Laguna Honda Hospital Changes Admissions Policy Giving Priority to Senior Residents

Laguna Honda Hospital, San Francisco's long-term care facility, will revert to a former admissions policy that gives senior residents with long-term nursing needs priority over other San Francisco General Hospital patients, San Francisco Public Health Director Mitch Katz announced Thursday, the San Francisco Chronicle reports (Lelchuk, San Francisco Chronicle, 2/18).

City officials in 2004 enacted a policy change that gave admissions priority to San Francisco General patients who no longer needed regular hospital care but required long-term care. As a result, more patients with substance abuse problems and mental illnesses were transferred to Laguna Honda.

Several doctors and other staff members at the hospital voiced concerns over the patient population shift.

In an effort to block implementation of the policy, patient advocate Michael Lyon in July filed two lawsuits in San Francisco Superior Court against the San Francisco Department of Public Health. One of the lawsuits alleged that the policy impeded fair and equal access to the hospital for the elderly and people with disabilities.

Katz in June defended the policy, saying that all patients regardless of age should be entitled to skilled nursing care, which Laguna Honda was established to provide (California Healthline, 7/23/2004).

Katz on Thursday said that the policy change had saved $1.7 million annually because it is generally more expensive to provide patient care at San Francisco General, which has a larger, more specialized staff than Laguna Honda. However, Katz said Mayor Gavin Newsom (D) had directed him to return to the original admissions policy.

Katz estimated that 75% of Laguna Honda's new admissions came from San Francisco General following the March 2004 policy change. Katz said that about 50% of Laguna Honda admissions would continue to come from San Francisco General under the reverted policy.

"It's clear the policy saves $1.7 million a year. But it's also caused a great deal of upset when people have felt Laguna Honda Hospital has traditionally focused more on people at the end of their life or people with medical disabilities only and have felt uncomfortable with the increase of people coming from General for shorter stays," Katz said.

Derek Kerr, a steward for the Union of American Physicians, said that following the policy change in March 2004, "There was a feeling that the institution had been violated. There had been no planning or discussion for this change."

According to the Chronicle, Laguna Honda is the largest nursing home in the United States. The facility has more than 1,200 beds (San Francisco Chronicle, 2/18).