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.

Zrinski Attempts to Minimize Gracedale's Problems

At last night's meeting of Northampton County Council, Executive Tara Zrinski spoke twice about Gracedale, both during courtesy of the floor and in her Executive report.  In hir first oration, she spoke about the good care the nursing facility provided to her mother, something she has done several times in the past. She never mentioned that this care was during a time when Jennifer Stewart King, and not Michelle Morton, was the Administrator. In her Exec report, she tried very hard to paint the home in a positive light. She noted that there were 14 citations in 2025, but only 4 "technical" violations this year. She did not point out that we're not even halfway through the year. She said the root cause of these problems go back several years. She said none of the citations this year reflect a failure to provide care, which is utter nonsense. In fact, the poor staffing is precisely why the home was cited in January and again in May.  I'd also say that a failure to follow doctor's orders, especially concerning medications and blood sugar levels, is indicative of outright negligence. 

She did finally mention Gracedale's downgrade from a Provisional I to a Provisional II license. She believes the root cause was the county's admission process, under which some risky residents were accepted. She said the home is now more selective in who it accepts. 

I'd like to know what the DOH has been at Gracedale 27 times since Michelle Morton was hired as Administrator. It's true that most of these complaints are unfounded, but the sheer number suggests to me that employees, residents and family are unhappy. This reflects on Morton's leadership. 

I'd like to know why, after being repeatedly cited for falling below the state minimum nursing care requirements, Gracedale was cited for that again and with a provisional license. Amazingly, Morton claimed this shortage was caused by call offs. Why on earth would the home fail to plan for call offs? 

I'd like to know how Gracedale, whose very mission is to take care of people, could ignore doctor's orders. 

We got answers to none of these questions because as soon as she was done with her Exec report, Zrinski asked for an Exec session to discuss "personnel."  And accompanying her into the back room were Morton and Human Services Director Sue Wandalowski, who is supposed to have nothing to do with Gracedale. That's the whole point of the new positions sought by Zrinski. No doubt, the purpose of the exec session was to scapegoat someone for problems that have grown worse since Michelle Morton arrived. 

Finally, I'd look to know when Zrinski was apprised of the downgrade to Provisional II. It certainly belies her previous reports. 

NorCo's Human Relations Comm'n Members Confirmed

At last night's meeting, Northampton County Council confirmed the following appointments to the newly established Human Relations Comm'n. 

Sylvia Keverenge Bethlehem, PA 18015 

Grace Crampsie Smith Bethlehem, PA 18018 

Peter Hristofas Easton, PA 18042 

Victoria Opthof-Cordaro Bethlehem, PA 18015 

Jessica Teel Sadler Wind Gap, PA 18091 

Marc Singer Easton, PA 18042 

Patricia Baranowski Wind Gap, PA 18091 

Reginald Belon Easton, PA 18042 

Thomas Raymond Dubreuil Bethlehem, PA 18020 

Arlene Ifill-Leon Easton, PA 18042 

Elena Kenney Bethlehem, PA 18018 

Ron Moyer Easton, PA 18042

I omitted precise mailing addresses. 

The vote was 8-0, with Council member Nadeem Qayyum abstaining (He said "absent"). Qayyum argued that the appointments should consist of "protected" classes, even though Council Solicitor Matt Deschler explained that we all can be considered a "protected" class, depending  on the circumstances. He wanted to know, as he did in a committee meeting the previous day, how many of the appointments were persons "of color." He asked Executive Tara Zrinski whether she went to churches and temples to recruit candidates, something she said she did not do or feel obliged to do. She said her picks were as diverse a group as she could possibly choose. 

NorCo Council Confirms New Fiscal Director, but at a Lower Pay Than Proposed by Executive

 At last night's meeting, Northampton County Council voted to approve the appointment of Deb Watlington as the county's new Fiscal Director, but at a lower starting salary than what had been proposed by Executive Tara Zrinski. 

Zrinski's appointment would start Watlington at a salary of $125,108, and with benefits would give her a total compensation package of $164,923. 

