EASTON, Pa. — A new strategic plan for Gracedale, the county-owned and -operated nursing home, aims to boost revenue, cut expenses and fill hundreds of vacant staff positions.
Northampton County officials shared the plan County Council's meeting Thursday.
Since the COVID-19 pandemic, the home in Upper Nazareth Township has struggled to retain nursing staff. Currently, only 20% of Gracedale’s nurse and nurse aide positions are filled, administrator Michelle Morton said.
“They are taking such advantage of us, and the bleeding has got to stop.”Northampton County Commissioner Kelly Keegan
By law, the home must maintain a set ratio of staff to residents. To make up for missing employees, administrators hire temporary nurses from staffing agencies at a much higher hourly rate.
“They are taking such advantage of us, and the bleeding has got to stop,” Commissioner Kelly Keegan said of the staffing agencies.
Morton’s first order of business is to improve recruitment and retention, according to a new strategic plan for Gracedale presented Thursday.
Administrators aim to fill 70% of all positions by the end of 2026; as of a few months ago, only 41% were occupied.
Full staff, 'lean management'
To attract more workers and keep existing employees longer, administrators plan to revamp hiring and onboarding processes, create new ways to recognize top staff and create recognition and engagement programs for workers.
Administrators also will create programs to combat bullying among staff; according to Morton, some departing employees have said they left because of mistreatment from coworkers.
Gracedale’s leaders said they hope relying less on expensive agency nurses will help buttress the home’s balance sheet. Morton hopes for Gracedale’s income to cover all of its expenses by the end of 2026, she told County Council.
To further reduce expenses, the home’s administrators plan to implement “lean management,” a framework for cutting costs by reducing waste, improving efficiency and focusing on creating value.
Morton’s strategy for ensuring the home’s fiscal health also means boosting income, chiefly by drawing more residents to the home.
To that end, Gracedale will build relationships with hospitals, whose referrals often determine where patients go to get lucrative short-term rehabilitation care.
The home could also offer new services, including dialysis.
Achieving better ratings
Administrators plan to attract more residents by improving Gracedale’s quality ratings, including their Centers for Medicare and Medicaid Services star rating.
That represents a reversal; County Executive Lamont McClure previously said the home would not prioritize chasing a higher-star rating.
Currently, despite a three-star overall rating, CMMS gives Gracedale one out of five stars for quality measures, short-stay quality measures and long-stay quality measures, which assess certain clinical data to evaluate a home’s care.
Leadership aims to achieve a four-star quality measures score.
Billing practices, too, will get a revamp to “optimize financial reimbursement” from insurers or programs such as Medicaid, which often pay for residents’ stays.
Gracedale’s new strategy also identifies potential challenges on the horizon: rising costs to provide care, potential changes to reimbursement formulas that could hurt revenue, and “public scrutiny/opinion/perception.”
