At the same time, the hospital has been working with consultants to prepare for recertification.
“The focus of this meeting needs to be primarily on how the Board of Supervisors can be a force for protecting the most vulnerable: those who are now residents at Laguna Honda and those of us could need a bed there at any time,” Teresa Palmer, a former Laguna Honda physician and geriatrician, wrote in a letter to the board ahead of its Tuesday hearing. “Administration at Laguna Honda and consultants obviously need more time to ‘turn the ship around.’ In order to prevent death and harm to current and future residents, this time needs to be made available by CMS.”
Last month, the California Department of Public Health fined Laguna Honda $36,000 for providing inadequate care to the patients who died after their transfers. Nearly all of those patients, who ranged in age from 63 to 100, were considered severely disabled, including some who were on feeding tubes, living with dementia or non-verbal, the agency’s citations show.
The citations also noted that the patients who died were identified as “not discharge ready” because they were frail or otherwise were not in a condition to be relocated.
The current regulatory crisis facing Laguna Honda began last spring, when federal regulators decertified the hospital after conducting a series of safety inspections triggered by two nonfatal drug overdoses the previous year.
Because San Francisco lacks an adequate supply of skilled nursing options, especially for people who rely on government health care plans like Medicare, most of those 57 patients were transferred out of the county. Two of the patients were sent to homeless shelters after discharge.
In August, city leaders responded to the relocation requirement and subsequent deaths by suing the federal government, arguing that CMS had imposed an arbitrary and unrealistic closure deadline that didn’t give the city enough time to appeal the original infractions.
Several months later, however, the city agreed to drop the lawsuit in exchange for federal regulators temporarily halting the transfers and continuing to pay the $18 million in monthly Medicare and Medi-Cal costs for the remaining residents through November 2023.
Patricia McGinnis, executive director of California Advocates for Nursing Home Reform, called out the hurried transfers as a form of abuse and criticized state and federal regulators for pressuring the hospital to carry out the closure plan, despite the severe risk it posed to many patients.
“We call on CMS to stop the Laguna Honda closure before more residents are killed, and the Legislature to investigate CDPH and hold its leaders accountable,” she said.
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