Kona Community Hospital News

By Tiffany DeMasters
June 15, 2025 · 5:00 AM HST

In May, 220 surgeries were performed at Kona Community Hospital by just four general surgeons, whose workload has been steadily rising and is expected to continue to do so.

They are facing burnout, said Jeffrey Palmgren, the chief medical officer of the West Hawai‘i Region for Hawai‘i Health Systems Corporation, which operates Kona Community Hospital.

Also facing burnout are the other limited number of specialty doctors on the Big Island.

To alleviate the increasingly unmanageable workload, a shared workforce agreement was entered into at the beginning of June by Hawai‘i Health Systems Corporation’s West Hawaiʻi Region, The Queen’s Health Systems on O‘ahu and Aliʻi Health Center in Kona. The O‘ahu medical facility will provide specialty doctors to help fill in the gap at the Big Island facilities.

Part of the initial agreement includes a Queen’s general surgeon flying from O‘ahu to the Big Island one week a month to perform surgeries at Kona Community Hospital.

The current surgeons who perform surgeries at Kona Community Hospital are employed by Ali‘i Health Center. With this extra surgeon, Ali‘i Health Center’s surgeons will be able to focus a little more on non-emergency care.

“This is augmenting what they can do,” Palmgren said.

Dennis Tognoli, interim CEO-President for Ali‘i Health Center, said this agreement is a positive for patients by providing more access to specialty services. It also brings more work-life balance to the surgeons.

The number of surgeries performed at Kona Community Hospital was 1,063 from January to May of last year. During the same time period this year, the number has increased to 1,142.

The collaboration among the health care providers also aims to pool resources to hire more specialists — especially cardiologists and oncologists — who can be shared between the Big Island medical facilities.

Dr. Daphne Hemmings from Queen’s was the first visiting surgeon to arrive, on June 6. She said this is the first step in a long relationship with the South Kona facility and Honolulu providers with Queen’s are excited about it.

“I’ve definitely been busy,” Hemmings said. “I’ve had surgeries every day.”

Procedures included an appendectomy, feeding tubes and small bowel surgeries.

During just her first week working at the rural community hospital, Hemmings said it opened her eyes and those of colleague’s on O‘ahu to the limited resources available in Kona.

The biggest issue she noticed was the sometimes untimely transfer of patients in critical condition to O‘ahu for care they can’t receive on the Big Island.

Hemmings said a patient came in needing neurosurgery after suffering head injuries in a car accident. But the patient wasn’t able to get on a flight to O‘ahu for further treatment for at least a couple of hours.

“We’re on the other side receiving patients so we don’t see the delay,” Hemmings said.

But she added: “It’s nice to be able to work together, and we’re working to forge a relationship and see where the gaps are.”

Palmgren has been working on addressing the medical provider shortage with Dr. Whitney Limm, chief physician executive at Queen’s Medical Center, since August 2023.

Palmgren said everyone knows there’s a disproportionate number of patients to medical care providers in West Hawai’i, with patients regularly having to travel to O‘ahu for care.

Palmgren said the goal of the partnership is also to bring more services to cardiology and primary care, as well as expanding urology services to North Hawai‘i Community Hospital, which is part of the Queen’s Medical Center network.

Currently, there is only one permanent oncologist on Hawai‘i Island. That oncologist is based in Kona.

Kona Community Hospital’s needs assessment report indicates West Hawai‘i needs three oncology experts. Patients now wait up to 30 days to see one, Palmgren said. Click here to review the needs assessment report.

The hope is to pool resources together so individual health care systems aren’t trying to fill the needs alone, Palmgren added.

Kona Community Hospital also is looking at sharing an oncology expert with Queen’s North Hawai‘i Community Hospital.

Palmgren said there are three part-time urologists who service Kona and three full-time urologists in Hilo. Wait times for a urology visit also is about 30 days.

There is one cardiologist in Kona and one in Waimea. Palmgren was unsure about how many cardiologists were based in Hilo. Wait times are approximately 65 days to see one, he said.

In the agreement, there also is a goal to develop a pipeline of future providers through graduate medical education.

Palmgren said Kona Community Hospital started building on the concept of collaboration for providers at that time when they thought they would be building a new hospital.

