Castle Medical Center due for $28M upgrade

Castle Medical Center is investing $28 million to renovate the hospital and expand its emergency room to keep up with demand in the growing Windward community.

The primary provider of emergency and trauma care in Windward Oahu is hoping to begin the project in November, said Castle spokes­woman Jasmin Rodriguez.

"We continue to not only grow with new programs and services, but our ER has gotten more visits than we ever had before," Rodriguez said.

"With the growth of the Windward side and, of course, the elderly population getting older, we needed to really expand our ER services to meet the needs of our community."

The number of emergency visits has increased by nearly 20 percent over four years to 33,161 in 2012 from 27,751 in 2008, according to a filing with the State Health Planning and Development Agency, assigned to regulate health care projects.

Certain parts of the ER will be closed in phases during the renovations, but the department will remain fully operational, Rodriguez said.

The 160-bed hospital opened in 1963 and has been expanded since then to address the needs of patients from Wai­ma­nalo to the North Shore. Still, much of the building’s original infrastructure is currently in place.

The yearlong project will expand Castle’s emergency department within the existing hospital footprint, increasing the number of beds to 25 from 18. Renovations will replace outdated electrical and air-conditioning systems.

The obstetrics and behavioral health departments, as well as the intensive care unit, admissions, laboratory and imaging areas will be entirely remodeled. The project does not include any expansion of the hospital’s parking lot.

Castle budgeted $23 million for construction costs and $5 million for new equipment. The hospital is owned and operated by Adventist Health, which will use cash reserves for the renovation project, the filing said.

The private, nonprofit hospital, with about 1,000 employees and 300 physicians, is projecting revenue of $20 million and expenses of $14.5 million in the first year of operations after the renovations and $5.6 million in net income.

In its filing, Castle pointed to a growing demand for primary care services as more people obtain insurance coverage through the federal Affordable Care Act, specifically with the expansion of Medicaid, the government health insurance program for low-income residents.

"Although once a source of care for primarily major injuries and life-threatening medical conditions, over the last several decades, hospital emergency rooms have increasingly become a source of primary care — especially to the medically underserved," Castle said. "The addition of these individuals to Oahu’s insured population will add to the stress already placed on hospital emergency rooms to provide primary care to individuals who do not have a primary care physician."

In addition to the hospital expansion, the company announced earlier this year that it will spend $24 million to renovate its medical office building — the Castle Professional Center — in Kane­ohe.

Castle said it will provide upgraded office space for primary care physicians and medical specialists. The medical center will expand ancillary services already offered in the building, including imaging services, laboratory, rehabilitation services, urgent care and pharmacy.

The existing parking structure at the Kane­ohe building will be demolished and replaced with a new structure that will accommodate 80 more vehicles. In addition, Castle’s investment in the office building will include infrastructure upgrades such as replacement of the current air-conditioning units, elevators and sprinkler systems, as well as a renovation of both the exterior and interior of the building.

That project is expected to start next year.