After months of protests from families, city supervisors and public health officials, California Pacific Medical Center (CPMC) announced that it will continue to care for 28 patients with complex medical needs, instead of transferring them to other facilities outside the city.

In June, the patients and their families received letters from CPMC saying that the skilled nursing unit where they lived at St. Luke’s Hospital, known as a “subacute” unit, was closing permanently. The hospital as a whole is closing because it doesn’t meet earthquake codes, but CPMC officials are replacing it with a new building on the same site in the Mission district. But they did not plan to include any subacute beds in the new hospital, nor would they create a subacute unit  in another new hospital under construction near Japantown.

But in an unexpected reversal,  CPMC CEO Dr. Warren Browner said Monday the hospital system will continue to care for the 28 patients who would have been affected. Spokesman Dean Fryer said the medical center changed course after hearing concerns about the potential impact of the transition on patients and their families. CPMC officials also changed their minds after facing challenges securing beds for patients elsewhere in the Bay Area.

Subacute nursing units treat patients with complex medical needs, such as those on ventilators, for months or even years. The patients don’t need as much care as a regular “acute” hospital patient, but do need a level of skilled nursing care that is difficult to provide at home.

The subacute unit at St. Luke’s is the last one in San Francisco based at a hospital. Regionally and nationally, hospitals have been shuttering these units. The patients demand a high level of care, but reimbursements for the treatment  — typically through Medicaid — are low compared to private insurance.

Families were concerned that the move from St. Luke’s to another facility would be difficult for patients, who are in medically fragile states, and would also impose a burden on them because of the cost and difficulty of traveling farther away for visits. The San Francisco Health Commission took the issue up as well, passing a resolution saying the closure of this subacute unit would “have a detrimental impact” on health services in the city.

When word circulated on Monday that the patients would stay in San Francisco, family members rejoiced. Leneta Anderson’s husband has lived in St. Luke’s subacute unit for 18 months. She visits him nearly every day at dinner time.

“I could cry right now. I am just thrilled, thrilled that my husband and the other patients don’t have to leave,” Anderson said over the phone on Monday. “It’s a victory.”

The new plan is for patients to move to another CPMC facility in August 2018 —  either the new Van Ness hospital, the new Mission Bernal hospital, which will replace St. Luke’s, or CPMC Davies.

Family members, subacute nurses, and city supervisors said Tuesday that their next goal is to increase access by advocating for the creation of more skilled nursing beds in San Francisco.

After Rallies and a Resolution, These Patients Will Stay in San Francisco 13 September,2017Laura Klivans

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Author

Laura Klivans

Laura Klivans is a community health reporter at KQED. In addition to KQED, her work can be heard on NPR, Here & Now, and PRI. Before getting hooked on all things audio, she worked in education, leading groups of students abroad. One of her favorite jobs was teaching on the Thai-Burmese border, working with immigrants and refugees.

Laura won the 2016 North Gate Award for Excellence in Audio Reporting and Production and the Gobind Behari Lal Award for Excellence in Reporting on a Science or Health Story for a radio documentary about adults with imaginary friends. She’s done many fellowships, including UC Berkeley’s Human Rights Fellowship and the Coro Fellowship in Public Affairs. Laura has a master’s in journalism from U.C. Berkeley and a master’s in education from Harvard.

She likes to eat chocolate. For breakfast.

lklivans@kqed.org, twitter: @lauraklivans, www.lauraklivans.com

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