Laguna Honda recertification effort underway; CMS pause gives city until Nov. 13 to prepare

Laguna Honda Hospital’s interim chief executive, Roland Pickens, told a committee of the whole of the Board of Supervisors on Sept. 13 that the hospital is focused on recertification with the Centers for Medicare & Medicaid Services (CMS) after being decertified earlier this year.

Pickens said the decertification stemmed from a sequence of state surveys triggered by incidents and follow‑up inspections; CMS’s statutory rules required termination of participation when not all deficiencies were resolved within a six‑month window. That step, Pickens said, put at risk the hospital’s federal funding stream he estimated at roughly $500,000 per day.

City and Laguna Honda leaders have since pursued a two‑track plan: immediately address compliance gaps and pursue recertification while negotiating with CMS to halt forced patient transfers. Pickens said the city secured a pause on additional patient transfers and continued funding through Nov. 13, giving staff resources to concentrate on recertification preparations.

Key steps reported by Pickens:

- Brought on two consultant firms with skilled‑nursing and public health expertise to assess the hospital, guide corrective actions and conduct pre‑certification “mock surveys.” - Completed an initial mock survey the week of July 21, identified deficits (notably infection control and hand hygiene), and launched over 100 targeted plans of correction. - Launched an intensive retraining program in August that covered nearly 1,200 staff across clinical and nonclinical roles with lecture, skills demonstration (e.g., donning/doffing PPE), and testing. - Instituted 24/7 observation rounds and a “severe finding strike team” to provide real‑time coaching and remedial action when serious gaps are seen. - Planned a second, higher‑stakes mock survey in October to validate sustained improvements and to judge readiness for a formal CMS survey.

Pickens said Laguna Honda will keep its full complement of licensed beds in place rather than de‑licensing 20 rooms that do not meet a 2016 CMS requirement about shared‑bathroom room size; whether CMS will include those 20 beds in a future recertification survey is an unresolved issue. He confirmed 57 patients had been discharged earlier in the year under CMS’s earlier transfer plan but said the city intends to prioritize repatriation of patients who want to return after recertification.

Pickens also reported a COVID‑19 cluster in late August that peaked at 55 cases; aggressive infection control measures reduced that number to a single‑digit case count by early September.

Supervisors pressed on timetables and staffing. Supervisor Melgar asked if staff progress will be sufficient before Nov. 13; Pickens said progress is substantial but the second mock survey in October will provide a clearer readiness signal. Several union and advocacy speakers urged the board to keep the facility open and to prioritize staffing; union representatives warned that a closure would imperil jobs and care for a medically complex population.

Ending: The board voted to continue the Laguna Honda update to a November meeting to follow the October mock survey and the next round of recertification work. No final regulatory decision was announced; Pickens said recertification remains the hospital’s primary goal and that the Nov. 13 pause creates breathing room to focus on corrective work.