin coverup.
DeleteExactly. We have been practically begging council to set up a few private meetings off site for union staff to give them the real picture and cost savings ideas management will not provide to them.the answers are all here with the people doing the work but the meeting has to be private. Wandalosky has instilled fear in staff No other director in the past has ever created this type of work environment. People here for decades left because of it. The morale is tanked. It is real. Gracedale same and Sue oversaw the operations there tonsome degree until recently. Council and the new consultant for gracedale need to step out of the comfort zone and do something different if they want the info and real ideas on how to save. If not it will be cut this and that and same old same old to balance budget.
DeleteIt is impossible for county council as a body to conduct back room meetings, with very limited exceptions. It is possible for individual council members to meet with employees, and i believe that already happens. The union has meet with Zrinski a number of times, and according to her, it is the union who suggested raising the wages of nurse supervisors (nonunion) before raising wages for front line workers. I get that all employees deserve an increase, but it should start with those paid the least. I question the wisdom of that advice.
DeleteMaybe council could invite Gracedale employees to oversight meeting on Dec 2 and invite them to stay afterwards for private meeting. The truth can be told then. They will be horrified by what is revealed to them.
DeleteTown Hall and Anonymous survey for Gracedale employees....coming very soon .
DeleteNobody speaks up at towne hall. Stupid to waste the time. Just a mask for admin to say the are doing something. If u wana do something LISTEN
DeleteAnon survey is a great idea. An invite after the gracedale meeting is a great idea. Council members can have an open door meeting date and time. Meetings are not impossible but they could find a way sounds like some staff is figuring it out. I hope they do it timely.
DeleteThe County Executive should not concern herself with a self-described “bottom feeding blogger.” And, this idea that Morton’s attitude toward Department of Health surveyors is relevant to all these licensure downgrades is disturbing on many levels. The only question should be were the plans of correction approved and implemented. There’s way more to this story than the fact that Morton is unlikable.
ReplyDeleteOh, boys and girls, you can't plat "kick the can" anymore.
ReplyDeleteShould have done this before creating a new department and adding 2 political patronage jobs.
ReplyDeleteCorrect. I thought the "continuum of care" hires were going to save Gracedale. I agree that they are just expensive fluff. All that was needed was the consulting firm to work with administration or actually take over administration of Gracedale as Premier did so successfully in the past. It'll unfortunately probably just be a matter of time until Gracedale progresses to a Provisional IV.
DeleteIt’s unfortunate that Premier was ever sent packing. They weren’t losing money every month; they were making it. What a bonehead idea to throw out what was working.
DeleteWhat were the 5 deficiencies? $160,000 in fines could pay for 2 nurses or 5 CNAs salaries. When do the workers who are creating these deficiencies pay for it? Is it true a nurse clocked in and left to go shopping? Was gone for several hours? The county is paying big bucks for the agency to get us to the point of a provisional III license.
ReplyDeleteYup agency nurse was getting paid by county taxpayers, even though she was on the clock. I guess her Walmart shopping trip was more important.
Delete"But Zrinski told Council last night that the "likelihood that Gracedale will close is very low."
ReplyDeleteRuh roh. I hear the Fat Lady warming up backstage. It's a shame it had to happen this way. Gracedale could have been sold when it still had value. Now, it's going to go away to essentially a sheriff's auction. It's good news for the residents, however. They deserve better than to be confined in such a poor performing place run by politicians who use it as a political prop.
Tara should close Gracedale. After the current last resident discharges, which will be years from now. Gracedale should be closed, not sold, closed. As the census dwindles, cut down on staff, close units, save taxpayers loads of money. When the last resident leaves, turn off the lights.
ReplyDeleteStaff in ancillary positions should’ve been cut 8 yrs ago when census was 450
DeleteI’m not a fan of the executive but I would like to applaud her report to council last night. She was upfront and honest. I don’t agree with her comments that Gracedale won’t close. This is a very serious issue and will be difficult to resolve given the agency staff. They don’t care about the residents. They care about the dollar. I also would like to know why all of a sudden the administration is calling other NHAs & hiring a consultant. This was suggested for at least 5 yrs. Why is the administration finally GETTING IT? Affinity was in the building for years. Why not hire a different group?
