Kona Community Hospital is running at or near capacity daily — but COVID, RSV and the flu aren’t to blame.
While other facilities on the island saw a bump in COVID-19 hospitalizations over and after the holidays, Kona Community Hospital has seen its population of COVID-19 patients hold steady at an average of one to two per day through mid-January, said Anne Padilla, community relations and program manager. At the same time, the hospital saw a decline in patients seeking care for respiratory syncytial virus (RSV) and found most flu cases can continue care at home.
“Our Emergency Department is at capacity most days, but COVID is not the culprit,” she said. “What we are seeing is partially the culmination of deferred healthcare in our community as a result of the pandemic. Also, patients have a much higher than usual acuity level, which requires longer hospitalizations.”
In addition, the 94-bed facility in Kealakekua is consistently at capacity because the hospital is unable to discharge patients to skilled nursing or long-term care facilities. Each day, 25 to 30 patients at the facility do need treatment in an acute-care setting, she said.
“This creates a need to hold and treat acute and ICU-level patients in the ED,” said Padilla.
On Thursday, for example, the 18-bed emergency department was holding 11 acute patients in need of an inpatient bed and five who needed to be transferred to Oahu fur a higher level of care.
“Transfers have become very difficult because there are no beds available at the hospitals that would normally receive those patients,” she noted. “Another fact is that our community is growing, but our capacity hospital has not.”
Two West Hawaii districts, North and South Kona, as well as parts of Ka‘u, are served solely by the HHSC-operated Kona Community Hospital, a level III trauma center. The hospital, which was founded in 1914, has operated at the site off Haukapila Street since the building was constructed in the mid-1970s with a planned capacity of 90 beds.
There were 2,964 admissions, 18,370 patient days, 409 births and 16,896 emergency room visits recorded in the fiscal year ending June 30, 2021, according to the HHSC’s most recent report to the state Legislature. In fiscal year 2010, the hospital saw 2,803 admissions, 15,875 patient days, 489 births and 17,580 emergency room visits.
Though the numbers have continued to increase, the facility has not seen the addition of new beds since the early 2000s when 24 beds were added, bringing the total count to 94.
At that time, the U.S. Census population of the North Kona and South Kona districts was 37,132, equating to about one bed per 395 residents. As of the 2020 count, the districts had a combined 54,369 residents leaving one bed per 578 people.
Talk of constructing a new hospital for Kona goes back decades. In the 2022 legislative session, a measure introduced by Rep. Nicole Lowen (D-North Kona) to appropriate $1 million to conduct a site assessment to find a viable location in North Kona failed to secure a hearing before the Senate Committee on Ways and Means.
The 2023 legislative session opens Wednesday, and as of press-time no measures or legislation had been introduced on the matter.
“At this time, our community can help ease the problem by seeking care sooner rather than later, and by visiting their primary care provider and utilizing urgent care centers for milder symptoms and non-emergencies,” Padilla said in response to how the community can play a part in ensuring beds are available to those who who need them most.