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Greystale update: staffing hours, census and Medicaid delays shape financial outlook
Summary
County staff presented an operational update on Greystale nursing facility showing improved in-house hours (43% Greystale hours vs. 57% agency), patient-day staffing above the state minimum, lingering Medicaid pending receivables, and grants for dementia and safety projects.
A county presenter providing the Greystale update told the Human Services Committee on April 2 that the facility has made measurable staffing shifts and is pursuing multiple grants to improve dementia care and safety while average census remains below budget.
"We're getting close to that halfway mark which is significant because a year ago we were at 75%," the presenter said when describing the recent shift from agency-contracted hours to Greystale staff hours (current split reported as 43% Greystale hours, 57% agency hours).
The presenter said the facility's hours-per-patient-day (PPD) remain above the state minimum of 3.2 and that the facility has not been below the minimum since clearing a prior deficiency. Monthly admissions and discharges were reviewed along with paid resident days and average census figures; the presenter said careful clinical screening for risky behaviors accounts for some of the lower-than-budgeted census.
Financial slides showed month-to-date and year-to-date gains and losses. The presenter emphasized that a substantial balance in Medicaid pending dollars (MA pending) prevents the facility from showing a positive annualized financial position until those receivables are processed: "Once we get our Medicaid dollars, we actually would be in the black," the presenter said, noting approvals can lag more than 300 days.
Officials reviewed resident characteristics, highlighting that 85% of residents have a psychiatric diagnosis, which the presenter said affects some quality-measure comparisons to state and national averages. The presenter also said a prior incident last summer automatically lowered the facility’s public star rating to one for at least a year and that staffing-star impacts were linked to a past PBJ data submission gap.
Regulatory updates included seven Department of Health visits in the year to date, with only one visit resulting in a staffing-related violation that the presenter said the facility has cleared. Several grant-funded projects are underway or planned: a dementia-live simulation training package valued at $5,700, an infection-detection collaborative, Pelican grants for memory-garden door locks and improved camera systems, and new psychogeriatric services (PGS) to expand psychiatric assessments, medication management and a 24-hour crisis line.
The presenter said Greystale is also adding a second peer-support group (Peer Star) and continuing partnerships with on-site providers to address residents’ mental-health needs.
The committee closed the update and moved to adjournment; staff said they will continue monitoring admission trends, Medicaid receivables, and progress on grants and staffing targets.
