By Teresa Palmer M.D. Family Medicine / Geriatrics
Laguna Honda Hospital and Rehab Facility (LHH) is now a fully functioning “5-star facility.” However, the Federal Government (CMS-the Center for Medicare and Medicaid Services) has refused to allow patients to occupy 120 safe and serviceable bedrooms.
This is based on a 2016 regulation for NEW skilled nursing facilities (SNFs). LHH is NOT new-it has been operating since the late 1800s and has never closed. It stayed open in 2022 after too many people died when, under CMS pressure to close, evictions were attempted: LHH COULD NOT be closed.
Laguna Honda has more than 1/3 of all nursing home beds in SF! (Even though 400 LHH beds were lost when a new, state of the art facility was constructed in 2010.) Many city “SNF” beds have been shut; there is a per-capita shortage of SNF beds in SF.
There are 769 SNF beds at Laguna Honda—over 550 of them are occupied now, and the remaining empty ones are filling. But with this Federal decision, only 649 may be occupied. Others who need to come to Laguna Honda either must take a chance on a facility out of county---many of which are severely understaffed-- or wait and hope that they will not get sick and die at a non “SNF” facility.
This could lead to an increase in very dangerous scenarios for San Franciscans who are in a low-quality facility or are getting inadequate care at home. What if you need help to move in bed and keep clean: “Is my infected bedsore sending me into septic shock yet?” Or maybe you have severe memory problems and like to walk: “How far south can I walk on freeway 101 at 3 a.m. without getting hit?” (These are real life scenarios taken from my experience as a geriatrician).
In fact, the state (California Department of Health Care) is willing to license these 120 LHH beds, and the San Francisco Department of Public Health (SFDPH) is willing to provide staff to care for people in those beds. But what our City movers and shakers are unwilling to do is to have a public fight with the current Federal Administration over this. There has been no discussion of litigation except for SF leaders (Mayor and City Attorney) refusing to consider it. The official reason is that this might not result in success with the current administration and besides: “local health departments like SFDPH must focus on protecting the broader system of care.” (https://www.sfchronicle.com/health/aging-longevity/article/laguna-honda-nursing-home-beds-increase-denied-20782338.php ) Are people who are elderly and/or too disabled to live outside a facility NOT part of the “broader system of care?”
On Monday August 18 at the 4 pm SF Health Commission hearing, the legally required yearly count of folks who have been transferred from San Francisco hospitals to out of county nursing homes in 2024 will be presented. The agenda and how to attend this meeting either in person or remotely will be available by Friday Aug 15 PM at https://www.sf.gov/departments--san-francisco-health-commission/events/upcoming (link).
Please show up or write in to remind our Health Department that we want to grow old in the City that we love, and, if we need it, in a bed at our own public nursing home: Laguna Honda. Those 120 beds must remain a priority!