SAN FRANCISANS FOR HEALTHCARE, HOUSING, JOBS AND JUSTICE Supervisors Hearing on Subacute Patients at St Luke's Hospital At Supervisors Hearing, Advocates and Families Will Demand CPMC Accept New Subacute Patients. California Pacific Medical Center and San Francisco City agencies will report on their progress in solving the City’s critical shortage of hospital-based Subacute Skilled Nursing beds. CPMC, SF's biggest and richest hospital chain, yielded to public outrage in September 2017 and abandoned its plans to dump 23 highly frail long-term Subacute patients out of town. However, CPMC refuses to accept new subacute patients. St. Luke’s is licensed for 40 Subacute beds and will be open until at least June 2018. St. Luke's is the only Subacute unit in San Francisco, so if Subacute patients cannot get admitted into the St. Luke's unit, they are sent out of town, away from families. CPMC and other hospitals avoid Subacute patients because they pay less than regular hospital patients: it's all about putting profits over patients. Community, labor, and family advocates insist that CPMC accept new Subacute patients from any hospital in San Francisco to prevent CPMC from reducing staff and quality of care for current patients as their numbers go down, and to prevent current and future subacute patient candidates from all over the city being sent to out of town facilities. Concerns about declining quality of care are justified. There are already cuts at St. Luke's subacute to Licensed Vocational Nurses (LVNs) and Certified Nursing Assistants (CNAs). Also, CPMC has staffed the Subacute Unit with new LVNs and CNAs who are not experienced in the needs of these frail patients, many of whom are on ventilators or have tracheotomies. Instances of patient neglect will be described at the hearing. Concerns about past and growing out-of-town transfers are also justified. So far, the Health Commission has left the solution for the Subacute crisis to the Post Acute Care Collaborative, a hospital industry group with no community input. PACC and the Health Commission have consistently endorsed “regional solutions,” a euphemism for sending patients out of town, away from their families where they are more likely to die. All hospitals in San Francisco admit to sending patients, especially Medi-cal patients out of town. We know hundreds were sent from public hospitals, but private hospitals have not divulged this information. Closures of hospital based Subacute units and post acute SNF rehab units contributed to this problem. San Francisco Hospital Industry representatives stated they could not find patients for those beds, while they sent candidates for the Subacute & regular SNF Units out of town, closing beds to new patients, and transferring patients to a lower level of care without tracking the outcomes. The SF Health Department must have ultimate responsibility for assuring adequate Subacute beds, and they must have the power to require private hospitals accept a proportional share of the burden in providing space and financing. Solving the Subacute crisis needs to start right now, with CPMC filling all 40 of its licensed beds. * * *
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