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4 N A T I O N A L N U R S E W W W . N A T I O N A L N U R S E S U N I T E D . O R G J U LY | A U G U S T | S E P T E M B E R 2 0 1 7 CALIFORNIA A bout six years ago, 63-year-old Franchesca Sims was happily living her life, working at South- ern Pacific in administration and being an integral part of her close-knit fami- ly that has lived in San Francisco for more than 70 years. Then a brain aneurysm struck. Almost overnight, Sims became totally dependent on others. She cannot breathe on her own and is hooked to a ventilator. She cannot eat on her own and receives nourishment through a feeding tube. She cannot walk or talk, but understands everything that is said to her. Her main caretakers are the registered nurses at San Francisco's St. Luke's Hospital (known officially as the St. Luke's campus of Sutter Health-owned California Pacific Medical Center), where she has lived for the past two years on the subacute unit. Now, just like so many other profit-driven landlords across the city and Bay Area, Sutter Health wants to evict Sims from her bed. Sutter announced in a June letter to a couple dozen families who have loved ones being cared for in the subacute unit that it planned to shut down the entire unit, and also St. Luke's skilled nursing facility (SNF), by Oct. 31. Families were provided a list of other facilities and told to do their own research to relocate their relatives. But given that there are no other subacute facilities within San Francisco and few within the Bay Area, they face being separated by hundreds of miles from their loves ones. "It's inhumane," said Katie Hamilton, Sims' sister, who is now organizing along with about 20 other St. Luke's subacute families as part of the St. Luke's Subacute Family Council to advocate for these patients to be able to stay at St. Luke's. Due to their work, they have so far successfully pressured Sutter to publicly state that it will continue caring for all current subacute patients. "They [Sutter] are taking money over my sister's life. There's no morals in this, no compassion." Hamilton said that she and other family members currently live less than 15 minutes away from St. Luke's and, because of their proximity, are able to visit her often and monitor her physical and mental well- being. Hamilton highly praises the registered nurses and other caregivers at St. Luke's, and just wants her sister's living and medical situation to remain unchanged. In addition, medical professionals, such as the current medical director of St. Luke's subacute unit, Dr. Gary Birnbaun, warn that these medically fragile patients "will die" if they are moved to freestanding suba- cute units not attached to hospitals. "Those patients cannot be transferred out of town. They will die, plain and simple, and everyone here knows it," said Birnbaun at a hearing held Aug. 15 by the San Francisco Depart- ment of Public Health over Sutter's plans. Birnbaun believes that the subacute patients should be allowed to stay in the existing St. Luke's facility until a citywide plan for serving such patients can be implemented. "Subacute patients are not like SNF patients. They are one step below the ICU and need to be near an ICU. Every- body who has worked on the subacute unit has seen patients who deteriorate in the space of 15 minutes. They cannot be in a freestanding facility." Even though Sutter is building two new hospitals in San Francisco, a replacement for St. Luke's and its massive Cathedral Hill project on Van Ness, it is refusing to main- tain or increase subacute and SNF beds in the city, presumably because those types of units don't make the kinds of profit margins Sutter wants. Sutter is notorious among RNs for cutting services, closing down units, and consolidating services within a region so that patients in some areas are left with- out care options. The public health commis- sion passed a resolution deeming the closure to be harmful to San Francisco, but wields little authority to force the unit to stay open. "When units are seen as revenue centers instead of places for healing, units close," said Jane Sandoval, an emergency RN at St. NEWS BRIEFS Sutter moves to evict San Francisco subacute patients Plans to close subacute and SNF units at St. Luke's Hospital