San Francisco Chronicle - (Sunday)
‘Stay tuned’: Becerra tours Laguna Honda
Like adversaries seeking detente, both sides in the conflict over the fate of San Francisco’s Laguna Honda nursing home met Friday and walked together through the beleaguered facility that is home to 550 frail and lowincome city residents.
This was the first visit to the nation’s largest nursing home for Xavier Becerra, the Health and Human Services secretary who oversees the federal agency that decertified Laguna Honda nearly a year ago.
That action on April 14 — six months after state inspectors said the public facility offered “substandard care” — was expected to end Medicare and MediCal reimbursements to Laguna Honda in a matter of months, starving it of twothirds of its annual budget of $334 million and forcing it to shut down. But a legal settlement between the city and federal regulators gave it until next November to achieve recertification and avoid closure.
Laguna Honda’s administrators, county health officials and advocates for the facility’s residents have been fighting for its survival ever since. The nursing home had 700 residents last year, but no one has been admitted since decertification.
Becerra took a private tour Friday with San Francisco’s Mayor London Breed, the city’s Health Director Dr. Grant Colfax, and Roland Pickens, Laguna Honda’s interim chief executive.
Afterward, Becerra said it was “gratifying to see a place where, if you’re going to have to leave a loved one, they’ll be treated with dignity.”
He said he met with staff who were candid with him about the challenges Laguna Honda faces in regaining its certification. He said he also spoke with patients, and that “most said, ‘Help keep Laguna Honda open!’ ” Will he?
“Stay tuned,” said Becerra, who grew up in Sacramento and served as California’s attorney general before President Biden tapped him for the cabinet position.
Now, administrators are working with certification experts on a top-to-bottom overhaul to try and meet deadlines.
Colfax, whose health department runs Laguna Honda Hospital and Rehabilitation Center, said the facility has “come a long way in holding ourselves accountable.” He said the staff has met all 126 “action milestones” set for it in January, and is on track to meet the 133 milestones set for February.
Pickens said these mainly have to do with infection control and proper coordination among caregivers — “but at the end of the day, it’s about regulatory compliance and keeping our residents safe.”
Some of the medically fragile residents of Laguna Honda have lived there for decades.
Last summer, regulators with the Centers for Medicare & Medicaid Services, which Becerra oversees, ordered the facility to move out every resident in preparation for closure.
Laguna Honda was able to transfer or discharge just 57 people because few skilled nursing facilities exist in the Bay Area that treat complex medical conditions and accept MediCal, California’s version of Medicaid.
When 12 of the people who were moved died soon afterward, officials suspected “transfer trauma,” which led to a public outcry. CMS paused the relocations in July. But they are set to resume on May 19 unless Laguna Honda shows it has made sufficient progress toward recertification.
While the nursing home’s advocates agree that Laguna Honda’s operations and practices need improvement, most have strenuously objected to what they consider an excessive punishment that doesn’t fit the crime.
Some blame Becerra for allowing the threat of closure to loom over Laguna Honda.
On Feb. 10, for example, Supervisor Hillary Ronen boycotted San Francisco General Hospital’s 150th anniversary celebration because it honored Becerra.
In a letter to the hospital’s foundation, Ronen wrote that “instead of offering to assist the city, Becerra and his employees have done everything to threaten and punish Laguna Honda, and by extension, its patients.”
On Friday, however, Ronen told The Chronicle she was happy that Becerra was “finally visiting this critical institution” to “personally see the poorest and sickest San Franciscans who would likely be on the street if not for Laguna Honda.”
Supervisor Myrna Melgar was out of the country Friday and unable to join the tour. Her district includes Laguna Honda, which sits at the southwest base of Twin Peaks.
But at the event honoring Becerra earlier this month, Melgar asked to sit next to him so that she could “bend his ear” about Laguna Honda, said her aide, Mike Farrah.
“Obviously, the relationship started poorly,” Farrah said. “But we are excited about the secretary’s visit to see firsthand the lives that are affected at Laguna Honda.”
Asked what he learned from his visit, Becerra said, “There are Americans who need to have someone who cares for them, and, unfortunately, there are a lot of Americans who don’t have family who can do that.
“We’re trying to do what we can to make sure we don’t let folks die on the street. A facility like this is critical to a community.”
At the same time, he said, people who send their family to Laguna Honda need to know that “the health and safety standards we would all expect are being provided.”