good morning everyone. i'm san francisco mayor london breed. and today i'm here to talk about laguna honda hospital and i'm joined by the director of department of public health dr. grant colfax as well as the director or laguna honda michael phillips and located in supervisor melgar and we also have a representative from our speaker of the house nancy pelosi's office, her director, dan bernal. we're here to talk specifically

about what we know have been challenges at laguna honda hospital. for over 150 years, this facility has been a beacon of hope. it's been a place that has cared for those who could not care for themselves and, in fact, it has survived the 1906 earth quake and during the pandemic, there were those who thought laguna honda would be similar to many of these care facilities around the country that we would see covid spread rampedly and people die in significant numbers and although we lost six people at laguna honda due to covid, we worked really hard to ensure the safety of the patients there. the people who worked there, the doctors, the nurses, the counselors, they were essential workers and they showed up to work every day to care for

these patients and san francisco was a model in how these skilled nursing facilities can do it right as it relates to protecting patients especially during covid. we were very proud. and i had no doubts because i saw this care firsthand for over ten years as my grandmother who suffered from dementia, this is where she lived. this is where the nurses made her smile. of this is where they painted her nails and did her hair and made sure even though she was in a facility where there wasn't much she could do that there was still a little bit of fun or excitement in her life. i've seen time and time again how these nurses would make arrangements to take these patients to experience things outside the facility so they can feel alive again. this work is hard work. and sometimes people get exhausted. and as a result, things may not

necessarily happen according to code. what we've seen in laguna honda hospital with a notice that we received is a request to make things right. and we have been well on our way to making things right, to improving the conditions, doing things we didn't do before. so, for example, there was some concerns about things getting into laguna honda that should not come into laguna honda and, in fact, part of the solution has been to make changes to how people enter. family members, visitors alike. and at one point when i went into laguna honda to see my grandmother, i would just sign in, put who i was going to see and room number. unfortunately, because of the challenges we're experiencing, that has all had to change. and now, dr. colfax will talk a little bit about what those changes are, but now it means significant changes to laguna

honda, who goes in, who goes out. how we provide patient care, how we provide support. in order to address some of the challenges that existed before, we've made significant changes. we knew that there would be state and federal officials at laguna honda this week to pay very close attention to everything that we were doing and making recommendations in order to ensure that we are first and foremost protecting the patients. making sure that they are safe. making sure that no harm comes to them and also supporting and uplifting the staff. laguna honda is a special place and, in fact, during the visit, what was seen were a number of things that we know can be corrected. someone who may not have taken off their gloves in a timely manner. signage in a needs to be posted to ensure that people are away

of what they're walking into. some things that in comparison to a couple months ago are things that are not only minor but can also be so we still have a long road ahead of us. there's still work to be done. but this pandemic has demonstrated not only to the city, but to the country what we are capable of doing when we focus on insuring life safety of the patients of this facility and the employees. the people who were essential workers. the people who were working to exhaustion to take care of the patients of laguna honda in some cases at the expense of

their own family. we know how valuable this facility is and our plan is to do everything we can in light of recent events to ensure that it remains open. that it remains a place of refuge for those who cannot care for themselves. that it remains in the shape that we know it needs to be to continue to do that. and here to talk more specifically about where we are, what's actually happening at laguna honda and what we plan to do to continue to ensure that this facility remains a viable facility for those who need care in this capacity is our director of the department of public health dr. grant coltax. colfax. >> good morning, and thank you mayor breed for your support of laguna hospital and the

recognition of the vital role it plays for caring for san franciscans most in need. we saw covid devastate nursing homes at the beginning of the pandemic and feared that might happen at the largest skilled nursing facility in the nation. but laguna honda rose to the occasion and served as the national leader for our covid-19 response. for over 150 years, laguna honda's been a pillar of our health care system here in san francisco. it serves as a safety net for those with complex medical and behavioral health needs who are at low or very low income. it is indeed a great pride of our city. while we are in a challenging situation now, the most important thing is that laguna honda is not going anywhere. we will continue to be an

