Section Update

Advocacy Work Continues with Laguna Honda


        • San Francisco Department of Health
        • San Francisco Mayor London Breed 
        • San Francisco Board of Supervisors
        • San Francisco city attorney
        • Various stakeholder groups, including the San Francisco-Marin Medical, Alameda County and San Mateo County Medical societies and patient/resident/family advocates


          One of the most significant and pressing issues for the section is the fate of Laguna Honda Hospital, San Francisco’s largest skilled-nursing facility (the largest of its kind in the state). It was decertified by the Centers for Medicare & Medicaid Services (CMS) several months ago, triggering a series of challenges for the county, including the loss of millions in Medicare and Medicaid reimbursement. In addition to seeking (re)certification by a mid-November 2022 deadline, Laguna Honda was also required to immediately initiate a closure and transfer plan. The process was disastrous, resulting in the deaths of several long-term residents almost immediately upon transfer. Despite advocacy from virtually every corner of concern, CMS remained intractable and would not pause or cease the transfers. 

          Two lawsuits were filed in this matter: one by City Attorney David Chiu, on behalf of the county, the other by former City Attorney Louise Renne, on behalf of Laguna Honda residents and families. Pursuant to a settlement agreement arising out of the county’s suit, Laguna Honda has a significant, albeit time-limited, reprieve.

          First, CMS agreed to continue paying for resident care at Laguna Honda until Nov. 13, 2023. Second, CMS agreed to continue to pause the involuntary discharges and transfers of residents until Feb. 2, 2023. During this pause, resident-initiated transfers and discharges will continue, which is a right to which Laguna Honda residents are entitled.

          The settlement agreement requires final approval by the Board of Supervisors and the mayor.

          Next Steps

          Hospital Council will continue to work in partnership with the county and others, to advocate for the certification of Laguna Honda to ensure it remains open and for the continued pause on patient transfers, in the interim.