Updated December 20, 2023 at 5:33 PM ET

The Northview Village nursing home shut down without warning Friday afternoon, displacing about 170 residents of the St. Louis facility. The privately owned facility housed aging adults, people with disabilities, and others seeking rehabilitative care, including mental health services.

Administrators told employees shortly before 3 p.m. Friday that the owners did not have funding to make payroll, Carolyn Hawthorne, a registered nurse at the facility, told St. Louis Public Radio.

Hawthorne later spoke to NPR on Wednesday. She has been a Northview Village employee for 11 years. Her 76-year-old aunt lived in the nursing home and was moved to another facility.

"She doesn't have a TV. Her wallet is missing. Her ID is missing ... she's uneasy," said Hawthorne, adding that she's devastated to see the community broken apart. "The residents have always been my family."

The sudden closure is raising serious questions and renewing longstanding concerns over care facilities and the steep challenges families and frontline workers face in the nation's care system.

The nursing home transported residents to several facilities, some without their families' knowledge. Many residents were forced to leave without their belongings.

St. Louis Mayor Tishaura Jones spoke at a rally with unionized workers from the nursing home outside of the facility on Tuesday. She's condemning the sudden closure.

"The owners of Northview Village should be ashamed of their abrupt decision to displace hundreds of residents and the frontline workers who care for them," the mayor said in a news release.

Employees say they learned they would not receive paychecks just hours before the closure. The Service Employees International Union (SEIU) represents 100 workers from the nursing home, including nurses, health aides, cooks and housekeepers.

Marvetta Harrison, a certified medical technician, has worked for Northview Village for 37 years. "The fact that they didn't tell us they were going to close shows how little they respect us, and how little they care for the residents who count on us to care for them," Harrison said in a union press release. "We will keep fighting for the compensation, severance pay, and paid time off that we are owed."

Northview Village is owned by Healthcare Accounting Services LLC, federal records show. NPR reached out to the business on Wednesday.

"Everything is in the hands of our lawyers at the moment," said a person who answered the phone. They declined to provide their name or the name or contact information for the lawyers.

Medicare gives the facility a one-star rating out of five, classifying Northview as "much below average." Medicare says the rating is based on health inspections, staffing and quality measures.

Health care union says owners "should be held accountable"

Lenny Jones, SEIU Healthcare Missouri state director, said the facility's owners "have uprooted the lives of hundreds of workers and residents with no warning, and they should be held accountable for these appalling actions."

"This is yet another example of nursing home owners across St. Louis prioritizing their own profits over workers and residents, which hurts our working families and communities," Lenny Jones added.

Groups that advocate for aging adults, people with disabilities, family caregivers and support workers say sudden closures of care facilities are happening more often.

"These situations are horrific, and while the immediate response needs to be about supporting displaced residents and workers in St. Louis, they point to a bigger conversation we need to be having, as a country, about where our loved ones want to age, and the system we need to build to get there," said Nicole Jorwic, chief of campaigns and advocacy for one such group, Caring Across Generations.

U.S. lawmakers propose boosting home care

Earlier this year, congressional lawmakers introduced the Home and Community-Based Services (HCBS) Act to boost funding to state programs and expand access to people who need these services. The bill would require state Medicaid programs to cover HCBS for eligible individuals.

"It is more cost effective than facility-based care, leads to better outcomes, and yet there are over 600,000 people on waiting lists for this care, and 53 million family caregivers filling in the gaps," Jorwic said. "So we need a home and community-based care infrastructure so if something like this happens, there is a support system in place to absorb folks impacted."

The federal Centers for Medicare & Medicaid Services said last month that it has been increasingly concerned about the quality of care at nursing homes, especially those owned by private-equity companies and other types of investment firms.

New CMS regulations take effect in January 2024, requiring the disclosure of certain types of nursing home ownership, including private equity firms. CMS says the changes will give the agency and states a more complete background on organizations and individuals that own and operate nursing homes.

A state investigation is ongoing

The Missouri Department of Health and Senior Services is investigating the closure of Northview Village. It tells NPR it can't comment on the ongoing investigation. MDHSS spokesperson Lisa Cox says the agency received notification of the unfolding situation Friday afternoon, as the facility was removing residents from the property.

"The facility operators were working to implement their emergency evacuation plan, and local EMS assisted with the relocation of approximately 170 residents," Cox said in a statement to NPR. "Our team remained on site monitoring the evacuation. The final resident left the facility before 6 a.m. Saturday."

Mayor Jones is calling for swift action.

"While we wait for the State of Missouri DHSS to hold the ownership accountable, the City of St. Louis' employment agency SLATE is arranging an emergency hiring fair to help these workers continue their careers. St. Louis remains steadfast in our support for protecting and supporting our healthcare workers," the mayor said in a statement.

The SEIU says it's working with elected officials, and community and faith leaders to ensure workers and displaced residents receive assistance during the holiday season.

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