To prepare our hospital and team for successful recertification. Our goal is to apply for and secure recertification before the september 19th date. We continue to make strides in making the nez changes in cms program. The 90 day cms survey number 3 took place in june of this year and resulted in 33 findings of noncompliance this is significant improvement from the first survey in November December of last year had 124 findings of insufficient operations. Our goal is to have all action plan mile stones completed by september first. So that laguna honda is recertification ready. That includes all mile stones related to the Monitoring Survey number throw. And mile stones related to nonmonitorings survey statements of deficiencies 2567s this are routinely received due to regular operations. The action plans for Monitoring Survey 3 has 290 mile stones. And the proposed action plan for nonmonterror findings has 85 file stones. Those are proposed as we are waiting final approval from cms they have not begin us comments asking you to make minor corrections to our first submission which we are submitting and hope to have approval. We started working on the mile stones in anticipation they will be approved. All of the mile stones are under way. Also Important Note they build on all improvements going back to survey number one of the analysis done in january in the initial 5 huh human mile stones that came over the last 6 months. Again our goal is to have all mile stones completed by september first so laguna honda is ready for recertification. On behalf of the team work at laguna honda i thank you, commission for your support over the last year. We could not have been in a place today without your support and advocacy. Let me know the appropriate time and happy to answer questions related this resolution. Thank you. We do need a motion to approve and like to yield to the chair of the laguna honda hospital joint committee who may want to move the resolution. I appreciate that president bernal come i would like to move approval of the resolution. To apply for recertification for laguna honda. Second. Secretary, Public Comment. Is there Public Comment in the room . Any folks on the line . Press star 3. I want to know that we had audio problem and is will ask the commission to do general Public Comment in a later time so the folks on the line have an opportunity on this and the minutes. So jeanette, unmute the caller. [inaudible] can you hear me . Yes. I hoped you will go back to the start of the agenda. This is item 5. Way out of order. The second to the last further resolve clause submits proposed resolution. There is concern. When it says the Commission Approves the laguna honda [inaudible] recertified a dual certified to [inaudible] and [inaudible]. This commission should explain publicly how a dual certified [inaudible] nursing facility may be different from a part and or as a distinct part [inaudible]. Laguna hondas state license is for 759 beds Skilled Nursing facility. Well, laguna honda submit the application for recertification immediately after adoption of this resolution today . Alternatively, will we have [inaudible] submitted by september first . Or will it have to be submitted after the expected fourth, 90 day Monitoring Survey that is askeded for september . In either case, this commission should tell the public today when the actual plan date is application will will you believe submitted. Is there a plan to split [inaudible] versus nursing facility care at laguna honda . Or use laguna honda [inaudible] or non[inaudible] and nonnursing facility purposes . Is there still a plan to put the [inaudible] parent cohort one laguna honda parent in the [inaudible] Behavioral Health cohort in the second patient [inaudible]. We need answers to these questions before you vote passing this resolution and return to the published Meeting Agenda im shocked you are taking it so out of order. And other members of the public may not be aware of this switcharoo with the agenda. That was the only handum. Is there someone else on the line . Do we have questions for mr. Pickens . Commissioner guillermo. I want to be on record in commending mr. Pickens and the laguna honda hospital staff and management for getting us to the point where we are able to apply for recertification. And in a timely fashion to meet the concerns about funding and relocation, so but you know having said that, i do want to make sure that we you understand how supportive we have been. Of all of the efforts over a year now. And for the staff that we dont get to see. How hard they worked and how difficult it has been in the circumstances. Again, support the application for recertification. And wish you the best luck in preparing it. Thank you. In commissioner chow. Yes. Thank you, mr. Pickens for all the work you have done over the years and i think it has shown not from the number of mile stones the severity of the citations from the surveys. If i recall the first had a large number that was really in the must do category. And now it looks like may be there is only one or 2 out of the 30 some odd surveys. See that the efforts that you put in over this period of time have shown itself now. In the duplicative survey process for number one and three to be really positive to allow us to mutual forward on the resolution. We know that the time that will take order to i think you referred to the application already sort of created and now you are all really please federal we get a sign off from the feds that your corrective action plans are acceptable. Which sounds