excellent place to receive excellent care. we will continue to be an excellent place to work. and we will continue to be a vital part of the city's health care system. the center for medicare and medicaid services known as cms gave laguna honda notice on march 30th that if we did not come into full regulatory compliance by april 14th, we would face termination in the medicare, medicaid program. this is very important because the overwhelming majority of laguna honda patient care is funded through this program. despite great efforts by the laguna honda community, both staff and residents to improve safety measures related to the initial challenge of prohibited items on campus during the survey revisit this week unrelated and technical infractions were found. these infractions were

primarily related to hygiene, documentation, and infection prevention and control. as a result, cms has moved to terminate laguna honda from the medicare, medicaid program. now laguna honda is a large and complex organization. i know that given more time, the team could have shown compliance. none of the infractions found this week would have led determination had it not been for the organization running out of time to show compliance. importantly, laguna honda did not lose its license and remains a licensed skilled nursing facility. but we take these findings seriously and know that responding to them and working with our regulatory partners, laguna honda will be a stronger organization. we look forward to showing this to our regulatory partners in

the near future as we begin the process of re-applying to the cms program. i want to end by acknowledging the hard work of laguna honda staff and show my gratitude to laguna honda patients and their families for entrusting us with their care. and now it's my pleasure to introduce the laguna honda chief executive officer michael phillips. thank you. >> good morning everyone. thank you, mayor london breed and thank you dr. colfax for your leadership and commitment to laguna honda hospital. it is an honor to serve laguna honda patients and it's an honor to work alongside laguna honda staff. this is a remarkable institution with a great history and a great future.

i know determination may cause anxiety, but i want you to know we will do everything it takes to make this right. i'm confident that we will meet the regulatory requirements and the high standards that we set for ourselves. for those of you unfamiliar with the process, to where we got today and explain our plan of action. laguna honda like all skilled nursing facilities has regular inspections by the state known as surveys and it has an obligation to report unusual occurrences. this is always the goal to improve the facility and the care that we provide to our patients. laguna honda reported two nonfatal overdoses to the state. this led to an extended survey

in october of 2021. during the state's first revisit program. one staff member did not follow protocols related to prohibited substances. this meant immediately that we were not in compliance. on march 16th, the state returned for a second revisit survey. during the second revisit, we discovered that a patient was smoking in a communal bathroom and another patient who was on oxygen had a lighter in their possession. this also meant that we were not in compliance. yesterday, we were informed

that we did not pass a final survey attempt due to the findings that mayor breed spoke of earlier. these were unrelated to the issue of quad and illicit substances. and patient safety. and i want to make three things perfectly clear today. first, we take these findings very seriously and we will address them immediately. secondly, laguna honda is here to stay for our patients, we will continue to serve you and for our staff, you will continue to work at laguna honda and thirdly, laguna honda hospital continues to be a licensed facility and is meeting all requirements of

licensure on a california regulations. as we work diligently to meet all requirements, laguna honda will continue to receive medicare, medicaid payments over the next 30 days. and due to the size of our facility, we will work with cms to further extend the 30 day payment period. and most importantly, we will immediately begin the process of reapplying for participation in the cms program. in fact, staff are already preparing for the recertification process and this will take place in the very near future. we look forward to recertifying with medicare and in the meantime, we will continue demonstrating our unwaivering commitment to patient safety. the work taking place right now

will ensure the longevity of laguna honda hospital and make our organization a stronger one and we will continue to serve the needs of san franciscans most in need. thank you very much. we'll try to answer any questions. >> thank you, mr. phillips. my name is myrna melgar. i am the supervisor for district 7. i have the great honor of representing this district where laguna honda is located. district seven like many other districts in san francisco has a large aging population and laguna honda is our jewel. it serves both who are most at need, the indigent, the elderly, and it does it with great love. it has decades of love from the staff, from our city to take care of folks who need that. we are here as representatives

of the commitment of the values that san francisco has of making sure that we come into compliance that these findings will be corrected and i am so grateful for the leadership of mayor london breed and dr. colfax to address these issues immediately to make sure that the staff have the proper training and to recognize that despite being in a pandemic for the past two years, staff have stepped up to implement new protocols as mayor breed talked about and also new hydroprotocols that are now being implemented so i'm thankful for the city all coming together to support this wonderful institution to ensure that for years to come, families will not be separated and that we will continue to have a top notch facility that is compliant with medicare and

