Wahiawa General Hospital faces life-or-death struggle

Nurse Diane Canon retired from Wahiawa General Hospital three times, the last time in 2014, but she’s still on call to fill in.

As she walks down the hall of the hospital, past framed photos of old Wahiawa landmarks — Top Hat, Casters and the old Wahiawa Drug Store — she recognizes one of her former patients shuffling down the hall. They share a long hug in the hallway while hospital staff and visitors file past.

Wahiawa Hospital is, for better and for worse, a reflection of the community it serves. It is absolutely beloved by the old-timers who had their babies here, said final goodbyes here, rushed to the emergency room to wait for news here. It grew when the town grew and struggled when the town struggled. And it has been overlooked, always an afterthought to whatever was going on in busy, important Honolulu.

Canon started at Wahiawa General in high school as a volunteer candy striper. Her daughter is now administrator for the nursing facility at the hospital.

“In all my years here, 40-plus years, Wahiawa always struggles, but we’re always able to pull through somehow. But this time, I’m really, really scared.”

To stay open, Wahiawa General Hospital is asking the state Legislature for $3 million a year for the next two years.

This is not the story of yet another state hospital with budget troubles. Wahiawa is an independent, nonprofit, unaffiliated with a larger organization like Queen’s or Kaiser Permanente. It is a true community hospital with neighbors who sit on the board of directors and a thrift shop run by a volunteer auxiliary. That $6 million would help keep the place running until its leaders can put together a long-term solution.

Wahiawa General started in 1944 as an outpatient clinic for plantation workers, military personnel and other Central Oahu and North Shore residents, back when Honolulu was an hour’s ride away on two-lane roads. Wahiawa was dramatically affected by the war, and the need for health care was clear, so community members made it happen. The wards were built and an emergency room with a station wagon ambulance driven by a hospital employee stood at the ready.

The hospital is now licensed for 160 beds — 53 acute care and 107 skilled nursing. The emergency room sees more than 20,000 people per year.

When the emergency rooms at the region’s other hospitals are full, Wahiawa takes the overflow, accepting patients from the Waianae Coast, North Shore and all the way to the airport.

“And we handle it,” said Dr. Danny Bamber, who grew up in Ewa Beach, lives on the North Shore and has been medical director of emergency for eight years.

His emergency room is brand new and shining. Renovations were completed two months ago, and now there are 18 private beds. For years, it was just four beds separated by curtains and a waiting room so tiny that people would wait outside despite the heat of the day or a blowing rain.

“We did what we had to do. I did stitches outside sometimes,” Bamber said.

Don Olden, a veteran of many different hospitals, was brought in as CEO nine years ago.

“Here, we identify a need and adapt to it that day,” Olden said. “Other places, it’s brought up through committees, and change can take months.”

Bamber agrees. “Here, I’ve heard nurses say, ‘Hey, I’ve got to go talk to Don about that.’ I’ve never seen that at any other hospital.”

When Hawaii Medical Center West shut down, Wahiawa’s emergency staff first heard about it on a radio dispatch: “HMC West closed, so brace yourselves.” They increased their staff the next day.

The impact was immediate. The number of ambulances that came to the ER went from six or eight a day to 13. The number of patients admitted doubled in a week.

“When West closed, we had to expand quickly. When Queen’s reopened it, we started to contract. It got complicated,” Bamber said.

Overall, though, the hospital is seeing more emergency cases. When Bamber first started, the ER saw 42 patients a day. Now, the average is 60.

The reasons for Wahiawa’s financial straits are complex yet familiar. Almost 85 percent of Wahiawa’s patients are on Medicaid or Medicare, which reimburse the hospital at a much lower rate than private insurance.

As the number of primary care doctors in Wahiawa has declined, so have their patient admissions. Now most of the admissions come through the ER, and the hospital has had to hire hospitalists to staff the floor, which come at a much greater cost. There have been layoffs in recent years as Wahiawa tried to adapt.

“It’s going to be a real challenge to balance between the business of health care and the family model, ” Olden said. “But we’re convinced we need to be affiliated with a larger organization. A lot of the costs will go away in a larger system.”

There are some numbers they don’t want to change:

Average wait time in the emergency room, “from door to doc” is 13 minutes.

Closest parking space to the front door: 30 feet.

Cost of visitor parking: Nothing.

Olden had been working on a plan on how to phase down if the hospital couldn’t make payroll. State Rep. Marcus Oshiro (D, Wahiawa-Whitmore-Poamoho) told him every option had to be exhausted before taking away this life-and-death facility from rural Oahu.

“Before you throw in the towel, give the Legislature and the governor a chance to rise up and shine and do the right thing and save the hospital,” Oshiro said. On Tuesday, the Senate Ways and Means Committee is holding a hearing on the bill to help Wahiawa Hospital.

Olden said, “We have an insurmountable task if this doesn’t come through.”