Laguna Honda Hospital Closure and Patient Transfer and Relocation Plan

The Closure Plan is currently paused. The federal Centers for Medicare and Medicaid Services (CMS) has agreed to the City’s request to continue the pause of involuntary discharges and transfers of Laguna Honda residents until September 19, 2023.

Laguna Honda provides safety net healthcare services to our city’s most vulnerable residents.

In April 2022, the federal Centers for Medicare & Medicaid Services (CMS) terminated its Medicare and Medicaid payments to Laguna Honda. CMS funds the majority of resident care at Laguna Honda.

Laguna Honda has an aggressive initiative in place to ensure the hospital continues to receive the vital CMS funding for resident care and is recertified in Medicare and Medicaid.

On July 28, 2022, CMS and the California Department of Public Health (CDPH) agreed to the City and County of San Francisco (City)’s request to pause all transfers and discharges. Accordingly, Laguna Honda immediately paused the discharge and transfer of all residents.

On August 15, 2022, Laguna Honda reached an agreement with CMS and CDPH to extend Medicare and Medicaid payments to Laguna Honda until November 13, 2022, and to continue the Closure Plan pause during this extension.

On October 12, 2022, the City reached a settlement with CMS and CDPH that paused the involuntary transfer and discharge of residents through February 2, 2023 and extended payments through November 13, 2023.

On May 18, 2023, CMS agreed to continue the pause of involuntary transfers of Laguna Honda residents until September 19, 2023. CMS also extended payments for the care of our residents through March 19, 2024.

This is the humane and compassionate path forward. Laguna Honda and the dedicated staff are fully committed to caring for our residents and achieving recertification.

Read more about Laguna Honda's Path to Recertification here.

Weekly Dashboard

The weekly Closure and Patient Transfer and Relocation Plan data dashboard is paused as of July 28, 2022 as all transfers and discharges were paused. During this pause, resident-initiated transfers and discharges will continue to occur, which is a right our residents are entitled to and aligned with hospital policy.


Closure and Patient Transfer and Relocation Plan

Laguna Honda initially implemented a Closure and Patient Transfer and Relocation Plan. The Closure Plan was paused on July 28, 2022.

As part of the Settlement and Systems Improvement Agreement with CMS, Laguna Honda was required to revise the Closure Plan. Laguna Honda worked with CMS and CDPH to finalize the plan and on Tuesday, April 18, 2023 CMS and CDPH accepted the revised Closure Plan.

Transfers under the revised Closure Plan remain paused until September19, 2023.

We are hopeful that we will never have to put this plan into action because of our continued improvements and future recertification with CMS.

The full revised Closure Plan is available for download below:


Learn More - FAQ

We know the Laguna Honda Hospital community has many questions about Laguna Honda’s participation in the Medicare and Medicaid Provider Participation Programs and the Closure and Patient Transfer and Relocation Plan.


About Laguna Honda Hospital

For more than 150 years, Laguna Honda has been a pillar of San Francisco’s healthcare system, caring for those most in need and providing critical services during pivotal moments in San Francisco’s history, including the 1906 earthquake, the 1918 flu pandemic, the HIV/AIDS epidemic, and the current COVID-19 pandemic. Today, Laguna Honda represents the largest commitment by any city or county to a publicly run skilled nursing facility, serving approximately 700 residents.

Laguna Honda serves as a safety net for residents with complex medical needs who are low or very low income and often have no other options for care. Many residents have complicated chronic medical needs along with behavioral health components (such as diagnosed mental illnesses and/or substance use disorders) and other social or behavior issues. We serve a broad audience in terms of both care and demographics, with more than 25 percent of our population identifying as African American, 18 percent as Latino, and 20 percent as Asian.

Laguna Honda is uniquely organized into 13 specialized nursing and rehabilitation programs. These programs draw upon the talents of practitioners in multiple fields to provide a holistic approach to our resident’s health.

Specialized care at Laguna Honda includes a nationally recognized program for memory care for people with Alzheimer’s and other dementias. Laguna Honda also has an award-winning restorative care program that assists residents to retain and reclaim physical competency. Laguna Honda’s Positive Care program is the only HIV/AIDS skilled nursing program in the San Francisco Bay Area serving approximately 60 residents living with HIV/AIDS.

At the same time, the hospital cares for people coping with the effects of complex or chronic conditions such as stroke, traumatic brain injury or degenerative diseases such as multiple sclerosis, and rehabilitative services that include physical therapy, occupational therapy, speech therapy and audiology, with monolingual care in Spanish and Chinese, palliative care and hospice services.

As we look toward the future, the need for Medi-Cal certified hospital-based skilled nursing facility (SNF) beds will only increase and are already limited today. Currently, Laguna Honda’s beds account for 34 percent of all SNF beds available in San Francisco. And, with San Francisco having only approximately 16 SNF beds per 1,000 adults aged 65 and older in 2020, and California’s population projected to increase by 66 percent for those over 60 from 2010 to 2060 as the baby boomer generation ages, we can expect a dramatic impact on the demand for California’s long term care facilities which already exceeds supply.

Last updated June 26, 2023