Sutter Health’s California Pacific Medical Center network made plans with the city in 2013 to open two new hospitals in San Francisco, which all sounds very lovely and commendable. But the details of that deal — which involve the demolition of St. Luke’s Hospital at Cesar Chavez Street and Valencia Street, and replacing it with a new Mission Bernal Campus set to open in 2018 — are now under heavy fire, as they involve the planned October 2017 closure of a subacute nursing care unit that would force at least two dozen elderly and sick San Francisco patients to be shipped out of the county to other facilities, as the Chronicle reports.

First, we should clarify what “subacute nursing care” is. The California Department of Health Care Services defines subacute care as “a level of care needed by a patient who does not require hospital acute care, but who requires more intensive skilled nursing care than is provided to the majority of patients in a skilled nursing facility.” In other words, it serves patients with severe needs who need to be hooked up to intravenous tube-feeding and or respiratory machines 24/7.

It's not the kind of population you want to be shipping around from county to county. But the closure of this facility would do just that, and would eliminate the city’s only subacute care unit.

“We are going to fight the efforts of individual hospitals that in name are nonprofit, but actually seem to be for-profit,” said Sup. Hillary Ronen, chair of the Board’s Public Safety and Neighborhood Services Committee, railing against Sutter Health.

But Sutter spokesperson Stacey Wells insists to the Chronicle that these are perfectly normal logistics involving only a few dozen patients, and that this move is part of a larger national trend in which subacute patients are being moved out of hospitals to smaller, more specialized facilities. In defense of claims that the hospital wants to treat fewer patients on Medi-Cal, she notes that Sutter is “the largest provider of care to Medi-Cal patients in Northern California, a fact we know the supervisors greatly appreciate.”

It’s unclear whether the supervisors can block or legislate away Sutter plans that are already very much underway. But their unanimous vote Wednesday shows that they're going to try. “Make no mistake. This is about money and this is about profit,” 30-year veteran of this unit Dr. Ken Burns told Mission Local at Wednesday’s committee meeting.

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