Appalling, outrageous, inhumane, unacceptable, heartbreaking, tragic were all words that doctors, nurses and families of patients used on Wednesday to describe the closing of the skilled nursing and sub-acute units at St. Luke’s Hospital.
The remarks were made at a hearing in front of the Public Safety and Neighborhood Services Committee meeting. It’s unclear if Board of Supervisors can prevent California Pacific Medical Center from closing the beds – a move that would impact 44 patients – but it was clear that the supervisors will try.
The units slated for closure care for patients with extreme health needs, such as patients requiring inhalation therapy or intravenous tube feeding. Closing the units means that the most vulnerable patients would have to be transferred to locations outside San Francisco, according to those who testified at the hearing.
“We now have no sub-acute beds in San Francisco,” said Supervisor Hillary Ronen, a co-sponsor of the hearing with Supervisor Ahsha Safai.
This means that patients with extreme health needs whose families live in San Francisco cannot receive care in San Francisco.
A speaker from the Department of Public Health said the city’s population is aging and if there is no change in the number of acute care units, there will only be 12 beds available per 12,000 people in the near future.
With an aging population the number of skilled nursing and sub-acute beds in hospitals should be increasing. However, the speaker from the Department of Public Health said that there is an “overall decline in skilled nursing beds.”
In its defense, Mary Laneer, from the California Pacific Medical Center (CPMC), a Sutter Health affiliate, said they are currently devising an individualized plan for appropriate and safe transition for the 44 patients affected by the closure.
Many of the family members of patients currently in St. Luke’s sub-acute units were outraged at this response. They want to avoid the transition in the first place.
“Patients are in jeopardy,” said Jane Sandoval, a registered nurse that has worked at St. Luke’s for 32 years. Moving them would mean moving them away from their families and support networks and from the nurses that they already know and trust. All the families are very happy with the service they have received at St. Luke’s and don’t want to move from there.
“CPMC (California Pacific Medical Center) is destroying excellence where they have created it,” said Supervisor Jeff Sheehy about closing down the units that patients and families have been so happy with and which, in many cases, have expanded patients’ lives.
Families of patients also said that the notification process left a lot to be desired. They say they were approached and told that they would have to choose somewhere to be transferred to.
“The word ‘choice’ doesn’t even belong in this conversation,” said Supervisor Sheehy about choosing a place to be transferred to. No one wants to be transferred to a place outside of the city where their families live.
Some believed that the new California Pacific hospital going up on Cathedral Hill would provide new sub-acute care beds that the patients at St. Luke’s would be able to occupy. However, Laneer said that of the more than 300 beds in the new hospital none would be sub-acute beds.
“Make no mistake. This is about money and this is about profit,” said Dr. Ken Barns, who worked at St. Luke’s for 30 years. Sub-acute beds are costly to maintain and are not a revenue center.
The Committee will continue to discuss the issue in its upcoming meetings.
But Ronen made clear where the supervisors stand on the issue.
“There is unanimous agreement that this unit must stay open,” she said.
