Health Commission delays vote on Laguna Honda bylaws after public outcry over 'long-term care' language

The San Francisco Health Commission voted Dec. 3 to continue consideration of proposed amendments to Laguna Honda Hospital's governing‑body bylaws after extensive public comment and questions from commissioners about whether changes would strip explicit references to long‑term nursing care.

The commission's staff and Laguna Honda leaders said the draft amendments reflect current practice and were written to comply with imminent acute‑unit licensing survey requirements. Secretary Moriwitz told the commission the changes are intended to "reflect current practice" and are not meant to shorten lengths of stay.

Speakers representing residents and oversight groups disagreed. Norman Degelman told the commission the revised bylaws as posted "delete long term nursing home care," warning the change "is a disaster for San Franciscans who require a nursing home for long term safety and survival." Benson Nadell, who leads the city's Ombudsman Program, said early readings of the draft suggested a shift toward "post‑acute" phrasing that could erode residents' understanding of rights including notice and appeals and could disadvantage non‑English speakers.

Laguna Honda interim CEO Deltar Saju outlined the facility's admission priorities and emphasized that the hospital’s mission, admission policy and priorities "have not changed" and that the term "post‑acute" was intended to be inclusive of long‑term care, consistent with language used in Laguna Honda documents since 2016.

Commissioners pressed for clarity and time to review changes line‑by‑line. Commissioner Christian said the document as released left readers "not understanding" what Laguna Honda would provide and said she would not vote to approve the bylaws that night. Multiple commissioners called for a redline version that addresses public comments and suggested explicitly inserting "long term care" where appropriate or adding a definition that clarifies that "post‑acute" includes long‑term nursing care.

City Attorney staff advised that simple insertions such as adding the words "long term care" after "post‑acute" could be considered non‑substantive and handled at the meeting, while specification of CEO qualifications or other definitions might be substantive and require additional notice. Deputy City Attorney Anne Pearson recommended continuing the matter to a specified date if further review was needed.

Given the concern from residents, ombudsmen and commissioners — and the stated risk that an unupdated bylaws document could create a vulnerability in an imminent acute‑unit survey — the commission voted to continue the item to the Dec. 17, 2024 meeting and directed staff to provide redlined revisions and answers to commissioners' questions before then. The motion to continue was moved and seconded and approved by the commission.

Next steps: Laguna Honda staff and the City Attorney were asked to prepare a redline incorporating public comments and to provide commissioners with answers to submitted questions in time for review before the Dec. 17 meeting.