A senior sitting in a wheelchair

A massive, publicly owned nursing home that saw four residents die after being discharged as part of a federal closure plan has been given a temporary reprieve.

San Francisco’s 769-bed Laguna Honda Hospital & Rehabilitation Center was terminated from the Medicare and Medicaid programs effective in April, and federal regulators had ordered the facility to discharge or transfer all its patients before a Sept. 13 closure deadline.

But as patients began leaving, local media reported at least four deaths occurred within days or weeks of a patient moving out. Some of them were attributed to “transfer trauma,” a topic that became the focus of the city’s Board of Supervisors in July.

Late last week, officials with the Centers for Medicare & Medicaid Services agreed to pause the transfers at the behest of the San Francisco Department of Public Health and the city’s Congressional representatives, the Associated Press reported.

After word of the post-discharge deaths spread, CMS appointed an on-site facilitator to assess the remaining transfers and discharges. It was that person’s observations that prompted the new pause, the length of which remained unclear Monday.

CMS Administrator Chiquita Brooks-LaSure described the situation at Laguna Honda as “unacceptable” in a statement shared with San Francisco news site Mission Local.

Brooks-LaSure said CMS “notified Laguna Honda that all transfers placed to date should be re-assessed to ensure patient safety.” She explained that the closure plan imposed on Laguna Honda was “required by statute” after the facility was found consistently violating health mandates for six months.

The city has argued, however, that finding enough places to care for patients with complex needs has been difficult. Through last week it had transferred or discharged only 57, including the patients that reportedly died. At least some of those residents were sent to homeless shelters, local media reported.

The San Francisco Chronicle in July reported on the four related deaths, highlighting the incongruent nature or moving patients out because of a pending closure, even though the facility is working to win back its certification before mid-September. Another publication put the number of deaths at five by July’s end.

CMS terminated payments to Laguna Honda after two nonfatal overdoses there in 2021. The facility has a 2-star overall rating and its Medicare Compare site features the red hand icon noting an abuse citation.

Opened as an almshouse in the mid-1800s, the facility has long taken in city residents who need long-term care for conditions such as dementia and substance abuse disorder but can’t afford private nursing homes.

Sen. Diane Feinstein (D) said Friday that Laguna Honda provides services for patients with few options. She wants CMS to work with San Francisco needed improvements and keep  the building open.

“If (the Centers for Medicare & Medicaid Services) does not reverse its decision, these patients would again be put at risk as they’re transferred to other facilities,” she said in a statement. “This is particularly concerning after some patients were reportedly sent to homeless shelters ill-equipped to provide the necessary medical services.”

Roland Pickens, Laguna Honda’s interim CEO, in late July said it would be possible for the facility to once again meet the CMS requirements of participation and be recertified.

“Laguna Honda has served San Francisco’s most vulnerable residents for 150 years and we plan to do so for another 150 years,” he said in a statement.