LOS ANGELES —When Keiro Senior HealthCare, the nation’s largest nonprofit health care organization for Japanese Americans, announced the sale of its facilities to a for-profit real estate company, many concerned individuals protested the sale as a betrayal of the original founders’ mission to serve the Southern California Japanese American community’s elders.

Keiro, which for more than a half-century has been a trusted resource in the community and whose stated mission is to enhance the quality of life for Nikkei senior citizens, revealed in September that it has sold its properties to San Diego-based Pacifica Companies LLC, for $41 million.

Keiro’s properties included in the sale are: Keiro Nursing Home, a 300-bed licensed skilled nursing facility in Lincoln Heights; South Bay Keiro Nursing Home, a 98-bed licensed skilled nursing facility in Gardena, Calif.; Keiro Intermediate Care Facility, a 90-bed licensed skilled nursing facility in Boyle Heights; and Keiro Retirement Home, an independent living facility with 127 units, also located in Los Angeles’ Boyle Heights district.

Shawn Miyake, president and chief executive officer of Keiro Senior HealthCare, which owns the facilities until escrow closes in early February 2016, cited ongoing demographic changes and increasing diversity in the community as contributing factors in the sale. He pointed out the high rate of interracial marriages among Japanese Americans, and the dispersal of many Nikkei to suburban areas far from Keiro’s facilities. “It’s difficult for people to access our facilities. And we’ve started to see that people are trying to stay at home as long as possible. When they do choose to go into a facility, many are choosing to go to places — including mainstream facilities — closer to where their children live.”

Gary Kawaguchi, chairman of Keiro’s board of directors, said, “We looked at the demographics in Los Angeles, and we see the Yonsei and Gosei are all getting into mixed marriages. A facility that has a Japanese cultural program, food and things like that doesn’t seem to be that high a priority for those generations.”

The mission for Keiro is to serve the elderly in the Japanese community, Kawaguchi added. However because of the effects of the Affordable Care Act, “in the future, the facility will be used more and more by non-Japanese. If that’s the case, then it might be best to sell Keiro, take the proceeds and use the money to support the Japanese community in another way.”

Years ago, the Retirement Home had one- to three-year waiting lists and “people were begging to come in,” Miyake recalled. “Today, on any given day, there are 10 empty rooms here … The board realized that unless Keiro made significant changes, they’re going to see fewer people coming in. They feel that while it’s a difficult decision, it’s one that they had to make.”

Keiro had originally agreed on a deal in 2014 with Ensign, but the state Attorney General’s Office, which oversees the sales of nonprofit organizations to for-profit companies, rejected the sale. Keiro then found a more acceptable buyer in Pacifica. The institution will have a new name after Pacifica takes over.

Pacifica seems like a “very good organization,” Miyake commented. “They operate about 50 retirement homes. The buyer elected to contract the operation of the nursing homes to Aspen Skilled Healthcare, whose specialty is skilled nursing, and the Keiro Retirement Home to Northstar, which had managed some of the buyer’s other buildings.”
Pacifica has the same mission as Keiro, Kawaguchi emphasized.

“They’re in the business to operate nursing homes and retirement homes. Their feeling is that as long as the Japanese are coming in, they will cater to the Japanese, even beyond five years … But if there are more empty beds, they’re going to have to find more resources to fill those beds. Based on the nationalities of the people in the group filling the beds, that’s who they’re going to cater to.”

Keiro Residents at Risk
Concerned Nikkei, alarmed that such a community treasure could be sold to outsiders, formed the Ad Hoc Committee to Save Keiro and warned that the 600 or so elderly Keiro residents and patients are “now at risk of losing their homes, someplace they were assured would be safe for the remainder of their lives.”

Charles Igawa, committee chair, reported that he and a handful of other concerned individuals, were worried about the Keiro sale and the subsequent lack of response from the community, so they decided to call two public meetings that resulted in petitions for two targets: one to Attorney General Kamala Harris’ office, and the other to Keiro management, directed to Shawn Miyake.

The petitions seek to convince the Attorney General to stop this sale; to compel Keiro’s board of directors to hold a public forum where questions could be voiced and answered; and for Keiro to give the public full access to all records regarding its transaction with Pacifica.

The committee wants to stop the sale because “it’s a matter of trust,” community activist Mo Nishida stressed. “It’s about our cultural heritage, about honoring our elders. Our visionary elders came up with the Umbrella of Care that allowed the seniors at Keiro to live a Japanese lifestyle, gave them a place to go. From a Japanese cultural standpoint, it’s a modern version of oyakoko (duty to one’s parents) where each generation shows gratitude and thankfulness and creates conditions where the elders could be comfortable. We have a responsibility and duty to take care of our elders, and Godammit, we should do it.”

The committee urges everyone to sign petitions to both Keiro and to the Attorney General’s Office to show how much the Nikkei community opposes this sale, Igawa stated. “We need 5,000 signatures for the petitions to send to Attorney General and to Keiro. We have 3,000 signatures already.”

Adamantly Opposed
Frank Omatsu, 91, the only surviving Keiro founder, said Miyake and the board made a “serious mistake,” according to Igawa. “He is adamantly opposed to the sale. He attended the meeting on Oct. 15 but Keiro management didn’t give him a chance to speak. Shawn had made a public statement that he made the decision to act on the sale after getting the founders’ blessings. Frank Omatsu publicly stated otherwise.”

In a YouTube video, Omatsu recalled that the founders of Keiro purchased five acres of land from the Jewish Home for the Aged in Boyle Heights and soon opened Keiro Retirement Home in 1975. Subsequently, Keiro Intermediate Care Facility began there in 1977.

