Evolution of City’s Oldest
Nursing Home Continues

By A.J. Fish
City Star Correspondent

From The City Star
Tuesday, August 28, 2007
Read the original article online here

Make it less of a hospital and more of a home.

That’s what critics of Laguna Honda Hospital’s future assisted living component cost projection study said at a Department of Public Health presentation Monday.

As the rebuild of California’s oldest nursing facility marches on, a cost projection study on Laguna Honda Hospital’s future assisted living component – which the study said will house from 140 to 280 beds – is drawing criticism for being too institutional.

The legal vagueness of the phrase “assisted living” is at the center of the disagreement. In short, opinion on how much assistance is needed for assisted living varies wildly.

But all five scenarios described in Laguna Honda’s draft feasibility study published in early August project that each resident – or each bed – must meet the high assistance standards for licensed Residential Care Facility for the Elderly (RCFE).

Construction costs of each bed meeting RCFE standards would range between $511,888 and $783,354, the feasibility study draft said. The operating costs would range from $127,728 and $171,806 per bed annually. Total construction costs would range from $148,103,501 to $246,000,532, and annual operating costs would range from $25,427,409 and $40,506,571 annually, the study said.

Before the study’s final draft is released in late September, some citizens present at the Department of Public Health presentation on the subject said they would like to see cost projections of other scenarios, where not all beds require RCFE standards.

“High quality housing can be cheaper than a high quality medical facility,” Long Term Care Coordinating Council Member Marie Jobling said.

The assisted living facility is just one of five components that comprise the hospital rebuild project of Laguna Honda, which was built in the 19^th century.

“San Francisco should increase its investment in home and community-based living arrangements with supports for seniors and people with disabilities.”
–  Report by Protection and Advocacy, Inc. on the Laguna Honda facility

In 1999 voters approved a $299 million general obligation bond measure to replace Laguna Honda Hospital with a structure that provides health care and “assisted living and/or other types of continuing care.”

Construction is currently underway for three of the five components.

A disability-rights interest group also published a response to the feasibility study, saying it should include a wider range of level of care.

Protection & Advocacy Inc., a California agency monitoring the human rights of people with disabilities, issued a report on the project after an examination of the presented options.

The report stated that, “although the Feasibility Study defines “assisted living” as a licensed Residential Care Facility for the Elderly (RCFE), in fact, both nationwide and in California there is no one definition of assisted living.”

The release went on to say, “because none of these options is cost-effective, and none affords residents the opportunity for maximum independence, interaction with non-disabled peers, access to the community, or choice in their daily lives, Protection and Advocacy recommends that San Francisco not build this facility on the Laguna Honda campus. Rather, San Francisco should increase its investment in home and community-based living arrangements with supports for seniors and people with disabilities.”

Laguna Honda’s staff thanked attendees at yesterday’s presentation for thoughtful feedback, which they said would be incorporated in the feasibility study’s final draft.