The state has approved a $25 million emergency room expansion at North Hawaii Community Hospital on Hawaii island.

The State Health Planning and Development Agency gave the green light to the 35-bed rural hospital in Kamuela, part of The Queen’s Health Systems, earlier this month. The yearlong project is scheduled to begin in January 2019.

The hospital, which serves more than 30,000 residents and visitors annually, said it is over capacity with only six treatment rooms in the emergency department. The expansion would create 13 rooms and additional triage space, Queen’s said in its application with the state.

The hospital expects ER demand to increase to 17,000 patients a year in 2025 from 14,000 in 2016. The expansion will improve access to care for seniors, low-income patients and other underserved groups, said Queen’s, which assumed control of the facility in 2014.

“Hawaii island has significant disparities in access to health care due to provider shortages, limited health services and substantial challenges in transportation,” Queen’s said. “When North Hawaii Community Hospital does not have the capacity to serve its community and goes on divert, patients must travel a significant distance to either Hilo or Kona to receive medical treatment. All those within the area served … will have greater access to life-saving emergency services.”

The community hospital with 325 employees has faced criticism in recent months with complaints from employees after the hospital restructured operations and laid off workers.

“We’re definitely building relationships with staff and physicians and everyone here,” said Cindy Kamikawa, hospital president. “It’s going well.”