Laguna Honda crisis reflects San Francisco's fragile health care system

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Laguna Honda crisis reflects San Francisco's fragile health care system
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Nearly 700 extremely low-income, medically fragile patients face displacement if Laguna Honda is not successful in its efforts to regain its lost certification.

A full review of federal inspection reports from Laguna Honda Hospital and Rehabilitation Center reveals a tipping point for many aspects of San Francisco’s public health system.

The surveys also found multiple examples of drug paraphernalia and illicit substances on-site, including fentanyl and methamphetamine. One report said a guest coming into the facility was suspected of bringing in drugs on multiple occasions. The facility is still licensed for the time being, but losing federal funding would be devastating to operations.The crisis unfolding at Laguna Honda in part represents the culmination of a years-long decline in public health resources for low-income elders and people with disabilities including those with substance use challenges.

“This should be addressed absolutely. But typically, what we see are just horrific, almost nightmarish conditions that terminate care for Medicare and Medicaid funding. In this case, it seems like lacked supervision or culture of drug use that needs to be remedied,” said Anthony Chicotel, an attorney with the California Advocates for Nursing Home Reform.

For instance, one citation involved a nurse who reported seeing a lighter, burned aluminum foil and plastic brown straws in a resident’s room indicating possible fentanyl use, but the nurse left the items where they were. In documents provided by federal regulators, the nurse said he had not been advised on how to handle such situations and stated “we need training” on how to deal with illicit drugs or supplies.

However, the growing gap in public health services beyond Laguna Honda’s walls for The City’s aging low-income and unhoused populations will be much harder to solve.Laguna Honda makes up a significant portion of San Francisco’s entire stock of skilled nursing beds, and The City is a key funder of assisted living services.

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