A committee was formed between Kona Community Hospital and Queen’s on O‘ahu in February to look at how the partnership can fill gaps in care. In December 2024, Queen’s announced its intention to build a hospital in West Hawai‘i.

Kona Community Hospital decided to scrap its plans for a new hospital.

“The ability to adapt and evolution of the agreement with the change in ‘who’ will build the hospital is a testament to the commitment to our shared vision,” Palmgren said.

While Kona Community Hospital has been looking more aggressively at building or expanding its own facility, Palmgren said the region recognizes the need to collaborate, not compete, especially if Queen’s moves forward with building a hospital.

“We’re trying to build relationships to seamlessly provide care,” Palmgren said. “The goal is to manage everyone’s care no matter where it’s coming from.”

Kona resident Charlene Mersburgh said the partnership will help people get the care they need on the Big Island without leaving their community.

She know how important that would be after spending much of 17 years traveling back and forth to O‘ahu to get treatment for her daughter, Ruth, who developed neuroblastoma, a form of cancer that develops in immature nerve cells, when she was just 4 years old.

“I see this agreement, and it’s exciting,” Mersburgh said. “Maybe it will mean it will save some trips for people.”

At the beginning of Ruth’s diagnosis, Mersburgh said the family moved to O‘ahu for about a year because there were no medical breaks in her young daughter’s care.

When they moved back to the Big Island, there were times they had to make weekly or bi-monthly trips to O’ahu for treatment.

“When you don’t have the care here on your island and none of the providers are coming over, the only option is to go to O‘ahu, Mersburgh said.

During those years, Mersburgh often took time off from work without pay to make those doctor visits, often back-to-back-to-back. She said it also would cost at least $1,000 for an overnight trip.

“You don’t have enough time to take a breath or even eat,” she said. “It’s just so exhausting.”

This new partnership between hospitals would have allowed her daughter to receive more of her care in Kona. Ruth ended up passing away in California in December 2023 while waiting for a lung transplant. She was 22 years old.

“She’s very missed in our world,” Mersburgh said.

KONA, HAWAI‘I – In a milestone collaboration aimed at transforming health care delivery in West Hawai‘i, the Hawaii Health Systems Corporation West Hawaii Region (WHR), The Queen’s Health Systems (Queen’s), and Ali‘i Health Center have formalized a shared workforce agreement after a year and a half of strategic dialogue.

This initiative brings together Kona Community Hospital, Kohala Hospital, and provider groups from Queen’s and Ali‘i Health Center under a unified effort to keep care local and strengthen specialty services on the island.

The groundbreaking agreement allows health care providers from all three organizations to deliver services across each other’s facilities, creating a seamless, patient-centered care experience and enhancing access to specialized care close to home.

“This agreement represents a huge step forward in how we collaborate to meet the needs of our West Hawai‘i communities,” said Dr. Jeffrey Palmgren, Chief Medical Officer of WHR. “By sharing our workforce and aligning our goals, we can build a true physician group culture that supports our current providers, attracts new talent, and ultimately keeps our patients from having to leave the island to get the care they need.”

The shared workforce model is designed to:

• Keep health care local by reducing the need for off-island referrals
• Expand access to a broader spectrum of specialty care
• Foster a unified physician group culture for improved recruitment and retention
• Develop a pipeline of future providers through Graduate Medical Education

“At Queen’s, we are deeply committed to our mission to provide quality health care services to improve the well-being of all the people of Hawai‘i,” said Dr. Whitney Limm, Executive Vice President of Clinical Integration and Chief Physician Executive at The Queen’s Health Systems. “This partnership sets the stage for sustainable growth in the region’s health care system, ensuring that patients receive high-quality, coordinated care.”

Dr. Daphne Edmonston Hemmings, a general surgeon with Queen’s University Medical Group (QUMG), will be the first physician to provide care to West Hawai‘i patients under this new agreement starting June 6, 2025. QUMG is a prestigious team of more than 750 providers representing 17 specialties.

“We thank West Hawaii Region and Ali‘i Health Center for this innovative partnership that will deliver access to a broader network of providers and services, advance workforce development, and improve the overall health of West Hawai‘i communities,” said Dr. Rick Bruno, President of QUMG. “Queen’s is pleased that this agreement will mean better care and an enhanced experience for patients on Hawai‘i Island.”

