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San Francisco Health NetworkLaguna Honda Hospital and Rehabilitation Center

Laguna Honda Hospital Executive Team Report

San Francisco Department of Public Health

Michael T. Phillips, MHA, FACHEMay 11, 2021

San Francisco Health NetworkLaguna Honda Hospital and Rehabilitation Center

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SAFETYPages 4 to 7• COVID-19 Case Check-In• COVID-19 Vaccine Rollout

QUALITY Pages 8 to 9• Survey Updates

CARE EXPERIENCEPages 10 to 13• Mental Health Awareness Month• Continued Safe Reopening• Laguna Honda’s Therapeutic Farm and Garden Profile• State of the Hospital

FINANCIAL STEWARDSHIPPages 14 to 16• Financial Updates• Statement of Revenue and Expenses

MAY 2021 UpdatesWORKFORCEPages 17 to 19• Nursing Leadership Updates• Nurses Week 2021• Team of Month of Recognition – Facilities

EQUITYPages 20 to 21• Department of Equity and Culture Updates

SAFETY

COVID-19 Case Check-In

• COVID-19 response remains one of our highest priorities.

• LHH continues to maintain very low case numbers. No resident has tested positive for COVID-19 since January 18, 2021.

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Staff and Resident CasesGroupTested

Total Confirmed Positive Cases

Recovered Cases

Active Cases Deaths

Staff 173 171 3 0Residents 63 57 0 6

Total 236 228 3 6Data as of 4/30/2021

SAFETY

COVID-19 Cases at Laguna Honda

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Date of Test Resident Staff Grand TotalTotal 2020 Cases 46 129 175Jan 2021 17 36 53Feb 2021 0 5 5March 2021 0 1 1April 2021 0 2 2Grand Total 63 173 236

Data as of 4/30/2021

SAFETY

COVID-19 Vaccine Rollout – Staff

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• Laguna Honda vaccinated an additional 12 staff members in April.

SAFETY

COVID-19 Vaccine Rollout – Residents

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• Laguna Honda vaccinated an additional 22 residents in April.

QUALITY

2021 Annual Skilled Nursing Facility Recertification Survey Completed

• This was a five-day survey conducted by a team of nine CDPH surveyors.

• Survey exit conference was conducted on April 19th, with 14 preliminary findings.

• We are awaiting receipt of the official CMS 2567 and will submit our plan of correction within 10 calendar days of receipt.

• This was a total team effort. A special thank you goes out to the Nursing, Food and Nutritional Services, and Quality Management teams for their focused participation during the survey.

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QUALITY

2021 Annual Fire Life Safety and Emergency Preparedness Survey Completed

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• This was a four-day survey conducted by a team of two surveyors.

• Survey focus was centered on the Environment of Care (EOC).

• Survey exit conference conducted on April 29th, with 22 preliminary findings. All preliminary findings were minimal in magnitude.

• We are awaiting receipt of the official CDPH 2567.

• A special thank you to the Facility Services team for their excellent preparation and performance during the survey.

• Also a special thank you to the Environmental Services (EVS) Team team for maintaining the exceptional appearance of the hospital during both surveys.

CARE EXPERIENCE

Mental Health Awareness Month: Spotlight On Psychiatry

Pandemic response:

• Established emotional support warm line for residents with emotional distress.

• Added telehealth as an option for engaging residents in treatment.

• Continued in-person individual services (routine and urgent): psychotropic med management, mental health treatment, neuropsychiatric services, substance treatment, behavioral consultation and planning.

• Established weekly behavioral rounds on key units to provide additional support.

• Started monthly Medicine-Psychiatry med staff case conferences to promote learning and collaboration on challenging cases.

• Participated in Code Home responses.

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CARE EXPERIENCE

Continued Safe Reopening at Laguna Honda

• Laguna Honda expanded visits to include on-unit visits on April 19, 2021 and added weekend visitation.

• In mid-May, Laguna Honda will expand residents out on pass.

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PHOTO CREDIT: PRECITA EYES, 2016

• We hosted Precita Eyes for a design workshop for the upcoming Woodside Avenue mural. Residents provided ideas and sketches. A painting “workday” is tentatively planned for the summer.

CARE EXPERIENCE

Laguna Honda’s Therapeutic Farm and Garden Profiled in SF Gate

• SF Gate profiled Activity Therapist and Farm Manger Henry Cortez and Laguna Honda resident Felipe Martinez (pictured right).

• The Farm and Garden remained open during the pandemic and this spring, animal-assistant therapy resumed in the hospital.

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• “As Martinez moves toward the goats — Agnes, Priscilla, Annabelle, Nathan and Oliver — they swarm him in excitement. Oliver is his favorite of the bunch. ‘He’s the leader,’ he said.”

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CARE EXPERIENCE

State of the Hospital – Admissions, Discharges, and Expirations

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FINANCIAL STEWARDSHIP

Finance Update

• FY20-21 Q3 Financial Report submitted to Controller’s Office and Health Commission.

• Current expenditure surplus projections in salary, fringe, and materials and supplies largely attributed to COVID operations and cost recovery.