While she agreed with the appointment, Council member Lori Vargo Heffner said that the starting salary should be $109,632 and proposed confirming the appointment at the lower rate. Her motion to amend was passed by a 5-4 vote, The Yes votes were from Vargo Heffner, Theresa Fadem, Tom Giovanni, Nadeem Qayyum and Dave Holland. Voting No were Council members Ken Kraft, Kelly Keegan, Jason Boulette, and Jeff Warren. 

At this lower rate of $109,632, Watlington's appointment was approved in a 6-3 vote. Voting yes were Vargo Heffner, Giovanni, Fadem, Holland, Boulette and Kraft. Voting No were Keegan, Warren and Qayyum. 

Before the vote, County Solicitor Melissa Rudas advised that the Executive has the right to hire a Fiscal Director at any salary she chooses, and that reducing the pay was an "exercise in futility." Vargo Heffner strongly disagreed, stating that Council approves the budget and corresponding salaries. 

This issue has arisen before. When he was Executive, John Brown knocked his Administrator's salary up by three steps without getting permission from County Council. Then Controller Steve Barron noted this increase violated Career Service Regulations (Section 4.01) that require County Council to approve any pay raise that bumps anyone up more than one step in the payscale.  The Home Rule Charter does specifically provide that County Council sets the wages (Section 202(11).

While Zrinski has the authority to award a one-step increase right now, it's unclear to me what authority she has to set a higher salary. 

Zrinski made clear in her introduction of Watlington that a higher salary was necessary to lure Watlington, a CPA, from Lehigh. So I fail to understand why Council went with a lower compensation package for someone who already is taking a pay cut. 

Zrinski Declines to Specify Race, Religion or Gender Identity of Human Relations Comm'n Members

During yesterday's NorCo Council Personnel Committee hearing, attended by five Council members*, a list of 13 nominations for the newly established Human Relations Commission was considered. Since I can only go by phonetic spelling of some of these hopefuls, I'll forego naming them until tomorrow. Things were going smoothly until member Nadeem Qayyum decided he had some questions. 

Qayyum, who has a very annoying habit of refusing to use his mike, decided he wanted to know how many of these selections are persons of color and wanted to know details like religion, etc. 

Zrinski, who is increasingly getting irritated by questions that Qayyum has written out in advance because his English skills are so subpar, said she declines "to specifically identify who is ... who is a person of color, who is Muslim, who is gay, who's trans. I am supposed to identify those individuals on this list? I would think that that is almost discriminatory."

I'd say it is definitely discriminatory.

"For the record, I need to ask these questions," explained Qayyum.

"Sure, sure, sure, sure, sure sure," responded Zrinski. "For the record, I'm not going to specifically identify people."

In the desire to be inclusive, we often make the mistake of being exclusive. 

_____

* This meeting was attended by Council members Nadeem Qayyum, Jason Boulette, Tom Giovanni, Dave Holland and Kelly Keegan.  

Pa DOH Downgrades Gracedale's License

Back in early May, NorCo Exec Tara Zrinski had good news about Gracedale, reporting that state Department of Health officials were very positive during the annual survey. Based on what she said, I expected to see that Gracedale's provisional license would be restored to regular status during a recent state licensure visit. Instead, that license has been downgraded from Provisional I to Provisional II. Though the county has been aware of this relegation, it has failed to make any public mention of it during any of the meetings since that time. This is not transparency. This is sweeping a problem under the rug and hoping no one notices. 

My understanding is that, at some point, Medicaid will refuse to reimburse nursing homes. This facility continues to move in the wrong direction. 

Zrinski Nominates a CPA as NorCo's New Fiscal Affairs Director

Northampton County Executive has nominated Deborah Watlington, a CPA, as the county's new Director of Fiscal Affairs. She was introduced at yesterday's Personnel Committee and is set for confirmation by County Council this evening. If confirmed, the county will finally have a Director of Fiscal Affairs for the first time since October of last year. 

Watlington, who as a degree in accounting and an MBA from Lehigh U, has been employed by Lehigh for the past 16 years.  She's worked in accounting for 30 years. She is currently Senior Financial Analyst in the Provost Office. 

She is one of 10 applicants for the job.  "I believe she will be an asset to the county throughout my tenure," said Zrinski. 

