San Francisco committee pauses health-code ordinance on hospital reporting after advocates urge broader data

San Francisco — The Public Safety and Neighborhood Services Committee on Feb. 10 considered an ordinance that would require general acute care hospitals in San Francisco to report annually to the Department of Public Health the number of patients transferred out of county for subacute skilled nursing care and demographic information about patients who qualify for such care but are not transferred.

Supervisor Gordon Marr, the committee chair, opened the meeting and introduced the agenda item. Supervisor Safaie, who sponsored the draft ordinance, said it responds to a long-standing shortage of in-hospital subacute beds in the city and cited a contract provision tied to CPMC that allowed elimination of subacute beds at St. Luke's Hospital. “With the elimination of all those beds, there would be no more subacute in-hospital care in the city and county,” Safaie said, adding that some patients have been moved to the Davies campus and that many families cannot travel out of county to visit loved ones on ventilators and other supports.

Safaie described the ordinance as a tool to collect focused data about subacute care, but said the draft needs refinement. He asked to continue the item so staff can meet with the Department of Public Health and community advocates to clarify which data elements and facility types should be reported. “We want to ensure that if that data is added, it doesn't dilute from the purpose of really zeroing in on subacute care,” Safaie said.

During public comment, caller Patrick Manette Shaw urged broader or rewritten language, saying the draft should expand which facilities must report, the types of receiving facilities tracked and the scope of out-of-county data. Shaw also told the committee he had obtained historic discharge data through a Sunshine Task Force order and disputed a claim he said Department of Public Health made in 2020 that the city's electronic medical-record system Epic could not track out-of-county discharges. “Even Epic Corporation has informed the Epic does in fact collect the name, city, [and] type of facility that patients are discharged to,” Shaw said.

Committee members acknowledged the need for more work and for consultation with DPH and community groups. After discussion, the committee voted to continue the ordinance to the call of the chair. The clerk recorded three ayes — Vice Chair Catherine Stephanie, Supervisor Safaie and Chair Marr — and the item will return to committee when staff and sponsors have refined the data elements and scope.

The clerk noted that items acted on at the meeting are expected to appear on the full Board of Supervisors agenda on March 1, 2022, unless otherwise stated. The committee adjourned after concluding its business for the day.