Laguna Honda starts to discharge patients
Nursing facility, forced to close over deficiencies, to relocate 700
San Francisco’s largest skilled nursing facility, Laguna Honda, has begun discharging patients as part of a federally mandated plan to relocate 700 mostly lowincome, vulnerable people and close by September.
The 156-year-old hospital has discharged two patients and transferred four since May, as part of a closure plan required by the U.S. Centers for Medicare and Medicaid Services. The federal agency decertified the hospital in April after finding deficiencies in safety protocols, hygiene practices and contraband reporting during inspections dating to last year.
The hospital remains licensed and operational, but it needs CMS certification to receive federal payments to care for most of its patients, who are on Medicare or Medicaid insurance plans. The agency has agreed to continue paying for these patients until mid-September, even though certification has lapsed.
Laguna Honda came under federal scrutiny in October after it reported two residents in July had non-fatal overdoses with illegal drugs. That triggered federal investigations into the hospital’s safety practices that led to CMS terminating its certification and halting payments after finding that the hospital failed to follow policy on safety protocols — including reporting smoking near oxygen. Asa result, the hospital must present a plan to close, which means finding alternative beds for the hundreds of remaining patients by September.
CMS has decertified at least two other California skilled nursing facilities recently — Kingston Healthcare Center in Bakersfield in February, and Healdsburg Senior Living Community in Healdsburg in December — after they agency found they failed to meet several requirements.
Finding beds for Laguna Honda patients is extremely challenging, the hospital said, because many are medically fragile, face language barriers, and need behavioral health services or social services — and because there are very few beds for Medicare and Medicaid patients in the region.
Separately and simultaneously, Laguna Honda is seeking to regain its CMS certification and plans to apply to do so, also around September. It has hired consultants to ensure it makes necessary improvements to meet federal regulations before reapplying for certification.
“This is a highly unusual situation,” Laguna Honda’s interim CEO, Roland Pickens, told San Francisco supervisors last Tuesday during a presentation on how the hospital plans to seek alternative facilities for
residents. “It’s very rare for an organization to lose its CMS certification, so we knew we needed help.”
The consultants “have actively gone over every inch of Laguna ... with a fine-tooth comb,” said Pickens, who took over the interim CEO role after the previous CEO, Michael Phillips, resigned this month.
The relocation of patients has not been entirely smooth. Aquelio Mederos, a former Laguna Honda patient who was discharged last week, said he was told only the previous Friday that he would be discharged and transported to Next Door Shelter, a homeless shelter on Polk Street in San Francisco.
Mederos, 72, had been living at Laguna Honda since April 2021 and was happy with the care he received there. He said he has also received good care at the shelter, but that the move felt
sudden and he did not receive a medical evaluation before leaving Laguna Honda.
Laguna Honda said he did receive the required medical assessments, which determined he no longer needed the level of care of a long-term skilled nursing facility like Laguna Honda.
The hospital will assess each patient to determine what type of facility would best fit their needs, Laguna Honda said. Each patient is encouraged but not forced to accept the placement, and they are entitled to appeal the decision.
Supervisor Rafael Mandelman called the federal action from CMS “Kafkaesque nonsense.”
“The state and federal government are coming after San Francisco providing beds that the state and federal government have abandoned,” he said during Tuesday’s board meeting. “This
is mind-boggling to me . ... How do they get to do this nonsense?”
CMS said Laguna Honda failed to comply with several federal requirements after multiple on-site safety surveys from October to March.
“Despite several opportunities to address their non-compliance, (Laguna Honda Hospital) was unable to demonstrate that it could ensure the health, safety, and well-being of its residents,” the agency said. “Because (it) remained out of substantial compliance for six months, CMS was required by statute to terminate the facility from the Medicare and Medicaid programs.”