like you feel it will be what we will be applying before the september 19th deadline. I do think that perhaps we should understand. Because this is a complex series of well resolve each look like we are not just asking for recertification but recognition on medicaid and medicare and whether well be a distinct part. Perhaps you can explain when well need to do to get us become to where we were in next for that question. We are applying to make laguna honda whole. As if it were before the decertification happened. The snf is a part Skilled Nursing facility the nf is nursing facility. Within the medicaid world, there are people who have Skilled Nursing needs and there are people who have nursing needs that are not skilled who are known as custodial and people who may have had the needs when first admitted and then improved in function and no longer have the needs. Those are the ones who will discharge to the communities. Because we laguna honda is licensed as acute Care Hospital because of the 11 beds. Any Skilled Nursing level is being done as a part because of those acute care beds. If the beds not at laguna honda we could apply as a sniff or nif or both. Because we have aushg cute care we are applying as an acute Care Hospital. Acute Care Hospital section is not under the cloud. It remained acute carement. And thats why we dont apply for acute care. And that therefore, each are required in order to get us back to where we were. It does not speak to. The whole issue of numbers of beds that is a difference from licensure . Right. You said after we get the license back, well say, and of course it is all the beds we had. Absolutely. And then work on if the feds did not agree with that all the the new task, which is to see we get a restoration of the beds. Thats correct. Okay. This is the first step to get relicensed like we were before. And to have the right medicare and medicaid recognition so that we are where we were before the decertification. In anticipation of approval of this resolution, irrelevant it it is a statement of the commissions commitment to the residents at laguna honda and a statement of gratitude and pride in off the hard work that every one of the Staff Members at laguna honda has done. They approached everything mile stone and every new task with professionalism and that same commitment providing care to residents we could not be more will grateful to all of the staff to our Labor Union Partner and mr. Pickens. A long process and we are proud to cast our vote for this resolution. The resolution passs. Thank you, mr. Pickens. Apologize for the make up on the agenda. There have been 2 versions and the version people may have work off of was not in the same order we proceeded we will go back quickly to offer Public Comment. About this on the minutes and yes or no be approximately comment again. Anybody here in the chamber on the phone would like to comment first. On the minutes. Will take those. Comments and well move in general Public Comment. So. I see a hand for the minutes janet please. Thank you. Mr. More winds. The minutes are misleading. Mr. Pickens commented extensively on the july 18th meeting about the medical director recruitment. [inaudible] what pickens [inaudible] the Current Practice involved per time employment and duties for medical directors at other Skilled Nursing facilities that is complete nonsense. Pickens lacks real longterm Care Experience. Laguna honda is not a hundred bed typical nursing home. Uniquely complex. 780 bed facility. Comparing other n will not enlighten pickens about the medical director po vision should be a full time job. The roll problems. Needing over do [inaudible]. Deserves a Board Certified medical director who will have a strong [inaudible] parents and for compliance. Rather than a mindless find someone with back fwround and experience to handle that provision. They will be starting [inaudible]. Pickens play book limited initial page. Disappointing but not surprising all laguna honda longterm Care Medicine are member and manager and [inaudible] in a Skilled Nursing facility. Without having. Time is up. Now general Public Comment for anyone who missed the opportunity. Unmute. Thank you. During the Public Comment on the direction [inaudible] not on todays agenda. Dont cut me off. During past meetings pickens stated an other will [inaudible] and or Sf Health Network are conducting a study expanding blafrl health in San Francisco. Is that working Group Meetings open to the public . How often do they mead if they are not Public Meetings why not. For pickens to statements during Commission Open session meetings, that work group is reportedly [inaudible] and considering whether or not to use space at laguna honda hospital by placing separate cohorts in laguna hondas 2 patient [inaudible]. Traditional patient in one tower and behavioral healing parents in the other. Is that plot still being considered . Actively . Is that work group issued a report yet . Will a report be presented in open session to the Health Commission or to some other Health Commission subcommittee. What other governing body within the Health Commission is the sponsor of that study and when will the public find out about it . After . You rearrange beds on the titanic . And beds at laguna honda. You need to come clean with this, commissioners. And im talk to youing commissioner bernal. Thank you. Please mute. Thats only Public Comment. Back on track with the agenda we will go to the directors report we have naveena bobba. Thank you. Good afternoon, commissioners. Naveena bobba. I will