Feds Grant Reprieve on Laguna Honda Patient Transfers Until May

Federal regulators have agreed to continue to hold off on patient discharges and transfers out of Laguna Honda Hospital and Rehabilitation Center until at least May 19, 2023, San Francisco officials confirmed on Wednesday.

The reprieve comes just one day ahead of when the pause on patient transfers was set to expire.

“The transfers and discharge of residents has been arduous as many have complex healthcare needs, and Laguna Honda and City leadership have strongly advocated against the involuntary transfers,” a statement released Wednesday from Laguna Honda officials reads. “The vast majority of residents and their families are fighting to remain at Laguna Honda and this continued reprieve of involuntary transfers provides stability, continuity of care, and short-term relief.”

City leaders, residents and their loved ones celebrated the decision.

“Laguna Honda is a critical part of San Francisco’s ability to care for our most vulnerable residents and is essential to the future of our city,” said Mayor London Breed, whose grandmother lived the final years of her life at Laguna Honda. “We appreciate that CMS has agreed to continue this pause of transfers from Laguna Honda while we work collaboratively towards recertification,” she said, referring to the regulatory body, the Centers for Medicare and Medicaid Services.

Joe Urban, whose mother-in-law was a resident at Laguna Honda, said CMS “did the right thing.”

“Restarting the discharges would have killed a lot of San Franciscans,” Urban said. “There’s no need to do it if Laguna Honda is making progress towards recertification.”

But relief may be temporary. The hospital is still working to regain certification with CMS to participate in government-subsidized health care plans like Medicare and Medi-Cal, which cover the majority of patients at Laguna Honda.

“I’m worried that May will be here before you know it and we will go through this again,” said Tony Chicotel, staff attorney with California Advocates for Nursing Home Reform. “With each extension, [another extension] become increasingly unlikely, and at some point I think it will stop happening.”

In April 2022, CMS decertified Laguna Honda after a series of inspections found the hospital out of compliance with safety measures for a skilled nursing facility. The hospital was then required to create and implement a closure plan, which included transferring or discharging all of its residents by September 2022.

The hospital, city leaders and senior advocates pushed hard against the transfers, citing how it can be physically and emotionally traumatic for older people and people with disabilities to be uprooted.

Laguna Honda transferred 41 residents to other skilled nursing facilities and discharged an additional 16 residents. Of those, 12 people died — eight of them within weeks, and four within months, of leaving Laguna Honda.

After reports came in that some residents had died after being transferred, San Francisco sued the federal government for failing to provide adequate time to repeal the original citations.

The city and CMS came to an agreement in July 2022 to pause transfers until Feb. 2, 2023.

The hospital maintains that it is working to prepare for recertification in the meantime.

“This is the humane and compassionate thing to do for the residents of Laguna Honda, their families and staff,” said San Francisco City Attorney David Chiu. “We certainly hope we don’t cut things as close next time. I know that the staff at Laguna Honda will work and do everything they can to address the issues and get us to that recertification. Our hope is we aren’t in this place again.”