SAN FRANCISCO — Chinese language Hospital, situated within the coronary heart of this metropolis’s legendary Chinatown, struggles with most of the identical monetary and demographic challenges that plague small unbiased hospitals in underserved areas throughout the nation.
Lots of its sufferers are getting old Chinese language audio system with restricted incomes who’re reliant on Medicare and Medi-Cal, which pay lower than business insurance coverage and infrequently don’t totally cowl supplier prices. And on account of an arcane federal rule, Chinese language Hospital receives a decrease fee of reimbursement than many different hospitals that deal with a lot of low-income sufferers. Add the excessive value of labor and provides on this post-pandemic world, and it’s not laborious to see why the hospital misplaced $20 million over the previous two years and tapped a virtually $10.4 million mortgage from the state’s distressed hospital mortgage fund.
But the 88-bed hospital has robust ties to the College of California-San Francisco and town’s public well being division. And it will get assist from companies, charities, and the encompassing neighborhood. For Jian Zhang, 58, the hospital’s CEO since 2017, fundraising is like respiration.
“I really feel prefer it’s a full-time job for me,” stated Zhang, who arrived in San Francisco from Guangzhou, China, as a global scholar in 1990, earned a nursing doctorate from the College of San Francisco, and has remained within the Bay Space.
Income from fundraising and different providers have offered a giant enhance, serving to the hospital considerably offset what it misplaced on affected person care in 2022, in accordance with the hospital and state knowledge. In contrast, Madera Group Hospital and Beverly Hospital have been far much less in a position to take action. These hospitals, which additionally serve low-income populations with many sufferers on authorities well being care packages, filed for chapter final yr.
Chinese language Hospital has its roots in a medicinal dispensary, based in 1899 to offer well being take care of Chinese language immigrants who have been successfully excluded from mainstream medical amenities. The hospital itself opened in 1925, and a second constructing was added subsequent door in 1979. In 2016, a brand new constructing changed the unique hospital.
Right this moment, Chinese language Hospital contains these two buildings plus 5 outpatient clinics providing Jap and Western medication, unfold out throughout San Francisco and neighboring San Mateo County. Via partnerships, Chinese language Hospital has been capable of provide specialty providers to its sufferers, together with eye surgical procedure, palliative care, and a stroke heart. And $10 million in grants it obtained from the state final yr will assist construct a subacute unit, which is for fragile sufferers who nonetheless want nursing and monitoring following a hospital keep.
In an interview with KFF Well being Information senior correspondent Bernard J. Wolfson, Zhang mentioned the challenges dealing with small unbiased hospitals, together with Chinese language Hospital, and supplied her imaginative and prescient for its future. The next Q&A has been edited for size and readability:
Q: What are a few of the predominant challenges your hospital faces?
We face all of the challenges different hospitals are dealing with, particularly the covid pandemic and its related unfavorable impression — the doctor scarcity and workforce scarcity, the labor value will increase. However as a small neighborhood hospital, we don’t have quite a lot of reserve cash. It’s laborious to make ends meet.
That may be a large problem due to the low reimbursement fee. We serve greater than 80% Medicare and Medi-Cal sufferers.
Q: What are some particular challenges of serving a largely Chinese language inhabitants?
On this market, with the workforce scarcity, and particularly after the pandemic, it’s even tougher to recruit bilingual physicians, and different bilingual workers.
And culturally, Chinese language sufferers, when they’re sick, must drink soup for therapeutic or eat sure different meals for therapeutic. You’ll be able to’t be offering sandwiches and salads. They gained’t eat that. So our kitchen has to offer Chinese language meals, has to boil soup, after which we now have to prepare dinner completely different meals for our sufferers who’re non-Chinese language.
Q: Are you involved concerning the state’s funds shortfall?
Completely. All of us have been anticipating that Medi-Cal would improve charges. Now we have been pushing that for a few years. But when it’s not going to occur, quite a lot of our packages we in all probability gained’t be capable of do. I’m very involved about it.
Q: Chinese language Hospital has its personal well being plan, and also you stated 40% to 50% of your sufferers are members of it. How has that helped?
It’s like Kaiser Permanente. You’ve your personal members, and also you handle them. You need your sufferers to be in outpatient. So that you deal with them, hold them wholesome, in order that they don’t want to come back to the hospital for acute care. That’s the way you get monetary savings.
Q: And I think about that getting mounted month-to-month funds — capitation funds — for a big proportion of your sufferers additionally helps?
Positively, capitation funds assist. Particularly through the pandemic. Give it some thought. For those who didn’t have capitation funds, when procedures have been canceled, you didn’t have revenue.
Q: What else has helped you climate the storm?
Now we have partnerships with San Francisco’s Division of Public Well being and UCSF. In the course of the pandemic, we took overflow sufferers from town, so we didn’t have to put off lots of people. We signed a contract with town to open up the second ground of our hospital to take overflow sufferers from Zuckerberg San Francisco Common hospital.
Q: You even have robust fundraising exercise.
We do have robust neighborhood assist. The hospital isn’t just a hospital to me. It’s actually a part of our historical past. Prior to now, it was the one place [Chinese people] might go. Wherever I went, to a convention, for instance, anyone would increase their hand and say, “Oh, I used to be born at Chinese language Hospital” or “My grandfather was born at Chinese language Hospital.” It’s actually, actually deeply rooted locally.
Q: What’s your imaginative and prescient for the way forward for the hospital?
Chinese language Hospital is essential to the neighborhood, and I need to see it survive and thrive. Nevertheless it undoubtedly wants assist from the federal government and from the neighborhood. Transferring ahead, we’ll proceed to construct on collaborations and partnerships.
This text was produced by KFF Well being Information, which publishes California Healthline, an editorially unbiased service of the California Well being Care Basis.
KFF Well being Information is a nationwide newsroom that produces in-depth journalism about well being points and is without doubt one of the core working packages at KFF—an unbiased supply of well being coverage analysis, polling, and journalism. Be taught extra about KFF.
USE OUR CONTENT
This story will be republished without cost (particulars).