Wahiawa hospital calls on finance doctor
A key architect of the plan to keep financially distressed Kahuku Hospital from closing is working on Wahiawa General Hospital's survival.
R. Don Olden, who was chief executive officer of Kahuku Hospital for four years, shifted to Wahiawa Hospital as CEO in January.
"Somebody from Wahiawa contacted me," said Olden, who was involved in putting together some of the largest hospital systems in California and was an executive with the troubled St. Francis health system before going to Kahuku.
"I went from one needy organization to another," he said.
Wahiawa General Hospital costs about $40 million a year to operate, and it was heading toward a loss of more than $3 million this year when he arrived, Olden said.
Some steps have been taken to halt the hemorrhaging, "but it takes longer than 30 days to make changes in hospitals."
Rich Meiers, Healthcare Association of Hawaii president and chief executive officer, said he has been telling legislators and others, "Without appropriate reimbursements, services are going to be cut across the state. We can't keep them open if we can't pay for them.
"We saw what happened at Kahuku, and the sisters had to sell (St. Francis) hospitals."
Meiers said Olden "is making Herculean efforts" to save Wahiawa Hospital. "It would be a shame if it doesn't survive. The whole North Shore will be uncovered (for medical services)."
Olden developed a business plan, approved by the hospital board last month, and asked the Legislature to increase the hospital's grant-in-aid to $850,000 from $200,000.
"I told the Legislature, if I had been here longer than a month, I probably would have asked for more," he said. "It's a real struggle to figure out what's going on in a hospital this size in 30 days."
Wahiawa is licensed for 103 skilled-nursing beds, which are nearly always full, and 59 acute beds, he said. It runs an average of about 40 emergency visits and about 24 to 25 acute patients a day, including intensive care.
The hospital also has a senior behavioral health program with seven or eight patients daily, Olden said.
His plan calls for suspending obstetric services and its more than $700,000 in related losses annually. A decision on closing permanently will be made about 30 days later, he said.
Three-quarters of the area's residents are using other hospitals for births, Olden noted, and Wahiawa averages only 20 to 25 babies a month. Costs include maintaining a round-the-clock surgical unit and a nurse anesthetist for emergencies, as well as salaries for OB nurses and other personnel. The anesthetist alone costs $300,000 a year to support the surgery unit.
Olden said "it would be superb" if the eight registered nurses in obstetrics would agree to shift to other hospital programs. That would help reduce extremely high costs for overtime and hiring agency nurses, he said.
"For those who don't want to, we will facilitate transition to another hospital."
He said Wahiawa must change its strategy to adapt to new market conditions and a competitive environment.
Surgeons have left Wahiawa for other hospitals in Honolulu and on the mainland, contributing to fewer patients and a major drop in revenues, he said.
Among his steps planned to improve the hospital:
» Recruit a general surgeon to provide leadership in surgical services, and an orthopedic surgeon.
» Along with the hospital's new ultrasound unit, acquire a computed tomography scanner for diagnostic services and treatment.
» Expand skilled-nursing services to meet the needs of the area's senior population.