On Friday, December 15, Northview Village Nursing Home, the largest nursing home in St. Louis, Missouri, closed abruptly, leaving 175 residents to be rehoused by the state. Around 160 workers were also left without a job and without their latest paycheck. 

While facilities are required by the state to give 60 days notice before closing, Northview Village officially closed on Friday afternoon with no prior warning and the last resident was moved on Saturday at 6 a.m. The state was called in to rapidly relocate residents to at least 15 different facilities across the area. Receiving nursing homes reported that residents arrived with only the clothes on their backs and no medical paperwork or medication. 

Family members and friends of residents were not notified until Saturday that residents had been moved. In most cases, families had no idea where their loved ones were and were left to call local facilities one by one in an attempt to find them. 

Photographs of the abandoned Northview Village Nursing Home paint a picture of how quickly residents were evacuated. Photos show residents’ belongings and medical supplies left behind, card games laid out on tables and TVs still on. One photo shows a room of empty electric wheelchairs which are very expensive and customized for the specific needs of a disabled individual.

Northview Village was made up almost entirely of Medicaid patients. Medicaid-heavy nursing home facilities have some of the worst conditions as Medicaid patients garner low reimbursement rates from the federal government. Nursing home owners are then incentivized to attract more patients paying privately, which reimburses providers at a higher rate than Medicaid, or to admit more Medicaid patients regardless of the resources and staff available.

Given the low payout from working class and poor residents these facilities have to operate on a shoestring budget in which the little money they are receiving is often siphoned off to the benefit of the owner and investors in the facility. As a result, many facilities that take Medicaid patients tend to be overcrowded, understaffed and under-resourced. More and more Medicaid facilities across the country are under threat as the federal government reimbursement rates cover only about 80 percent of the cost of care.

As documented by the Centers for Medicare and Medicaid, Northview Village had over 12 federal violations since March 2021 and holds a one-star rating. There have been many complaints from staff, residents and their families, prompting 24 investigations by the state since 2016. 

Northview Village workers first grew suspicious when they arrived for their shifts Friday morning to find they were not receiving their usual biweekly paycheck. Some workers left when it became clear that the administration had no concrete answer for the missing paychecks. Workers were notified later that day that the facility had run out of funding and was closing that day. Workers have still not received their paychecks. 

Workers reported that there was no advanced warning of the closure. Certified medical technician Marvetta Harrison told the St. Louis Dispatch, “This is really wrong. I have worked in that building for 37 years. Not only did they mistreat us, they mistreated the residents we take care of.” 

Workers informed reporters that they were given a number to call to request payment, but workers are placed on indefinite hold when they call. 

Nursing home workers are low-paid and often rely on overtime hours to support their families. The average starting pay for a Certified Nurse Assistant (CNA) in St. Louis is $17.75 an hour and the state minimum wage is $12.00 an hour.

Angela Hendeson, who worked at Northview for 40 years, told St. Louis 5 local news, “People don’t know how they are going to eat. How they are going to pay their bills or anything.”

Northview is owned by Healthcare Accounting Services LLC, which is owned by Mahklouf “Mark” Suissa from Chicago, who owns nine other nursing homes across Illinois and Missouri. 

One day after the sudden closure, Healthcare Accounting Services issued a letter to employees explaining that the company is not responsible for the workers’ lost employment and pay. The letter sought to shift the blame to unknown “other partners” without further explanation. “Though Northview is a part of Healthcare Accounting Services and under the umbrella of ownership of Mr. Suissa, this particular facility is also owned by other partners.”

This subterfuge speaks to the complex systems of ownership in the nursing home industry, with many facilities owned or heavily invested in by private equity firms and Real Estate Investment Trusts. It is also commonplace for nursing home owners to outsource goods and services with companies that they themselves own or invest in, further boosting their personal profits. 

While nursing home owners seek any means to increase their profits and dodge culpability, nursing home workers continue to be some of the most oppressed workers in the healthcare system. Care tasks are physically demanding and staffing levels are abysmal. Nurse-to-patient ratios of 1:30 or 1:40 are not uncommon and nursing assistants struggle to find the time to feed, bathe and toilet residents. Workers are often lacking the most basic supplies, such as wet wipes, linens and adult diapers. 

The onset of the COVID-19 pandemic has greatly exacerbated and exposed nursing home conditions. Throughout the pandemic, numerous incidents have shocked the public, from the admission that 800 patients and staff at Brighton Rehabilitation and Wellness Center in Pennsylvania had been infected to the gruesome discovery of 17 corpses piled up in a New Jersey nursing home. A recent investigative report by the Detroit News exposed over 167 complaints related to staffing and infection control at 67 nursing homes in the Detroit area. 

Nursing home workers have been striking in greater numbers, joining the broader movement of healthcare workers fighting against poor staffing, unendurable workloads and falling wages. In July, 4,000 nursing home workers in Los Angeles held a series of eight pickets to protest severe understaffing. In October, 250 nursing home workers in Metro Detroit went on a two-day strike to protest worsening conditions and high staff turnover rates. 

The sudden closure and relocation of residents is the last in a long string of abuses suffered by Northview Villages residents. This poor quality of care is commonplace in nursing homes and exposes the failure of the American healthcare system to take care of its elderly and infirm. The Northview Village abrupt shutdown calls to the forefront the need to organize the fight for socialized medicine, eliminating the profit motive from healthcare and reestablishing it on the basis of human need.