Amid other challenges, Laguna Honda Hospital and Rehabilitation Center in San Francisco has been grappling with a COVID-19 outbreak that has outpaced those in some previous years of the pandemic.
The latest uptick in cases arrived at a particularly tough time. The hospital is facing a major regulatory crisis that threatens to close the 153-year-old public skilled nursing facility, home to more than 500 residents, many of whom require high levels of nursing care.
COVID “cases were generally mild, and many were asymptomatic and identified due to Laguna Honda’s proactive testing of entire units until no new cases are identified for 14 days,” a spokesperson for Laguna Honda said in an email on May 12. “Laguna Honda Hospital was a model for pandemic response, and we continue to respond effectively to COVID by slowing the spread of the virus on campus and caring for residents if they test positive.”
The largest resident outbreak in 2023 peaked in April at 79 cases, and as of May 15 there were 10 residents with active cases, signaling a significant downward trend.
The outbreak in 2023 surpassed the total number of COVID cases that occurred at Laguna Honda in 2020 (46) and 2021 (32), when nursing homes across the country saw devastating impacts of the virus, which disproportionately affects older adults. The highest number of overall cases at Laguna Honda occurred in 2022, which had a total of 246 cases.
“Throughout the pandemic, Laguna Honda has responded to many surges, and we will continue to respond as needed due to the contagious nature of the virus and continually emerging variants and the importance of residents hosting visitors and leaving campus for outings and appointments,” the spokesperson said.
Path to recertification
In 2022, the hospital was found out of compliance on a number of safety issues across multiple regulatory surveys that were triggered after Laguna Honda self-reported two nonfatal overdoses that occurred on-site.
As a result, 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 incomes.
In order to sustain health care funding while Laguna Honda worked to address its deficiencies, the Centers for Medicare and Medicaid Services required that the hospital craft and implement a plan to prepare for closure. That plan involved assessing and relocating as many patients as possible in 2022.
Of 57 residents who were transferred or discharged during that process, 12 died shortly after their relocations. The city sued the federal government in response, and the transfer process was paused temporarily as part of a settlement agreement.
In February 2023, regulators agreed to extend the pause on transfers to May 19.
