As a result of the findings, federal regulators stripped Laguna Honda from Medicare and Medi-Cal, subsidized health care plans that cover the vast majority of residents at the facility, most of whom have extremely low or fixed incomes.
Centers for Medicare and Medicaid Services required the hospital to craft and implement a plan to prepare for closure, and in return, the agency would temporarily sustain funding to the hospital. That plan involved assessing and relocating as many patients as possible in 2022.
Of the 57 residents who were transferred or discharged during that process, 12 died shortly after their relocations. Community members and government officials, including Mayor London Breed, Rep. Nancy Pelosi, and others, publicly decried the regulators’ decision and advocated for a different response. The city sued the federal government following the relocation deaths, and the transfer process was paused as part of a settlement agreement.
Since then, Laguna Honda has taken steps to address deficiencies in areas such as medication storage and hygiene control. Regulators marked just 33 areas for improvement in a June 2023 monitoring survey to check progress, compared to the first survey that had 124 findings, according to the San Francisco Department of Public Health.
The California Departments of Public Health and Health Care Services will review the application next to determine what is to follow.
Time is of the essence. The hospital is currently facing a deadline of Sept. 19 before the current temporary pause on involuntary transfers could resume. If relocations do resume, residents will have the right to appeal their transfer and must first be assessed for appropriate options.
It’s not clear exactly how long the process could take or whether the federal and state regulators could again delay the deadline. Pickens, however, said he hopes the regulatory process will be completed in time to prevent any additional involuntary transfers.
“I want to emphasize that applying for recertification is not the end of our work to improve our facility, but rather the beginning of a new era of excellence for Laguna Honda Hospital,” Pickens said in a letter to residents sent on Aug. 14.
Nursing home reform advocates and members of the Laguna Honda community welcomed the news of the reapplication.