Marvin Querry, 86, was on his tractor planting rye on his 770-acre farm in western Missouri when the call came in early November.
It was the social worker from the Barone Alzheimer’s Care Center, where Querry’s wife, Diane, resides. The plant would close due to financial difficulties, she said, reading from a statement.
It was a painful moment for Querry, a retired physics professor and former dean of academic affairs at the University of Missouri-Kansas City. “I was shocked,” he said. “Where could I find another place so wonderful to look after Diane?”
It’s rare to hear people talk about a nursing home as they talk about this 40-bed facility in Nevada, Missouri – a city of nearly 8,300 people near the Kansas border – with deep devotion, respect and gratitude.
“We could not ask for a more loving and thoughtful staff than those working at Barone,” wrote a woman whose mother lives there, on a petition to save the facility. In a company where staff turnover is constant, many of Barone’s employees have been there for five years or more.
“The care there, it goes beyond words,” said Kay Stevens, whose 94-year-old mother moved into Barone in May. “The residents are treated so well and it’s such a happy environment.”
But even an excellent reputation and deep community support cannot overcome a stark reality: The future of nursing homes is deeply uncertain as older adults and their families shy away from care in these institutions, where nearly 142,000 residents have died of covid-19.
With ongoing expenses related to the pandemic and empty beds, 54% of nursing homes report operating at a financial loss, according to a national survey released in June by the American Health Care Association, a long-term care organization. Only a quarter are convinced they can handle it next year or longer. At least 134 nursing homes closed their doors in 2021, on top of 170 closures in 2020.
Although covid aids have helped many nursing homes in the short term, “things are much more uncertain going forward,” said David Grabowski, a professor of health policy at Harvard Medical School.
Baron’s fortunes reflect these broader trends. Before the pandemic, all 40 beds were full and there was a waiting list of 25 people. About 60% of patients paid privately for care; the other 40% were on Medicaid, the government’s program for poor people. The facility made money even though it was not much.
Then covid began to circulate, and an outbreak of 32 covid cases and four associated deaths in the weeks following Thanksgiving in 2020 created enormous stress. Querry’s wife, Diane, 76, was one of the residents who fell ill, but she recovered.
Between January and October last year, Barone’s financial loss totaled $ 675,318, according to data from William Denman, city treasurer of Nevada, who owns the facility. Even more alarmingly, another city-owned nursing home, the Moore-Few Care Center, which has 108 licensed beds, lost more than $ 1.1 million in the same period.
Moore-Few, which does not include a locked area for patients with dementia, experienced a covid outbreak after an employee came to work with symptoms in October 2020. In the following weeks, 47 residents contracted the virus, and 10 died. A subsequent investigation resulted in an “immediate danger” quote from the Centers for Medicare & Medicaid Services, a signal of serious problems that pose a risk to residents and require prompt action, and a fine of $ 144,693. Investigators found that the nursing home had not screened staff adequately for covid or prevented them with symptoms from working.
Since then, about half of Moore-Few’s beds have been empty.
Financial and operational problems of this nature “can not continue,” said Denman, a retired businessman who grew up in Nevada. “We’ll lose both of these homes if we do nothing soon.”
But there is great disagreement about how to move forward.
Marvin Querry has become an activist – a role he had never expected to play at this stage of his life – and led to opposition to Baron’s closure.
The day after he heard about the proposal to close the home, Querry asked several pointed questions at a five-member board meeting overseeing Nevada’s nursing home. More than 100 members of the local community attended the meeting, many of them angry and saddened. The board ended up presenting plans to vote on the home closure so far.
A few days later, Querry, with the help of his daughter, created an online-change.org request requesting detailed financial information about Nevada’s nursing homes and protesting against Baron’s closure. Within a month, it had collected more than 1,500 signatures.
Querry also attended city council meetings and ran ads in the local newspaper three times a week with the petition. “I’ve spent almost $ 3,000 on these ads. I’m willing to spend $ 30,000 – or more – because of the care [at Barone] is unsurpassed. “
He wants nothing less for Diane, 76, whom he has been married to for 47 years and who has lived in Barone for two years. Every night, Querry goes there to eat his dinner.
Karen Hertzberg, who owns a local furniture store and whose husband, Steve, 68, moved to Barone in September, feels just as much about saving the facility. “We need time for conversation, for research, to find funding,” she told me. Steve has severe sclerosis with related cognitive dysfunction and is completely dependent on assistance.
One option could be a new city tax that would pay for Nevada’s city-owned long-term care facilities. When the city’s hospital faced financial problems several years ago, voters passed a dedicated tax. It generates about $ 800,000 a year for the hospital, whose financial difficulties continue.
“We came together to save the hospital, so why not save our seniors? We have to stand up and fight for this,” said Jennifer Gundy, a lifelong Nevada resident and CEO of On My Own, a center. which helps older adults and people with disabilities to live independently.
But what if current trends continue beyond the pandemic? What if families shun nursing homes and keep their loved ones at home? And what if short-term solutions – grants for covid-related funding, donor contributions, new urban funding – do not compensate for long-term financial shortcomings?
Faced with controversy over the Barone Care Center’s potential closure, four members of Nevada’s long-term care board resigned. When four new members joined the board in mid-December, Moore-Few’s administrator and up to a dozen employees also announced their resignation. The feeling of crisis seems more acute than before.
Officials send mixed messages. “Our intention is to do what needs to be done and absolutely keep it [Barone] open, ”said George Knox, Nevada’s mayor. “I do not think anything has been decided yet,” said Judy Campbell, chairman of the city’s long-term care council. “We just have to get back to square one and see if there is any chance of keeping Barone going.”
Meanwhile, the members of the community are determined not to retire. “I have no idea what’s going to happen, but I’m not giving up,” Querry said. “I will do everything I can to save this place that is so important to all of us.”
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