Marvin Querry, 86, was on his tractor, planting rye on his 770-acre western Missouri farm, when the decision got here in early November.

It was the social employee from Barone Alzheimer’s Care Heart, the place Querry’s spouse, Diane, is a resident. The power could be closing due to monetary hardship, she mentioned, studying from a press release.

It was an agonizing second for Querry, a retired physics professor and former govt dean for educational affairs on the College of Missouri-Kansas Metropolis. “I used to be shocked,” he mentioned. “The place may I discover one other place as great to take care of Diane?”

It’s uncommon to hear folks discuss a nursing dwelling the best way they discuss this 40-bed facility in Nevada, Missouri — a metropolis of practically 8,300 folks close to the Kansas border — with deep affection, respect and gratitude.

“We couldn’t ask for a extra loving and considerate employees than those that work at Barone,” a girl whose mom lives there wrote on a petition to save the ability. In a enterprise the place employees turnover is fixed, lots of Barone’s employees members have been there for 5 years or extra.

“The care there, it goes past phrases,” mentioned Kay Stevens, whose 94-year-old mom moved into Barone in Could. “The residents are handled so properly, and it’s such a joyous setting.”

However even a sterling fame and deep neighborhood assist can’t overcome a stark actuality: The way forward for nursing houses is deeply unsure as older adults and their households shrink back from care in these establishments, the place nearly 142,000 residents have died of covid-19.

With ongoing bills associated to the pandemic and beds sitting empty, 54% of nursing houses report working at a monetary loss, in accordance to a nationwide survey launched in June by the American Well being Care Affiliation, a long-term care commerce group. Solely 1 / 4 are assured they’ll make it by the following 12 months or past. No less than 134 nursing houses closed their doorways in 2021, on high of 170 closures in 2020.

Though covid reduction funding has helped many nursing houses within the quick time period, “issues are far more unsure going ahead,” mentioned David Grabowski, a professor of well being coverage at Harvard Medical Faculty.

Barone’s fortunes mirror these broader tendencies. Earlier than the pandemic, all 40 beds had been full, and there was a ready record of 25 folks. About 60% of sufferers paid privately for care; the opposite 40% had been on Medicaid, the federal government’s program for people who find themselves poor. The power was being profitable, though not loads.

Then covid started circulating, and an outbreak of 32 covid circumstances and 4 related deaths within the weeks after Thanksgiving in 2020 created huge stress. Querry’s spouse, Diane, 76, was one of many residents who grew to become in poor health, however she recovered.

Diane and Marvin Querry, pictured in 2018, have been married for 47 years. Diane has lived at Barone Alzheimer’s Care Heart in Nevada, Missouri, for 2 years. (Paula George)

Between January and October of final 12 months, Barone’s monetary losses totaled $675,318, in accordance to information from William Denman, metropolis treasurer of Nevada, which owns the ability. Much more alarming, one other city-owned nursing dwelling, Moore-Few Care Heart, which has 108 licensed beds, misplaced greater than $1.1 million in the identical interval.

Moore-Few, which doesn’t embrace a locked space for sufferers with dementia, skilled a covid outbreak after a staffer got here to work with signs in October 2020. Within the following weeks, 47 residents contracted the virus, and 10 died. A subsequent investigation resulted in an “rapid jeopardy” quotation from the Facilities for Medicare & Medicaid Companies, a sign of great issues that pose a danger to residents and mandates fast motion, and a effective of $144,693. Investigators discovered that the nursing dwelling had not adequately screened staffers for covid or prevented these with signs from working.

Since then, about half of Moore-Few’s beds have remained empty.

Monetary and operational issues of this kind “can’t proceed,” mentioned Denman, a retired businessman who grew up in Nevada. “We’re going to lose each of those houses if we don’t do one thing quickly.”

However there’s appreciable controversy over how to transfer ahead.

Marvin Querry has change into an activist — a task he by no means anticipated taking part in at this stage of life — main the opposition to Barone’s closure.

The day after he realized of the proposal to shut the house, Querry requested a number of pointed questions at a gathering of a five-member board that oversees Nevada’s nursing houses. Greater than 100 neighborhood members attended that assembly, lots of them indignant and distressed. The board ended up tabling plans to vote on the house’s closure for now.

Just a few days later, along with his daughter’s assist, Querry created an online change.org petition requesting detailed monetary details about Nevada’s nursing houses and protesting Barone’s closure. Inside a month, it had gathered greater than 1,500 signatures.

Additionally, Querry attended metropolis council conferences and ran advertisements within the native newspaper thrice per week that includes the petition. “I’ve spent virtually $3,000 on these advertisements. I’m keen to spend $30,000 — or extra — as a result of the care [at Barone] is unsurpassed.”

He desires nothing much less for Diane, 76, whom he’s been married to for 47 years and who’s lived at Barone for 2 years. Each night, Querry goes there to feed her dinner.

Marvin Querry — pictured along with his spouse, Diane, in February 2020 on her first day on the Barone Alzheimer’s Care Heart in Nevada, Missouri — is main the combat to save the nursing dwelling from closing. (Paula George)

Karen Hertzberg, who owns a neighborhood furniture store and whose husband, Steve, 68, moved to Barone in September, feels equally strongly about saving the ability. “We’d like time for dialog, for analysis, for locating funding,” she informed me. Steve has extreme a number of sclerosis with associated cognitive dysfunction and is totally depending on help.

One possibility could possibly be a brand new metropolis tax that will pay for Nevada’s city-owned long-term care services. When the town hospital confronted monetary bother a number of years in the past, voters handed a devoted tax. It generates about $800,000 a 12 months for the hospital, whose monetary difficulties proceed.

“We rallied to save the hospital, so why aren’t we saving our seniors? We’d like to arise and combat for this,” mentioned Jennifer Gundy, a lifelong resident of Nevada and govt director of On My Personal, a middle that helps older adults and other people with disabilities stay independently.

However what if present tendencies proceed past the pandemic? What if households shun nursing houses and maintain family members at dwelling? And what if short-term options — grants for covid-related funding, contributions from donors, new metropolis funding — don’t make up for monetary shortfalls for lengthy?

Confronted with the controversy over Barone Care Heart’s potential closure, 4 members of Nevada’s long-term care board resigned. As 4 new members joined the board in mid-December, Moore-Few’s administrator and up to a dozen staffers additionally tendered their resignations. The sense of disaster appears extra acute than earlier than.

Officers are sending combined messages. “Our intent is to do no matter has to be accomplished and completely maintain [Barone] open,” mentioned George Knox, Nevada’s mayor. “I don’t suppose something is set but,” mentioned Judy Campbell, who chairs the town’s long-term care board. “We simply have to return to sq. one and see if there’s any likelihood of preserving Barone going.”

Within the meantime, neighborhood members are decided not to again down. “I do not know what’s going to occur, however I’m not giving up,” Querry mentioned. “I’m going to do all the things I can to save this place that’s so vital to all of us.”

We’re keen to hear from readers about questions you’d like answered, issues you’ve been having together with your care and recommendation you want in coping with the well being care system. Go to khn.org/columnists to submit your requests or ideas.

Judith Graham: [email protected], @judith_graham