SF to Pay $5.8 Million in Class Action Settlement Over Elder Abuse at Laguna Honda

San Francisco is poised to pay out $5.8 million after reaching a settlement in a lawsuit claiming staff at Laguna Honda Hospital and Rehabilitation Center took explicit photos of patients and disseminated them for non-medical purposes, along with other abuse and privacy violations.

The settlement is the latest rectification and first class action for the patient abuse scandal at Laguna Honda Hospital, one of the nation’s largest public nursing homes, following reports between 2016 and 2019 that thrust the facility into turmoil. Both parties have agreed to the payment, which will go before the city’s Government Audit and Oversight Committee on Thursday for approval.

The $5.8 million settlement will be distributed among 735 current and former Laguna Honda patients.

“This on its face says, ‘Look, you had a systemic problem. This was going on and this was hurting everybody,’” said Kathryn Stebner, who represented plaintiffs in the case. “We bring class actions to make a political statement, to try to make social change. And I think this does send that message.”

The 159-year-old hospital has long served as a safety net for some of the city’s poorest and most vulnerable residents, with some living at Laguna Honda for years.

The lawsuit was initially filed in 2020 on behalf of a Laguna Honda resident, claiming staff took photos of his genital area during an enema procedure and that staff circulated the image for non-medical purposes. Another named plaintiff, Tommy O. Johnson, alleged his health information was also wrongly used.

Attorneys later filed a class action motion in 2024 alleging that all patients at the hospital between 2022 and 2023 were subject to compromised care. The period of time was while the hospital was uncertified and undergoing major changes, after regulators with the Centers for Medicare & Medicaid Services found several health and safety issues across multiple inspection surveys.

“Laguna Honda is unwavering in our commitment to resident safety and wellbeing,” a spokesperson for the city’s Department of Public Health, which oversees the massive facility, said in an email. “The 2019 patient mistreatment incidents were antithetical to what Laguna Honda stands for as the safety-net healthcare facility caring for San Franciscans most in need.”

The class action is one of three recent lawsuits over the abuse scandal that broke out just before the pandemic. Another lawsuit was filed on behalf of individual residents who had fallen and suffered injuries such as broken hips, Stebner said. The third lawsuit, settled in 2023 for $2.2 million, focused on 11 individual patients at Laguna Honda after a group of nurses were found to have taken nude photos of some patients and drugged and abused others.

Nursing home reform supporters with the Gray Panthers, a group of advocates focused on long-term care and other issues facing older San Franciscans, estimate that the city has had to pay nearly $12 million in fines and lawsuit settlements relating to the sexual abuse scandal.

A spokesperson for the San Francisco City Attorney said the class action settlement is an “appropriate response.”

The facility took several steps after uncovering evidence of patient mistreatment and privacy violations between 2016 and 2019, including firing staff who took part in abuse and reorganizing the hospital’s leadership.

But problems for Laguna Honda didn’t end there.

In 2021, two non-fatal overdoses occurred on-site involving methamphetamine and fentanyl, triggering a series of inspections. Federal regulators then decertified Laguna Honda in April 2022 after finding issues with staff hygiene and other problems, such as smoking and drug use on site.

The hospital was forced to pause admissions while it worked to regain certification with Medicare and Medi-Cal, which covers the vast majority of the elderly and low-income residents at Laguna Honda.

Meanwhile, federal regulators had the hospital begin discharging patients in anticipation of a possible shutdown. More than 50 people were discharged or transferred to other skilled nursing facilities, and some ended up in homeless shelters. Twelve frail and elderly patients died shortly after their transfer out of the facility to other nursing homes.”State and federal regulators agreed to pause the mandated discharges in 2022, after an outcry from San Francisco officials and advocates.

The facility achieved recertification again in 2024 after undergoing rigorous inspections and retraining for staff.

“Laguna Honda has undergone significant restructuring and has been the focus of extensive improvements facility-wide, including new policies, enhanced quality management protocols, and new programs that align with national best practices,” the Public Health Department spokesperson said. “This is all with the goal of creating a lasting culture of safety, transparency, and continuous improvement.”

The population at Laguna Honda has dropped from more than 700 residents in November 2020 to 541 as of September 2025, according to city data.

Teresa Palmer, a physician who worked at Laguna Honda for nearly three decades, said the class action settlement underscores the need for more staffing at the facility.

“All kinds of abuse and neglect are expressions of understaffing of both supervisory staff and direct care staff,” Palmer said. “People are so overworked and fear retaliation, and things are covered up because staff are just trying to get through the day.”