Health Department: CMS extends pause on involuntary transfers at Laguna Honda through May 19 as recertification work continues

The San Francisco Health Commission heard on Feb. 7 that the Centers for Medicare & Medicaid Services (CMS) agreed to extend the pause on involuntary transfers and discharges at Laguna Honda Hospital until at least May 19, 2023. Dr. Grant Colfax, San Franciscos director of health, told commissioners the extension recognizes months of improvement work but that the hospital must continue making changes for any further extension.

The extension matters because it preserves residents long-term placement while Laguna Honda implements corrective steps tied to a settlement agreement with CMS. "CMS has agreed to our request to continue the pause of involuntary discharges and transfers of Laguna Honda residents until at least May nineteenth of 2023," Colfax said. He told the commission DPH has shared multiple documents with staff, including a root cause analysis (RCA), a draft RCA in response to a 90-day monitoring survey, and a draft action plan; all remain draft and may be revised after CMS review.

Why it matters: CMS has signaled additional enforcement powers if Laguna Honda does not deliver required documents and improvements. Members of the public at the meeting urged faster leadership changes and more transparency. Caller Patrick Monette Shaw told the commission that his records requests found no pilot leadership analysis had been provided and said CMS had demanded rapid hires: "CMS wants Laguna Honda to prioritize and expedite installing . . . permanent leadership with appropriate nursing home experience," he said during public comment, and later told commissioners "Get rid of Pickens, Sangha" (referring to senior leaders he said lacked nursing home administration experience). Those accusations were made during public comment and were not framed as formal staff findings.

DPHs account: Colfax said the department completed 120 milestones for Laguna Honda and has posted job openings, including for a nursing home administrator, and that the action plan is being updated in response to CMS feedback. He also said CMSs monitoring surveys added new focus areas (resident quality of care, food and nutrition, and life-safety/fire issues) that require additional RCAs and action-plan revisions. Colfax emphasized transparency: some draft documents were shared with staff earlier that morning for visibility.

What did the commission do? Commissioners asked for follow-up at the Laguna Honda Joint Committee and for detailed recruitment timelines for executive hires. There was no commission vote tied to Laguna Honda during the meeting; the record shows the department will continue working with CMS on a revised closure plan and on implementing the action plan.

Next steps: DPH will continue to revise and share the action plan and RCAs as CMS provides feedback and will proceed with national recruitment for a skilled nursing-home administrator. Public commenters asked for rapid public-record releases and a clearer hiring timeline; DPH said it would provide follow-up to the commission and stakeholders.

Provenance: DPH director remarks and related public comment appear in the directors report and the general public comment period (transcript segments beginning with SEG 255 through SEG 396).