Federal regulators have threatened to pull critical funding from San Francisco’s Laguna Honda Hospital after two patients overdosed at the facility last year, a dramatic measure that could force the hospital to shut down.

Officials with San Francisco’s health department, which runs Laguna Honda, said Wednesday that the hospital had fallen out of regulatory compliance, putting its funding from Medicare and Medicaid in jeopardy. Laguna Honda, one of the largest skilled nursing facilities in the country, is run by the city and cares for more than 700 patients, including people with dementia, drug addiction and other complex medical needs, who live on the hospital’s campus.

The hospital has until April 14 to remedy a number of issues identified by state health officials — including the presence of contraband found on Laguna Honda’s campus — in order to stave off a potential financial calamity that could displace hundreds of medically fragile patients.

State officials said they were working with Laguna Honda to bring the hospital into compliance and avoid closure.

“There’s a commitment from (Department of Public Health) and the city to keep Laguna Honda open,” Roland Pickens, director of the San Francisco Health Network, told The Chronicle. “But it would be very difficult financially to remain open without the reimbursement” payments from the Centers for Medicare and Medicaid Services.

Laguna Honda began a correction plan with the California Department of Public Health in October, after state officials found the hospital “in a state of substandard quality of care,” according to a statement from the San Francisco Department of Public Health.

The finding came after staff at Laguna Honda reported two overdoses at the hospital in July, neither of them fatal. Hospital officials disclosed these incidents to the state, adhering to a self-reporting requirement that Laguna Honda implemented in 2019, after a state investigation turned up evidence of patient abuse.

By documenting the overdoses, Laguna Honda triggered an extended survey by the state, which led to the state’s conclusion in October that the hospital had fallen out of compliance. With the correction plan in place, hospital staff had six months to fix deficiencies and enhance safety measures, including steps to eliminate drug paraphernalia or illicit substances from the campus.

Although Pickens and Laguna Honda CEO Michael Phillips said in an interview that the hospital worked diligently to retrain its staff and remind workers to be on the lookout for banned items, state regulators witnessed violations when they inspected the site. In January, state regulators concluded that one hospital worker was not following protocols. This month, inspectors discovered a patient was smoking in a communal bathroom, while another patient on oxygen had a lighter.

On March 22, the state put Laguna Honda in immediate jeopardy for noncompliance with federal regulations and standards, a severe designation that officials lifted five days later after the hospital quickly responded with restrictions on visitors bringing in items and increased safety searches, among other reforms. Laguna Honda officials are contemplating new security infrastructure, such as scanning machines at entrances to screen visitor packages for prohibited materials.

Still, the six-month window is closing for the hospital to substantially finish its corrective plan, while also resolving the problems uncovered at the subsequent site visits.

The looming deadline puts strain on an institution that managed to avert a deadly coronavirus surge in 2020, but is still grappling with the abuse scandal of 2019, which Pickens and Phillips said had no bearing on the current remedial plan. Last year the city agreed to pay $800,000 to settle one of three lawsuits filed by patients alleging they were abused by staff. One of the cases is a class action, involving multiple plaintiffs.

Phillips, the CEO, pointed to the challenges that plague Laguna Honda.

“We care for some of the most vulnerable residents in the city of San Francisco,” he said, many of whom have histories of substance abuse, which may persist as they undergo treatment. Since the hospital is not a locked facility, people can come and go as they please, opening the possibility that they may procure drugs outside and then return to campus, Phillips said.

“Despite our best efforts, illicit substances will eventually find their way onto our campus,” Phillips said. “We’re continuously looking for ways to improve our protocols so that we can find more innovative ways to identify these substances and keep them away from our residents.”

Staff at the hospital struggle to balance patients’ privacy and freedom of movement with the need to sustain a safe environment and take a hard line on illicit substances or materials. Phillips and Pickens said their discussions with regulators have been amicable and collaborative, but that the state is still obliged to follow a process that puts the hospital at risk of shutting down.

“It’s a perfunctory process that was triggered by the October incident,” Pickens said, suggesting that if the state had been quicker to validate all of the hospital’s reforms, “perhaps we wouldn’t be so close to the April 14 deadline.”

Laguna Honda relies on payments from Medi-Cal and Medicaid to fund most of its services, since most patients are low- or extremely-low-income and burdened with complicated medical needs. It was unclear where patients would go if the hospital is unable to stay afloat.

