What’s missing from Ka‘u Hospital makes it a better place than most, Ocean View resident Earl Laver says.
“It doesn’t smell like a hospital,” Laver said, during a visit with his wife, Kay, who stays in Ka‘u Hospital’s small long-term care unit.
Kay Laver has stayed in several Hawaii Island hospitals and one nursing home over the years, including Kohala Hospital and Kona Community Hospital. Earl Laver said he prefers Ka‘u for several reasons, the fresh air on vog-free days high on that list. The care from Chief of Staff Dr. Dexter Hayes is also a factor making Ka‘u the best choice for his wife, as was the new activities coordinator, Jessica Camba-Penera, who has revamped the programs for long-term care residents.
“The only thing I could say is they could use more money,” he said. “They’re doing a wonderful job.”
The hospital’s gross annual revenue is about $8 million, with an operating revenue — what the hospital actually makes, administrator Merilyn Harris said — closer to $5 million. The hospital’s cost to do business is closer to $6 million. A state subsidy, $1.4 million last year, a smaller amount than previous years, makes up the difference, she said.
“There have been times we have broken even,” Harris said. “It’s unlikely we’ll do that this year.”
But what really fills in the budgetary gaps are community fundraisers and donations, Harris said. During a recent tour of the hospital, which sits just above Hawaii Belt Road as it passes Pahala, Harris couldn’t pass through a room for patients, treatment or staff without pointing to something the hospital purchased thanks to community fundraisers.
In the emergency room, nurse Kris Reed noted the touchscreen monitors nurses use in an emergency are the same kind used at The Queen’s Medical Center on Oahu. Across the room, a color-coded metal cabinet is filled with information on how to treat children in emergencies, with a different drawer devoted to children of different sizes.
The lunchroom has custom wooden cabinets, also donated.
The staff members give back, too. On Wednesday, two hospital clerks and another employee set up an amplifier, then provided the long-term care residents with live music. Five years of fundraisers by the South Point Red hats, Ka Lae Quilters and the Ka‘u Golf Group has netted more than $100,000. O Ka‘u Kakou raised enough money to buy a 14-seat, wheelchair-accessible van.
“We kind of say they did it one cookie at a time,” Harris said, describing the fundraising efforts. “They’re our guardian angels.”
More improvements are coming soon, Harris said, including new doors, which will replace doors that don’t seal, and, eventually, a new roof and air conditioning system. Those improvements will help filter sulfur dioxide and other volcanic emission particulates from the air circulated within the hospital. It will also mean, Harris said, the end to the days of open windows throughout the hospital, although a few windows will be left that can be opened on vog-free days.
The $4.7 million vog mitigation project is expected to start in August and take at least 18 months. That project is funded by the state’s Capital Improvements Project budget, as is a $248,000 parking lot project, which includes entrance door replacement. Harris said the hospital was left off the CIP budget for years, with little state money arriving, but as more community members showed interest in supporting the hospital, more state money also seemed to come in. She credited Rep. Robert Herkes, D-South Kona, Ka‘u, for his efforts in securing funding for the hospital as well.
Donations aren’t the only way to stretch the hospital’s budget, Harris said. As part of the Hawaii Health Systems Corp.’s East Hawaii region, Ka‘u is able to save money on things like human resources and other areas just by having Hilo Medical Center staff take on some of those duties. The smaller hospital was able to switch to electronic medical records because of that affiliation with Hilo as well, Harris said. The transition hasn’t been completely smooth and problem-free, but Ka‘u did become the first critical access hospital in the state to achieve the federal government’s “meaningful use” designation. That designation is required to get maximum reimbursement for making the switch to electronic medical records.
The hospital has four emergency room beds and five acute care beds. It houses the only pharmacy, a Longs Drugs, in the district, as well as a walk-in rural health clinic. But the biggest portion of the hospital’s duties, and space, is for long-term care. The 16 beds are always full, Harris said, and the hospital has a waiting list of patients who would like to stay there. Each room has its own paint scheme, with patterned, aloha print curtains helping create individual decor. The point, Harris said, is to avoid an institutionalized, hospital environment.
Without the hospital in Pahala, Ka‘u residents would have to drive an hour to Hilo or two hours to Kona for emergency medical care. Harris said the hospital is adding more services, such as providing some care for patients undergoing chemotherapy, even if hospital staff can’t offer all treatments.
The hospital is doing “anything we can do here so they don’t have to travel,” she said.