The Nikkei and Jewish people were the only ones to have a place like Keiro to care for their elderly, the retired banker continued. “No other minority group has something like this.”

Omatsu added in that interview that his mother thought Keiro should be a place where Japanese elders would not feel like they were being thrown away, suterareta kimochi ga shinai yoni.

Protecting the Elders
Helen Funai Erickson, a volunteer in Keiro’s Nikkei Women Legacy Association writing program, related, “The elders started coming up to me and saying ‘Helen, what should we do? I’m afraid. What should we do in five years? I hope I die.’ I mean, it’s really horrifying to hear that.”

That’s why she got involved in the ad hoc committee, Erickson explained. “I just want to protect the elders, because if they think they just want to die before the five conditional years of the sale are up, that’s no way to live … Many don’t have families or finances, they’ve sold their homes and have nowhere else to go. I just wanted Keiro to guarantee to protect them at least until they pass away.”

The former Nisei Week Queen added, “How can you turn your back on even one needy elder when Keiro was set up primarily with the mission to help the poor Japanese elders live a decent life until they die? That was their original mission, but now apparently that mission has been changed.”

Cultural Sensitivity
Addressing the fears voiced by many that employees may be terminated and concerns about cultural sensitivity being maintained, Keiro’s CEO revealed that Northstar’s president, Rick Jensen, lived in Japan for a few years, speaks Japanese and teaches Japanese culture classes.

According to Miyake, Aspen’s president, Jay Brady, said he is half Japanese, and had visited his aunt when she was a resident of South Bay Keiro Nursing Home. “He has not only the cultural knowledge but he also has specific knowledge of the nursing home that he now will help to manage.”

Miyake is confident that Aspen and Northstar will “come in and do a good job. The principle players from those two companies have a cultural sensitivity that is unique in this situation.”

He pointed out that when Attorney General Kamala Harris approved of the sale, she put a number of conditions on the sale for five years, including stipulations to maintain the program’s cultural sensitivity, to hire all current employees at the facilities, and to support the volunteer program now in place at Keiro.

“Just because the conditions are set on something for five years … doesn’t mean it’s going to stop after five years,” he added. “It could continue for 10 to 15 years if Japanese want to continue coming here.”

Keiro was able to successfully negotiate a one-year rent freeze, Miyake added. “So far I’ve been fairly confident that the buyers are going to handle it carefully. Pacifica understands that it’s a major concern for the residents.”

Under the Attorney General’s conditions, Keiro is committed to taking the net proceeds from the sale and dedicating and prioritizing the use of those proceeds to serve older Nikkei adults, Miyake said. “What’s interesting about that condition was that’s exactly what Keiro’s mission is.”

Keiro has been doing work over the last 10 years focusing not only on the people in its retirement homes and nursing homes but in the community at large, he stated. Some of the services include education to veterans regarding benefits under both the U.S. Department of Veterans Affairs and Medicare; and education for caregivers, including safety tips for home care.

People have questioned Keiro’s sale price, including individuals in the committee with expertise in real estate value assessment, Igawa said. “Looking at the $41 million Keiro sales contract, some of the experts said the Lincoln Heights property alone is valued at over $40 million. Some also suggested that the Boyle Heights property is also of considerable value, much higher than $41 million.”

Refuting comments made by critics that the board members will profit from this sale, Miyake emphasized, “Seriously, these people are all volunteers working without compensation … People know the board members, and know that they’re credible.”

Miyake, who has worked at Keiro for 21 years, revealed, “This is one of the most difficult things I’ve done in my career as a health care administrator. On a personal level, it’s been extremely painful to do this. We want to do what’s best for the most people in our community.”

People’s Mandate
There is a strong interest within the Japanese-speaking segment of the Japanese American community in the issue of the sale of Keiro, said Igawa, a social scientist with particular interest in the Southern California Nikkei community. “At least two-thirds of the Keiro residents are Japanese-speakers, according to estimates. That doesn’t signify the change in demographics Shawn Miyake and the board spoke of. In previous encounters, they said the Nisei population was just about gone, and the ‘post-Sansei’ generation has increasingly less interest in community affairs, including Keiro’s issue. That’s their misinformation.”

The Keiro-sponsored meeting held Oct. 15 drew an audience of about 600 people, reported Igawa. “An overwhelming majority of the audience was on our side. It was a decidedly mature audience, including senior citizens, many of whom came in wheelchairs, and many of them Keiro residents. It took courage for them to come … Some of those canvassing for petition signatures were told in no uncertain terms by Keiro management that such activities would be unwelcome.”

Nishida said he had a couple of personal friends he used to visit at the Keiro Nursing Home. “They felt satisfaction that they were really taken care of. It’s better than being at home alone, and nobody’s coming to visit.”

The volunteerism and caring for people at Keiro are “things that you’re going to find nowhere else in the country, in no other culture,” he said. “People from all over the country are declaring that caring for the community’s elderly is a mandate of our people.”

Nishida ranted, “If Miyake and the board don’t want to carry on the mandate, they should resign and let the people who want to carry on do so. What is this [bleep] about this small group of people all of a sudden is going to sell it and not tell anybody.”

The fact that no board members have said anything, Nishida feels, is a “breach of trust and loyalty to the people who live at Keiro, 600 people whose lives are all [bleeped] up right now. They were told that they would be ‘OK there for the rest of their lives, you don’t have to worry, we’ll take care of you.’ Then that trust was torn to shreds.”

The people on the board need to take responsibility for what they’re doing, Nishida raged. “We’re talking about a direct, flagrant violation of cultural values and tradition that make us who we are. If they don’t respect our heritage, they might as well get the hell out of here. They’ve got no right to impose their crap on us.”