with all our state regulations. thank you so much for your interest in being here and i also am grateful and will now bring up dan bernal who is here representing speaker pelosi's office. thank you, mr. bernal. >> thank you, supervisor melgar. chief of staff in san francisco for congresswoman and speaker of the house nancy pelosi. while speaker pelosi could not be here today, she asked me to protect the health of all san franciscans for your dedication and your care for the staff and the residents of laguna honda hospital and for so eloquently leading and sharing your personal experience and your family's experience with laguna honda. it's so critical at this time. so thank you, mayor breed speaker pelosi laguna honda has long been the pillar of health.

at this very moment, this indispensable institution is ensuring that hundreds of patients with complex medical and behavioral health conditions can get the care they need regardless of their financial means. and during the pandemic, the dedicated staff of the hospital has been outstanding in controlling outbreaks and keeping its vulnerable patients safe from the virus. it is unfathomable to support life-saving programs for some of our most vulnerable san franciscos especially as we continue to be threatened by the pandemic. this 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 health care provider. my office is working closely with mayor breed and the biden administration to support laguna honda's devoted staff

and ensure that the hospital can address its issues, come into full compliance and continue to serve our community for decades to come. thank you. >> thank you, dan, for being here today and thank you to everyone for their support. i also want to express that we in addition to the work that we are doing directly at laguna honda, we have had significant support from our congresswoman jackie spear as well and so we appreciate her as well as our other sfral and state officials who have reached out to work with us to ensure that laguna honda is protected and safe for the people that we are here to serve and at this point, we are open to answering questions related to laguna honda.

>> in funding, how long is that gap. >> we don't at this time believe there will be a gap in funding and i'll let mr. phillip answer that because as he explained in his remarks. we still funding for the next 30 days and expect reimbursement for those patients through this program. but we're in the process of submitting an application. and we expect that with the particular concerns that have been expressed, those things are going to be fixed immediately. and so as a result, we expect that our application will be approved and we should not see any gaps in funding and is there anything you want to add, mr. phillip to that? >> i think that's correct. a process where there is an

immediate 30-day extension of payment. they have also indicated, we haven't received signature assurance, but they have indicated there is a possibility for us to have a further extension of our payment. and i think not only for laguna honda but for cms as well, there's a strong consideration for our patient population and i think they will work with us to do everything within their power to ensure that we have the funding that we need until, you know, we proceed with our recertification. >> [ indiscernible ] >> yes. and i don't want to minimize the findings that c.m.s. found

over the last few weeks and last couple of days specifically. but all these things that were found we are. >> [ indiscernible ] >> thank you for that question. as you know, laguna honda is a very large facility and with over 700 patients and so we receive a lot of visitors for those patients.

we recently implemented a process whereby a visitor is screened at the entrance. we have the san francisco sheriff's department personnel providing those screenings and visitor belongings are either visitors can take the belongings back to their vehicles or they can place them in lockers that we provide for them that are secured and cleaned between use. and it's a very orderly process. we've had it in place now for about a week. the first couple of days were, of course, you know, we had to work through some issues, but by the second day, things were just fine and i think patients and families really understand the necessity for doing this. so everyone is working with us, you know, to implement these

new procedures. >> will it be for staff as well in terms of what they're allowed to come in with? >> there won't be changes for staff, we do have processes for staff where we have to ensure, you know, covid related processes and protocols, but otherwise, this won't apply to our staff. >> all right. thank you very much.

>> commissioner griffin: here. >> commissioner hallisy: here. >> commissioner jupiter-jones: here. >> commissioner mazzola: here. >> the san francisco recreation and park commission acknowledges that we occupy the unceded ancestral homeland of the ramaytush ohlone people. we honor the people for their enduring commitment to mother earth. as the indigenous protecters and of the land, the ramaytush ohlone has never ceded, lost nor forgotten their responsibilities to this place. as stewards of parkland we recognize our duty to honor the ramaytush ohlone. as uninvited guests