highlight a couple items in the directors report one i want to highlight the fact that the home health has licensing [inaudible] during it. It was a survey done over 7 days. There were only 3 minor deficiency found. A tribute to home health program. And they were commended for the ability to meet the needs of patients throughout the pandemic. Supporting patient who is had limited resource. And another item that was related that was not mentioned the [inaudible] had a revisit from cms as you recall. Came out a couple months ago and this was a follow up survey. They got an excellent recommendation. And relicensing resurvey from cms. Congratulations to those and steams. The other thing i wanted to call attention to is that our Population Health division is working with a fill mg and culture product to produce a Short Documentary about the covid pregnancy. This focuses on the community efforts. I saw preview of this and it was wornful to see all the commune out as well as to seat documentary and see again relive that experience the Community Coming together to protect those that were impacted by covid this is the official launch of this film and will be 3 screenings throughout san pran and urge people to see it. Really to support the community and cell brit and the work they have done. The other itemil talk about the sfg got a star from cms. This is something to celebrate. Achieving an extra star is hard for safety net hospitals to do. Because they are not as well funded and patients are very complex. They managed do this by highlighting several things they are done, including lower than upon expected death rates including the hospital that handles high vol um patients. And the Care Experience exceptional. And it is above the means for clean liness and recommend it as a hospital. Care scored better not that National Mean for low infection rate and reduced spread of infection and care with almost 99. 9 of staff vaccinated for covid and the ability to keep staff Health Employment toed congratulate the team. It was a well deserved star and really grateful to the work they do. I will end the report with a covid update. Im sure you are seen that there is a [inaudible] up tick a local up tick. In wastewater results. Our will team does montort sure virus Alert Network and seen increase rates the rates are lower than when we had seen prior. However issue given this during the summer people are garth and more travel wore getting the message out if you have not got your booster you should do so much those over 65 may be also eli didnt believe for a sect booster they should check. And maintain some of if you are concerned about corid maintain when we talked about throughout the pandemic masking and if you are vulnerable. May be avoiding crowded areas and if you get sick are eligible talking to doctor about medications. So happy to answer questions. Secretary, do we are Public Comment. We are on item 40 directors report. I see a hand. Unmute the caller. Excuse me. Sorry. The directors report just presented stated in background file posted line. 90 day Monitoring Survey and another nonMonitoring Survey. Conduct in the june. 290 additional Monitoring Survey mile stones and 85 nonmonitor mile stones the total a combined 375 additional mile stones. After may 13th deadline of the in the now 1 mont period, between today august first and september first. This does not bode well for the recertification application being submitted to in time in the summer and end quote. If it ran promised for a long time. I noticed the application has not been submitted by temperatured during this june 20 meeting picken stated laguna honda had initial low 220 mile stones which [inaudible] over 520 mile stones. By the time all mile stones would robbery completed by may 13th. Now laguna honda almost 400 more mile stones [inaudible]. Important andly, demonstrate the mile stones are release the root cause for port 5 and 6. After all. The two ies 6 monitor report dated july 10, stated on page one, that [inaudible] implied address form 2567 [inaudible] by june 59. 90 day monstore survey number 6 addressed the form [inaudible] plan from three complaint related surveyed. Conducted between march 13 and march 17th and other surveys involving complaintos april 4 and 19th. You need to time is up. Mute him. I will make sure there was no Public Comment in the room. Okay. That is all the Public Comment on this item. Comments or questions on the directors report . Vice president green. Thank you for the encouraging things in the report t. Wonderful the star award exclude my understanding of the jcc the star award is based on data from a few years ago. Some may have been during the pandemic. There have been steps the staff the general taken to improve and this statistics we have seen on parameters that go in the star rating continue to being better i would not be surprised if we gained one more star. There is a lag temperature is exciting we got this and i think we feel based on what we see there are more to come. Extend our gratitude to everyone there. It is markable deserves 5 stars as far as we are concerned. I agree Vice President green. Other quick comment the access documentary screened we like to know when and where that is happening if the secretary can find out and see if we can participate in that. Would be great. No other comments on the directors report we have already voted on the resolution regarding laguna honda recertification. Now move on to item 6 and back on track for the healing Information Technology quarter low review. Welcome our chief Information Off