“This partnership reflects the power of working together with a shared vision of community-centered care,” added Dennis Tognoli, Interim CEO of Ali‘i Health Center. “We’re proud to be part of this initiative, which will expand services, improve continuity of care, and create new opportunities to grow our local health care workforce.”

Learn about legal directives for end-of-life medical wishes at caregiver resource fair : Big Island Now

By Tiffany DeMasters
September 26, 2024 · 3:00 AM HST

The hardest part of being a caretaker for Teresa Kuala‘au is watching her husband Wendell of more than 40 years wither from the once muscular, 180-pound Hawaiian fisherman to only 129 pounds as he battles diabetes and non-Hodgkins lymphoma.

Now, the emotional exhaustion and uncertainty is even greater for 64-year-old Kualaʻau because it’s her husband’s third bout with cancer. But Kualaʻau does have some peace of mind that she knows her 69-year-old husband’s end-of-life medical wishes.

Twenty years ago, the couple created advanced health care directives at the advice of their primary care physicians. They have been updated over the years.

On Saturday at the second annual Empowering Caregiver Resource Fair, Kona Community Hospital is hoping to educate more caregivers about health care directives and how they can better take care of their loved ones who are suffering from declining health and themselves.

The event will be at the Sgt. Rodney JT Yano Hall, 82-6156 Māmalahoa Highway in Captain Cook from 9 a.m. to 12:30 p.m.

So far, 63 people have RSVP’d.

Anne Padilla, spokesperson for Kona Community Hospital, helped organize the first caregiver resource fair in 2023, where a little more than 100 people attended. She said the need to educate caregivers about advanced health care directives became apparent when it was learned that many of the waitlisted patients at the hospital who were awaiting discharge to a skilled nursing facility for continued care and/or rehabilitation did not have one.

At the first resource fair, speaker Amy Hamane with Community First Hawai‘i said the biggest concern among caregivers was they didn’t have a legal document about the medical wishes of the people they were caring for.

“When someone is no longer able to speak and communicate, having an emergency situation, the directive documents what your wishes are if you’re unable to communicate,” Hamane said.

Community partners will share their expertise and connect caregivers with local resources. Speaker topics include:

• Understanding Dementia-Related Behaviors presented by the Alzheimer’s Association
• Advance Health Care Directives presented by Community First Hawaiʻi
• Safe Lifting and Transfer Techniques for Caregivers presented by Kona Community Hospital’s Rehabilitation Department

Third Circuit Court Judge Peter Kubota also willl be at the event to discuss planning ahead of a loved one’s death and what documents need to be done.

Additionally, the hospital created Emergency Medical Folders that provide a central location for caregivers to store and organize medical information, including lists of medications and the health care directive.

Kuala‘au said the folders come in handy if she shows up at the hospital with Wendell and she’s too shaken to communicate with the health care workers, noting the folder includes all the information a doctor would need, including a medication list, names of doctors and even a power of attorney document.

Padilla said the folders help streamline information when it’s needed. Last year, they gave out 100 folders.

Call 808-322-4559 for more information about the resource fair or register online to RSVP for the Empowering Caregiver Resource Fair.

Kuala‘au will provide her services free as a notary public since these documents require notarization or two people witnessing.

The workshop is co-hosted by Community First Hawai‘i and the hospital.

In the advance health directives made by Wendell and Teresa Kualaʻau, they have named each other as the person who can make decisions about their health if they are unable to do so.

They both also include instructions that they won’t wont to have their lives prolonged if death is inevitable, with Teresaa Kualaʻau saying: “There’s no sense in that.”

But having these wishes documented is important, she said, “so family members aren’t guessing.”

Kona Community Hospital launched a Hospital Site and Needs Assessment initiative to evaluate our community’s healthcare needs and the feasibility of a new hospital.

