We are writing with deep respect and shared commitment to excellence to request your reconsideration of the recent layoff of Melanie Zuk-Moya, Physical Therapy Assistant III, from the inpatient rehabilitation team at UCSF Parnassus. 

Since joining UCSF in 2021, Melanie has been a highly valued clinician and a vital member of the Acute Care for the Elderly (ACE) unit’s interdisciplinary team. With over 19 years of acute care experience, she has consistently brought professionalism, skill, and compassion to her work with older adult patients supporting UCSF’s mission to deliver equitable, evidence-based care. 

Melanie played an integral role in the post-COVID revitalization of the ACE program, which had been significantly impacted by pandemic-related disruptions. Her leadership in restoring core elements of the ACE model, especially early mobilization and group-based functional activities, helped reestablish the unit as a national model for high-quality geriatric care. 

The ACE unit is the centerpiece of geriatrics care at UCSF Health. It is built on a fully integrated, interdisciplinary model that includes physicians, nurses, social workers, pharmacists, occupational therapists and physical therapists including a dedicated physical therapy assistant. With Melanie’s departure, the team is no longer whole. Due to current staffing shortages, the rehabilitation department does not have sufficient capacity to reassign a physical therapist to fill this role. Without a dedicated PTA, we are unable to sustain the intensity and consistency of care delivery that defines the ACE model and the outcomes it achieves. 

This fully staffed ACE team has achieved these True North Goals which likely cannot be sustained with the loss of a PT: 

Strategic Growth:  
0.7-day reduction in average length of stay  
6% decrease in 30-day readmissions  
Financial Strength:  
Reduction in cost per case by $850 

Patient Experience:  
Melanie coordinated and led the ACErcise program, a weekly group mobility session designed for hospitalized older adults. The program has been a hallmark of ACE care and is well-received by patients—94% report high satisfaction with the experience, citing its positive impact on engagement and mobility. 

These outcomes, and the program’s innovative interdisciplinary approach, have contributed to UCSF’s rise from #15 to #3 in the U.S. News & World Report national rankings for Geriatrics, now the highest-ranked specialty at UCSF. The ACE unit has been central to this progress, and Melanie’s role on the team has supported its success. 

We recognize that organizational decisions are made in the context of complex operational and budgetary considerations. However, we believe that the loss of Melanie’s role diminishes the ACE unit’s capacity to deliver the outcomes that have made it a national leader. 

We respectfully urge UCSF leadership: 

Suresh Gunasekaran, President & CEO at UCSF

Sam Hawgood, Chancellor of the University of California

Lukejohn Day, Chief Medical Officer  

to explore any possible path to reinstate Melanie Zuk-Moya in her critical role on 15L and the ACE team.