NHCH, Queen’s will decide on affiliation in December


North Hawaii Community Hospital and Queen’s Health Systems next month will render a decision on a formal affiliation.

“The (Queen’s Health Systems) board has to make the (final) decision, but we’ve undertaken the due diligence process, and, so far, we have not found any red flags that we can’t deal with, so, management is showing courage. We know there are many challenges, but, the fact is, we feel encouraged by the opportunity,” said Art Ushijima, Queen’s Health Systems CEO.

The Queen’s board next convenes Dec. 16 on Oahu, when the recommendations from the due diligence process will be presented to board members who will then render a decision, Ushijima said. NHCH’s board will likely make a decision regarding affiliation before Dec. 16.

Dozens of people packed the Waimea Middle School cafeteria for a talk story session held during the Waimea Community Association’s monthly meeting. Many attendees questioned Ushijima directly, prying for details on a variety of topics.

Concern about the organization of the Waimea hospital’s board and how many North Hawaii residents would be on it, should an affiliation become reality, came up several times during the meeting.

“There will always be local community representation. North Hawaii Community Hospital is a 501(c)(3) hospital so there will always be as we do on Molokai,” Ushijima said, explaining that Molokai residents serve on the Molokai General Hospital’s board. “By the rules of the Internal Revenue Service, the majority of the board must be Queen’s board members or from Queen’s but there will totally be and has to be representation from the community.

“There will be representation from North Hawaii on the North Hawaii Community Hospital board — and we will leave it at that.”

Others questioned what Queen’s would do to address physician shortages, particularly doctors practicing in primary care, in North Hawaii.

“It’s one of those things that we have to put on the list on how we can increase primary care physician services — it’s not just unique to north Hawaii,” Ushijima said noting that Queen’s is still assessing the needs of the community and how to address them.

Leinaala Crawford, who heads NHCH’s Native Hawaiian Program, pleaded to Ushijima and Queen’s for help with the health care situation in North Hawaii.

“I spend my whole day out here taking care of people who have nothing. I have patients in the hospital … dying because the care is so bad for our local people,” she said. “I’m sorry I’m so emotional about this stuff. We need help out here. We are having an emergency with our people out here.”

North Hawaii Community Hospital and Queen’s Health Systems — corporate parent of Queen’s Medical Center on Oahu — announced on June 25 that the two entities through a formal agreement were exploring an affiliation that officials touted would improve health care on Hawaii Island.

Ushijima said NHCH Board Chairman Bob Momsen contacted the system in spring 2012 and again in December about the two entities working together. At the time, Queen’s was conducting the due diligence process that would result in the system’s acquisition of St. Francis West, now known as Queen’s Medical Center West Oahu.

After Queen’s acquired the Oahu hospital, it began looking at NHCH, Ushijima said. In June, the Queen’s board decided there was a “unique opportunity” and the due diligence process exploring a formal affiliation began.

During an August Waimea Community Association meeting, Momsen said the need to find a partner to bolster the hospital’s management abilities, information technology system, and financial stability led to the agreement to consider a formal affiliation.

“It is increasingly difficult for a small, independent hospital to satisfy all the requirements for management systems and IT systems and prove (to) government, HMSA, Medicare, the quality of care is excellent,” Momsen said. “They want to pay more for hospitals that can prove that. On our own, we will fail to do that.”

The formal affiliation, if realized, would build upon a clinical affiliation started in 2005 to help streamline the transport of cardiac patients needing care beyond what NHCH can provide. If it does occur, a transition team will be created, a permanent president appointed, and a three-year transition plan created, Ushijima said.

North Hawaii Community Hospital, which opened in 1996, wouldn’t be the first hospital in the state to enter into a formal agreement with Queen’s Health Systems. Queen’s has had a formal affiliation with Molokai General Hospital since it assumed the hospital’s debt load in 1986.