LOS ANGELES — Keiro Senior HealthCare, which in early February finalized the sale of its four facilities to a for-profit real estate developer, looked beyond criticism from activists opposed to the transaction and declared Keiro’s intention to go forward with programs to benefit local Japanese American seniors.

Gary Kawaguchi, Keiro’s chairman of the board, told the Nichi Bei Weekly that it was time to sell the facilities and move on because Keiro’s board of directors felt they could no longer service the Japanese community. Proceeds from the sale will aid Keiro in supporting older adults in the Nikkei community “make the decisions required to age on their own terms.”

The new owner, Pacifica Companies LLC, has leased the management and operation of the facilities to Aspen Skilled Healthcare Inc. and Northstar Senior Living Inc.

The transition in operations from Keiro has been “seamless,” Aspen President Jay Brady stated in an e-mail to the Nichi Bei Weekly. “Keiro set us up for success by endorsing to us well-trained and quality employees who care about our residents and who deliver great care and customer service. We have been thrilled with all aspects of the transition and feel fortunate to be working with so many bright and talented staff.”

Aspen and Northstar worked with Keiro in renaming their facilities to be “as culturally sensitive as possible,” Kawaguchi said. The names for the Aspen-operated facilities are Kei-Ai Los Angeles Healthcare Center (formerly Keiro Nursing Home) in Lincoln Heights, Kei-Ai South Bay Healthcare Center (formerly South Bay Keiro Nursing Home) in Gardena, Calif. and Sakura Intermediate Care Facility (formerly Keiro Intermediate Care Facility) in Boyle Heights. Northstar manages Sakura Gardens (previously known as Keiro Retirement Home) in Boyle Heights.

Aspen plans to run the Kei-Ai skilled nursing facilities and the ICF similar to how it has run historically for decades, Brady said. “We will serve the Japanese American community, we will accept Medicare, Medi-Cal and private insurance plans, we will maintain the cultural sensitivity (food and activities) that have been part of the operating culture and retain, support and hire Japanese-speaking employees, and we will grow the business to better serve the community. In short, very little has changed since Aspen took over.”

There has been an increase in the number of residents at Kei-Ai L.A. nursing home, and number of residents at South Bay and Sakura ICF remains the same, according to Brady.

“Aspen is focused on maintaining the culture that was established by Keiro and enhancing the business so that we can efficiently serve the Japanese American community,” stated Brady, whose mother is Japanese and grew up in Hawai‘i. His aunt was a resident at Keiro South Bay Nursing Home for years. “We would love to further develop the business so that it is the overwhelming choice for all residents/patients with Japanese heritage.”

Enhance Quality of Life
Keiro will retain its original name and continue its mission to enhance the quality of senior life in the Nikkei community, Kawaguchi said. Keiro’s permanent offices are located at 420 East Third St., Suite 1000, Los Angeles, because “we felt it was important to be in Little Tokyo.”

Acknowledging the strong feelings on both sides regarding the sale, the Keiro chairman commented, “We believe the sale is in the best interest of Japanese American and Japanese seniors, and we are committed to working with the new owners to provide consistency for residents, families and volunteers by continuing many of the cultural and educational programs that are valued by the residents.”

Many older adults in the Nikkei community plan on living at home for as long as possible, he explained. “To do that they will need to know how to minimize the impact of chronic health conditions, adopt lifestyle habits that support aging well, how to be the most effective caregiver, and make the best health care decisions for themselves and their family members.”

There are approximately 196,000 Japanese in Los Angeles, Orange and Ventura counties, and about 57,000 are caregivers for older adults, stated Kawaguchi, adding that Keiro is expanding its reach, from serving 600 older adults in the four facilities to supporting 70,000 senior residents in those three counties.

At this time, the Keiro spokesman said, there are three defined program areas: 1) services to older adults through the Genki Living educational program, conferences, and one-on-one consultations; 2) support of caregivers with workshops, conferences, six-week courses; and 3) programs for residents of Keiro’s former facilities.

The new operators have contracted with Keiro to manage the volunteer program, which is “so important to the residents’ quality of life,” Kawaguchi said. “Almost all of the volunteers have been serving our residents as usual, which was important to us because it maintains the same culturally-sensitive care environment as before.”

Audrey Lee-Sung, Keiro’s director of development & communications, stated via e-mail that approximately 2,500 individuals and groups participated in Keiro’s volunteer program as of the end of 2015. “We expect this number to stay roughly the same for 2016.”

