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Laguna Honda Medicaid recertification secured; residents press for clear timeline on Medicare, admissions and contract spending

San Francisco Health Commission · September 5, 2023
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Summary

DPH announced Medicaid recertification for Laguna Honda, securing Medicaid funding for most residents. Public and commissioners pressed for clarity on Medicare application timing, admissions procedures and consultant contracts tied to recertification and repair budgets.

The Health Commission heard updates and public concern Sept. 5 about Laguna Honda Hospital’s certification, admissions and related contracts.

Director Grant Colfax told commissioners that the California Department of Public Health and the Department of Health Care Services approved Laguna Honda for Medicaid recertification, ensuring critical Medicaid dollars for the facility. Colfax said the hospital’s Medicare application was submitted to CMS on Aug. 23 and that Laguna Honda is “survey ready,” though he noted Medicare surveys are unannounced.

Several remote and in-person commenters questioned that timeline. A caller noted a Board of Supervisors Budget and Legislative Analyst filing that listed a Sept. 17 Medicare submission date and asked why the commission had not reconciled the discrepancy. Patrick Munoz asked whether the Medicare application had actually been submitted in August or would be submitted in September and flagged that the budget request for $40.5 million in emergency repairs seemed to rely on different timing.

Public speakers and clinicians also asked when resident admissions would resume and whether Medicare certification is required to welcome new long-term residents. Dr. Teresa Palmer asked for a ballpark timeline for admissions resumption, questioned RN recruitment and oversight for complex patients, and urged priority for previously evicted Laguna Honda residents who remain in need of care.

Commissioners and staff described related policy adjustments on admissions within the Laguna Honda policies and procedures: the JCC requested language clarifying that residents involuntarily transferred during decertification would have first priority when admissions reopen. The consent calendar vote included approval of a set of policies and procedures for Laguna Honda with revised admissions language; commissioners were asked to review implementation in six months.

Public commenters also raised concerns about the size and role of consultant contracts (notably HSAG) tied to Laguna Honda’s recovery and whether additional consulting dollars were necessary after recertification. The commission adopted the consent calendar, which included contract approvals, and did not withhold approval for the items presented at the meeting.