One of the largest nursing homes in the country could close its doors in November, roughly six months after the federal government said it would take away the publicly owned facility’s federal funding.

San Francisco-based Laguna Honda Hospital & Rehabilitation Center previously had until Sept. 13 to transfer or discharge all of its 600-plus patients, but in a joint statement issued on Aug. 15 the California Department of Public Health, the Centers for Medicare & Medicaid Services (CMS) and the city and county of San Francisco, issued an extension.

The nursing home came under the spotlight when the Centers for Medicare & Medicaid Services (CMS) determined the nursing home was “in a state of substandard care,” according to a San Francisco Chronicle report.

The nursing home had failed to meet compliance standards including resident assessments, comprehensive resident centered care plans, quality of care, pharmacy services and administration, according to a CMS memo.

Laguna Honda was founded in 1866 and at one time cared for 780 residents, according to its website.

While it was not immediately clear from the joint statement why the two-month reprieve was given, it did come after the city filed lawsuits earlier this month against the federal government that argued the deadline was too soon and put the facility’s patients at risk, according to the article.

Back in May, before the extension had been granted, the facility had begun transferring patients who were considered frail. Laguna Honda transferred or discharged 57 residents and nine died shortly after moving, the Chronicle reported.

The transfers were paused in July, and Laguna Honda has not admitted any new residents since Jan. 14.

“During this extended period, transfers and discharges of current residents will remain paused. As has been standard throughout this process, residents who want to leave the facility retain the right to do so,” the joint statement read.

The city is set to argue its appeal of the initial CMS decision in October, according to the Chronicle.