There are approximately 475 Aspen employees at its three former Keiro facilities, Brady said. “Aspen gave offers to all Keiro employees that were able to fulfill their job descriptions at the time of the acquisition. There have been some resignations since acquisition; however the reasons for the resignations were unrelated to any concerns to new ownership and are very small in number.”

Koreisha Senior Care & Advocacy
Members of the Ad Hoc Committee to Save Keiro, which opposed the sale of the nonprofit Keiro’s facilities, formed a new group in March to fight for the welfare of residents in the former Keiro facilities.

Koreisha Senior Care & Advocacy, the new nonprofit organization, which gained 501c(3) tax-exempted status from the Internal Revenue Service, was created as the successor to the Ad Hoc Committee in the aftermath of Keiro’s sale which closed escrow Feb. 8. Officers of the KSCA’s board of directors include: President Jonathan Kaji, Vice Presidents Dr. Takeshi Matsumoto and Dr. Keiko Ikeda and Treasurer Rex Hamano, CPA. The board of directors includes Seiji Horio, Traci Imamura, John Kanai and Bradley Matsuda.

The immediate mission of Koreisha (elderly in Japanese) will be to “ensure the safety and meet the growing senior care demands of the Japanese American community.

“When Shawn Miyake and the Keiro board members sold off the facilities … they violated the faith and trust of the entire Japanese community. We fully intend to hold them responsible for their unethical and immoral actions,” Kaji said.

“We believe that thousands of people in the Japanese American community will cease any donations to Keiro and will swing their financial support to Koreisha,” he added.

Employee Morale Is Down
Kawaguchi stated that Keiro has been working closely with the new operators to make the transition as smooth as possible and predicted that the residents would be “cared for in the same culturally-sensitive care environment as before.”

However, a former Keiro employee and current Aspen staffer who requested anonymity disputed Kawaguchi’s assertion of a smooth transition, “The morale of the employees is down. It is true that some employees have already left and some more wanting to leave.”

One major change brought by Aspen is the significant increase in the employee portion of the health insurance premium, stated the employee in an e-mail on May 18. “Keiro used to pay about 80 percent of the premium for the employees and the dependents, and that’s one of the reasons why I’d say that the employees stayed despite the low wages. I don’t know much about how Northstar operates, but Aspen pays 75 percent of the premium for employees only, and the cost of the premiums for dependents is 100 percent employee’s responsibility. This led to reduction in net wages for most employees.”

Kei-Ai, a for-profit company, is “trying to save money wherever possible,” the employee stated. “Since the transition, Aspen downgraded the incontinence supplies (diapers), and some residents’ families complained about it. Due to the complaints, I believe Aspen now changed them back (to what Keiro used to provide).”

Quality of care also directly correlates with staffing shortage, the employee pointed out. “There are licensed nurse and nurses’ assistant positions open for all shifts. As far as the nurses’ assistant (CNA), there are as many as 12 positions currently not filled. Due to the shortage, some staff members have to work overtime including double shift (16-hour). The reason for such shortage is three-fold: nursing wages are not competitive; coupled with increase in health insurance premium; and vicious cycle of chronic overtime work situation that stems from shortage of staffing.”

Employees’ Paychecks Bounced
The problem of staff resignations is because of low salaries, Kaji charged. “We’ve learned that Keiro did not increase staff salaries or hourly wages for eight years. Also, the employees were only given one year’s seniority, even if they’ve served for many years.”

“While Shawn Miyake bragged about the great care that the Keiro residents received, he intentionally hid the fact that staff was grossly underpaid, overworked and that a significant amount of work was done by unpaid volunteers,” Kaji said. “Now, all of these management failures are being exposed in the light of day and Koreisha will report these to the appropriate state agencies for investigation and prosecution.”

Additionally, Koreisha learned recently that Aspen sent out employee paychecks that bounced due to insufficient funds.

The anonymous staffer explained, “What I heard happened was that some banks put a hold on the check. Those who receive direct deposit did not have any issue, but those who received the paper checks could not withdraw the money for 10 days. The explanation they gave was that the hold has nothing to do with Aspen’s way of paying; rather, it has everything to do with each employee’s relationship with their bank. I still don’t quite understand why, but Aspen is recommending for those employees to change the bank to Chase.”

“It’s true, we had a few bounced checks in early April,” Brady stated. “In over six years of existence Aspen has not bounced one check until this incident … In early April we upgraded to a new payroll system and during the initial payroll run had challenges with reporting and properly funding banking accounts. In the process, a small number of employees’ checks were denied because of insufficient funds. This problem was not isolated in the new Kei-Ai facilities, but was a company problem that was resolved within 24 hours. We have not experienced any further payroll or checking issues.”

