Despite recent citations from the state Department of Health, Northampton County leaders in charge of Gracedale Nursing Home say the county-run facility is moving in the right direction.<\/p>\n
Gracedale\u2019s administrator, Michelle Morton, said the facility has largely corrected deficiencies cited in May 2026 Health Department reports. At the same time, Northampton County Executive Tara Zrinski is set to unveil a plan that would transform the Gracedale campus, preserving its role in the community while improving and expanding it.<\/p>\n
\u201cGracedale can be treated as a strategic public asset rather than a passive expense,\u201d Zrinski said in a post on her Substack<\/a>. \u201d \u2026 The county can use Gracedale to serve both present-day residents and the long-term stability of the county\u2019s continuum of care system in this new era we are building.\u201d<\/p>\n Morton, who was named administrator for Gracedale in April 2025, said the issues highlighted in state reports are largely emblematic of problems that existed before she took over the facility, and not its current direction. She added that Gracedale now has letters from the state showing that it is in full compliance with all rules and regulations.<\/p>\n The Department of Health does not provide comment outside of what is already in reports. However, it told The Morning Call that in June, Gracedale was upgraded to a provisional license II by the department, indicating that though there were deficiencies present during the most recent review, Gracedale was taking adequate steps to address them.<\/p>\n What the state found<\/p>\n Earlier this year, Gracedale was cited by the Pennsylvania Department of Health for deficiencies related to understaffing, improper medication administration, allowing residents to leave the facility without permission, and for a resident bringing dangerous or forbidden items onto campus after returning from a permitted leave.<\/p>\n One incident, in which a resident brought a knife on to campus, constituted an immediate jeopardy situation, the most serious determination possible from a safety inspection, and one that can result in facilities losing Medicaid and Medicare certification if they do not remediate issues as soon as possible.<\/p>\n Gracedale previously was placed on a provisional license I by the state and its Medicare rating was downgraded to one star after a series of safety reports were issued over the course of 2025<\/a>.<\/p>\n A report published May 14 by the state documents the immediate jeopardy incident. According to the report:<\/p>\n A resident was admitted to Gracedale in September 2024 with chronic pain syndrome and a history of substance use issues related to alcohol and opioids.<\/p>\n Under a doctor\u2019s orders, this patient was allowed to leave the facility and would frequently take a bus off campus to go on day trips, but he was not allowed to leave with his medication. Clinical records revealed that this resident would often keep pain medications in his mouth for later instead of swallowing them, so staff was ordered to monitor him and ensure he swallowed them, and to report it to the provider if he refused.<\/p>\n In 2026, it became clear the man was having substance use issues again. During a room cleanup, a nurse found an unopened alcoholic beverage. On another occasion, a nurse noted he \u201csmelled of alcohol, his face was red, flushed, and sweaty,\u201d and he was holding a bottle containing a clear liquid. He told the nurse the smell was his cologne and the liquid was mouthwash. Yet another time when a nurse warned him about drinking alcohol while taking scheduled narcotics, he replied, \u201cI am a biker, that\u2019s what we do; we drink, smoke, play pool, and party.\u201d<\/p>\n A physician spoke to the resident about his drinking and then discontinued several of his medicines for safety reasons. It was ordered that he continue receiving oxycodone but be monitored even more closely. On April 2, it was ordered that he be placed on one-to-one supervision.<\/p>\n On the afternoon of May 5, the resident returned to Gracedale after an independent leave of absence. A nurse noted he was intoxicated \u2014 his gait was unsteady and uncoordinated, he was sweating profusely, his speech was slurred and he was being verbally aggressive.<\/p>\n To prevent him from causing a further disturbance, he was taken outside to the smoking area while staff and the resident\u2019s one-to-one observer tried to defuse the situation. The resident continued to act belligerently and aggressively, causing other residents to become frightened and leave.<\/p>\n Around 3:13 p.m., a physician ordered that the resident be sent to the emergency room. About 15 minutes later, the man fell and hit his head. He was taken by emergency services just before 5 p.m. While a nurse was trying to transfer the man to a stretcher and clean up the area, they found multiple marijuana vape cartridges, one bottle of vodka, three empty bottles of whiskey, a large hunting knife, a wallet with cash and cards, and a container of untaken, prescribed medications that he had stockpiled. The police confiscated the vape, cartridges and knife.<\/p>\n According to the state, the patient\u2019s possessing marijuana vape cartridges, alcohol and a knife created the immediate jeopardy situation.