Every day (particularly on weekends and holidays) patients on the Medicine service have clinically improved and are ready for discharge, yet remain in the hosptial because of difficulty in finding an appropriate skilled nursing facility where they can continue their rehab.  Each non-indicated day in the hospital needlessly costs thousands of dollars, occupies provider time that could be spent caring for acutely ill patients, and subjects patiens to many of the harms and infection risks that we know exist in the hosptial setting.  Many other hospitals (including SFGH) already have integreated non-acute care facilities affiliated with their main hospitals that can be used for helping to place patients in more appropriate care levels. Perhaps a ward of Mt. Zion or other similar UCSF facility could be modified to accomodate such patients.