Most in the community have heard the news that the Board of Keiro Northwest (KNW) recently decided in a 7 to 5 vote to close nursing home operations, also known as the Keiro Rehabilitation and Care Center, at KNW. The current residents have until October 1st, 2019 to find new accommodations. The news, which broke on May 8th, sent shock-waves through the community and led to a full auditorium of around 400 community members at KNW’s Town Hall, held Tuesday evening at the Stroum Jewish Community Center on Mercer Island.
Originally founded as Issei Concerns and previously known as Nikkei Concerns, the nonprofit was established as a culturally suitable elder care service for aging Issei whose families could not care for them at home. It has since grown to provide nursing home services, classes and assisted living for the Asian American community. Nikkei Manor, the assisted living facility, was said to be one of the programs that would continue beyond the closure of the nursing home program. Many of those who showed up to the town hall on Tuesday have or had loved ones who are current residents of the facility.
The meeting was moderated by Representative Sharon Tomiko Santos, who took questions from the audience directly as well as reading questions submitted in writing. Community members became emotional when speaking about their family members’ experience at KNW and expressed direct concerns over what would happen to their loved ones currently residing there. Others were concerned over the actions and future of the organization and the facility itself, as it has not yet been decided what will happen to the facility or the property after the closing. A document handed out at the meeting stated that KNW is focused on rehousing the residents before deciding the matter, but the questions at the town hall demonstrate the community’s pressing interest in both the residents’ wellbeing as well as the organization’s future.
Reasons for the closure, as currently known to the public, are financial and multifaceted. A main problem cited in the 2.5 million dollar deficit was lowered Medicaid reimbursements from the government, as there is a shortage of facilities that accept Medicaid patients. This compounds the difficulties for both the organization and the residents and their families, as many elderly Asian immigrants cannot afford the high cost of privately run care, while Medicaid patient care seems unsustainable in the current financial reality. Some general information about KNW’s financial losses and unsustainable model were given out, but there was not a unanimous answer or a single clear set of facts as to how the organization arrived at this point and how it should react to such a drastic state of affairs. The Board reported there had been severe financial difficulties as far back as 2011, for which a task force called the Blue Ribbon Committee was established to seek out potential remedies, but it was stated that these strategies did not pan out.
As reported originally, the Board vote and opinions were split with the majority voting to close (Option 1) the nursing home and others voting to explore partnerships and affiliation before deciding to pursue closing (Option 2). Though a motion to go through a 60 day due diligence period was approved after the vote for Option 1, Board Treasurer J-F Manina, who voted for Option 2, stated that the Board had not pursued any due diligence previous to the vote to close and wondered why more potential partnerships had not been investigated earlier. Board members who supported Option 2 stated they were not necessarily against closure, but believed there should have been more exploration before choosing to close. Some audience questions also asked similar questions behind the reasoning for and against partnering and affiliation and wanted more specific facts on any actions leadership had taken previously to try and fix the situation. Board members who voted in favor of Option 1 stated their beliefs that affiliation was the wrong choice for the community and that KNW would no longer be able to retain control of its operations or assets if the organization entered into a partnership. Board President Tomio Moriguchi believed that the financial situation was so dire that KNW would likely have to close even if they entered a partnership, but in that case KNW would not have any control over the method and process of closure.
Staff members of KNW were also in attendance to ask their own questions and give answers and comments, including the current CEO, the current Medical Director, and the Director of Nikkei Manor. The audience cheered and applauded the staff and the atmosphere was supportive of their voices. Nikkei Manor Director Lisa Waisath presented over 100 signatures collected from staff in favor of pursuing affiliation over closing. The Board stated that there will be task forces for strategic direction and governance, and possibly other areas, established for bringing on community members who want to be involved in deciding the future of KNW. No other specifics were available at the time of the meeting.
Several employees from the Washington State Long-Term Care Ombudsman program were present as well. The program, which was established by law but operates as a fully independent nonprofit agency, provides free and confidential advocacy and negotiation services for seniors living in long term care. A memo from the program representative was available at the meeting detailing the rights of KNW residents, the role of the Ombudsman program during the closing process, and the potential for “transfer trauma,” or physical and mental distress that patients can experience due to a facility move. The Ombudsman program will provide oversight of the closure as well as care staff in the event that residents have not found a replacement home before KNW staff have phased out. It is not currently known specifically what types of care the Ombudsman program would provide in this situation.
Due to the high attendance and limited amount of time for the meeting, many people’s questions did not get answered directly at the meeting, or the full perspective from the Board and Staff was not able to be heard. It was also clear that many specifics about the future of KNW had not been decided yet. Although the Town Hall was the start of a community conversation about KNW, it seems that there will need to be future opportunities for people to ask questions and provide comments in order to properly address the community’s concerns.