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Inside SF’s Laguna Honda: The potential closure of the nation’s largest public nursing home

Donna Deufemia’s brother, Anthony Deufemia, has been living at Laguna Honda Hospital since 2021 with a painful spinal condition. He’s had a hard time walking lately, and medical staff fear the damaging repercussions of a severe fall, let alone the potentially fatal consequences if he were to be transferred out of the hospital.

Yet that remains a real risk. Since April of this year, the hospital has faced the prospect of having to close its doors for good.

Laguna Honda, the country’s largest publicly funded skilled nursing facility, is staring down a federally mandated closure, though patient transfers are currently on pause and funding was recently extended. The 156-year-old nursing home must regain federal certification so it can continue receiving funding—if it does not, its approximately 700 medically fragile patients, like Anthony, will eventually be moved to other facilities.

“It's been very, very stressful. I mean, visions of seeing your brother lying on the street like you see homeless people because he can't walk,” Donna said.

In the midst of this uncertain future, The Standard spent time at Laguna Honda documenting the lives of patients, families and staff. At play is the fear of “transfer trauma,” a non-clinical term used to describe health disorders or death that can result from forcing ill or elderly patients out of a nursing facility. Before Laguna Honda paused its transfers, nine patients died following hospital discharge. 

As Laguna Honda strives for recertification, the question looms: If the hospital does eventually close, where will its 700 at-risk residents go?

Mike Kuba can be reached at