Join hospital officials on the following dates for Public Informational Sessions to learn about current and future healthcare needs of West Hawaii:

Monday, June 24
5:30 p.m. – 7:00 p.m.
West Hawaiʻi Civic Center, Building A
74-5044 Ane Keohokālole Highway
Kailua-Kona, HI 96740

Thursday, June 27
5:30 p.m. – 7:00 p.m.
Kona Community Hospital
Conference Rooms, Admin Building
79-1019 Haukapila Street
Kealakekua, HI 96750

You can read the full Strategic Analysis and Recommendations Report here.

KCH moves forward on supplemental wastewater treatment facility

By LAURA RUMINSKI West Hawaii Today | Friday, June 9, 2023, 12:05 a.m.

https://www.hawaiitribune-herald.com/2023/06/09/hawaii-news/kch-moves-forward-on-supplemental-wastewater-treatment-facility/

Kona Community Hospital is one step closer to constructing a wastewater treatment system.

In a letter to the Office of Planning and Sustainable Development Environmental Review Program,Clayton Mcghan, KCH CEO said the Draft Environmental Assessment (DEA) assesses the potential effects of constructing and operating the proposed project.

Kona Community Hospital at risk of closure due to outdated utilities

April 2, 2023 · 5:00 AM HST
* Updated April 2, 2023 · 6:18 AM

https://bigislandnow.com/2023/04/02/kona-community-hospital-at-risk-of-closure-due-to-outdated-utilities/

An operating room at Kona Community Hospital was a chilly 67.7 degrees early Friday morning, perfect conditions for performing surgeries.

However, as summer approaches, Dylan Palazzo, Director of Surgical Services, said temperatures in the sterile environment will spike. Warmer days, machines running hot and body heat from people performing or assisting in the procedures can raise the temperature in their three operating rooms to upwards of 75 degrees with higher humidity — which raises the risk of bacteria growth.

These conditions, at times, have led hospital staff to have to close operating rooms until they cool down to continue with procedures.

“We reach out to maintenance and they do what they can to get the temperature back in range, but sometimes we have to wait it out,” Palazzo said.

These spikes are due in part to Kona Community Hospital’s decades-old cooling and ventilating system. While they’ve never had to postpone a surgery because of spiking temperatures, Palazzo said it’s only a matter of time.

The nearly 50-year-old hospital — built in 1974 — runs the risk of closure every day due to outdated utilities. And if they do conk out, elective and trauma surgeries will end and the hospital runs the risk of losing its Level 3 Trauma Designation, which requires at least one operating room to always be available to provide emergency surgeries.

“It’s just like a homeowner. You don’t know when the water heater is gonna go out but when it does, you better have $10,000 to replace it,” said Diane Hale, the hospital’s chief nurse executive.

Hospital leaders have been attending 2023 State Legislature sessions to bring attention to their urgent needs and advocate for approximately $17 million over the next two years to address the cooling and ventilating system problems as well as install campus-wide lighting and security cameras. There also is a need to deal with waste-water treatment issues.

A significant portion of the funding would be used for an uninterruptible power source to minimize equipment damage from frequent brown-outs, which are partial, temporary reduction in system voltage.

“We’re making a lot of noise trying to get our story out there,” said Judy Donovan, Marketing & Strategic Planning Director for the hospital.

The hospital hopes to secure $4.9 million in 2024 to start on the infrastructure and cooling system upgrades. They hope to receive the remaining $11.3 million in 2025.

Clayton McGhan, West Hawaiʻi Regional CEO, said Kona Community Hospital started its efforts to get state funding in December by meeting with the Hawai‘i Island Delegation.

“We shared with them our challenges, and it was well received,” McGhan said.

McGhan attended Opening Day of the State Legislature in January and has been back to Honolulu on several occasions to discuss the hospital’s plight with lawmakers.

The last major renovation the hospital had was in 2020 when the three operating rooms were upgraded. In the early 1990s, the hospital built an additional building for same day surgeries, with a recovery room and Intensive Care Unit. The hospital also expanded its acute and long-term care to 75 beds.

In the early 2000s, a new administration services building was constructed across from the emergency department entrance, the Behavioral Health Services Unit opened and the new building for chemotherapy and outpatient services was also added onto the hospital. The air conditioning and utility systems have been upgraded and repaired piecemeal over the years. McGhan said a lot of the equipment remains outdated.

“We need to fix the infrastructure to manage the [power] load that’s put on it,” he said.

