3 SF emergency departments have the highest percentage of unhoused patients across the state

Stephanie Sierra Image
Friday, December 30, 2022
3 SF ERs have the highest number of unhoused patients across CA
Three San Francisco emergency rooms have the highest percentage of unhoused patients across the state, according to an analysis of state data.

SAN FRANCISCO (KGO) -- Three San Francisco emergency rooms have the highest percentage of unhoused patients across the state, according to an ABC7 I-Team analysis of state data. Some health officials are worried about the potential long-term impacts to staffing and bed availability.

The percentage of unhoused patients admitted to several San Francisco emergency rooms is up to six times more than other hospitals across the state, including Los Angeles.

According to ABC7's data analysis, on average unhoused patients make up less than five percent of most emergency department admissions across the state. But in San Francisco that figure is up to 32%.

"I think it's pretty impressive, it's a bit shocking to me," said Dr. Joanne Sun, the medical director for St. Francis Memorial Hospital and St. Mary's Medical Center in San Francisco.

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Both hospital emergency departments, along with Zuckerberg San Francisco General are among the top three in the state with the highest percentage of unhoused patients.

Data analyzed from the state's Department of Health Care Access and Information shows 32.1% of unhoused patients make up ER admissions at St. Francis Memorial Hospital, 24.7% at Zuckerberg San Francisco General Hospital, and 19.4% at St. Mary's Medical Center.

"I think it's mainly due to our location," Sun said. "We're very close to the Tenderloin. Our ambulances are required to bring the patient to the closest ER."

Sun says providers are seeing the same unhoused patients repeatedly, often under the influence, requiring additional nursing resources and in some cases enhanced security.

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San Francisco's Tenderloin Center, which offered shelter, food or substance use treatment, officially closed after nearly a year of being in service.

"There have been many workplace violence instances," Sun said, adding her colleagues agree there's more violence in and around the hospital in general. "That domino effect's into our staff feeling unfit and unable to come into work, so we're short staffed."

Hospitals offering care for unhoused patients typically eat more of the cost. For example, 65% of the unhoused ER patients at St. Francisco Memorial Hospital and St. Mary's Medical Center have Medi-Cal and the program's rates haven't been raised since 2012. Another 20% self-pay so the hospital often isn't reimbursed.

Sun says it's financially impacting both Dignity Health hospitals with potential to limit available staffing and bed availability.

"I absolutely believe that in terms of recruiting and retention," said Sun. "We're talking about all levels of staffing in the hospital."

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Dr. LukeJohn Day is the Chief Medical Officer of Zuckerberg San Francisco General Hospital. He says the disproportionately high percentage of unhoused patients in the ER isn't straining staffing, but the overall demand for patient care has required more space.

"We've opened additional units within our hospital to care for more patients that require hospitalization," said Day. "We're just seeing a higher volume across the board for all of our patients."

Six of the top 10 hospitals that have the highest percent of unhoused ER patients are in San Francisco, according to state emergency department performance data.

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