McClure questioned about Gracedale
In January, the state Department of Health released its annual inspection of Gracedale, Northampton County’s nursing home. It cites 11 deficiencies directly related to resident care. Medicare now lists the home as a two-star, or below average, nursing facility.
This is in stark contrast to the five stars (much above average) assigned to Lehigh County’s Cedarbrook. Executive Lamont McClure has pointed his finger at Premiere, the private nursing home manager hired under the Stoffa administration. He terminated the county’s $500,000 a year contract late last year, and is using an in-house administrator. This decision, along with current conditions at the home, were considered by Northampton County Council’s Human Services Committee Feb. 21.
Interim Administrator Jennifer D. Stewart-King reported on conditions in December, when there were about 665 residents.
- Over $200,000 was paid to outside agencies for nursing care.
- The number of bedsores was a net of 53. (They do not count residents who have them when they arrive).
- There were 119 reportable infections.
- There were 332 incident reports.
- There were 172 falls.
She advocated for electronic health records, noting they are in use at Cedarbrook. She acknowledged a need to institute pain and wound committees as well, saying employees were ignored when they asked for these things in the past. “[County Executive]. McClure was the only one who heard us,” she said.
McClure may have listened to some employees, but he also fired the Director of Nursing. She was a county resident who was Director of Nursing at the more highly rated Cedarbrook. In a letter she sent to County Council last year, she explained what happened to her.
“Gracedale has been neglected for years. Not just the last four years but for many decades. The outdated and appalling status of the living conditions for the residents of Gracedale actually brought me to tears the first time I saw the cinder block walls and furniture obviously from decades ago. The resident mattresses had not been replaced for years (actually no one could tell me when), leading to resident skin pressure injury. An assessment revealed these mattresses were no longer offering any pressure reduction. The mechanical lifts recently assessed found 22 lifts were in poor condition. The most vulnerable of our population have been ignored and the taxpayers should be appalled as I was. However, my goal was to work to improve the conditions and the mattresses have been replaced, some furniture has begun to be purchased and the next step was to begin mechanical lift replacement. The ultimate goal being to develop a purchasing replacement plan yearly to assure that this would never happen again.
“I knew the position would be a challenge, and I happen to love a challenge that works to improve the lives of residents in long term care. So imagine my response in early December when I received a letter from the new county executive-elect that stated, “this past November our voters spoke loudly and issued a mandate for change.” It went on to say “ I write at this time to inform you that you will not be re-appointed to your position in the new administration” and “your last day of employment with the County of Northampton will be January 1, 2018.”
McClure hired a new director of nursing, but she suddenly changed her mind. As a result, Gracedale had no director of nursing until July. The person who was hired had no experience at a nursing home. She told council she would transform Gracedale into a five-star facility. It remains a two-star home with a negative health inspection.
McClure’s decision to remove Premier as an outside manager was challenged by council members John Cusick and Bob Werner.
Cusick noted that when Premier took over, the county was paying $6 million to fund the home. Premier turned a $6 million deficit into a $3.3 million operating surplus.
“I think that is a big plus,” observed Cusick.
McClure responded that Premier prioritized cost over care and ruined morale. “They were tasked to run the home so there would be no county contribution,” he asserted.
Werner asked whether the county had ever looked at the operational assessment done by Premier. Human Services Director Sue Wandalowski acknowledged she was unaware of it. Werner then asked McClure whether he performed an operational assessment before terminating Premier. McClure said he performed no operational assessment.
“How did you determine you were going to do a better job without a plan?” asked Werner.
McClure said his decision was based on interviews with county employees, as well as the $500,000 Premier charged every year.
Though he didn’t mention it, McClure has been concerned that Premier’s record at other public nursing homes has been the subject of negative surveys and complaints.
Council President Ron Heckman concluded Gracedale needs more attention. He noted that in the past, there were bi-weekly meetings to provide oversight.
“We as a group have to think about the largest department in our county with the largest number of residents and the most employees,” he said.
And then they adjourned.