Laguna Honda staff report progress on Medicare recertification; one deficiency from anonymous complaint remains under correction

Roland Pickens, director and CEO of the San Francisco Health Network, updated the Health Commission on the status of Laguna Honda Hospital's Medicare and Medicaid recertification process, reporting that the facility achieved Medicaid recertification in August 2023 but still requires Medicare recertification before admissions resume.

“Since announcing our recertification in August of 2023 in the Medicaid program, we've received many questions about what this means for accepting new admissions,” Pickens said, adding that Medicaid recertification was secured but that full CMS recertification requires Medicare approval.

Pickens said survey teams visited Laguna Honda in April for the December 2023 Medicare recertification survey and again April 29–May 3 to review facility-reported incidents and anonymous complaints. He reported zero deficiencies identified from the December Medicare survey and none related to two plans of correction addressing falls, but acknowledged one deficiency resulting from an anonymous complaint (referred to as a Form 2567) that the facility is addressing.

Pickens said two plans of correction are being finalized and were scheduled to be submitted to the California Department of Public Health (CDPH) by the close of business on Thursday; CDPH typically has up to 10 days to respond but has signaled it will expedite review. If CDPH accepts the plans and CMS validates implementation, Laguna Honda will be positioned to receive final Medicare recertification and resume admissions. Pickens said former residents who meet skilled nursing criteria will be prioritized for readmission.

Public commenters and commissioners pressed staff for additional detail. Remote commenter Patrick Monet Shaw asked whether the April deficiencies were rated immediate jeopardy, sought the scope and severity of the citations and asked whether CMS/CDPH had conducted any May site visits. Pickens said the facility had received a 2567 for one anonymous-complaint-related deficiency and that staff are expediting plans of correction but that regulators control the exact timeline and may require further on-site review.

Commissioners asked whether new anonymous complaints or facility-reported incidents could trigger additional surveys; Pickens said survey activity may occur at short notice and that the team is preparing to respond quickly. Commissioners and staff emphasized a new pattern of more frequent regulator reviews as anonymous complaints and FRIs have been handled faster than in past years.

The commission did not take formal action on the recertification item; staff committed to return with updates on CDPH and CMS responses and to continue reporting to the Laguna Honda Joint Conference Committee and the full Health Commission.