Hawaii Medical Center’s Ewa hospital closed on Wednesday after transferring the last of its patients to its Liliha facility.

HMC, formerly known as St. Francis Medical Centers, said that five Ewa patients were moved to Liliha, which has about 20 remaining patients.

Over the past couple of weeks HMC has discharged or transferred about 100 patients.

"The 20 patients who remain at HMC have complex, chronic medical needs that require long-term care," said CEO Maria Kostylo. "Transferring these patients has been challenging, and we need area hospitals and long-term care facilities to step in to help as they had earlier pledged to do."

Bruce Anderson, president and CEO of the state community hospital system known as Hawaii Health Systems Corp., said his company has worked with the bankrupt hospitals to transfer eight patients into its long-term facilities over the past week.

Hawaii Health Systems does not operate acute-care hospitals on Oahu.

"My understanding is there are four patients who remain who have complications which make it difficult for us to take those patients," Anderson said. "We currently don’t have the equipment or staff to feel that we can safely care for those patients. We’re hoping that someone will be able to provide the support they need."

Meanwhile, HMC officials said they laid off 500 workers on Christmas Eve, more than double the number they had originally announced Friday.

The company said earlier this month that it is closing its hospitals in Liliha and Ewa due to financial difficulties. It has a combined work force of nearly 1,000 at the two hospitals.

After sending out about 200 notices to terminated workers on Friday, the company subsequently notified 300 more employees not to return to work during the Christmas weekend.

When HMC officials took a closer look at patient numbers they realized there were fewer patients and therefore required fewer workers, the HMC spokeswoman said.

The business and finance offices are still operating at the Ewa facility. Once HMC is able to transfer all patients, it expects to shutter its Liliha hospital in early January.

HMC, which has been in bankruptcy since June, was forced to shut down and abandon a plan to sell the hospitals to California-based Prime Healthcare Services.

St. Francis Healthcare System of Hawaii, HMC’s largest secured creditor, objected to the sale because the Catholic religious order would have been paid only about one-fourth of the nearly $40 million it is owed.

St. Francis Healthcare announced in late October it was pulling out of a bankruptcy reorganization plan that would have returned the facilities to the religious order.

The Franciscan sisters sold the hospitals in January 2007 for $68 million to HMC LLC, then a for-profit joint venture between Hawaii Physician Group LLC, composed of 130 local doctors, and Kansas-based Cardiovascular Hospitals of America.

St. Francis provided the bulk of the financing for the sale — $40.2 million.

HMC first filed for Chapter 11 bankruptcy protection in August 2008.

It emerged in August 2010 and became a nonprofit organization governed by a nine-member board of directors before filing its second bankruptcy in June.