California hospitals are finding that some families and residents are prepared to fight back when they try to close sub-acute units. Such was the case at St. Luke’s sub-acute unit in San Francisco after the California Pacific Medical Center (CPMC) announced in June 2017 that it would close the unit. The 24 residents – many whom have lived at St. Luke’s for years and depend on various medical devices and specialized nursing care to keep them alive – were threatened with transfers to facilities as far away as Sacramento and Los Angeles. Instead of accepting the trauma, isolation and likely death that would accompany such evictions, the families chose to fight back.
The families organized a family council; connected with city, union and activist leaders; held press conferences and protests; and repeatedly testified at public hearings about the need to stop the closure of San Francisco’s last remaining sub-acute unit. Their eloquent protests attracted widespread media attention in the Bay Area and earned strong support from the Board of Supervisors. On September 11, CPMC (an affiliate of Sutter Health) surrendered, issuing an announcement that the sub-acute unit would remain open for now and that all of the remaining residents would be relocated to a different CPMC campus in San Francisco sometime next year.
The failed attempt to close the sub-acute unit at St. Luke’s is part of a years-long trend by California hospitals of abandoning sub-acute care in favor of adding beds for highly profitable acute care. On September 21, 2017, KALW, a public radio station in San Francisco, aired a report on the impact of disappearing sub-acute beds in California hospitals, citing a 17.8 percent drop in hospital-based skilled nursing facilities. As hospitals close more of these specialized units, there is increasing danger that the evicted residents will be exiled to very distant facilities, separating them from everyone and everything they care about. Death often follows.
In San Francisco, the families and residents did not accept this fate. Their successful campaign against the closure sends a strong message to California hospitals with sub-acute units that each of their residents deserves to be treated with the utmost care and respect and they will pay a heavy price if they decide to treat any of them as a disposable product.