Laguna Honda leaders say action plan submitted to CMS; public and commissioners press whether state closure plan can be averted

Laguna Honda executive Roland Pickens told the Health Commission on July 18 that Laguna Honda submitted a root-cause analysis and time‑bound action plan to the Centers for Medicare & Medicaid Services (CMS) on July 12 and is awaiting CMS review. "That action plan with milestones was submitted to CMS last week on July 12," Pickens said, adding the plan includes milestones with many completion dates around Sept. 1 to align with a planned recertification timeline.

The presentation outlined recent leadership hires — including nursing home administrator and chief executive officer Sandra Simon, an assistant nursing home administrator, and Greg Chase as the facility’s first director of facilities and capital projects — and said Laguna Honda is continuing searches for additional senior clinical leaders. Pickens described a sequence of CMS monitoring surveys dating to late 2022 and said progress has reduced some repeat findings, while some deficiencies remain in areas such as individualized care plans.

Public callers and several commissioners pressed whether the department’s recertification efforts can preclude a closure plan that the state was directed to prepare. "A closure plan...is due, so that the more than 500 remaining Laguna Honda residents can be evicted and dispersed statewide," Dr. Palmer said during public comment, asking whether recertification makes that plan unnecessary. In a stark appeal, Palmer added, "people will die if they are forced to leave Laguna Honda," saying the facility still provides a level of care many private nursing homes do not.

Pickens said the closure plan was requested by CMS of the state (not produced by Laguna Honda) and that CMS has discretion under the settlement agreement to extend any transfer pause if Laguna Honda can demonstrably show progress toward recertification. "Per the terms of the settlement agreement...as long as Laguna is able to show progress towards recertification, that is sufficient to provide an opportunity for CMS to extend any transfers and or reimbursement," Pickens said.

Commissioners sought detail on the trajectory of deficiency counts across surveys and on specific milestones. Commissioner Chao noted the drop from the earlier full survey findings to the most recent survey’s 33 cited items and asked what differences remain and how the change affects the recertification timetable. Pickens said individualized care plans are now largely certified by external consultants and that the facility expects to be at or near full compliance for those plans by the end of July.

Several commissioners and public speakers explicitly urged transparency and more public release of root-cause analyses and action-plan documents. A caller asked when the root-cause analysis (RCA) reports would be released publicly; another asked that the Moss Adams contract be presented to the commission as previously requested. Commissioners said they expect Laguna Honda staff to provide clearer documentation and to return with revised timelines if CMS changes conditions.

The commission did not take a formal vote on recertification during the meeting; commissioners used the update and public comment to press for clearer milestones, faster public release of RCA materials and assurances about the implications of the state closure plan. The chair acknowledged the work of Laguna Honda staff and labor partners while emphasizing the commission’s role in oversight and follow-up.

Next steps: Laguna Honda management said it will continue recruitment for key leadership posts, provide requested clarifications about milestones and documentation to commissioners, and await CMS review of the July 12 action plan. Commissioners asked staff to return with clarified wording, additional documents and updates at upcoming meetings as the September timeline approaches.