Losing 120 Laguna Honda Beds
Re: Dropping the City Attorney's Lawsuit
- Was the 4,891-page document submitted by the City Attorneys (including a 30-page argument submitted by four attorneys) so weak that it didn’t stand a chance at overturning CMS’ Termination decision?
- Did the submitted arguments miss the mark by failing to show that CMS’ citations did not match CMS’ own standards?
- What about the failure of the California Department of Public Health (CDPH) and CMS to meet their own Termination Procedures and Schedule of Termination Procedures? Their own regulations state that if they do not follow their established procedures, both documentation and timeline, that “it might be alleged at a hearing that the termination action was based on error.”
- Have the City Attorneys verified that CDPH and CMS complied with the following documents:
- State Agency Documentation Requirements?
- Schedule of Termination Procedures?
- I don’t believe the State Agency followed the 90-day timing for Termination procedures. That’s because LHH did not receive the Form CMS-2567 report within ten working days from the 10/14/21 Substandard Quality of Care Survey.
- Secondly, the 1st Revisit was conducted on 1/20/22, 98 days later, instead of within 45 days as required. What timeline was CMS following? Based on my calculation, there are 180 days between 10/14/21 and 4/13/22. If CMS felt no urgency to implement the 90-day proceedings to decertify LHH, does it mean that delivery of care at LHH was acceptable? CMS also did not impose the full required penalties in terminating LHH’s Provider agreement. Instead, CMS stated that it exercised a rare use of discretion to provide for a transition funding period beyond 30 days. So, CMS believed that quality of care services at LHH did not warrant closing the facility services any time soon.
- Was the CMS Notice to the Public timely and accurate?
- Does the document include notice of at least 2-15 calendar days before the effective date of termination? No, the Notice listed the same day (April 14, 2022) as the day when the Provider agreement was to be terminated.
- Among the findings in the 10/14/21 Survey report, only F-0689 (*Free of Accident Hazards/Supervision/Devices) fell under a higher severity rating to warrant a substandard quality of care determination. There were no deficiencies under Resident Assessments, Comprehensive Resident Centered Care Plans, Pharmacy Services and Administration groups that reached a scope and severity level to warrant Substandard Quality of Care findings. So, the CMS Notice to the Public is erroneous.
- Strangely, the 10/14/21 Substandard Quality of Care report shows findings from the later 2nd (March 28, 2022) and 3rd (April 13, 2022) Re-visit Surveys. This is not the usual process and warrants further inquiry. Why did CMS add 31 pages of subsequent survey findings to a report that was completed on 10/14/21? What is their justification?
- Why did CMS reduce LHH’s daily Civil Money Penalties from $2,455.00 to $550.00 on 1/21/22, but did not post the Statement of Deficiencies on the CMS Nursing Home Compare website?
- Lastly, did the State Agency and CMS apply the correct Scope and Severity ratings to F-0689 before decertifying a 700-resident safety net facility? And did our City Attorneys understand these concepts sufficiently to ask CDPH and CMS for evidence that decertifying LHH was well-founded before conceding to a Settlement?
Laguna Honda deserves a fair and correct decertification process - and Settlement Agreement - in order to keep enough beds to meet the skilled nursing needs of San Franciscans.