Admissions & Billing Admission Criteria
Laguna Honda complies with California and federal laws related to nondiscrimination. Patients are welcome at Laguna Honda regardless of race, color, creed, religion, national origin, ancestry, gender, sexual orientation, disability, HIV status or related condition, marital status, political affiliation, or age if over 16.
Applicants to Laguna Honda are screened for medical necessity and level of care before any admission processing.
Determination is made objectively and on an individual basis according to the following criteria:
- Resident of the City & County of San Francisco
- Primary diagnosis is a medical condition (not psychiatric) that requires nursing facility care (Laguna Honda Medicine Department verified)
- Existing physical or cognitive functional limitation requiring care that cannot be provided at a lower level (e.g. Board & Care, intermediary facility)
- Requires active daily rehabilitation on an inpatient basis
- Need for ongoing rehabilitation aimed at raising functional status
Administrative requirements for admission:
- Completed Interfacility Referral form
- Medi-Cal authorization # and Medicare eligibility data as available
- Private insurance coverage verification and/or HMO disenrollment documentation
- Thorough and updated medical information including medication list and tuberculosis status
- Physician and nursing assessments including current Activities of Daily Living (ADL) ability level
Exclusion criteria:
- Communicable disease for which appropriate isolation facilities are not available at Laguna Honda
- Person under police hold unless 24-hour guards are provided by the Sheriff’s Department
- Active substance use requiring higher level of care as determined by admission screening process
- Mental illness or developmental disability requiring an organized program of active psychiatric intervention, according to Title A of the California Administrative Code, paragraph 278.2(1), (b), (c)
- Ventilator dependent
- Active medical problem requiring ICU care
- Primary psychiatric diagnosis without coexisting dementia or other medical diagnosis requiring SNF or acute care
- Highly restrictive restraints such as 4-point soft.
- Significant likelihood of unmanageable behavior due to:
- Actively suicidal
- Dangerous to self or others
- Violent or assaultive behavior
- Criminal behavior including but not limited to possession of weapons, drug trafficking,
- Possession or use of illegal drugs or drug paraphernalia
- Sexual predation
Discharge Information
Every Laguna Honda patient has an active discharge plan.
All patients are either receiving rehabilitative therapy to improve their functionality and transition to independent living or assisted living, or they are receiving long term care.
Our long term care patients and their families participate in regular evaluations with a team of care providers that includes nurses, doctors, and social workers in order to determine their eligibility for discharge to lower levels of care.
Patients who no longer require skilled nursing care are assisted by the Laguna Honda social work team and case managers from the Department of Public Health’s Targeted Case Management program to find accessible and appropriate alternative housing.
With support and advice from their care team, patients may choose to move to board and care homes, assisted living facilities, or accessible apartments that have support services on-site or provided by community-based organizations.
Laguna Honda patients and applicants for admission may also receive housing under the Diversion and Community Integration Program (DCIP), a joint project of the Department of Public Health and the Department of Aging and Adult Services. Under DCIP, potential patients who may not require the care provided at Laguna Honda, are diverted to accessible housing subsidized by the city.
Price Transparency
The Centers for Medicare & Medicaid Service, through its Price Transparency Rule, requires that hospitals make public standard charges. In compliance with the rule, Laguna Honda is making available the following:
- A price estimator tool with shoppable services that allows consumers to estimate the amount they will be obligated to pay when receiving shoppable services.
- A Machine Readable File with gross charges, discounted cash prices, payer-specific negotiated charges, and de-identified minimum and maximum negotiated charges.
Shoppable Services
The prices for services are based on typical visits, and not intended to be representative of the services that may be required for every visit. The actual price a patient is responsible for may be higher or lower based on the actual services provided.
Machine-Readable File of Standard Charges
This is a machine-readable file that contains columns for the hospital’s gross charges, payer-specific negotiated charges, discounted cash prices (if any), the de-identified minimum negotiated charge, and the de-identified maximum negotiated charge for all items and services provided by the hospital. Currently, the hospital does not offer discounted cash prices to third party payors.
Call 628-206-8448 for more information.
Charge Description Master
List of Billable Items
The Charge Description Master (CDM), or Chargemaster, is a listing of items that could be billed to a patient, payer, or health care provider. The most current Chargemaster can be found on the State of California Department of HealthCare Access and Information (HCAI) website.