Halfway to the closure date of the sub-acute unit at St. Luke’s Hospital, many of its patients still don’t know where they’ll be going.
Families told representatives from California Pacific Medical Foundation on Thursday that the list of Bay Area facilities they had been given by hospital staff to choose from failed to offer real alternatives nearby.
“You’re supposed to be working with families, finding sub-acute care. Is there a list of anything that is available?” one person asked. “My sister looked into it, and says nothing is available in the Bay Area.”
Liz Cong, California Pacific’s clinical manager, said patients had been given two lists, one with facilities within 25 miles and one with facilities outside that range.
“You’re correct, a lot of them, at the time, didn’t have any capacity,” she said.
Some families have been offered placements at a facility in San Jose.
California Pacific runs St. Luke’s, and patients in sub-acute care there were notified in early June that the facility would close Oct. 31. Equivalent care will not be provided at the new hospital being built next door, which is due to be completed sometime in 2018. 24 of St. Luke’s 40 sub-acute beds are still occupied.
Since June, families, doctors and advocates have voiced outrage at the prospect of moving these medically fragile patients, many of whom cannot walk, speak or care for themselves. CPMC representatives have repeatedly stated that they would not be endangering patients by moving them.
Sub-acute patients are particularly tricky to place because they need round-the-clock care and specific services — like attending to tracheotomies — that many hospitals don’t offer. California Pacific has, for years, operated the only sub-acute facility in San Francisco.
CPMC’s CEO, Dr. Warren Browner, said the new St. Luke’s won’t include a sub-acute facility because of a reduction in the nonprofit’s beds — part of a 2013 agreement with the city that dramatically downsized a new hospital being built at Van Ness Avenue and Geary Boulevard.
Browner pushed back on the notion that the closure of sub-acute care was due to cost-cutting.
“One issue that comes up frequently is that this is somehow about money. It’s not about money, it’s about beds,” he said.
“If you knew that you were gonna close six [sic] years ago … why weren’t we told that when our loved ones were brought here?” asked Rick Vallejo. “Instead of dropping this bombshell on me all of a sudden? Why weren’t we informed the day that they were brought down here that this place was going to close?”
“It has been a privilege to be able to care for your loved ones for that period of time. I think all of you realize there are no other subacute facilities in San Francisco,” Browner responded. “For the past many years, you and your families have enjoyed the privilege of being in San Francisco. So I’m not really sure you would have made a different decision, even back then.”
He added that state regulations restricted California Pacific from announcing the closure sooner.
That did not sit well with patients and their families.
“You didn’t do me a favor by letting her be here. I made the mistake of bringing her here, and now she’s been here for six years, and now you want to put her out?” Vallejo said.
Beyond frustrations that the hospital will close, families are also upset that hospital staff didn’t do more research on the options available.
“My understanding of talking to the families, there were many places listed that are not sub-acute, that did not do that level of care,” said Terry Palmer, a geriatric doctor who has been advocating for the St. Luke’s patients. “Why was that done?”
“Any questions you have with facilities on the list, we’ve got a team that’s very capable to sit down with you answer questions about what those facilities can and can’t provide,” responded Susan Bumatay, another CPMC administrator.
But with the October closure date looming, families are becoming antsy.
“If we don’t find anything that is a good fit in time, what is your plan?” someone asked.
“Come Oct. 31, if we haven’t found appropriate facilities, we’re going to continue working with families,” Cong said.
“No one is going to get kicked out. We will work responsibly with every patient,” Browner said.
Raquel Rivera, whose sister has been in the sub-acute unit for seven years, asked if CPMC would postpone the closure date.
“As soon as I can come up with a plan I know will work, I’m happy to postpone it. … It would be irresponsible for me to make believe that postponing will solve the problem,” Browner replied.
Keeping the facility open indefinitely, however, does not appear to be an option — Browner said the hospital license from the old building will need to be transferred to the new one for it to operate.
The Health Commission will hold the second of two public hearings, the first of which drew hours of testimony, to evaluate the impact of the facility’s closure, on Tuesday, Sept. 5.