By Randall Yip, Executive Editor
(This article was produced as a project for the USC Annenberg Center for Health
Journalism’s 2024 California Health Equity Impact Fund.)
California state regulators cited Kei Ai Los Angeles Health Care Center during the height of the COVID19 pandemic on November 16, 2020 for not having a dedicated infection specialist as mandated in a new state directive that month. The skilled nursing facility would be hit three more times over the next 10 weeks for COVID-safety procedures designed to prevent the spread of the deadly disease.
45 residents would die during the time regulators issued those citations against the 300-bed facility, according to records obtained by AsAmNews from the County of Los Angeles through a Public Records Act request.
A check of a state database found Kei Ai Los Angeles endured more deaths than any other skilled nursing facilities in the state. In all 115 residents died of COVID there from May 2020 through December 2022. That’s the period the state maintained a dashboard of COVID-deaths. Skilled nursing facilities such as Kei Ai Los Angeles provide nursing, medical and rehabilitation care.
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The medical director of Kei-Ai Los Angeles did not get back to us with a comment after numerous attempts.
No other skilled nursing facility in California had more than 100 COVID deaths. The closest were the 99-bed Rinaldi Convalescent with 78 deaths and the 391-bed Santa Anita Convalescent with 76 deaths. All three facilities are in Los Angeles County.
Crystal Yee’s father Kin Jin Han was among the 115 to die of COVID at Kei-Ai Los Angeles. He died on December 28, 2020. He had been under care there for six years.
“I never understood why Kei-Ai allowed positive COVID patients to come to the nursing home when I thought the elderly were considered the most vulnerable,” she said in a statement made available to AsAmNews through the office of Rep. Judy Chu (D-Pasadena). “Kim Han contracted COVID from a patient that was in his room which was considered non-COVID area who was positive,” she claimed.
Kei-Ai Los Angeles is one of 25 facilities the county designated as COVID facilities under a program designed to find beds for coronavirus patients, although not all ended up taking patients.
30 patients living at Kei Ai Los Angeles during the pandemic were under the care of Dr. Kenji Irie. He says 19 of them died of COVID.
He spoke to AsAmNews and described preventative measures at Kei-Ai LA to protect against the coronavirus as “loose and inadequate.”
Public records obtained by AsAmNews of health inspection reports uncovered numerous notices of violations issued by investigators from local, state and federal agencies for a 25-month period beginning in November 2020.
The next month on the 16th, state investigators notified Kei Ai it failed to segregate staff working with COVID-infected patients from those in other areas of the hospital. The findings indicated that the “deficient practice” had the potential for the “spread of the coronavirus disease to the residents, staff and community.”
January 23, 2021 inspectors say they found a used surgical mask sitting atop a cart, putting everyone at Kei Ai at risk of COVID.
Two days later, authorities say they observed six different staff members failing to put on personal protective equipment before entering a patient’s room or taking it off prior to exiting the room-another violation of COVID protocols.
The 45 deaths that occurred from December 2020 to January 2021 at Kei Ai LA is more than any other two-month period at Kei-Ai LA.
“When my patients were infected by COVID, I tried to see them immediately before they were transferred to the isolation unit. Their roommates were not wearing masks,” Dr. Irie said.
Required precautions such as double masking, changing of gowns and gloves did not always happen among the staff there, according to Irie.
“They were not done adequately,” he said.
Joyce Valenzuela Miyauchi and Margaret Miyauchi-Leong say they feared their father would have been one of the 115 who died of COVID at Kei-Ai Los Angeles. He tested positive while being treated there in December 2020- a fact confirmed by their father’s doctor, Dr. Takeshi Matsumoto.
“He (Dr. Matsumoto) said dad was so sick, we thought we were going to lose him. That was a shock to me, because every time we’d call, he was fine,” Valenzuela Miyauchi said.
In separate interviews, the sisters told AsAmNews they would call Kei Ai to talk to their father during his bout with COVID but were told he was either watching TV in the lounge or having breakfast in the dining room.
“Didn’t make sense if he had COVID, said Miyauchi-Leong. “Why is he out in a room where there are other people unless everybody has COVID?”
Under the county’s COVID-designated facility program, those with COVID were isolated on the third floor or red zone. Those potentially exposed to COVID were put in the so-called yellow zone while everyone else stayed in the green zone. However, according to Dr. Matsumoto, the system fell apart.
“That whole thing that isolation and quarantine system had failed. All the patients everywhere were contracting COVID throughout the whole nursing home. It became a moot point even having a quarantine area or isolation area, because the entire building was infected. Every floor had cases of COVID.”