<\/p>\n The next day at 2:12 a.m., the resident returned to Gracedale. He was upset, yelled at staff and woke his roommates to ask where his wallet was. A nurse who walked into his room saw the resident repeatedly inhaling a white powdery substance over a table. After seeing the nurse, the resident grabbed antifungal powder, poured it over the substance and told the nurse it was now antifungal powder.<\/p>\n According to Gracedale, after these events, the resident was forbidden from taking leaves of absence; he was taken off oxycodone and placed on suboxone and a lidocaine patch instead. He also was to be monitored for symptoms of withdrawal.<\/p>\n It is unknown if the man is still a resident at Gracedale.<\/p>\n In another incident, a different resident left the facility without anyone finding out for several hours, according to the state report.<\/p>\n That resident had been admitted Dec. 22 with diagnoses of bipolar type schizoaffective disorder, diabetes and chronic kidney disease.<\/p>\n This resident was regularly administered psychiatric medications, as well as medications for hypertension and muscle spasms. They also had their blood sugar levels checked before meals and at bedtime.<\/p>\n Though the patient had impaired cognitive function, some recall difficulty and experienced \u201cinstances of delusional thinking,\u201d a physician determined that the patient was able to leave the nursing unit so he could smoke unsupervised.<\/p>\n However, on May 13, the patient left the facility without authorization around 5 p.m. and did not return for several hours. In an interview, Morton said that this patient did not leave on their own and was instead taken off campus by the visiting family member of another resident.<\/p>\n While the patient was gone, a nurse documented results for the resident\u2019s blood sugar at 8:34 p.m. twice. The resident\u2019s record showed they were reported missing around 9 p.m.<\/p>\n Just after 10 p.m., an officer from an unnamed local police department called Gracedale to tell them that the resident was standing outside the police station. The nursing supervisor did not know that the resident had gone missing.<\/p>\n Then, at 10:34 p.m. and 10:39 p.m., the same nurse who documented the man\u2019s blood sugar struck out the results and instead documented that the resident had declined. The director of nursing later confirmed to state inspectors that the nurse had falsely documented the patient\u2019s blood sugar and then altered the clinical record after police called.<\/p>\n The resident returned to the facility at 1 a.m. May 14. According to Gracedale, after the incident, this resident was moved to a secure unit and a wander guard was placed on that unit. Speech therapy was also requested so that more thorough cognitive evaluations could occur.<\/p>\n Gracedale also was cited once in January, for failing to meet minimum staff ratios for certain shifts or nursing care hour requirements, and on May 1 for deficiencies related to medicine administration, accurate documentation and staff-to-patient ratios.<\/p>\n Gracedale\u2019s response<\/p>\n In response to the citations, Morton said, Gracedale instituted correction plans, changed policies and increased education for staff.<\/p>\n Morton said the resident\u2019s May disappearance was an exceptional circumstance, after the resident approached a visitor for a ride.<\/p>\n \u201cWho would ever think that a family member would listen to a resident who says, \u2018Hey, can you give me a ride to Easton?\u2019 And the family member said, \u2018Yes.\u2019 And took him and dropped him off. Like, who would have expected that?\u201d Morton said.<\/p>\n After this incident, Gracedale made multiple efforts to educate visiting families that taking another resident off campus is not allowed, Morton said.<\/p>\n Gracedale also told the state, as part of its correction plan, that it would more thoroughly monitor residents who were not at risk of eloping or were free to smoke while unattended, while continuing to allow them to move throughout the facility. Each unit of the facility would check on these residents during morning care, meals, medication administration, evening care and an hour before the end of each shift to ensure that they are accounted for. A protocol also was established for handling patients not on their unit during those specific times.<\/p>\n Morton added that the situation with the resident who brought the knife onto campus was complex, and multiple factors led to it occurring.<\/p>\n In part, she said, Gracedale had stopped evaluating whether they could meet the needs of new admissions and was accepting most residents who were sent to them.<\/p>\n She said this led Gracedale to have a large share of younger residents with behavioral health problems. Gracedale is not a behavioral health facility, however, and it isn\u2019t always equipped to meet these patients\u2019 needs, nor is it an appropriate setting for them in most cases. However, with a lack of inpatient behavioral health centers in the community, there is nowhere for these individuals to go.<\/p>\n Morton said residents\u2019 rights at a nursing home are important and the facility isn\u2019t allowed to violate them. Residents of Gracedale are just that \u2014 residents, not inmates at a jail.<\/p>\n \u201cFor example, the man that had the knife \u2014 we\u2019re not allowed to search residents\u2019 rooms and properties,\u201d Morton said. \u201cThey have the same rights as is any other citizen of the United States. We can\u2019t just go in and search. We can\u2019t just tell everyone you can never leave. We try to do that on a more individual basis, so the gentleman who was going out and about, he had orders from his physician that he was capable of having an independent leave of absence on his own. So, he was going out every day.