San Francisco officials report Medicaid recertification for Laguna Honda; Medicare survey and 120‑bed waiver still pending

Laguna Honda Hospital and Rehabilitation Center has regained Medicaid certification, city health officials told the San Francisco Health Commission on Sept. 19, but the facility still awaits a separate, unannounced Medicare recertification survey from the Centers for Medicare and Medicaid Services (CMS).

Sandra Simon, presenting on behalf of Laguna Honda leadership, said the California Department of Public Health and the Department of Health Care Services recertified the facility for Medicaid; CMS later amended the official recertification date to Sept. 5. Simon said Laguna Honda submitted a change-of-information application on Aug. 23 at CMS direction, but CMS later required a full new Medicare application, which Laguna Honda submitted Sept. 15. Simon said CMS may conduct a full, unannounced survey at any time and that the facility remains under active monitoring.

"We are the new and different Laguna Honda Hospital," Simon said, describing completed fire/life safety corrections, operational improvements and a multi‑hundred‑milestone action plan that Laguna Honda and a quality‑improvement expert (QIE) continue to implement.

Why it matters: Laguna Honda provides skilled nursing care for many San Franciscans, and Medicaid and Medicare certification are prerequisites for federal reimbursement and for restoring some beds and admissions. Commission members and public commenters framed the status as a relief but pressed staff for details on survey timing, milestone oversight and bed reactivation.

Commissioners pressed staff to clarify when a Medicare survey might occur and whether it would be conducted by CMS alone or with CDPH participation. Troy Williams, described in the meeting as incident commander for Laguna Honda’s recertification effort, said the survey process is "completely unannounced" and could come within weeks or months. Williams and Simon explained that CMS initially offered to assist transferring information from the incorrect change‑of‑information form to a new application but later could not do so, requiring city staff to prepare and submit a full application.

Public commenters called for faster resumption of admissions and for continued rigorous oversight. Ann Colletidis of the San Francisco Grey Panthers urged that Laguna Honda's beds be preserved as the city’s nursing‑home capacity. Another commenter, Patrick Manets, argued milestones should not have been paused and urged immediate submission of a waiver application for restoring 120 beds, citing federal regulatory language and recommending submission to the state agency cited in 42 CFR.

City staff said paused milestones reflect an internal change in how progress is tracked and do not halt quality‑improvement work: many milestone activities are being folded into an active QAPI (quality assurance and performance improvement) program to keep Laguna Honda "survey ready." Simon said the hospital will prioritize readmitting former residents who were transferred for regulatory reasons and will only admit new residents when improvements are sustained.

The commission approved related policy items recommended by the Laguna Honda Joint Conference Committee during the meeting’s consent calendar vote. No formal commission vote was recorded on Medicare certification; the sanitation to resume involuntary discharges was not advanced at the session.

What’s next: Laguna Honda’s Medicare recertification survey remains pending; city staff said they will continue to implement and report on milestones, and will pursue the 120‑bed waiver process as appropriate once regulatory prerequisites are met.