By KEIKO IKEDA
It shocked me to find these numbers.
In this time of pandemic and global concern over the spread of coronavirus, the extremely high numbers of residents and staff who have been infected with the virus at two Kei-Ai Nursing Homes (formerly Keiro Skilled Nursing Facilities) are alarming, to say the least. This is a serious problem and a threat to the Japanese American community, whose only remaining culturally sensitive Nikkei nursing homes in the nation are these two facilities.
Just a reminder to those who may not be aware of the history of the facilities, Keiro senior facilities were nonprofit prior to the sale in February 2016, and they became private when they were sold to a for-profit corporation, Pacifica Companies.
According to the L.A. County Department of Public Health’s updated postings of the cumulative number of infected cases in the Los Angeles area nursing homes, Kei-Ai South Bay (71 occupancy) had 61 cases of residents who tested positive, 42 staff with positive outcome and 18 COVID-related deaths. Although not at the same rate of increase as it was in March and April of this year, the number of infected individuals has continued to rise over the recent months.
Kei-Ai Los Angeles (286 occupancy) had 99 residents and 59 staff with positive results and 22 deaths. The numbers are staggering with a vast majority of the residents having tested positive at Kei-Ai SB and close to 160 cases of residents and staff having had the virus at Kei-Ai L.A. Furthermore, the Department of Public Health’s announcement shows that Kei-Ai LA has been designated as a COVID-19 facility. (http://publichealth.lacounty.gov/acd/nCorona2019/COVID19Facilities.htm).
As of today, neither the operator (Aspen) nor the owner (Pacifica) of the facility has provided information on the COVID-19 designation to the residents, their families, health care providers or the community. According to earlier articles written by Rafu Shimpo, Aspen is closely following the Center for Disease Control (CDC) guidelines.
However, even if CDC does not require the notification, is it not the right thing to inform those who would be directly impacted by Kei-Ai L.A. taking in more COVID patients from various hospitals? After all, those who suffer and die from the virus are the residents and the staff. Moreover, many of the residents are Nikkei elders who entrusted their care to those who run the facility.
A designated COVID-19 facility takes in patients from hospital ICUs where they were cared for and no longer show severe symptoms. It means that the facility has allotted a separate section that isolates, quarantines, and medically treats those with mild COVID symptoms. It also means that staff working in the COVID section must be trained, wear protective gear, and provide extra services to those in the special unit. In addition, they must make some structural changes and test the patients regularly.
While this entails increased cost, the facility operator receives a hefty COVID-19 bonus in reimbursement from government as well as private insurances. Which means that for every Medicare patient in the COVID section, the operator receives anywhere from $700-$1,300 per day for additional care, and for each Medi-Cal patient, the reimbursement is close to $250 per day.
This arrangement serves the operator and the owner of the facility well and it relieves the hospitals of their overload. They can argue that they are doing their best to serve the community during the pandemic. However, this arrangement is at the cost of suffering and deaths to the residents and the desperation of family members who experience distress and helplessness in seeing the county’s postings of rising COVID cases at Kei-Ai nursing homes.
The Keiro sale was based on conditions stipulated by the California attorney general. The 13 conditions were to last for five years, or until February 2021, and the Attorney General’s Office is to enforce the conditions. One of the conditions is for the buyer to participate in both the Medicare and Medi-Cal programs and to maintain the same types and levels of care that were provided prior to the sale.
The designation of Kei-Ai L.A. as a COVID-19 facility and Kei-Ai South Bay’s acceptance of short-term post hospitalization cases have changed the types and levels of care at these facilities. Patients who were transferred from hospitals have changed the facilities to highly risky places. As a result, morbidity and mortality of residents in the facility are higher than prior to the sale. These changes are violating the AG’s condition to maintain the pre-sale levels of care for at least five years. Moreover, they threaten the lives of the Japanese American seniors.
The COVID-19 designation of Kei-Ai L.A. must be voided to prevent any more spread of the virus and loss of lives. Notification to residents, families, staff, providers and the Japanese American community of major changes in the operation of the facilities is a must in order for the Nikkei community to continue to entrust the facilities to take care of our elders.
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Keiko Ikeda, Ph.D. is a psychologist in private practice for the past 40 years in Los Angeles. She is also the vice president of Koreisha Senior Care & Advocacy. Opinions expressed are not necessarily those of The Rafu Shimpo.