Senator asks HHS to keep Laguna Honda Hospital open after losing Medicare funding

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In a letter to the Department of Health and Human Services, California Senator Diane Feinstein asked the agency to reverse a decision by the Centers for Medicare and Medicaid Services to terminate Medicare and Medicaid participation for San Francisco's Laguna Honda Hospital.

CMS cut the hospital's funding in April after an inspection turned up fresh violations.

According to the City of San Francisco, funding was frozen for 30 days due to "compliance issues" at the hospital, with the San Francisco Department of Public Health telling the hospital it needed to crack down on contraband including drug paraphernalia, following a pair of patient overdose incidents.

Laguna Honda is a skilled nursing and rehabilitation center owned and operated by the San Francisco Department of Public Health.

Newer compliance violations, according to SFIST.com, included incidents with hand hygiene, documentation issues and infection prevention. One unit in the hospital lacked signage for personal protective equipment, two missed medication doses and, in one instance, a staff member improperly stored a face shield.

The Health Department said there wasn't enough time to fix those deficiencies before the end of CMS' review period, leading to the agency's decision to cut off the Medicare and Medicaid funding, which comprises about two-thirds of the hospital's overall funding.

Feinstein wrote in her letter that this decision "would upend the treatment and force the relocation of some of the most vulnerable residents in San Francisco."

"I strongly urge you to reverse this decision and instead direct CMS to work cooperatively with Laguna Honda Hospital as it makes whatever changes are necessary for recertification into the Medicare and Medicaid programs," wrote Feinstein.

WHAT'S THE IMPACT?

Citing the hospital's 150-plus years of operation, Feinstein said Laguna Honda continues to serve as a safety net facility for approximately 700 patients, many with complex medical needs and a lack of options when it comes to receiving healthcare services.

She said the hospital will now need to relocate several patients.

"According to San Francisco health officials, these patients will need to be moved outside of the San Francisco Bay Area, including in Northern California, the Central Valley, Southern California, and even possibly outside of California," wrote Feinstein. "Transfers to other states will complicate the process even further given the need for each patient's Medicare and Medicaid benefits to be transferred to the receiving state."

Crediting hospital leadership with taking the findings seriously, Feinstein said the hospital has taken steps to make improvements in patient safety and care, and has retained experts to conduct a "comprehensive organizational assessment."

"CMS' decision to relocate these vulnerable patients adds unnecessary risk to their health and well-being," said Feinstein.

Laguna Honda has been facing issues for years. In 2019, according to SFIST, the Health Department looked into allegations of patient abuse, including more than 20 dementia patients who were allegedly subject to verbal and physical abuse by a group of about six employees. The hospital paid out about $800,000 in the first of three lawsuits connected to that investigation. And in 2020, the hospital experienced an outbreak of infections that killed three elderly residents.

The Health Department said the hospital is currently re-applying to continue its participation in the Medicare and Medicaid programs.

THE LARGER TREND

Feinstein isn't the only member of Congress to press for Laguna Honda to keep its doors open. On April 14, after CMS decided to cut funding, House Speaker Nancy Pelosi called the facility "indispensable."

"It is unfathomable that Laguna Honda could lose the vital federal funding it needs to support life-saving programs for some of our most vulnerable San Franciscans – especially as we continue to be threatened by the pandemic," Pelosi said in a statement at the time. "That is why it is both urgent and essential that city, state and national officials work together to help address areas of concern and protect this crucial healthcare provider."

Pelosi said she was working with the San Francisco mayor and the Biden Administration to ensure the hospital can come into compliance.
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com