By Lisa Marie Dahm, Special to NHN

Things are changing at Kohala Hospital in Kapaau. If you have visited recently, get ready for an Oz-like experience when you cross the threshold.

Recently, the hospital has been undergoing a total transformation. New floors, soothing green and white wainscoted walls, and new windows and curtains have breathed new life into the building.

“I love watching people’s faces when they walk in,” said Janet Schmidt, chief nurse executive. “They almost do a double take.”

The original Kohala Hospital was built in 1917 as a plantation hospital.

A new building was built in 1962 that now serves as a critical access hospital that offers 24-hour emergency care, long-term residential care, inpatient and outpatient laboratory and x-ray services, and acute and skilled nursing inpatient care.

Shaped like a “T,” the east wing holds the lab, medical records and radiology, the emergency room (ER) and acute inpatient care and a few long-term patient rooms. The long-term care residents, activity room and a nurse’s station are set in the west wing.

“The building is extremely old,” Kalua said. “It was built with Hill-Burton funds in the 60’s and it has had some additions. Much of what is in the floor tiles are original.”

According to Kalua, the original floor tiles contained asbestos, which requires a specific removal method that includes abatement, then an air quality sampling before new tile is laid. The floor is scheduled for completion by June 1.

“They were cracked and looking awful,” Kalua said. “It just really needed a big facelift.”

Resident bathrooms will also be renovated. Kalua said in addition to the facelift, they also used the opportunity to “rearrange the wing a bit.”

They moved medicals to the center and created a waiting area for the lab. The hospital built a new, state-of-the-art radiology room with a $500,000 cost completed in Nov. 2010.

“We are slowly working our way through,” Kalua said.

Kohala Hospital is part of the Hawaii Healthcare System Corporation (HHSC.) There are about 1,800 emergency room visits per year, with 55 employees and between a $5 and $6 million-dollar budget per year. There is a physician on call 24 hours a day, seven days a week.

Kalua said the hospital developed future plans to create a new ER in a far east area of the building that will include four beds, a new ambulatory entrance as well as ambulance bay doors and a turnaround, a waiting area and a handicap parking stall.

The completion of the new emergency room will allow for greater privacy and a separate space for long-term care patients and for emergency room patients, said emergency room physician Dr. Robert Watkins, who has served in the area for more than 30 years.

The hospital is not an acute care hospital, and for anything beyond the hospital’s technological capabilities, the patient is stabilized and transferred to North Hawaii Community Hospital or Kona Community Hospital, both acute care hospitals. In some cases, the patient is flown off-island.

According to Dr. Watkins, transit time for many conditions can make a critical difference for a patient. Kohala Hospital is about 25 miles from North Hawaii Community Hospital in Kamuela through mountainous terrain and about 55 miles from Kona Community Hospital.

“It is important for people to be able to get to an emergency room in their area,” Dr. Watkins said.

Kalua said one of the challenges in improving the hospital is finding the funding. Since Kohala Hospital is state subsidized, it competes with other state programs for funding. The hospital often turns to the Kohala Hospital Charitable Foundation (KHCF) as well as the Kohala Hospital Auxiliary to fund special need items.

“Our foundation, our auxiliary and our community really help us,” Kalua said. “We have a good relationship.”

Tommy Tinker, foundation president since 2006, said the foundation formed in 2003 in response to a proposed closure of the hospital. The community worked together to keep the hospital open.

“In 2002, the legislature made overtures to closing the hospital,” Tinker said. “It scared everybody.”

Over the years, the foundation has raised more than $500,000. The Fourth Annual Golf Tournament on Feb. 11 netted about $37,000. The second major fundraiser of the year, “Beer Boots Brats and Barbeque” at Kahua Ranch will be held April 28 and all proceeds from both events will benefit the new ER. The foundation has already raised $200,000 for the ER.

The foundation purchased new electrical beds at $2,300 each and a new phone system for the hospital. They also bought a new van for long-term care patients, portable x-ray and ultrasound machines, a new food cart and stove for the kitchen and painted the hospital.

The Kohala Hospital Auxiliary has also contributed much to hospital improvements. Ida Otake, president of the Kohala Hospital Auxiliary and the retired director of nurses, said the auxiliary has been serving the hospital for more than 20 years and has about 25 auxiliary members, some on the hospital staff.

Some of their projects include enclosing a lanai to use as hospital space for $25,000, replacing equipment, supporting the activity programs for the long term care residents, purchasing wheelchairs and jerri chairs, and other small furnishings and a television for the day room. They also purchased window curtains and partition curtains.

Their main fundraiser is a spaghetti dinner that usually serves about 400 meals and raises about $5,000 per year. Dues for the auxiliary are $10 per year.

“It is a very strong moral support knowing that there is a support system through the auxiliary,” Otake said.

Schmidt said that although it is a challenge working through a renovation project, she and the staff are excited.

“My staff has been incredibly patient,” she said. “I have very few complaints because they really do see the end result. They are all positive and willing to make this work.”