In a recent meeting, the San Francisco Department of Public Health (DPH) outlined significant efforts to address the critical shortage of subacute and skilled nursing facility (SNF) beds in the city. With increasing demands for healthcare services, the DPH is actively working to develop new subacute beds and improve access for hospital discharges.

The DPH has been in discussions with local hospitals to establish partnerships aimed at expanding subacute bed availability. In 2022, the department issued a request for proposals to identify facilities capable of providing subacute skilled nursing services. Two facilities were selected: Chinese Hospital, which is set to offer subacute care, and San Francisco Healthcare and Rehab, which will focus on skilled nursing overflow.

Chinese Hospital is currently utilizing a dedicated 23-bed unit for overflow from San Francisco General Hospital (SFGH) and is pursuing certification for both skilled nursing and subacute care. The hospital has also received a $5 million state grant to renovate a unit, which will add 30 new subacute beds once completed. Meanwhile, San Francisco Healthcare and Rehab is working to become a contractor for skilled nursing overflow, enhancing the city's capacity to manage patient discharges effectively.

The meeting also highlighted the financial implications of recent healthcare reforms, particularly the implementation of CalAIM, which has altered long-term care reimbursement structures. The DPH plans to collaborate with health plans to ensure the financial viability of subacute beds, aiming for a more stable future for these essential services.

Public comments during the meeting underscored the urgency of the situation. Concerns were raised about the increasing number of patients being transferred out of county due to the lack of available local beds. A speaker noted that the city has lost a significant number of SNF beds, emphasizing the need for aggressive action to increase local capacity.

As the DPH continues its efforts to enhance subacute care in San Francisco, the community remains vigilant about the challenges posed by limited resources and the pressing need for accessible healthcare services. The next steps will involve ongoing discussions with healthcare partners and addressing the financial challenges posed by recent policy changes.