“As you can imagine, there’s a shortage of skilled nursing beds throughout the country,” Pickens said. “California and San Francisco are no exception. It would take quite a while, if it ever came to trying to find new placements for those 700 patients at Laguna.”

He hopes for what he says is a more likely scenario: All agencies collaborate to bring Laguna into compliance by April 14.

In a statement, California Department of Public Health officials said, “Resident and worker safety remains our highest priority, and we continue to coordinate closely with Laguna Honda Hospital and Rehabilitation Center, and our local and federal partners to help ensure the facility meets the regulatory requirements to provide safe and appropriate care to all residents and patients,” the statement read.

Phillips contended that, in spite of past missteps, Laguna Honda has done everything it can to earn the public’s trust.

“As you can imagine, there are thousands of interactions with caregivers and patients throughout any given day,” he said. “There are multiple opportunities for bad outcomes. And yet, in the vast majority of cases, there are no bad outcomes. There are just a small handful of these things that happen, and we report them, as we are required to do.”

Rachel Swan is a San Francisco Chronicle staff writer. Email: rswan@sfchronicle.com Twitter: @rachelswan

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SAN FRANCISCO (CBS SF) – Thousands of residents of the San Francisco Bay Area were without power by dozens of times on Sunday evening after rain showers triggered by a cold front sweeping the area combined with layers of dust accumulated over several months of the drought Short circuit power transformers and electrical lines.

Pacific Gas & Electric reported outages that stretched from the Dublin-Pleasanton area in the East Bay to much of the neighborhoods between Colma and South San Francisco on the peninsula.

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“Several neighborhoods in South San Francisco are experiencing power outages, including intersections controlled by traffic lights,” San Mateo County officials said in an email alert. “Please stop at these intersections as you would with controlled four-way stop signs. PG&E and the fire brigade are working to fix the problems. “

The PG&E website estimated that power would be out for more than 5,000 customers in the Dublin-Pleasanton area at least until about 10:15 p.m.

Hundreds of homes in Vallejo were also without power, as well as in the Richmond-San Pablo area.

“PG&E has multiple locations in @CityofVallejo, but there is no estimate of when all failures will be resolved,” tweeted the Vallejo Fire Department. “The areas affected by the failure have increased as more line failures continue to occur.”

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Meanwhile, the Alameda County Fire Department tweeted, “For the past hour, your ACFD firefighters have been busy responding to electric boom fires due to the rain. If you see cable vaults, retire to a safe place and call 9-1-1. “

Several minor outages have also been reported in downtown Burlingame, Pleasanton Hill, San Jose, Daly City, San Francisco, Oakland, Richmond, San Pablo, Crockett, and Rodeo.

According to PG&E, a total of 35,028 customers were without power on Sunday evening, 9,593 of them on the San Francisco Peninsula and 14,783 in the East Bay.

PG&E said crews have been deployed across the region to work on restoring electricity. There were no ETAs as to when power would be restored.

The culprit on Sunday evening was the first of several cold fronts to set up in the Pacific and is expected to sweep through the parched Bay Area this week.

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“The showers are currently stretching from Monterey Bay to the Napa Mountains,” said the National Weather Service on Sunday night. “These showers have brought from a few hundredths of an inch of rain on parts of our coasts and bays to nearly a quarter of an inch of rain on some of the highest peaks along the North Bay coastline.”

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MARKLEEVILLE, Alpine County (CBS SF) – Additional mandatory evacuations were ordered in areas around the Tamarack fire on Monday as authorities warned of possible mudslides or debris flows because of the rain forecast for the region.

The Alpine County Sheriff’s Office ordered the mandatory evacuation of the Blue Lakes Road, which runs west of the fire area. The evacuation is in addition to the existing evacuations for Markleeville, Grover’s Hot Springs Park and Campground, Shay Creek, Markleeville Village, the Poor Boy Road area, Carson River Resort, Sierra Pines, Upper and Lower Manzanita, Crystal Springs, Diamond Valley Road, Hung A Le Ti, Alpine Village and Woodfords.

The Alpine and El Dorado County’s sheriff’s offices announced Monday that they are escorting evacuated residents to secure pets, papers and other emergency items. The accompaniments take place on Mondays from 4:00 p.m. and 8:00 p.m. Future dates for additional escorts will be set based on current fire activity.

