The North Hawaii Community Hospital said it is laying off 13 full- and part-time workers to cope with continued operating losses.

The 39-bed hospital in Kamuela said the cuts will occur this month and has offering affected workers a package that includes 20 hours of severance for each year of service, medical and dental insurance through the end of May and access to counseling.

The hospital said it has had operating losses totalling $15 million over the last two years, including a $10 million loss in 2008 that was the worst in the facility's 14-year history. It said the problems occurred because of a number of factors, including the loss of an orthopedic surgeon, people deferring care because of the economy and the need to increase efficiency in some units.