Health Commission: St. Luke’s subacute closure ‘‘will have a detrimental impact’’; urges delay of discharges

The San Francisco Health Commission on Aug. 31 adopted a resolution finding that the planned closure of the hospital‑based subacute and skilled‑nursing unit at CPMC’s St. Luke’s will have “a detrimental impact on health care services in this community” and recommended that CPMC delay discharging current patients until equivalent in‑county options are identified.

The vote followed a presentation from CPMC and the Department of Public Health, and more than three hours of testimony from families, nurses and community advocates. CPMC’s Warren Browner told the commission the hospital has been meeting with families and seeking beds in nearby counties, and that the system has requested a formal extension of the closure date from the California Department of Public Health to the end of the year to give families more time. “It is our intention to find the best possible fit for each patient and family and provide the support they need to navigate this transition,” Browner said in his update to the commission.

Department of Public Health staff provided the commission with data on city capacity and trends. Sneha Patel of DPH’s Office of Policy and Planning told the commission that San Francisco currently has about 2,439 licensed skilled‑nursing beds and roughly 119,000 adults age 65 and older, and that, without new beds, the city’s bed‑per‑senior rate would drop substantially by 2030. Patel also said San Francisco General made 827 discharges to skilled‑nursing facilities in the last fiscal year and that about 10 percent of those went out of county.

Family council members and relatives described what they called “transfer trauma,” recounting cases in which relatives transferred outside the city had deteriorated or suffered care disruptions after relocation. Raquel Rivera, family council coordinator for St. Luke’s subacute unit, showed a video and urged the commission to require CPMC to keep the unit open past its planned closure. A range of nurses and clinicians told the commission that the St. Luke’s subacute patients are medically complex and that moving them to freestanding facilities or distant counties risks serious harm.

Community groups and labor coalitions urged stronger language and specific directives for CPMC and DPH, including a DPH report identifying all licensed or relicensable beds in city hospitals, and a short deadline for that report. Several speakers said the draft resolution should include a commitment that CPMC not reduce staffing levels for the existing subacute beds until equivalent staffed beds are guaranteed elsewhere.

Commissioners debated edits to the draft resolution, including explicit language that the closure would have a detrimental impact and an added further resolve recommending a delay of discharges until alternatives are identified. The commission approved the amended resolution by voice vote; the record shows a unanimous voice vote on adoption after commissioners agreed to the amendments.

The resolution stops short of imposing penalties on CPMC and does not, by itself, change licensing or ownership decisions. Instead it registers the commission’s official finding and asks DPH, CPMC and other stakeholders to work on short‑ and long‑term solutions, including a post‑acute care collaborative expected to produce a fuller report later in the year.

The commission also scheduled related follow‑up: continued PAC collaborative work and a Sept. 28 joint meeting with the Planning Commission on the CPMC development agreement. The Health Commission did not make a binding regulatory order at the Aug. 31 meeting; it adopted a formal finding and recommendations and asked staff to continue work and reporting to the commission.

The meeting adjourned after committee reports and a closed‑session vote not to disclose the closed‑session discussion.