CAB Controversy
Another contentious issue is the Community Advisory Board, established by Keiro to support the new operators and ensure continuity during and after the transition. The CAB, with 10 individuals selected by Keiro, is composed of persons representing residents, families and community supporters, including both English- and Japanese-speaking segments. Community participation during this transition is intended to ensure the facilities’ new programs are culturally relevant and meet the needs of the community.

Critics complained that three positions promised to the Ad Hoc Committee and Koreisha were eliminated unilaterally by Keiro, which claimed that since KSCA did not submit names to them, no seats would be provided.

“Is the CAB just a propaganda tool of Keiro?” asked Koreisha President Kaji. “The Attorney General carved out three Ad Hoc Committee seats out of the 10 created for the CAB. We intend to enforce our rights for representation on the CAB.”

Koreisha has demanded that State Attorney General Kamala Harris enforce her own conditions on the Keiro sale, which created three seats on the Community Advisory Board.

Residents Complain
Meanwhile, Dr. Matsumoto related that some of his patients at Sakura Gardens complained about the quality and quantity of meals — the udon noodles are inferior to the ones they used to get, and the amount of meat or chicken served now is approximately one-third of previous servings.

The residents also grumbled about a decrease in transportation accessibility, he added. “They now only have one driver … They used to be able to go to Little Tokyo to shop and had more flexibility when they could go see a doctor, dentist or the pharmacy. Now there is a significant reduction in freedom of movement for the residents.”
Matsumoto said some of his patients are unhappy with Aspen and Northstar. “One resident I know is leaving the Sakura retirement home, and one patient at the Intermediate Care Facility transferred to Hollenbeck Home, about a block south of Sakura retirement home. I had one patient at Kei-Ai nursing home that also transferred to Hollenbeck couple of weeks ago. It’s a pretty nice place and, in fact, about one-third of the residents and patients there are Japanese.”

It’s “kind of curious” why they go to Hollenbeck and not to Keiro, he said. “Shawn Miyake and Gary Kawaguchi are always saying Keiro has vacancies, that it’s only 80 percent full. That’s just a bunch of B.S. The retirement home vacancies … only started when it became public that the Keiro facility was going to be sold. Prior to that, there was a waiting list.”

Matsumoto, who has 33 years of experience sending patients to Keiro, said, “Even as far back as 2014, I had trouble getting patients into Keiro Nursing Home because they said they didn’t have enough beds.

“The reason … was because they were understaffed.”

Dr. Matsumoto said Aspen needs to give the employees raises because they were underpaid about five to eight percent by Keiro. “If you ask the employees, they will tell you they haven’t received any raises from Keiro in about five to eight years. These people were abused by Keiro. I have no love for Keiro management because they didn’t really take care of our caregivers very well.”

Aspen may be more cooperative in dealing with the needs of patients and their families because they’re “under the microscope with the Attorney General’s Office and the Fair Employment and Housing all looking at the deal,” Matsumoto noted. “Aspen is being very careful … I don’t mind sending my patients there because I want to be sure there are enough Nihonjin there so that the nurses who are Japanese speaking will have a place to work as well.”

Although Kawaguchi said “rents will be stable for one year” because of Keiro’s agreement with the Attorney General and Pacifica, Matsumoto warned that there could be financial problems for Sakura Gardens residents next February when the one-year moratorium on rent increases expires.

When Matsumoto talked to Pacifica not too long ago, they said they were “probably going to raise the rent by five percent next year,” he reported. “Unfortunately, in that part of town there’s no rent control … The residents are going to be hit with a raise in rent … at least five percent. The real problem for some of the patients, old ladies who are single and have no families, with no homes to go back to, they’re going to have a hard time”

Probably one of the good things about Keiro Retirement Home was that it was “reasonably affordable, if you compare it to Hollenbeck or others,” he said.

Matsumoto wants to make Kei-Ai “better than Keiro … so that the Japanese-speaking patients, the Japanese American Sansei, Yonsei, hapa, whatever, will be proud to go there and want to go there.”

“We’re not bringing back Keiro,” he said. “It’s gone.”

Pacifica and Northstar have not responded to requests for information about the situation at the former Keiro facilities.welfare of the residents of the four facilities who were abandoned by Keiro,” explained Kaji, who said KSCA will also seek to identify or create new facilities to