ReplyDeleteShe was up front and actually acknowledged (at last) what many here have been saying for some time - the place needs help. She has spoken with Holland and treated him like an asset instead of ignoring him. She acknowledged that the county attitude to surveys was all wrong and hinted that Morton might be the reason. Maybe she's realized that the grand jury report is not full of perjury and lies, as she previously declared. It was not a monologue but an actual report.
DeleteBut she has not presented the plan to be given to DOH…she has none
DeleteWhat else could be presented to the DOH that hasn’t already been submitted? The resident’s are not being taken care of. You can have every policy and procedure under God’s great earth, which I’m sure every facility has, but if the staff doesn’t follow it all the time you’re screwed. They weren’t even checking a care kardex. That’s CARE 101.
DeleteThis is ridiculous! From what I remember back in the day gracedale was the counties Cash Cow. Unfortunately the money they made went into the general fund and the politicians used it like it was their personal money, you get what you vote for. You one of the Blue Wave wait and see what you get
ReplyDeleteReally not following the Gracedale issue too closely but did she really say she is not sending something out because Bernie might get it? Lol. Absurd
ReplyDeleteShe did. I'm beginning to think she has a problem with me, lol. She's in good company. I get that impression from a lot of people. And yes, I am a dumpster diver. But we're on the same side actually. I think we both want the county and Gracedale to be better. To her credit, she responds to every text I send her.
DeleteTo me it sounds like she doesn’t want transparency. It’s a bad look. Keep dumpster diving Bernie!!
DeleteHah! BDS---Bernie Delusion Syndrome!
Deletecounty executive is worried about Bernie getting a report? This is the behavior of a scared child afraid to hand in a half ass written book report. We need a professional to run this county. We need a strong confident intelligent leader who knows how to rally the troops and create effective teams of people to handle difficult situations. She is out here half crying at a meeting saying "we get it now". This is absurdity. How can she just "get it" now when residents have been exorcised and bones broken and we just get it now? Changes need to be made and instead of making them with your heart Tara make them with a sound team of true professional and get a new team of leaders.
Delete"... likelihood that Gracedale will close is very low."
ReplyDeleteWell that's mighty comforting. How did things get so precipitously worse in 11 months?
Prior to removing Premier Management as administrator from Gracedale, did anyone from the administration make an effort to preserve or memorialize data for future review and analysis?
ReplyDelete2:06- Preserving important assets, data, and information goes against Administrations “Scorched Earth Policy” of wiping those things out as people leave so that there is no “Continuum” of responsibility. Most of these administrator’s motives are capricious and they suck as managers.
DeleteSo now, on top of $150,000 plus fines, new salary for Carson, and
ReplyDeleteHow much will it cost tax payers to hire a nursing home management administrator?
How does TZ “know” Gracedale won’t lose its license, her magic ball?
Time to sell and help pay for that 43% tax
ReplyDeleteEveryone needs to keep in mind of the fact Zrinski has been involved with the county the last 10 years as council member, controller and now executive. She has had her hand and the knowledge of the severity and challenges at Gracedale. She has had access all along and time to consider what to do to rectify the problems. You would think she would have come into the executive position with that plan ready. Alas, she didn’t and made her desire for taxes hikes more important than taking care of one of if not the biggest issue in the county. Simply put, she was unprepared and has demonstrated she is more about the Political Position as opposed to any true sincerity about the county. She has fooled many into believing her allegiance was to the county as opposed to her personal conquests. It’s a shame the HRC fails to have an ability to remove such poor administration
ReplyDeleteGood point and explanation as to why nothing changes and she cries to council instead of making real changes to her cabinet..
DeleteTara should tender her resignation. The job has proven too big for her.