Qayyum, who earlier had reservations about the Human Relations Comm'n appointments and the salaries for Continuum of Care directors, had written questions about whether Watlington had direct government financial experience, but conceded she had good qualifications. 

He also complained about the proposed salary of $125,108. Zrinski responded that this salary is actually lower than what she was getting at Lehigh. His numerous objections are hard to report because he consistently fails to use his mike.

Finally, Council member Kelly Keegan interjected that "it seems like we're badgering a woman we're lucky to get." 

For once, I agree with her. 

A Trip Around the LV Blogosphere

For a time, the Lehigh Valley Blogosphere was pretty much a desert. Aside from Michael Molivinsky and your truly, few others were willing tor had the time to provide a local perspective. Thanks in part to Substack, that has been changing in recent years. 

Molovinsky on Allentown is an old fart who focuses primarily on Allentown, as his blog title suggests, although he does occasionally roam into other issues. Now if you read this guy, you might think he really must be some obnoxious asshole. But if you meet him in person, you'll soon realize you were right. Especially if you are employed by The Morning Call. Actually, Michael and I are friends. This is a matter of necessity because everyone else hates us. 

Lehigh Valley News Briefs is an excellent place for in-depth stories on what really is going on in our bizarre non-profit community, where entities like DaVinci, the Bethlehem Food Co-op and Lehigh Valley Public Media routinely con local officials into doling out our tax dollars for ventures that go nowhere. Publisher Jeff Ward is an accomplished alumnus of Bloomberg News. 

Armchair Lehigh Valley is made up of journalists and editors who at one time or another worked for the dailies. These folks have a lot of institutional knowledge about the Lehigh Valley that unfortunately is missing from what's left of our local newspapers. They do a great job of covering local campaigns and elections. Armchair's latest entry is a report about a complaint filed against Lead Left, a PAC that poured $1.7 million into the Pa.07 Congressional primary in an effort to keep Bob Brooks or Ryan Crosswell from getting the Democratic nod. 

Comm'r Ron Beitler is actually a Facebook page that gives us all a bird's eye view of what is happening in Lehigh County. Beitler is a thoughtful conservative who re-registered as an Independent recently and speaks out very persuasively on issues like Mark Pinsley's so-called "wealth tax". 

Upper Nazareth Township Meetings, penned by Becky Bartlett, is a no-nonsense news site that focuses solely on what is happening in Upper Nazareth. I envy Becky because, without any training, she can tell a story without government without opinion, the way that I and others just need to do. 

Apocalypse Vibes is written by Rich Wilkins, who at one time worked on Congressional races all over the country. He has a much better insight into congressional races than most of us. 

Allentown Truth is all about the inner workings of Allentown, written from the perspective of an anonymous person who really detests Mayor Matt Tuerk. His latest is that the City had a Blues, Brew and BBQ event at which no one showed. I don't know if that's true because I wasn't there. But if nobody was there, that should include the anonymous blogger who claimed no one was there, which would mean at least he was there.  

LVCI offers the perspective of a local Everyman who sees a strange world whiz by. Sometimes he laughs. Sometimes he cries. 

If there are other local blogs out there worth reading, please let us know in the comments. 

Pinsley's So Called Wealth Tax Under Fire

Blogger's Note: Below is an op-ed written by Lehigh County Comm'r Ron Beitler (Independent), Lehigh County Comm'r Antonio Pineda (Republican) and Phil Armstrong, former Lehigh County Exec, Democrat. 

Lehigh County Controller Mark Pinsley has proposed recycling an antiquated county intangible personal property tax by branding it a “wealth tax.” Once levied by counties in Pennsylvania, it disappeared 25 years ago for many reasons: legal challenges, administrative problems and broad acknowledgement that it was bad policy.

Most concerning, the current label of a “wealth tax” is a sales pitch. Political marketing. It makes the proposal sound narrow, targeted and aimed only at billionaires. That is not accurate.

