Closing ‘essential’ St. Luke’s Hospital could hurt poor

Despite a recent history of financial struggle, St. Luke’s Hospital in the Mission has become a crucial safety net for many of The City’s poor and underinsured residents.

The private acute-care facility’s future is at the center of deadlocked negotiations between the Mayor’s Office and California Pacific Medical Center, the Sutter Health affiliate that rescued the hospital from debt in 2001.

CPMC has pledged a $300 million seismic rebuild of St. Luke’s if it can also build a new $1.9 billion hospital on Cathedral Hill. But CPMC wants assurances that it could close St. Luke’s if the hospital chain’s financial situation deteriorates significantly.

The Mayor’s Office, spooked by recent financial projections that it says put CPMC closer to an escape clause in the proposed deal, wants the trigger jettisoned in favor of an ironclad agreement that St. Luke’s will be rebuilt and operated for at least 20 years. Meanwhile, the Board of Supervisors is still weighing final approval of the project.

“St. Luke’s has been an essential emergency room hospital for those that are living on the south and southeastern side of The City,” said Barbara Garcia, director of San Francisco’s Department of Public Health, which oversees San Francisco General Hospital, the county’s only other acute-care facility.

If St. Luke’s were eliminated, “San Francisco General will be inundated with patients that we cannot serve,” Garcia said.

St. Luke’s also ensures “equity of access” for uninsured or underinsured patients who can’t afford care at other hospitals, Garcia said. Under federal health care reform, the number of Medi-Cal patients is expected to jump significantly, she said.

“You’re not going to get the same level of care for the poor at Cathedral Hill,” Garcia said.

Cathedral Hill, although it borders the Tenderloin, would join the majority of The City’s hospitals in its proximity to more affluent northern neighborhoods.

“We are the safety net for San Francisco General,” said Dr. Ed Kersh, chief of staff at St. Luke’s. Kersh said St. Luke’s has come a long way from being “one of the worst hospitals” more than a decade ago to being recognized for quality and safety in 2011 by a national hospital accreditation agency.

Kersh credited the dedication of medical staff to St. Luke’s mission of providing high-quality, low-cost health care to all.

“The doctors who work here don’t get rich,” Kersh said. “They do it because they subscribe to the mission.”

But those same doctors will likely opt for greener pastures than San Francisco if St. Luke’s closes, according to Kersh. He said the current situation resembles the one in 2006, when CPMC proposed closing St. Luke’s and turning it into an outpatient facility, and medical staff protested.

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