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Laguna Honda Hospital pauses patient transfers

A Laguna Honda Hospital employee walks into the administration building from the hospital and treatment center’s courtyard in San Francisco, Calif. on Monday, May 16, 2022. | Camille Cohen

Laguna Honda Hospital has stopped transferring patients after several residents died within days of being relocated to other facilities.

Federal regulators that ordered the San Francisco nursing home to relocate patients after yanking its certification this past spring agreed Wednesday to let the facility halt transfers for the time being.

To date, Laguna Honda says it has transferred 41 vulnerable patients to other skilled nursing facilities since the Centers for Medicare and Medicaid Services ended its certification and withdrew funding. Of those, two patients remained in San Francisco and 16 have been discharged—three of whom went to homeless shelters. 

San Francisco Department of Public Health Director Dr. Grant Colfax said suspending transfers is in the best interest of patients.

“No other city in the nation has made the commitment San Francisco has made for a public skilled nursing facility to serve its most vulnerable residents,” he said in a press release announcing the pause Thursday. “Today’s agreement to halt all patient discharges and transfers will allow the dedicated Laguna Honda staff to focus on caring for patients and not moving them.”

In April, the Centers for Medicare and Medicaid Services ended Laguna Honda’s participation in Medicare and Medicaid, which cut off funding and thrust the 156-year-old hospital into an existential crisis.

As a result, and as part of a closure plan mandated by federal regulators, Laguna Honda had to figure out where to rehouse the 700 or so patients under its care.

But finding new placements has proved challenging, officials said. And the vast majority of residents have had to go to facilities outside of San Francisco—away from their family, friends and longtime community.

As of Thursday, officials say, five patients have died shortly after being transferred.

“Finding appropriate placements at a new facility is a challenge and takes time,” the city public health department said in Thursday’s press release. “In many cases, residents have relied on us for their healthcare for years and their continued wellbeing is our highest priority.”

Officials said pausing the transfers affects about 600 patients.

In a prepared statement to The Standard, Centers for Medicare and Medicaid Services Chiquita Brooks-LaSure said agency officials “are deeply concerned” about reports of patients dying after transfer.

Laguna Honda was placed under a closure plan after the federal agency found “significant health and safety violations were found at the facility, Brooks-LaSure said.

As part of the closure plan, she said regulators require Laguna Honda to “perform thorough and adequate medical assessment of every resident before a transfer or discharge decision is made.”

To that end, the Centers for Medicare and Medicaid Services assigned an on-site facilitator on Tuesday and agreed to pause all patient transfers that were scheduled over the coming weeks. Further, the agency directed the hospital to reassess all transfers to date to ensure they were in the best interest of patients.

The Centers for Medicare and Medicaid Services “was required by statute to terminate the facility from the Medicare and Medicaid programs after six months of substantial non-compliance, including failures to train staff on appropriately disposing of illegal drugs and repeated findings of failures to investigate staff-to-resident abuse allegations,” Brooks-LaSure explained. “Recent events at the facility are unacceptable, and it is our priority that regardless of income, people have access to safe, high quality care conditions.”

Roland Pickens, CEO of the San Francisco Health Network and interim head of Laguna Honda, applauded the decision to stop relocating patients—many of whom have complex health needs, such as Alzheimer’s and dementia—as the facility tries to regain its federal certification and funding.

Pickens said federal regulators forced the hospital to complete patient transfers within four months, even after his team asked for at least 18 to err on the safe side.

Despite the challenges presented by the months-long closure plan, he said he’s hopeful the hospital will find a way to regain its certification and stay open.

“Laguna Honda has served San Francisco’s most vulnerable residents for 150 years,” Pickens said, “and we plan to do so for another 150 years.”