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Laguna Honda recertified for Medi‑Cal; Medicare review pending as hospital ramps up operations
Summary
At a committee‑of‑the‑whole hearing Sept. 26, city and health officials outlined progress toward full recertification of Laguna Honda Hospital, noting Medicaid (Medi‑Cal) recertification effective Sept. 5, continued work for Medicare certification, and an incremental approach to resuming new admissions.
The San Francisco Board of Supervisors, sitting as a committee of the whole on Sept. 26, heard city Department of Public Health officials and Laguna Honda leadership describe progress toward full federal certification of Laguna Honda Hospital and the steps needed before the hospital can resume new admissions.
Roland Pickens, director of the San Francisco Health Network and interim Laguna Honda CEO through the transition, told the board that the California Department of Public Health and the California Department of Health Care Services recertified Laguna Honda as a Medicaid (Medi‑Cal) provider and that the Centers for Medicare & Medicaid Services (CMS) has set Sept. 5 as the formal Medicaid recertification date after administrative review. “We are now preparing for a thorough and rigorous facility wide full CMS Medicare certification that can come at any time,” Pickens said.
Pickens and new Laguna Honda CEO Sandra Simon said the hospital still is not admitting new Medicare patients while it awaits a full Medicare survey and any resulting plan of correction. Simon, who joined Laguna Honda in late June and described decades of skilled‑nursing experience, said recent operational changes—standardized individualized care plans, new nursing leadership initiatives, daily interdisciplinary meetings—are new and being embedded into daily workflows.
City officials said the facility is operating below full capacity pending Medicare approval and that transfers of patients who no longer require skilled nursing care continue where appropriate. Pickens said the hospital currently has roughly 480 residents with individualized care plans and that admissions will be incremental to ensure staff and systems remain adequate.
Board members pressed for specifics on timelines, bed counts and behavioral health services. Supervisor Mandelmann asked about “the 120 beds” and how behavioral‑health and substance‑use needs should be managed; officials said a working group has been meeting and will present recommendations to the Health Commission in October. Pickens explained that a subset of rooms—“triplets” that share bathrooms—were taken out of operation under CMS physical‑plant standards and that staff are preparing waiver requests and facility changes to restore the 20 triplet beds back into service promptly when allowed.
Public commenters included former Laguna Honda staff and clinicians. Dr. Theresa Palmer, a geriatrician who worked at Laguna Honda for 15 years, praised the improvements and urged the board to continue oversight, saying she supported regular board review until the hospital is readmitting patients.
Following public comment, Supervisor Melgar moved, and Supervisor Mandelmann seconded, a motion to file the hearing; the board took the motion without objection and filed the hearing record.
Why it matters: Laguna Honda provides long‑term skilled nursing care to San Francisco residents, many supported by Medi‑Cal. Restoring full certification and admissions affects bed availability for skilled nursing care in the city and can relieve pressure on the regional health system.
What happens next: CMS may schedule a full Medicare survey at short notice; Laguna Honda and DPH will submit a plan of correction should the survey identify findings. The working group on behavioral health will report to the Health Commission in October and the hospital will continue incremental operational changes prior to resuming full admissions.
