Hemorrhaging S.F. hospital plots major surgery. (San Francisco; California Pacific Medical Center)

California Pacific Medical Center, facing losses of up to $20 million this year, is considering downgrading the high-end private institution to a community hospital, eliminating specialties, scrapping research and curtailing education and training.

Calling the upmarket hospital's current focus on cost-cutting "a strategy for failure," CEO Aubrey Serfling has asked the board to approve radical changes. Under the proposal, California Pacific would reportedly discontinue high-tech surgical specialties such as liver, heart and kidney transplants and pediatric specialties, cut deeply into educational and training programs, and eliminate the hospital's university-style research efforts. Up to 700 new layoffs apparently will also be on the table.

California Pacific, the region's largest …