Supervisors press CPMC and DPH for a permanent plan as St. Luke’s subacute beds face relocation

Supervisors and community members pressed Sutter Health’s California Pacific Medical Center (CPMC) and the San Francisco Department of Public Health (DPH) on Nov. 29 over the threatened closure and relocation of St. Luke’s Hospital’s subacute and skilled nursing unit, the only city‑licensed subacute beds in the city and county of San Francisco.

Sponsor Supervisor Asha Safai said the 40 licensed subacute beds at St. Luke’s are “an extremely important lifeline” for residents of Districts 9 and 11 and warned that losing the beds would create a citywide public‑health crisis. Family members and advocates described last‑minute notifications, staff turnover and the emotional harm of transfers.

Raquel Rivera of the family council told the committee that CPMC “arrived unannounced at St. Luke’s Hospital, providing individual family meetings on that very same day,” and said families had not been included in planning. Physician and advocate Ken Barnes said CPMC has not admitted new subacute patients since 2012 and described a shrinking census and staffing attrition that he said threaten care quality.

CPMC’s Dr. Warren Browner said the system is preparing to serve current St. Luke’s patients at CPMC’s Davies campus and that Davies could be ready to accept patients “as early as June” next year. Browner defended current staffing levels as above California Department of Public Health requirements and said an internal risk‑management review and a CDPH visit found no decline in quality of care.

The Department of Public Health, represented by Sneha Patel, presented data showing most hospital discharges in San Francisco go home (about 79 percent), roughly 9 percent go to skilled nursing facilities and fewer than 0.5 percent receive subacute care. Patel and Director Barbara Garcia described a two‑track approach: short‑term measures to secure capacity in the region (including conversations with St. Mary’s and other providers) and a longer‑term post‑acute care strategic plan the department expects to finalize in the spring.

Garcia said DPH lacks regulatory authority to mandate private hospitals provide specific levels of care but said the department would work with hospital systems, labor and community partners to incentivize in‑county capacity. She told the committee the city is aiming at a higher target than the current 40 beds and has used a working figure of about 70 beds in internal planning discussions.

Speakers from the ombudsman’s office and labor unions urged greater transparency, data collection and family involvement in any retooling of the Davies facility. Ombudsman Benson Nadell asked that family groups be allowed to monitor approvals by OSHPD or the Department of Health Care Services for the reconfigured unit. Labor and community groups urged that CPMC and other hospital systems participate financially and operationally in a citywide solution.

Procedurally, the committee discussed a follow‑up schedule for the issue. The body initially set a March 28, 2018 follow‑up but later rescinded that date and continued Item 1 to the call of the chair so staff, DPH and stakeholders can report back sooner. Supervisors asked DPH and CPMC to return with transition details and for reports on dollars the department spends purchasing out‑of‑county subacute beds.

What happens next: DPH will continue short‑term negotiations with hospital partners and pursue its post‑acute strategic plan; CPMC says it will transfer current patients to Davies when licensing and staffing are in place; the committee will reconvene the matter at the chair’s call and expects status updates from DPH and the hospital system.