ReplyDeleteIf not too late, now would be the opportunity to call in Premier Health Care team and ask for the help needed to right this situation. I believe Diem Freeman and Dave Holland have the knowledge and expertise to address all the problems. TZ
ReplyDeletecould potentially turn a grave situation into a positive by reaching out and asking how much and how soon, but she needs to act quickly.
Former executive Lamont had an editorial in the Morning Call paper 11-1-26 Gracedale not his fault. Lies! He and some on Council at fault!
ReplyDeleteNot that I like Tara but this is truly a gracedale issue and the situation they're in now despite previous decisions is not specifically on her. Yes she should have considered many things before a very rare provisional III. The problem is very simple actually. First too many residents for number of staff. Second agency staff dont know about policy as there is no training on policies. Policy needs to be taught to all agency or they're clueless. Policies should be reviewed and updated annually and as new problems occur to assure the best policies. But the audits need to be on the staff to see if theyre aware of and following policy. The two new position people hired could help with that while educating themselves and the staff. Constant audit results in constant education of all staff and will improve outcomes. Giving audits for staff to do also helps but that's not a first step in a place in this much trouble. As noted above staff need to be held accountable and terminated if they cant follow policy. It doesn't matter if you have low number of staff. Numbers dont matter as much as quality staff.ive said it a million times cut census and start fresh. As for a management company..they cant change things without the county executive support abd the resources. It is a lot of money for nothing unless their recommendations are implemented. They assess, give a report..monitor care but you need quality management in house support to make it work and worth the money spent. Gravedale is not manageable as it is..something has to change. I have known counties who employ a management company to micromanage them and that won't work when you have this critical of a situation. There's very little time to turn this around.
ReplyDeleteDon’t trust the documentation on the audits the Gracedale staff does. They document anything just to get the audit done. YOU NEED TO HIRE PEOPLE THAT CARE. PEOPLE OF CHARACTER. PEOPLE WITH A HEART. The front line workers will change the place for the better. They don’t work there for money. All they really want is to be treated with respect. They know how bad their bosses were as workers.
ReplyDeleteMeanwhile agency supervisors do their rounds in the units . They get out of the units as fast as possible. They walk in units with noses up in the air. They never acknowledge Gracedale staff. They never remove things that are blocking fire extinguisher. Never assist residents. They see other Agency nurses passing meds while talking on phone. They see agency aides sitting on their butts. They are all buddy, buddy and just talk about all the money they're making and sending back to their home countries in the Caribbean. Or the latest plastic surgery they're getting.
DeleteIs Tara a sort term villain and long term hero or a short term hero and long term villain ? I guarantee you in Tara’s mind she’s a short term hero and a long term hero. The only term she’ll be is a one.
ReplyDeleteNARRATOR: In the end, Gracedale was doomed by the very party that said it would save Gracedale. Bernie and Angle and Stoffa were right years ago. They're still right now. Tara has had her hands in Gracedale for a decade. How dare she make excuses and blame others. And she was paid all along. Disgraceful.
ReplyDeleteTo be clear, I believe I was wrong about selling Gracedale. First, the people spoke and I respect that an overwhelming majority wanted to keep it. Second, after the referendum, I visited Gracedale during a volunteer day and was astonished by the love that the people who worked there had for the elderly. Can’t say if that is still true but that humbled me. Third, Premier proved it could turn the home around. While the quality of its work waned after D and holland left, I thought they were very good. Fourth, Jennifer Stewart was among the group who really care about residents. She may not have been the cutting edge, she was a product of that home and its ethic of care. So I would not support the sale of the home today until and inless we’ve done everything humanly possible to make it a good facility.
DeleteYou should volunteer next week. You'll see how different Gracedale is. And go to different units. Talk to Gracedale staff. You're gonna be in shock.
DeleteGracedale did nothing on its own to deserve the current wrath, but the executive, administrators and managers of Gracedale failed in their oversight and work implementation over a number of years. The Gracedale Home made money and was deficiency free under Premier Management, but once county executive McClure threw them out, it began a downhill journey. They need Premier back.
DeleteWhy can't we sell it to a health network to run it properly and have competent staff to make sure these patients are taken care of and getting the treatment they deserve? St Lukes maybe? Look how they turned Easton around.
