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

It was the social worker from Barone Alzheimer’s Care Center, where Querry’s wife, Diane, 76, is a resident. The facility would be closing because of financial hardship, she said, reading from a statement.

It was an agonizing moment for Querry, a retired physics professor and former executive dean for academic affairs at the University of Missouri, Kansas City.

“I was stunned,” he said. “Where could I find another place as wonderful to care for Diane?”

It’s rare to hear people talk about a nursing home the way they talk about this 40-bed facility in Nevada, Mo., a city of nearly 8,300 people near the Kansas border — with deep affection, respect and gratitude.

“We couldn’t ask for a more loving and thoughtful staff than those who work at Barone,” wrote one woman, whose mother is a resident there, on a petition to save the facility. In a business where turnover is constant, many of Ba­rone’s staff 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 joyous environment.”

But even a sterling reputation and deep community support can’t overcome a stark reality: The future of nursing homes is deeply uncertain as older adults and their families shy away from these institutions, especially after nearly 142,000 residents died of COVID-19.

With ongoing expenses related to the pandemic and beds sitting empty, 54% of nursing homes report operating at a financial loss, according to a national survey released in June by the American Health Care Association. Only a quarter are confident they can make it through the next year or beyond.

Although COVID-19 relief funding has 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.

Barone’s fortunes reflect these broader trends. Before the pandemic, all 40 beds were full, and there was a waiting list. The facility was making money, although not a lot.

Then the pandemic took hold, and an outbreak of 32 COVID-19 cases and four associated deaths in the weeks after Thanksgiving 2020 created enormous stress. Querry’s wife, Diane, was among the residents who became ill, and she recovered.

In 2020, between January and October, Barone’s financial losses totaled $675,318, according to data from William Denman, Nevada’s city treasurer. Nevada owns the facility. Even more alarming, another city-owned nursing home, Moore-Few Care Center, which has 108 beds, lost more than $1.1 million in the same period.

Moore-Few experienced a COVID-19 outbreak after a staffer came to work with symptoms in October 2020. In the following weeks, 47 residents contracted the virus, and 10 died. An investigation found that the nursing home had not adequately screened staffers for the virus or prevented those with symptoms from working. The center was fined $144,693.

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

There’s considerable controversy over how to move forward.

Marvin Querry has become an activist — a role he never anticipated playing at this stage of life — leading the opposition to Barone’s closure.

The day after he learned of the proposal to close the home, Querry asked pointed questions at a meeting of a five-member board that oversees Nevada’s nursing homes. More than 100 community members, many angry and distressed, attended. For now the board ended up tabling plans to vote on the home’s closure.

A few days later, Querry created an online petition protesting Ba­rone’s closure and requesting detailed financial information about Nevada’s nursing homes. Within a month the petition had gathered more than 1,500 signatures.

Querry attended city council meetings and ran ads of the petition in the local newspaper. “I’ve spent almost $3,000 on these ads. I’m willing to spend $30,000 — or more — because the care (at Barone) is unsurpassed.”

He wants nothing less for Diane, to whom he’s been married for 47 years. She’s lived at Barone for two years. Every evening, Querry goes to the center to feed her dinner.

Karen Hertzberg feels just as strongly about saving the facility. Hertzberg’s husband, Steve, 68, moved to Barone in September. He has severe multiple sclerosis with related cognitive dysfunction and is completely dependent on assistance. “We need time for conversation, for research, for finding funding,” said Hertzberg.

One option to save Barone could be a new city tax that would pay for Nevada’s city-owned long-term care facilities. When the city hospital faced financial trouble several years ago, voters passed a dedicated tax. It generates about $800,000 annually.

“We rallied to save the hospital, so why aren’t we saving our seniors? We need to stand up and fight for this,” said Jennifer Gundy, a lifelong resident of Nevada and executive director of On My Own, a center that helps older adults and people with disabilities live independently.

The sense of crisis seems more acute than ever as officials send mixed messages.

“Our intent is to do whatever has to be done and absolutely keep (Barone) open,” said Nevada Mayor George Knox.

“I don’t think anything is decided yet,” said Judy Campbell, who chairs the long-term care board. “We just have to go back to square one and see if there’s any chance of keeping Barone going.”

Community members remain vigilant.

“I have no idea what will happen, but I’m not giving up,” Querry said. “I’m going to do everything I can to save this place that’s so important to all of us.”

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Kaiser Health News is a national newsroom that produces in-depth journalism about health issues.