There was no warning when a line of vans showed up outside the largest nursing home in St. Louis Friday afternoon, workers at the home said.
Older residents, some with dementia, were whisked away in wheelchairs while still wearing hospital gowns, employees of the Northview Village nursing home recalled. Amid the chaos as Northview Village emptied its halls, younger patients, some of whom were being treated for injuries or mental illness, walked out into the street on their own, according to Carolyn Hawthorne, a registered nurse who had worked at the nursing facility for nearly 11 years.
“It was one big travesty,” she said of Northview Village’s sudden closing, which left relatives of some of the home’s 170 residents scrambling to figure out where their loved ones had been relocated. Ms. Hawthorne’s own aunt, 73, was among residents suddenly moved to facilities around the region. “It was just heartbreaking.”
The Missouri Department of Health and Senior Services, which regulates nursing homes, said that it had launched an investigation into the abrupt closure of Northview Village, though a representative for the agency said on Tuesday that it could not comment on the investigation.
A representative at Healthcare Accounting Services, which owns the nursing home, as well as several other care facilities in Missouri and Illinois, said on Tuesday that the company would have no comment.
The nursing home sector in the United States has grappled with overlapping challenges in recent years, including staffing shortages exacerbated by the Covid-19 pandemic, sicker patients and rising medical and supply costs. As a result, several facilities have become insolvent.
Northview Village had been losing money for several years, according to Medicare cost reports. According to SNFdata Resources, which tracks the nursing home sector, Northview Village had been losing money since at least 2018. Data that Northview Village provided to Medicare late last year said its operating expenses for 2022 totaled more than $16.4 million, while its revenue was roughly $13.3 million.
It is exceedingly rare for nursing homes to suddenly shutter. Usually, state regulators have some warning and can work with owners to arrange a sale or at least find new homes for residents.
In the case of Northview Village, employees and relatives said, there was no warning. Workers said they found themselves suddenly unemployed, even as relatives searched to find new facilities where their family members had been taken.
Lisa Cox, a spokeswoman for the Missouri Department of Health and Senior Services, said that state officials had no advance warning that the facility was facing dire financial problems, and that, as of Tuesday afternoon, some families still had yet to learn the whereabouts of their relatives because of the “emergent nature of the relocation.”
Outside the facility on Tuesday morning, Mayor Tishaura Jones of St. Louis joined a rally and led employees and their supporters in a chant of “Shame!”
“Shame on this owner for treating the people who live in this facility like pawns who can just be moved on a moment’s notice,” she said. “Shame on this owner for not paying the employees what they deserve and just shutting down this facility in the dead of night.”
The first inkling of the crisis came on Friday when workers said they had learned that they would not be paid, according to Marvetta Harrison, a certified medical technician who worked at the facility for 37 years.
Soon, the vans showed up.
“There was disbelief,” Ms. Harrison, 59, said. “It all happened so quickly.”
Ashley Denmark, a St. Louis doctor whose uncle lived at Northview Village, learned about the evacuation on social media. She and other relatives spent the weekend in a state of panic trying to find their uncle, who is 76 and an Army veteran who has schizophrenia.
“It was nerve-racking,” Dr. Denmark said. “He’s not someone who is able to advocate for himself or protect himself.”
Marjorie Moore, executive director of VOYCE, a St. Louis group that advocates long-term care residents and their relatives, said the residents were believed to have been sent to at least 14 other facilities in the region. Many rely on Medicaid, which can complicate effort to find them new homes, she said.
“These people were certainly not in good health and need a lot of care,” she said. “It’s almost like their entire world has been ripped from them.”
Northview Village had received a one-star rating, out of five, by a federal ratings system, grades that can be inflated, a Times investigation found this year. According to the U.S. Centers for Medicare and Medicaid Services, nursing staff at Northview Village had spent nearly two hours on each resident a day, about half of the national average.
In the past three years, the facility received more than 20 citations after inspectors investigated complaints. Since March 2021, it received more than $140,000 in fines for not meeting federal standards.
Lenny Jones, the Missouri state director of the Service Employees International Union, said that Northview Village had struggled with staffing shortages. In recent years, he said, younger people with mental illness and substance abuse issues comprised a larger share of the patients in the facility, compared with the mostly older population.
On Tuesday, the home’s workers were trying to find out if the company planned to pay them for their final weeks of work, even as they scrambled to apply for jobs and assistance.
“This was the paycheck they were expecting before Christmas,” Mr. Jones said.
Heidi Haywood, 42, a certified medical technician at the facility, said she had intended to spend her anticipated paycheck on a modest Christmas dinner for her six children.
“Now I have no job, no money and very little food left,” she said.
Alain Delaquérière contributed research.