This is not a tax exclusively on the ultra wealthy or the “Elon Musks” of the world. Plain and simple, it's a tax on personal financial assets. It hits common savings tools and certain small business ownership interests. Stocks, bonds, mutual funds and non-retirement brokerage accounts are all specifically named in the Controller’s report. The enabling law also raises unresolved questions about other useful family, retirement and estate planning tools, including custodial brokerage accounts, 529 college accounts and private mortgages held as assets. These are all tools working families, seniors, parents saving for their children and small business owners use to make responsible plans for their futures. As presented, this tax has no minimum income threshold. And adding one later may only deepen the legal problem because the 1913 law does not clearly give the County the authority to create one.

This is all part of the central problem. The public is being sold a narrow tax on extreme wealth, but the actual proposal reaches everyone. Repeating a misleading label does not change what the tax actually does nor does it change who it hurts.

This is not a Republican, Democratic or Independent concern. That is why the three of us, from different political backgrounds, agree on this point: Lehigh County should not revive a legally risky tax on savings, common investment tools and small businesses.

While some might dance around what this really is, others are more direct, describing this kind of saving as “hoarding wealth.” We strongly disagree. For generations of Lehigh Valley families, including people who worked hard their entire lives at places like Mack, Bethlehem Steel and other local employers, saving was not "hoarding wealth". These were not millionaires hiding money. They were working families taking responsibility for their futures, supporting children, driving modest cars, fixing what they could and planning ahead so they would not have to depend on the government later. That is basic financial discipline. We should encourage it, not punish it.

At a time when credit card debt is near record highs, younger folks struggle to save or invest, family sustaining jobs are harder to find, and basic costs keep rising, the answer is not to punish folks who manage to save. We should want people to work, save, invest and build security, not tax the same dollars a second or even third time because they planned responsibly.

The proposal also hits small businesses at exactly the wrong time.

Supporters claim owner-operated small businesses would be excluded, but Mr. Pinsley’s own report admits very common small business structures are actually the source of the majority of revenue. These are not exotic structures used only by the wealthy. They are common ways small businesses, especially family businesses, are organized.

Small business owners routinely work 50, 60 or more hours a week under pressures most never see: payroll, rent, insurance, utilities, supplies, repairs, maintenance, taxes, compliance, permitting, staffing and constant uncertainty.

For most small business “wealth” is not cash sitting in a bank account. It's tied up in equipment, inventory, buildings, debt, invoices and the business itself. On paper, a business owner may look successful. But in reality, many are fighting every month to make payroll, cover bills and keep the doors open, yet still find time and resources to sponsor youth teams, support fundraisers, and donate to fire companies, schools, churches, nonprofits and community events. This is exactly the wrong environment to pile another tax on small business owners and could force them to either cut back on their community support, or not grow their business.

The legal risk is also serious.

If this tax were clearly legal and clean, the county would not need outside tax counsel, as recommended by the Controller in his report, to find a constitutional workaround. This alone should raise alarms. This sounds less like confidence in the law and more like shopping for a legal theory to support the outcome they want. Passing a constitutionally suspect tax does not just invite a lawsuit. It would send taxpayers the bill.

Lehigh County should focus on controlling costs, delivering core services and encouraging economic growth.

This is not a bold new idea. It's a recycled bad idea that every county that once had it walked away from. Taxing savings discourages saving. Taxing investment discourages investment. Taxing small business ownership discourages growth, expansion, and job creation.

Do not be fooled. This proposal is not a so-called wealth tax. It is an asset tax. A broad tax on common savings tools and small businesses that punishes responsible behavior, creates huge legal risk and adds another burden at exactly the wrong time. Lehigh County should reject it clearly, publicly and permanently.

Commissioner Ron W. Beitler, Independent

Commissioner Antonio Pineda, Republican

Phil Armstrong, former Lehigh County Executive, Democrat

Gracedale - Four Deficiencies, Including Failure to Meet State Nursing Care Minimum ... Again

Since the beginning of this year, Gracedale nursing home has done its best to establish a very positive social media presence. It has highlighted Valentine Day, Mardi Gras, its executive chef, volunteers, a food truck festival, its employees and tuition assistance program and even its very own prom night. Without question, there are good things to say about the home and the people who work there. NorCo Exec Tara Zrinski has said she plans to unveil her long-range plans for the facility at the next Human Services Committee. The fact remains, however, that it still has issues. The home has been the subject of eight visits from the state DOH this year. On two of these inspections, Gracedale was cited for deficiencies.

