KAHUKU — Although there have been several years of financial hardship and revenue shortfalls at Kahuku Hospital, yesterday's announcement that it will close was still a jolt to the staff, patients and area residents.

Kahuku is the only hospital and emergency room within an hour's drive, a point that some staff said shouldn't be taken lightly.

"A lot of people are going to die needlessly," said Dr. Richard Price, who operates the ER. "I think it's going to be a tragedy people will awaken to in time but they won't realize it until it's much too late I'm afraid."

He said employees were shocked by the decision and that emotions vacillated between sorrow and anger yesterday.

With 27,000 residents and one ambulance between Kualoa and Waimea Bay, Price said, the closure presents particular problems for acute heart patients, severely asthmatic children and women in emergency childbirth.

Rising operating costs, revenue shortfalls and a $3 million debt contributed to the closure, said Eric Beaver, chairman of the hospital board. The hospital has been operating in the hole for the past six years.

It turned to the state for help, but was never given all it requested or needed. The message was clear, Beaver said.

"It seems like everybody is saying we don't think this model is the right model for this community," he said.

The hospital will close Dec. 31, when patients staying there will be transferred to other facilities. No new patients are being accepted.

The hospital will be filing for bankruptcy, Beaver said.

Hospital debt is not limited to this North Shore hospital. Other healthcare facilities are struggling, including the Molokai General Hospital, Hana Health Center and Wai'anae Coast Comprehensive Health Center, each of which sought state subsidies this year.

The much larger St. Francis-Liliha and St. Francis-West hospitals were sold in the past year to survive.

In California, about one out of every six hospitals has closed over the past 15 years, according to a press release from Kahuku.

Kahuku is the first Hawai'i hospital to close in recent history.

SUBSIDY FALLS SHORT

Gov. Linda Lingle requested a $1.4 million subsidy for the hospital in the state Department of Health budget, said Dr. Chiyome Fukino, department director. The Legislature cut that request to $500,000, but after appeals from the hospital, $500,000 was added.

That wasn't enough.

Fukino said the community's biggest loss will be of emergency room services.

She said she thought the hospital board and its managers were doing the best they could to keep it afloat.

"I believe the board and the management at Kahuku have tried very hard, since I've been working with them, to become as efficient as possible," she said.

The community will suffer, said Irene Carpenter, a Sunset Beach resident and president of the board of the Ko'olauloa Community Health & Wellness Center in Kahuku.

For emergency services, residents will have to go to Castle Medical Center in Kailua or Wahiawa General Hospital, each at least an hour's drive from Kahuku.

"So we're extremely interested at looking at ways we can pull various resources in the community to try to keep that emergency room open," Carpenter said.

An emergency room would cost about $1 million to $1.5 million to operate, according to Beaver. Ironically the hospital's subsidy request was for $1.4 million this year, he said, adding that to provide another ambulance service would cost about $2 million.

Beaver said he'd welcome community input in keeping the ER service available.

"This is really a public policy issue," he said. "It's not necessarily a private-sector market decision issue. My opinion is that an ER will not pay for itself. There's so much charity and bad debt that runs through ER because the law says you have to service people."

Price, the ER doctor, said an emergency room in the community is necessary, especially with the projected growth in the hotel industry and housing, 500 units in Malaekahana alone.

As an ER doctor at Kahuku for many years, Price said he's seen near-drownings, numerous automobile crash victims, surfers crushed by waves, and the injured after the Mother's Day slide at Sacred Falls.

He's working with the Ko'olauloa Wellness Center to keep the ER open on an emergency basis.

"It would have been far better to make a smooth transition," he said. "Now we're working feverishly to put something together."

BACKUP PLAN

Keeping the ER open has the support of the land owner, Continental Pacific LLC, which recently purchased the hospital land and other property from Campbell Estate, said Eric Morrison, Hawai'i general manager of programs for Continental Pacific.

Morrison said he was surprised by the announcement despite the hospital's troubles. The hospital board and manager had come to Continental Pacific with scenarios for staying open and the company was open to the plans, he said.

However, the company did consider the hospital closure a possibility and had asked Ko'olauloa Wellness Center to step in if necessary, Morrison said.

"We asked them to put together a contingency plan to take over the ER in case the hospital were to close," he said. "We're doing all we can to make sure there at least an emergency room medical care on the North Shore."

Reach Eloise Aguiar at eaguiar@honoluluadvertiser.com.