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Missouri House bill would set minimum staffing at assisted living centers

House Minority Leader Crystal Quade, D-Springfield, speaks alongside members of Service Employees International Union (SEIU), during a press conference on Friday, Feb. 23, 2024, at Northview Village in Kingsway West. The nursing home abruptly closed on December 19 displacing more than 180 residents.
Eric Lee
St. Louis Public Radio
House Minority Leader Crystal Quade, D-Springfield, speaks alongside members of Service Employees International Union during a press conference outside a closed St. Louis nursing home Friday. Quade has introduced legislation she says will increase transparency into the operation of assisted living facilities.

Missouri House Minority Leader Crystal Quade this week introduced legislation to ensure minimum staffing levels at assisted living facilities and to provide more transparency about their owners.

Quade, D-Springfield, who is a candidate for governor, introduced the bill to the public Friday outside the now-closed Northview Village nursing home in St. Louis. The facility made national headlines in December when it abruptly closed overnight.

The operators of the facility said they were unable to pay staff, and the closure displaced more than 170 residents, confused families and left more than 180 workers without jobs.

The bill would establish minimum staffing for assisted living facilities, require a professional nurse to serve as a director of nursing and designate a charge nurse for each shift.

It would also require owners to submit an application that discloses companies the facility does business with and real estate investment trusts.

Northview’s closure was a “tragic reminder of what can happen when facilities are allowed to go understaffed and without proper oversight,” Quade said. “Missourians deserve to know that their family is cared for, and those responsible for that care are trained, staffed properly and will be held responsible.”

Lenny Jones, state director of the Service Employees International Union, which represented many of the former Northview staff members, said the owners bought the facility on North Kingshighway and then charged rent to a separate LLC within the same ownership group.

The bill would keep such deals in check, Quade said.

“Companies will create an LLC … but then create another company that they then charge rent for, and then they're profiting off of that rent,” she said. “When the rent increases go up, then that impacts staffing hours, how much folks are paid. And that's one that this legislation would prevent.”

Medicare records show several people who live out of state owned shares in Northview Village.

The two families that own the biggest stake in the company could not immediately be reached for comment.

Proponents of the legislation said the nursing home industry is vulnerable to nonlocal business owners who cut staff to maximize profit, which leaves workers and residents at risk.

“Nursing homes are being bought by venture capitalists and other out-of-state interests,” Jones said. “They're stripping assets from the homes, decreasing staff to resident ratios and moving money to their other businesses. They don't care about the people they're impacting, and they don't care about our communities. They only care about their bottom line.”

In January, the Missouri Department of Health and Senior Services released a critical account of Northview Village’s overnight closure.

“The facility failed to take measures to ensure security of the residents and staff during the evacuation and failed to secure resident belongings from theft. The failures jeopardized the health and safety for all residents and staff,” according to the DHSS report.

Correction: A previous version of this article misnamed the Missouri Department of Health and Senior Services.

Sarah Fentem is the health reporter at St. Louis Public Radio.