Starr Bradford’s mother, who has dementia, had lived at Northview Village for decades. So when the University City resident was scrolling through Facebook in December, she recognized a building in the background of a livestreamed video.
“At first I was like, wait, [that] looks like my mom's nursing home,” she said. “Then, I'm like, ‘that is her nursing home!’
“The residents, where did they get moved to? … Nobody had an answer.”
Public attention focused on a chaotic scene unfolding at the north St. Louis nursing home, one of the largest in the state. As the sun went down on Dec. 15, health workers from other facilities had begun hastily evacuating the facility’s 174 residents. The rushed closure continued into the early morning, according to a state report that recounted the facility’s final hours.
“I got dressed. And I zoom down there,” Bradford said. “I got down there, walked in, because the building was still open. But it was trashed.”
Without warning to residents or workers, Northview Village’s operators had closed the north Kingshighway nursing home. Several residents’ families had no idea where their loved ones had ended up.
Missouri Department of Health and Senior Services officials later said the closure jeopardized the health and safety of Northview's residents and staff. It drew the ire of politicians and activists for nursing home residents, who called for investigations into the owners and operators of the north St. Louis home and criticized the proliferation of facilities owned by out-of-state business interests.
But so far, it appears the only punishment has been a $56,000 fine from the federal Centers for Medicare and Medicaid Services.
Bradford soon found her mother had been moved to another St. Louis facility in Grand Center. Other families didn’t find their relatives for days. Police found one person with schizophrenia who walked away during the closure weeks later, at a restaurant around a mile from the closed facility.
‘There’s no excuse’
A state report detailing Northview's final hours explains facility managers shut the home down after its owners could not make payroll for their employees.
Two families, the Rothners and the Suissas, owned the majority of Northview Village, partly through trusts, according to CMS documents. Directors Lorraine and Mark Suissa and Eric Rothner did not respond to requests for interviews.
The shutdown upset family members of residents, said Jamie Opsal, executive director of the St. Louis City Senior Fund, a government office that distributes money to organizations that help older adults.
“I did speak with a daughter of one of the residents that said, ‘my mother has dementia, and I don't know where she's at,’” she said. “And she was just beside herself. She was scared. She was worried about her mother. And it was hard to hear.”
The St. Louis Area Agency on Aging, the city health department’s mental health board and other organizations quickly convened and approved funding for wellness checks and to replace residents’ belongings.
“[Case managers] were trying to provide just simple personal care items like sweatpants, like shoes, a jacket, combs for their hair,” said Anneliese Stoever, director of the Area Agency on Aging. “I mean, the items that people were requesting weren't huge items overall. Most of it was, 'I need clothing, I need undergarments, I was taken out without any shoes on.'”
Volunteers from VOYCE, a local ombudsman program for long-term care facilities, visited Northview after the facility closed. They said there were quilts still on the bed and shoes neatly lined up, as if residents expected they were going to come back soon, according to the organization's representatives.
Lawyers for Northview said in court documents that operators of the facility could not have foreseen the closure, since it was a result of employees walking off the job.
A former employee sued, claiming the closure violated federal workplace laws.
“[They] only announced a delay of funds, not that the facility was to be shut down,” Northview’s lawyers wrote. “The shutdown occurred as a direct impact of the looting and rioting of the employees.”
Industry watchdogs said it’s unlikely the owners didn’t know about the financial crisis facing the facility.
“This is not a hamburger stand where someday people stop showing up,” said Richard Mollot, executive director of the Long Term Care Community Coalition, which advocates for nursing home residents, in an interview earlier this year. “This is a nursing home that has been in operation for many years, has had a steady stream of funds. And you know the money is coming in, there’s no excuse for closing in this way.”
Who’s watching out for residents?
The Centers for Medicare and Medicaid Services, which reimburses facilities for the care residents receive, sets rules for nursing homes to follow and can issue fines or pull Medicaid payments.
CMS leveed the $56,000 fine on the Rothners and Suissas, citing an unsafe evacuation, administration problems and the facility’s failure to keep residents safe from hazards and accidents.
But that fine isn't enough to hold nursing homes accountable, said Sam Brooks, public policy director at the advocacy group National Consumer Voice.
“That's nothing to them,” he said. “That's the cost of doing business.”
Brooks said he was also frustrated with federal CMS regulators.
“They could take additional steps, not allowing them to license … [or] payment denials for Medicare and Medicaid,” he said. “But they continue to tolerate it.”
The Missouri Department of Health and Senior Services is in charge of inspecting long-term care facilities and issuing their state licenses. And the state attorney general’s office could sue owners or operators who run afoul of rules.
The Missouri attorney general’s Medicaid Fraud and Control Unit is investigating how Northview used Medicaid funds. A spokeswoman said the office is making sure former residents receive proper care in their new homes.
A DHSS spokeswoman said the department has been working with Northview’s former owners to monitor the other facilities they own in the state — examining employee payrolls and vendor payments and ensuring residents got trust refunds. State employees also conducted surprise visits to two facilities they owned in St. Louis.
If authorities don't take action, family members or residents could file lawsuits against the Northview.
A former employee, Carolyn Hawthorne, has sued the owners of Northview Village in federal court in St. Louis on behalf of its workers, claiming the business violated the WARN Act. Federal regulations require employers to give 60 days' notice to employees before mass layoffs or workplace closures in non-emergencies.
Court documents show lawyers for the Suissas and Rothner have asked the court to allow them to withdraw from the case, since the owners have stopped paying them.
In civil lawsuits against Northview in St. Louis and St. Louis County circuit courts, the city's collector of revenue is seeking $15,000 for unpaid personal property taxes and penalties, and the Advanced Elevator Co. claims the company owes $30,000 in unpaid bills.
While those cases make their way through the courts, family members of former Northview residents are trying to make sure their loved ones are cared for.
Starr Bradford wonders if her mom is safe in her new home. When Northview closed, workers moved her to Grand Manor, another facility in which Suissa had an ownership stake.
A new company, St. Louis-based Reliant Care Management, recently bought the facility. Bradford wonders if other homes could suddenly close.
“That's my issue,” she said. “If it can happen at Northview, who is to say that it cannot happen at this facility?”
According to Medicaid records, the Rothners and Suissa have ownership stakes in more than a half-dozen other facilities in Missouri and Illinois — including ones in Edwardsville, Maryville and Fenton.