<\/p>\n \u201cAnd I think that\u2019s a good example \u2014 how do you need a nursing home if you\u2019re capable of taking the bus and going out and about all day long and then coming back at the end of the day? But again, there is nowhere else for these people to live.\u201d<\/p>\n Morton said Gracedale has become more selective about admissions. Under her leadership, Gracedale reinstated its red, yellow, and green checklist for admissions. Under the system, green means an applicant can be admitted without needing any additional approvals, yellow means staff needs to evaluate whether Gracedale can meet the potential resident\u2019s needs before acceptance, and red means a resident is outside the scope of what Gracedale is capable of dealing with.<\/p>\n \u201cWith admissions when I arrived, we were saying yes to everyone,\u201d Morton said. \u201cWe have a mission to take care of residents in our county and we pride ourselves on taking care of people that sometimes have nowhere else to go, but at the same time we still need to manage our risk and be sure that we\u2019re taking care of that resident as well as keeping other residents around that person safe. We haven\u2019t had any trouble with people that we\u2019ve admitted since then.\u201d<\/p>\n In response to the incident involving the knife, Gracedale told the state that it altered its leave of absence policy to require residents be evaluated for signs and symptoms of intoxication when they return. If they appear intoxicated, staff will attempt to search them for contraband. Residents who refuse will have their leave of absence privileges revoked and be placed on one-to-one supervision until the matter can be reviewed with the interdisciplinary team, the resident\u2019s physician and the medical director.<\/p>\n Policies were also changed related to residents who are not swallowing medications and those who have a diagnosis or history of substance use disorder.<\/p>\n Staff were educated and reeducated on existing and new policies related to the deficiencies found in the report. Audits were completed of the daily patient census sheets and leaves of absence for residents with identified risks.<\/p>\n The future of Gracedale<\/p>\n Morton said Gracedale is meeting its state-mandated staffing minimums and that the number of staff members has grown since a year ago. Staffing is still a challenge, though, as it is at nursing homes across the country due to Medicaid reimbursement issues.\n<\/p>\n \u201cWe have a very high percentage of Medicaid residents and the process for Medicaid approvals takes pretty long,\u201d Morton said. \u201cIt\u2019s almost a year. So we have a lot of residents for whom we\u2019re not getting paid yet.\u201d<\/p>\n She said on paper, it appears like Gracedale is losing money, but in reality, that is because the patient census recently increased but it is not yet able to be reimbursed for those new residents.<\/p>\n Morton and Zrinkski, in an interview, said Gracedale\u2019s one-star rating on the MedicareCompare website <\/a>is not reflective of the current state of Gracedale, because it\u2019s based on data dating to April 2025, when the nursing home was struggling.<\/p>\n \u201cYou\u2019re not going to see the results of that right away,\u201d Zrinski said. \u201cSo we might take another year until we see the health inspection rating go back up.\u201d<\/p>\n Morton said that Gracedale\u2019s quality measures also are frozen because of an incident involving a nurse<\/a> who attacked a patient last June.<\/p>\n \u201cThat was a horrible, horrible instance but \u2026 who could have predicted that a nurse was going to have a mental breakdown in the middle of her shift? She was fairly new in our building. I think it was her fifth shift,\u201d Morton said. \u201cWe didn\u2019t know her well, but she seemed OK at the beginning of her shift. We do the proper screening. Actually, we do above and beyond the state-required screenings for agency [staff] and our own staff.\u201d<\/p>\n She said that after the fact, they were informed by the state that they had done everything they could.<\/p>\n Morton said Gracedale is not the disaster zone it has been portrayed as in recent media coverage, and one of the things that helps her know Gracedale is moving in the right direction is all the positive feedback she hears from staff.<\/p>\n \u201cI had a team member approach me today. She\u2019s been there four years,\u201d Morton said. \u201cShe came in and she goes, \u2018I want you to know I\u2019ve been reading the newspapers and the blogs and it\u2019s such a shame that this happens because I\u2019ve been here four years and you\u2019ve done more in just the last year alone than anyone ever did.\u2019 \u201d<\/p>\n The county is looking to the future, too.<\/p>\n Zrinski recently unveiled a plan for the future of the Gracedale campus. It would include a new 700-bed, skilled nursing facility, a medical office building, a dialysis center, residential housing for the Gracedale workforce and shops. The original Gracedale would be renovated and converted into supportive living and aging-in-place apartments. There would also be childcare facilities, making it a multigenerational campus.<\/p>\n