• Revenue surplus is attributed to increased per diem and relief funding related to public health emergency.

• Finance team preparing for fiscal year end close which will include a substantial effort to reconcile and claim COVID expenditures.

• Working across DPH to finalize COVID-19 budget and staffing plan for FY21-22.

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FINANCIAL STEWARDSHIP

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Statement of Revenue (Q3)

Projection Revised Budget Original Budget Variance % VarNET PATIENT SERVICE REVENUE:Medi-Cal Revenue 198.04 185.49 185.10 12.56 6.8%

Medicare Revenue 7.57 9.83 9.83 (2.26) -23.0%

Patient Fees - - - - n/a

Other Patient Revenue (0.30) 0.54 0.93 (0.84) -154.6%

TOTAL NET PATIENT SERVICE REVENUE 205.32 195.86 195.86 9.46 4.8%

OTHER OPERATING REVENUE:Fees/Fines/Licenses 0.56 0.56 0.56 n/a

Other State/Misc (0.33) 0.28 0.28 (0.61) -216.4%

Revenues from Other Departments 0.24 0.24 0.24 n/a

Multi-Year Projects 6.67 6.67 4.70 - n/a

Transfer-In 4.62 4.62 2.00 - n/a

TOTAL OTHER OPERATING REVENUE 11.77 12.38 7.79 (0.61) -4.9%

TOTAL OPERATING REVENUE 217.09 208.23 203.65 8.85 4.3%

FINANCIAL STEWARDSHIP

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Statement of Expenses (Q3)

Projection Revised Budget Original Budget Variance % VarOPERATING EXPENSES:Salaries 149.97 154.38 152.41 4.42 2.9%

Mandatory Fringe Benefits 69.84 73.79 73.21 3.95 5.4%

Non-personnel Services 12.81 12.52 10.63 (0.30) -2.4%

Materials and Supplies 30.87 32.95 24.36 2.08 6.3%

Capital Outlay 2.66 2.66 1.72 - n/a

Services Of Other Depts 18.25 18.25 17.83 - n/a

Annual Project Related 2.00 2.00 1.40 - n/a

Multi-Year Projects 17.64 17.64 9.37 - n/a

Transfer-Out 2.00 2.00 2.00 - n/a

TOTAL OPERATING EXPENSES 306.04 316.19 292.93 10.15 3.2%

WORKFORCE

Nursing Leadership Updates

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Maria Chavez-Lagasca, Utilization Management/Patient Flow Nurse Manager: Maria started her career at ZSFG and has over 30 years of experience as an acute nurse. At ZSFG, Maria worked in Utilization Management and was the charge nurse for 10 years. InSeptember 2019, she transferred to LHH and became the South 5 Nurse Manager, LHH’s COVID-19 unit during the pandemic.

Namnama (Namie) Angeles, South 5 Nurse Manager: Namie has been a nurse for over 20 years. Prior to LHH, she worked at Jewish Home for the Aged where was a manager for the Rehab and Dementia Care Units. In 2016 she joined the LHH team as a staff nurse. LHH recognized her leadership skills and soon she became a relief charge nurse for North 4 and North 3. She later transitioned and became Float Nurse Manager.

WORKFORCE

Celebrating Excellence in Nursing

Nurses Week (May 6 – May 12)

• A committee is hosting a special 2021 Nurses Week to ensure our nursing staff are celebrated. This includes activities on campus and citywide recognition.

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The DAISY Award

• LHH joins healthcare facilities throughout the country in recognizing excellence in nursing through the DAISY Award.

• DAISY Award nominees were recognized this morning in a ceremony and award recipients were announced. Well over 200 nominations were submitted – a record for LHH.

Thank you to Kathleen MacKerrow, LHH’s DAISY Award lead.

WORKFORCE

Team of the Month Recognition: Facility Services

• The team of Carpenters, Clerical Support, Electricians, Gardeners, Locksmiths, Painters, Plumbers, Stationary Engineers and Utility Workers keeps our beautiful campus working efficiently and safely for residents, staff, and visitors.

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• During COVID-19, the team took on many new projects such as setting up our testing site, supporting outdoor visits, installing plexiglass barriers, and installing social distancing signage throughout the hospital.

EQUITY

Department of Equity and Culture Updates

• The Department of Equity and Culture held the first Equity Council. The Council’s mission is to eliminate discrimination and promote inclusion at LHH. Over 40 representatives from across LHH participated.

• The Department published our first Equity Newsletter that was shared with the LHH community.

• Laguna Honda remains aligned with the citywide Racial Equity Action Plan (REAP).

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EQUITY

Department of Equity and Culture Updates

• LHH equity leaders, along with divisional equity leads across DPH, co-facilitated a DPH-wide healing forum and conversation following the verdict in the Derek Chauvin trial. Over 300 DPH staff attended.

• LHH equity leads participated in a DPH-wide Racial Equity Town Hall, that highlighted the Racial Equity Action Plan and divisional priorities. Over 560 DPH staff attended.

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San Francisco Health NetworkLaguna Honda Hospital and Rehabilitation Center

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Thank you