Anyone interested in assistance is recommended to visit the Mad Dog Cafe at 290 Old Pony Express Way in Markleeville.

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The U.S. Forest Service said there was a 60 percent chance of rain on Monday, with the possibility of flooding in drains and debris flows in steep terrain in the fire area. Even if it rains in the area, the fire could remain active, said the forest service.

The wildfire also forced Highway 89 to be closed at the Highway 4 intersection. Highway 4 remains open west of the intersection. The latest reports of the incident suggest that the Tamarack fire burned more than 25,000 acres on Monday afternoon.

On Sunday, the advancing flames forced federal park officials to close the Pacific Crest Trail, which has also been closed between Carson Pass (Highway 88) and Ebbetts Pass (Highway 4). The trail stretches for 2,650 miles from Mexico to Canada and has attracted thousands of hikers. It is divided into five regions: Southern California, Central California, Northern California, Oregon, and Washington.

A firefighter walks towards a house as he battles the Tamarack Fire in the Markleeville community of Alpine County, California on Saturday, July 17, 2021. (AP Photo / Noah Berger)

Over the weekend, a determined group of firefighters battled the advancing flames of the Tamarack fire, preventing the fire from entering the heart of the evacuated Sierra community of Markleeville. The fire had consumed 23,078 acres on Monday morning without containment.

The fire began as a small smoldering flame that was ignited by lightning over the July 4th holiday. The fire came to life on Friday and quickly grew from 500 acres to more than 18,000 acres over the next 36 hours.

There was no containment, but the rapidly growing numbers of firefighters brought into the fight against the flames appeared to have saved much of Markleeville after the fire nearly encircled the community on Saturday. The fire was advancing north, away from the small mountain community.

The fire initially overwhelmed the 50 firefighters who were monitoring the fire. By Monday morning, the number of firefighters had grown to over 750.

Among those evicted from their homes was Rodney Pryor, who lives in Shay Creek.

“They gave me a couple of hours before they said, ‘You have to get out now!'” He said. “So I got a lot of stuff in my RV. All of my valuable things. “

Flames lick the side of the road as the Tamarack Fire burns in the Markleeville community of Alpine County, California on Saturday, July 17, 2021. (AP Photo / Noah Berger)

The National Weather Service said thunderstorms were expected south of US Highway 50 between 10 a.m. and 1 p.m. Monday and were moving north. More isolated storms were likely in the Reno-Carson and Tahoe regions, as well as northwestern Nevada and far northeastern California.

Aside from concerns about flash floods from new burn scars and steep terrain, other impacts include gusty and erratic runoff winds, hail and frequent lightning, in addition to the heavy local rainfall.

There was also a risk that a larger area of ​​blown dust would move over parts of western central Nevada later Monday and well into the evening, causing a rapid drop in visibility.

The weather service had previously issued a red flag warning for the region from 11 a.m. on Sunday until Monday morning. Dry light was also expected to rumble through the Tahoe area, adding to the risk of forest fires.

Gusts of up to 40 miles per hour were expected.

“A red flag means that critical fire weather conditions are either now or about to occur,” weather forecasts said. “A combination of strong wind, low relative humidity and warm temperatures can contribute to extreme fire behavior.”

At least two buildings were destroyed.

The fire forced the cancellation of the “Death Ride” on Saturday, a 103-mile bike tour in the so-called Californian Alps over three mountain passes of the Sierra Nevada.

Kelli Pennington and her family camped near town on Friday so her husband could join his ninth ride when they were told to leave. They had observed the smoke development during the day, but were surprised by the rapid spread of the fire.

“It went so quickly,” said Pennington. “We left our tents, hammocks and some groceries behind, but we got most of our things, pushed our two children into the car and left.”

Paul Burgess, who had pulled up from Los Angeles to take the ride, said most of the cyclists he met were grateful to avoid the risk of fire.

“You just said it was going to go that way,” said Burgess. “It’s part of climate change to some extent, it’s part of many fuels that don’t burn, the humidity is low, the moisture content of the fuels is low, and … across the state, many parts are like a tinderbox.”

For long-time residents, the flames and evacuation brought back memories of the 2012 acorn fire that burned in the area.

“Everything has been rebuilt here and this area is threatened for the second time,” said local resident Andrea Fierle.

© Copyright 2021 CBS Broadcasting Inc. All rights reserved. The Associated Press contributed to this report.

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