Residents of Laguna Honda Hospital, a 700-bed skilled nursing facility run by San Francisco, received notices Monday saying they could be evicted as part of a closure plan mandated by federal regulators, who have threatened to pull funding after two patients suffered nonfatal overdoses last year.
Many of the patients would have no place to go if they were evicted, said an official with Mayor London Breed's administration. The notices do not mean an eviction will necessarily take place as the city has tools to keep the facility open, the official said.
Supervisor Aaron Peskin, who had called for hearings to address the federal funding crisis at Laguna Honda, said mass evictions could worsen a city homelessness crisis that recent data said was improving.
“This is one of the largest crises I’ve seen in over 20 years I've been in and out of office,” said Peskin, “with real human beings being taken care of by the city, being blown to the four winds.”
The notice said Laguna Honda is required to transfer or discharge all of its current patients by mid-September, with a possible two-month extension. The plan, and notification of patients, was a requirement for federal regulators to consider reinstating the hospital’s crucial Medicare and Medi-Cal funding.
Monday’s notice was dubbed a “Closure and Patient Transfer and Relocation Plan,” which would “ensure the safe, orderly, and clinically appropriate transfer or discharge of each patient with a minimum amount of stress.”
But given the already acute shortage of nursing beds in California, such a pledge is impossible, said Mike Connor of California Advocates for Nursing Home Reform, a lobbying group. Moving infirm or elderly patients from nursing facilities often causes trauma that can result in death. For that reason, federal and state laws forbid moving patients without plausible steps in place to ensure their safety.
“Our advice to Laguna Honda residents is to stay put, and if they receive transfer and discharge notices, they should appeal them immediately,” Connor said. “Nursing home laws have strong protections against unsafe transfer. They can win these appeals.”
Laguna Honda is one of the largest U.S. facilities offering skilled nursing care for people with problems such as drug addiction, dementia and other illnesses, or who are unable to walk or have other long-term medical problems.
U.S. authorities had threatened to pull Medicare and Medicaid funding for patients at the facility unless San Francisco set up a plan to solve problems such as drug use, hygiene, patient care and infection prevention.
Hospital officials have expressed confidence in being able to regain certification with Centers for Medicare & Medicaid Services. But after follow-up inspections the agency announced that on April 14 it would terminate the hospital's funding relationship with the Medicare program. Medicare and Medi-Cal payments account for approximately two-thirds of Laguna Honda’s $300 million budget.
Laguna Honda’s ordeal began in October, when state inspectors said the hospital was doing an inadequate job of barring drug paraphernalia. The city said it addressed the drug contraband problem. But a follow up federal report in April said there were still problems with assessing patients, with creating care plans and with the quality of care.
In response, the city has hired outside experts in getting hospitals re-certified, and moved staff to the facility to prepare for the next federal inspection, according to a city memo.