Laguna Honda reports full CMS recertification and resumes admissions; commissioners press for clearer admissions data

Laguna Honda Hospital and Rehabilitation Center told the San Francisco Health Commission at its final meeting of the year that the facility has completed a multi-year recertification effort and has resumed accepting new residents.

Interim Nursing Home Administrator and CEO Deltar Sidhu said staff and leadership secured Medicaid recertification in August 2023 and Medicare recertification in June 2024 after intensive corrective-action work and surveys by the California Department of Public Health and the Centers for Medicare & Medicaid Services. "This milestone provided much relief and joy to our residents, families and staff," Sidhu said.

The commission heard an admissions update from Albert Lam, Laguna Honda's chief medical officer, who said admissions resumed July 31, 2024; the facility had admitted 48 residents and denied 27 applications as of Dec. 12. Lam said the majority of admissions have come from the San Francisco Health Network, including Zuckerberg San Francisco General, and that the hospital currently has no wait list and is reviewing applications as they arrive.

Commissioners and public commenters pressed Laguna Honda staff for more granular admissions information. Ombudsman Vincent Nadell asked for demographic breakdowns and clarification of admissions categories (long-term care versus acute rehabilitation). Dr. Palmer, a long-time Laguna Honda clinician and public commenter, urged better outreach to community providers, more accessible application assistance for families and a "no-wrong-door" approach so San Franciscans who need long-term care can find and access available beds promptly.

A remote commenter raised concerns about the way the admissions slide deck displayed averages and axis scales, arguing the presentation overstated apparent gains in daily census between July and November and omitted discharge and death denominators; the commenter recommended expedited outreach to non-SFHN facilities and urged the commission to pursue a waiver to open 120 additional beds.

Laguna Honda officials responded that they are working on expanded community outreach, town halls and clearer publication of admissions criteria and data to reduce denied applications and increase community referrals. Lam said the team is prioritizing former Laguna Honda residents and continues to adjust processes to ensure residents meet the facility's clinical criteria.

The hospital highlighted clinical and operational gains underpinning recertification: a 31% reduction in residents with pressure injuries, a falls rate reported below the national average (3.5%), a medication error rate averaging 3.8% (under the 5% CMS threshold), reduced staff vacancy (from 11.4% to 5.4%) and hiring-time improvements for key classifications. Laguna Honda also reported 23 successful resident transitions back to the community during the fiscal year.

Public commenters and several commissioners said they will follow up at the Joint Conference Committee and in future meetings for more detailed admissions metrics, including stratification by admission type (long-term care vs. rehabilitation), age, payer source and the tool used in utilization review.