Burdened by inadequate cost reimbursements, the Rehabilitation Hospital of the Pacific is closing some outpatient clinics and enhancing its inpatient program to care for more acute and complex patients, says Clair Jones, president and chief executive officer.

“;It was a strategic, financial and economic decision,”; he said in an interview. “;To continue to play an important role in Hawaii's health-care community, we've recently had to make some difficult decisions to better position ourselves.

“;We're taking action now and refocusing on our niche of providing physical and occupational therapy for those with complex conditions such as strokes, traumatic brain injury and spinal cord injuries so that people can return to home, community and productive activity. That's especially important in today's economy.”;

Jones said REHAB, the only acute medical rehabilitation center in Hawaii and the Pacific, is closing two of its seven outpatient clinics: The St. Francis clinic at Hawaii Medical Center West will close April 24 and the Mililani Town Center clinic will close May 22.

REHAB is working to transfer ownership of its clinics in Kihei, Maui, and Kailua-Kona to staff members to operate as private physical therapy practices, he said.

The 100-bed REHAB hospital in Nuuanu will be maintained as a “;specialty niche program”; for Hawaii with new skills, programs and technologies, Jones said.

“;We will look at increasing capabilities to take patients that have much higher acuity and complexity than we currently do,”; he said, adding that that's the trend nationally. And with Hawaii's older population, he said REHAB wants to care for patients with chronic diseases, as well.

This will be “;a real plus for helping Hawaii's acute hospitals be able to move patients to a health-care continuum, as well,”; he said. “;It will be a plus for the whole community.”;

REHAB Hospital, like all other health-care facilities in Hawaii, has been “;operating in a challenging environment that has been exacerbated by our current economy,”; Jones said. Costs to provide rehabilitation services have increased while reimbursements have declined, he said.

Jones said 25 of REHAB's total workforce of 450 employees will lose jobs, but will have an opportunity to transfer to the inpatient facility.

The Aiea and Nuuanu clinics, which see many REHAB patients when they go from inpatient to outpatient status, will remain open and serve patients who visited the Ewa and Mililani clinics, Jones said.

The Hilo outpatient clinic also will remain open.