Healthy NHCH begins makeover

Waimea’s hospital ended the last fiscal year with more than $1 million in operating profit, a first for an organization that has registered consistent losses since it opened in 1996.

North Hawaii Community Hospital is also embarking on an aggressive campaign to update buildings, equipment, information technology and record-keeping in the wake of a recent affiliation with The Queen’s Health Systems, according to the hospital’s acting president Kenneth Graham.

“We will be spending $12 million this fiscal year,” he said.

NHCH, with 300 employees, will have about 320 people working when the transition surrounding the merger is complete, Graham said. About 40 positions are open across the facility. Thirteen of those are slots for physicians, nine of them are new, Graham told West Hawaii Today following a Thursday night informational meeting of the Waimea Community Association.

Ten of the 13 physician openings are for specialties, including cardiology, surgery, oncology and obstetrics, Graham said. The hospital is in the midst of a recruitment effort with the hope of filling four to five positions by year’s end.

“Two of the first four doctors will be full-time OB,” he said. “We are looking at some excellent candidates.”

The hospital is also working to address a shortage of primary care physicians.

“There’s been a good effort at recruitment,” NHCH board of trustees member Robert Hastings said in a phone interview. “The biggest plus for everybody is economic stability. We have that now.”

Four management positions have been filled at the hospital and another four remain open.

NHCH intends to expand its emergency room from six beds to more than 15 and replace the aging “Lucy Building” within three to five years as part of a longer-term facilities plan.

About $1 million has been spent so far this year on new EKG monitors, beds, sanitation, an infant security system and other equipment. In the coming months the hospital will replace the air conditioning and air duct systems and repair the roof. NHCH is also upgrading its information technology and will have a new medical records system in place within 20 months that will tie into the larger Queen’s system.

They’re the kind of improvements that have been needed but couldn’t be undertaken because the financially struggling hospital didn’t have the money, Hastings said.

“Everyone I’ve talked to, even the ones who aren’t happy about individual details, agree the affiliation is the right thing for the hospital,” Hastings said.

NHCH has a goal to make a profit in the first three years and improve its quality scoring, Graham said. The hospital had to borrow to meet payroll in January but since then has been self-sufficient.

A major goal is to grow the clinic and outpatient services, he said.

“Our big hope is people can get a doctor quickly and get the treatment they need quickly,” he said.

The hospital also plans to recapture patients from its service area who are currently going to Hilo and Kona, negotiate rate increases with payers, and initiate a new customer service program called “We’re Bringing Back The Aloha.”

Graham — who told one resident on Thursday that he’ll stick around until he’s made to leave — was appointed in January, shortly after NHCH entered the affiliation with The Queen’s Health Systems in the hopes of increasing financial stability and quality of care, as well as making additional improvements. Physician recruitment and retention — long an area of need at NHCH — would follow from putting the hospital on more stable economic footing, said the hospital’s board of directors chairman Bob Momsen and The Queen’s Health Systems CEO Art Ushijima.

Prior to this year, the hospital had operated at around a $4 million loss annually. Looking to stem that bleeding, last year the hospital hired Huron Consulting Group to get NHCH on a better financial track. In January, Momsen said that savings and revenue sources identified by Huron would have ensured that the hospital at least broke even this year, even without the affiliation with Queen’s.

Kona Community Hospital has also hired Huron to evaluate the hospital’s efficiency and identify areas of potential cost savings. The hospital’s directors would like to enter a partnership with a larger health care corporation similar to the arrangement in Waimea.

Graham acknowledged the transition to a larger corporate model has caused apprehension for some, including concern that the hospital’s midwife program may be put on the chopping block.

“We are absolutely keeping the midwife program,” he said. “People can choose to have a midwife or a doctor in a white coat.”

“We will not be doing repeat C-sections,” he added. “That will be done on Oahu.”

All of the positions are open to employees from anywhere on the island, he said.

“We’re a nonprofit. We have no boundaries,” he said.

“I’m optimistic,” Graham said. “Nothing is perfect. We are solid financially, and I’m confident it’s going to be a gem of a hospital.”

Email Bret Yager at byager@westhawaiitoday.com.