The hospital’s pharmacy also has been working to expand by building a clean room suite, which allows pharmacists to prepare IV medications and store them for longer.

Missy Elliott, Director of Pharmacy, said the pharmacy has a room — the segregated compound area — that enables the safe mixing of medications for inpatients and infusion patients. However, the compound area only lets the hospital store those mixtures for 12 hours because the air circulation doesn’t flow in the right direction. A clean room suite status requires air to flow from the ceiling down. Currently, the air is flowing from the ground toward the ceiling.

While the airflow is going in the wrong direction, Elliott said the room is immaculately pristine, and tested regularly with no bacteria or mold growth.

But because of the short shelf-life of the mixed medications in the current segregated compound area, “we waste a lot of stuff,” Elliott explained. “In a clean room suite, it keeps stuff for up to a week. It will help us provide better care for inpatients and those who get outpatient care.”

The clean room suite will be built on the backside of the hospital, but will still be accessible through the pharmacy.

Building a clean room suite also is part of a requirement by the Federal Drug Administration.

The hospital pharmacy came under FDA scrutiny in 2019 due to a complaint about unsafe practices within the segregated compound room. During a review, the FDA found the room had bacteria growth in the past and remediation steps weren’t properly documented.

The FDA reinspected the pharmacy in February 2022. Elliott said inspectors came out and spent time watching the hospital pharmacists for a week, checking for any potential violations and watching them prepare medications. In July 2022, the FDA issued a closeout letter that said the pharmacy had addressed all the original issues it was initially cited for and no new citations were issued.

Part of the FDA’s review was the understanding that the pharmacy would build a clean room suite. The original deadline for the room to be completed was next month. All the pieces are in place to build it, but the contractor won’t sign a contract until the hospital has the funding, Elliott said.

In the meantime, Elliott said the hospital “promised” to keep the FDA updated.

Elliott also said the pharmacy could be providing more service and the hospital is proactively working toward that goal.

“We’ve taken on a lot of new tasks,” she said. “Our big push to increase patient safety is to have a pharmacy available 24 hours a day. Our services just keep growing. Our hours need to grow as well.”

Funding for Kona Community Hospital projects was added to Gov. Josh Green’s proposed Executive Budget for 2023-2025 earlier this month. The added infrastructure project comes at a price tag of $21.7 million and covers funding for four different projects that if not completed could put the facility at risk of closure:

• central utility plant
• site utilities [heating, ventilating and air condition systems]
• loading dock
• building infrastructure

Additionally, proposed funding includes an expansion of the hospital’s pharmacy.

When Green, who was a doctor on the Big Island for many years, released his initial proposed Executive Budget for 2023-2025 in December, it included several funding priorities, including $50 million for Hilo Medical to expand its Intensive Care Unit and medical Surgical Unit.

Blake Oshiro, senior advisor to the governor, said they are awaiting a public release of the Senate Ways and Means version of the state budget to see if funding for Kona Community Hospital is appropriated. They hope to see those papers sometime next week.

“The House and Senate must still confer in the final weeks of April so we will continue to work with the legislature so that they understand the importance of these projects,” Oshiro said. “We will find out at the end of April whether this funding is in or out of the budget.”

State Rep. Nicole Lowen, whose Big Island district includes the hospital, said she and other area representatives have agreed that Kona Community Hospital upgrades are a high priority item, adding funding requests for the hospital goes into the budget every year depending on the expressed needs.

Last year, for example, the legislature secured $500,000 for a hospital site and hospital needs assessment, which now is in the process of being conducted. The hospital also has received $2.5 million for oncology services upgrades and replacing equipment and $674,000 for pharmacy expansion, “which as we now know wasn’t enough due to rampant inflation,” Donovan said.

“We just go by what we’re told [by the hospital] on what their highest needs are,” Lowen said. “This is the first year we’ve been made aware of the risk-of-closure items.”

Lowen added: “We [area representatives] have never been anything but completely supportive of health care in West Hawai‘i.”

If the State Legislature doesn’t approve the funding, Hale said the hospital would be forced to use its limited operating budget — money used to pay salaries and purchase equipment — to start the projects.

“We don’t want to cut services and we don’t want a riff in our employment,” Hale said.