ReplyDeleteGreat idea. County move this to professional.
Delete“The two new position people hired could help with that while educating themselves and the staff.”
ReplyDeleteDoesn’t sound like this is really the place for OJT, not to mention it’s two high-paying positions added to an already beleaguered county budget. Kind of like offering driver’s education training by putting inexperienced drivers into a race car at Indy during the first pit stop.
I agree and I wrote it! But theyre paying them now and what are they accomplishing when they have no knowledge of nursing homes! At least its a way to get something for their salary
DeleteGracedale started going downhill right after Premier was let go. They started picking people they wanted to send for NHA certification. Then hired them as the NHA with no experience to run a 725 bed facility. They did the same thing with the ANHA. Both ANHAs left or were asked to leave within a yr or 2. They got a free education. Didn’t have to pay anything back. How stupid are the people running this county?
ReplyDeleteSomeone knows alot!
DeleteThe clock is ticking …we will see what happens in 6 months. The exec and her staff failed to hit the timelines and fix DOH problems found prior which caused the downgrading of the
ReplyDeleteLicensing to occur.
Mark this date: May 2027
Bernie you have defended Gracedale for years, yet the place is a shit hole.
ReplyDeleteI am told I’ve trashed the place for years and you claim I’ve defended it for years. Which is it? The reality is that I’ve written the bad and good over many years.
DeleteGracedale is actually one of the strongest nursing homes in the Valley. Ask anyone who goes to corporate-owned nursing homes. Not all, but many of them are far below the quality of care of Gracedale. Privately held nursing homes are a BUSINESS with a clear profit motive, and the profit is made off the backs of the residents. Upcharging, making residents look sicker than they really are with garbage consults from physiatry, respiratory therapy etc… Gracedale is different from those other nursing homes, in that Gracedale’s existence is not to make a buck off poor people’s illnesses and debility, but to give the best quality of life possible while being completely hemmed in by Medicaid limitations and the unions.
Delete9:06 is a liar. I have gone through the Pa DOH nursing home facility locator and have compared Gracedale against other nursing homes in NorCo as well as against other county-owned nursing homes. Objectively, Gracedale is the worst. That is just reality. Until you recognize that and make changes it will continue to deteriorate.
Deletehttps://lehighvalleyramblings.blogspot.com/2026/09/how-does-gracedale-stack-up-with-other.html
https://lehighvalleyramblings.blogspot.com/2026/02/pa-nursing-home-facility-locator-shows.html
9:06 definitely a liar!
DeleteHemmed in by the unions. They apparently haven't done anything for Gracedale employees. Have you seen how low paying their wages are at Gracedale?
DeleteBernie,
ReplyDeleteIt appears that exorcist nurse trial now pushed back to Jan 4, 2027. Why? She needs to be tried for her assault on Gracedale resident. Heard she had tried applying for another nursing job in NJ after the assault. Wtf!
The Premier of David Holland and D Freeman was sold. The new Premier put in Ray Soto.
ReplyDelete7:24. You are incorrect. Premier is still managing and helping nursing care…look it up
ReplyDeleteMice in one unit at Gracedale that are being fed by residents is very unsanitary. And the worst part is that this is occuring near the kitchen that feeds staff and residents.
ReplyDeleteLol. You should see the jails kitchen at night. The mice know their out times from what im told.
DeleteAbout two years ago at Gracedale water bottles had to be used to bathe residents and for them to drink, because of Legionnaire's possibly being in water. That went on for several weeks/ months. There is always something happening or going on at Gracedale. It just never ends.
ReplyDeleteDefinitely rooting for Gracedale to succeed and stay county owned. It is vital. I am happy to see the county is exploring a Management company. That’s really the only option. There is no competence to do it in-house. Very few of those standalone operations are left. There are good management companies such as CHR, Premier, or Affinity. You better make that happen soon before you lose it though. You also need to go through different channels, such as talking to other homes or the industry associations to get resources. There is no shame in looking for help.
ReplyDelete