The largest nursing home in St. Louis, which was shuttered abruptly in December, is now facing more fines linked to safety and administration requirement violations when moving residents out.

The Centers for Medicare & Medicaid Services (CMS) is fining Northview Village directors Makhlouf and Lorraine Suissa and Eric Rothner more than $18,000 per day, totaling more than $56,000 for such violations over three days according to a report from St. Louis Public Radio.

All three directors are based in Illinois. The Suissas own several other properties in the region and downstate Illinois, while members of the Rothner family own or operate other SNFs in the state, according to the report.

The Missouri Department of Health and Senior Services (DHSS) found that Northview failed to take measures to ensure the security of residents and staff, and failed to secure resident belongings from theft.

Residents were disoriented and crying, and emergency personnel needed to sedate at least one resident who didn’t want to leave, DHSS said in its report. Another resident with a diagnosed mental illness was unaccounted for until weeks later – a member of the public spotted this resident at a restaurant near the closed facility according to police reports.

The latest fines follow 12 federal violations since March 2021 while the facility was still open, totaling more than $140,000 and ranging from $2,200 to more than $45,000. Two abuse and neglect complaints were clocked by the U.S. Department of Health & Human Services (HHS) as well, along with nine quality of life complaints resulting in fines totaling $86,373, according to Medicare records.

Resident advocates have said that instead of levying fines, CMS should investigate other facilities owned and/or operated by the directors.

“I’ve seen million-dollar fines,” Sam Brooks told St. Louis Public Radio. Brooks serves as director of public policy at Consumer Voice. “Even that is a cost of doing business. … If they’re not fit to own and operate nursing homes, they shouldn’t be. That’s the penalty that they should be facing.”

In January, HHS issued a scathing 59-page report detailing the failures of leadership immediately before and after Northview closed. About 170 residents were sent to different nursing homes in the region and family members were oftentimes unable to track down their loved ones for days after the closure.

In a letter outlining the recent fines, CMS cited an unsafe evacuation, administration problems and the facility’s failure to keep residents safe from hazards and accidents.