The most recent published survey (they appear online 41 days after the event) was on May 1. The state DOH was there for four reasons: a Medicare and Medicaid Recertification; state licensing; civil rights compliance, and one complaint. Unfortunately, several deficiencies were found. (You can read them yourself).

Two residents were victims of Chemical Restraints. - Many nursing home residents suffer from dementia. Others may need antianxiety medication at times. But when it is prescribed, it must stop after 14 days unless the resident is re-evaluated by a physician. Two residents were being given these medications beyond the 14-day limit. 

The home failed to implement doctor's orders for four residents. -  These include a failure to take blood stool samples, failure to notify physician of dropping blood sugar as requested; administering blood pressure medication despite physician order that it be skipped if resident's heartbeat is too low; and failure to follow a doctor's order to provide a resident with a certain kind of boot that prevents bed sores. 

Inaccurate assessments - In at least two instances, nursing staff failed properly to document a resident's condition. In one case, nurses inaccurately reported that a resident had no falls when notes reflect he did. In another, a nurse incorrectly reported that a resident was receiving dialysis. 

Failure to provide minimum required nursing care. - Gracedale has been cited repeatedly over its failure to meet the state minimum nursing care standard, including earlier this year. It blew it again over one of 22 das reviewed. 

Zrinski has previously stated on several occasions that Administrator Michelle Morton is doing a good job. The facts tell a different story. 

Will this negatively impact Gracedale's effort to have its provisional license recertified to regular? Online, the home is still listed as having only a provisional, but as previously stated, there is a 41-day lag between real time and what appears online. 

Brooks Bash of Volunteer Firefighters Catches Attention of Washington Free Beacon

Like it or not, and I don't, Bob Brooks is the Democratic nominee for the Pa. 07 Congressional District, which includes Lehigh, Northampton, Carbon and a small part of Monroe County. Incumbent Republican Ryan Mackenzie, a Trump acolyte, lust know he's in trouble. But leave it to my party and the experts at the DCCC to pour in enough money to ensure that the shadiest of four Democrats has been proclaimed the party's standard bearer. Mackenzie is wasting no time in making sure that the entire Congressional district knows all about Brooks before November. He's getting some free help from the right-wing Washington Free Beacon, which purports to cover "the enemies of freedom the way the mainstream won't." 

The Beacon's Chuck Ross has some up with something I failed to cover during the primary, and that is Brooks' revulsion at professional firefighters who dare act as volunteer firefighters in their own communities. Ross points to angry social media posts from Brooks, calling them "scabs" and "shitbags." 

This country currently faces a severe decline in volunteer firefighters. The number of volunteers has declined about 25% over the past two decades, while emergency calls have increased 70%, particularly in the MidAtlantic.  The shortage is so serious that Lehigh and Northampton Counties both offer real estate tax rebates to volunteer firefighters. 

I understand that Brooks may have no issue with volunteer firefighters so long as they stay out of a municipality covered by a professional and unionized fire department. But does that make sense. The Lehigh Valley's three cities have all had major fires over the years during which volunteer firefighters from other municipalities assist. The most recent example of this is at an Easton hotel. Should a professional Easton or Bethlehem firefighter refuse to assist if he is also a volunteer at Plainfield's fire department and that company responds?  Should they just stand by and watch a building burn? 

Union solidarity is one thing. Public safety should trump it. 

A Little More About That NorCo Naturalization Ceremony

New Citizen with Exec Tara Zrisnki and Judges Dally and Clark

I closed out last week by telling you about a naturalization ceremony for 29 new citizens at Jacobsburg State Park. Northampton County has since that time published pictures of that happy event.

Naturalization ceremonies have always been a big deal in NorCo, but having the oath administered at Jacobsburg is a first.  The county's photographs show that President Judge Craig Dally and Judge Jeremy Clark did the honors. Mike Sanatanasto was there for the Bar Association. There was a cool-looking color guard, and some of the new citizens worse costumes that included Lady Liberty and the American (not Philadelphia) Eagle. 

OK, enough nice stuff.