San Francisco opens 822 Geary stabilization unit; Laguna Honda earns 5-star CMS rating

Deputy Director Bava presented the director's report to the San Francisco Health Commission on May 5, announcing the opening of a new crisis stabilization unit at 822 Geary and updates on other behavioral-health and recovery housing beds.

Bava said 822 Geary, a stabilization unit for people experiencing mental-health crises in public settings, opened last week with four beds and will ramp to 16 over six to eight weeks. The unit is intended as a short-term (up to 23 hours) stabilization site for street outreach teams and to reduce emergency-room burden. Bava said the unit is funded through existing medical funding streams and that early use included about a dozen people since opening.

The director's report also noted upcoming openings this summer of two DPH recovery-bed sites, the Keene and the Marina Inn, while Harbour Light (withdrawal management) will expand through an upcoming contract. Sharon and James Baldwin Place were identified as Housing and Shelter Services (HSH)-run sites with timelines to be provided by HSH.

Bava said Laguna Honda Hospital received a five-star rating from the Centers for Medicare & Medicaid Services in its recent survey, reflecting improvements in quality of care, staffing and resident services.

Public comment and Laguna Honda follow-up requests - During public comment, Jim McAfee, partner of Laguna Honda resident Randy Welch, reported ongoing concerns about care for his partner and said CMS had not interviewed families during the recertification process; he asked commissioners to pay attention to family access and clinical concerns. McAfee described specific incidents including falls and a past hospitalization. - Another commenter urged the commission to ask the City Attorney's Office to follow up with CMS on Laguna Honda's resubmitted 120-bed waiver request dated April 11, 2025; the commenter asked for active city follow-up to prevent delays.

Out-of-county discharge data request Remote public comment from a community member requested that DPH present out-of-county discharge data for calendar year 2024 from all public and private hospitals, as required by San Francisco ordinance 77-22. The commenter said the 2024 data were overdue and asked the commission to direct staff (Miss Patel at SFDPH policy and planning) to present the report at the May 19 full commission meeting. The commission did not formally act on that request at this meeting but the comment was recorded.

Commissioner questions Commissioners asked about the sustainability of funding for the new beds and the timeline for ramping services. Bava said funding for the CSU is from medical funding sources and appeared sustainable so long as those funding streams continue; staff said they would follow up with details about funding for Keene and Marina Inn, as some sites use general-fund support.

Why it matters The stabilization unit and new recovery beds are intended to provide short-term alternatives to emergency departments and to expand the city's continuum of care for substance use disorder and behavioral health. The Laguna Honda CMS rating affects federal reimbursement and public confidence in the skilled nursing facility that serves many San Franciscans.

Speakers quoted and cited - Deputy Director Bava, San Francisco Department of Public Health (director's report) - Jim McAfee (public commenter on Laguna Honda care) - Remote commenter (asked for out-of-county discharge data under Ordinance 77-22)

Ending Commissioners asked for follow-up on funding details and timelines for the new beds; community members asked for faster presentation of mandated discharge data and for the City Attorney to follow up with CMS on Laguna Honda's waiver resubmission.