McGhan said it’s difficult to think about the idea of not getting state funding with the hospital already running the daily risk of closure.

“This hospital is a community hospital,” he said. “Everyone deserves to have their health and wellbeing needs met.”

Grateful for your support

Saturday, April 1, 2023, 12:05 a.m.

Dozens of people recently rallied for Kona Community

Hospital on Queen Ka`ahumanu Highway adjacent to the LDS Church. Waving signs and shakas, hospital

leadership, board members, doctors, staff, and family came together to thank the community and Big

Island legislators for their support while the hospital seeks funding for crucial infrastructure upgrades.

“I am overwhelmed by the support our community is giving us,” said Clayton McGhan, Kona Community

Hospital Chief Executive Officer. “We love this community we call home, and it’s clear the people here

care about their hospital. They are the reason this funding is important. We’re also very grateful to our

government leaders, including Senator Kanuha and Representatives Lowen and Kahaloa for their

support. They have listened to and championed our needs during this legislative session.”

Kona Community Hospital is seeking almost $19 million from the state legislature to upgrade its nearly 50-year-old facility on Haukapila Street in Kealakekua. The funds would cover improvements to areas like its central utility lines, HVAC system, and the hospital’s pharmacy drug compounding facility.

Without the full appropriation to fix these items, the hospital might lose its ability to perform surgeries

and provide some emergency care. Patients and their relatives know that it could be the difference between life and death.

The sign-waving event provided an opportunity for hospital personnel to show their appreciation. “The overwhelmingly positive reaction of cars passing by filled our hearts,” said chief nurse executive, DianeHale. “We truly are grateful for our community’s support.”

Kona Community Hospital achieves international Baby-Friendly designation.

March 29, 2023 · 9:48 AM HST

https://bigislandnow.com/2023/03/29/kona-community-hospital-achieves-international-baby-friendly-designation/

Kona Community Hospital has achieved the highly prestigious international Baby-Friendly designation after a rigorous review process conducted by Baby-Friendly USA, the organization responsible for bestowing this certification in the United States, according to a press release from Kona Community Hospital.

To receive this distinguished honor, a hospital must adhere to the highest standards of care for breastfeeding mothers and their babies. These standards are built on the Ten Steps to Successful Breastfeeding, a set of  evidence-based practices recommended by the World Health Organization and the United Nations Children’s Fund for optimal infant feeding support in the precious first days of a newborn’s life.

The positive health effects of breastfeeding are well-documented and widely recognized by health authorities throughout the world. For example, the Surgeon General’s 2011 Call to Action to Support Breastfeeding stated that “Breast milk is uniquely suited to the human infant’s nutritional needs and is a live substance with unparalleled immunological and anti-inflammatory properties that protect against a host of illnesses and diseases for both mothers and children.”

Kona Community Hospital joins a growing list of more than 20,000 Baby-Friendly hospitals and birth centers throughout the world, 600 of which are in the United States. These facilities provide an environment that supports breastfeeding while respecting every woman’s right to make the best decision for herself and her family.

“This designation is the culmination of a lot of hard work and determination across our organization, all with a  goal of helping families get off to a good start,” said Heidi Fromm, the hospital’s obstetrics nurse manager. “We are proud to offer an environment that supports best practices shown to increase breastfeeding exclusivity and duration and are committed to give moms who choose to breastfeed the best chance for success.”

Hospital staff clean up beach in Kona on Hawai‘i Island

February 4, 2023 · 12:00 PM

https://bigislandnow.com/2023/02/04/hospital-staff-clean-up-beach-in-kona-on-hawaii-island/

Kona Community Hospital Employee Engagement Committee members conducted a beach cleanup at Old Airport last weekend, on Saturday, Jan. 28.

The committee, hospital employees, and family members spent several hours picking up rubbish on the shores of the beach park and in the picnic areas. Over a hundred pounds of trash were collected.

“We wanted to give back to our community outside of our facility as a healthcare community,” said Michelle Gray, current chairman of the employee engagement committee.

CEO Clayton McGhan said, “Kona Community Hospital staff are amazing … It was great to see the staff and their families come out for a singular purpose, to preserve the life and beauty of our beaches.”