Until 2016, Kei Ai Los Angeles was owned by the non-profit Keiro which dedicated itself to improving the quality of life of Japanese American seniors. It sold its skilled nursing facility along with three other senior care homes in Los Angeles to Pacifica for $41 million.
The former Keiro Nursing Home served a largely Japanese American population with culturally sensitive care. Over the years, members of LA’s Japanese American community say the number of Japanese American residents at the now Kei Ai Los Angeles has declined, but believe there is still a sizable Japanese American population at Kei Ai LA.
The California Center for Quality Health Care oversees licensed health care facilities such as Kei Ai Los Angeles in the state.
Between 2021 through 2024, the state received roughly two and a half times the number of complaints against Kei Ai Los Angeles than other facilities of similar size. Most were not COVID related, but the violations speak to the overall level of care that patients feel they received.
In all, an examination of public records by AsAmNews found that between November 2020 through last year, regulators issued 12 COVID-related citations against Kei-Ai Los Angeles.
Many of them were repeat violations involving personal protection equipment or PPE.
On August 19, 2021 federal investigators concluded Kei-Ai failed to ensure its nurses wore N95 masks while in the yellow zone, an area for patients exposed to COVID.
One investigator witnessed a certified nursing assistant enter a patient’s room in the yellow zone without face protection or a shield. The facility did not also designate a separate break room for staff working in the COVID-quarantine area.
One month later, regulars cited similar PPE violations and say a separate breakroom for staff working in the quarantine area had yet to be designated.
Of the 12 COVID-related violations, eight involved PPE. Four times they were cited for lack of a separate break room for staff working in the quarantine area.
One Certified Nursing Assistant was quoted in a report as saying “At the beginning of the COVlD-19 outbreak in the facility, staff assigned to the red zone did not have a room as their break area. The facility separated by the end of the red zone hallway as a break area. We used to take off our masks and eat in that area. It did not even have a microwave to heat up our food and we had to go downstairs to use the first-floor bathroom. I voiced my complaints multiple times, but nothing happened. lt was not safe at all to take our masks off to take a break, but we had no choice. We needed to provide financially for our families. Eventually no nurses wanted to work ln the red zone anymore. A lot of nurses and residents tested positive.”
Several times Kei-Ai Los Angeles submitted a plan of corrective action that included additional training and better monitoring and audits of work performed. However, the pattern of citations continued.
The California Department of Public Health along with regulatory agencies at the local and federal level all declined our request for interviews by phone or video call.
The situation at Kei-Ai Los Angeles has frustrated Rep Chu for years.
“There seems to be a constant state of complaints as well as health citations, and it seems to be higher (number) than the average for nursing homes,” said Chu. “In addition, there were the highest number of COVID-19 deaths of any skilled facility (in the state). How could you possibly make this a COVID facility considering the circumstances?”
Under the county public health office’s own guidelines, a facility with “high level regulatory findings in the previous 24-month period will not be eligible for consideration” as a COVID-designated facility.
According to Chu, a pattern of continual complaints against the now Kei Ai Los Angeles goes back to 2017.
Between 2017, the year after it was sold by Keiro, to 2020, the state issued four enforcement actions against the facility and fined it a total of $52,000.
Between 2021 and through this year, regulators received 474 complaints against the facility resulting in 20 enforcement actions and $764,000 in fines.
The Los Angeles County of Public Health defended its decision.
“Kei-Ai LA did not have an IJ level deficiency (the highest level of deficiencies) in the four years prior to the designation (as a COVID-designated facility),” it said in a statement emailed to AsAmNews. “Kei-Ai LA had a designated, separate area to care for COVID patients and was willing to follow the COVID protocols developed for SNFs (Skilled Nursing Facilities). Kei-Ai was an early adopter of facility wide COVID testing, masking and vaccine uptake as recommended by LACDPH and national guidelines.”
Pacifica which bought the facility from the non-profit Keiro in 2016 is now listed in public records only as the landowner. The majority owner listed is ALAL Inc which is 100 percent owned by Aspen Skilled Healthcare, Inc – which is also listed in state records as the owner.
AsAmNews reached Aspen Skilled Healthcare Inc’s CEO Ryan Case by phone. Public records show Case has a 33% interest in Aspen Skilled Healthcare Inc.
“I prefer not to comment at this time,” he said. He has not responded to subsequent phone calls, texts or emails from AsAmNews.
Kei-Ai Los Angeles medical director Lisa Ma has also not answered our calls, texts or emails other than to say she might have time to talk with us later in the week. That was back in February. We have not heard from her despite numerous attempts to reach out since then.
(Editor Note: If you have information about what happened at Kei-Ai Los Angeles, we want to hear from you. Reach out to us at info at asamnews dot com).
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