The Queen’s Health Systems plans to build an 80-bed hospital next to the Kailua-Kona Costco on Hawaii island that would include a helipad to cut travel time to its trauma center on Oahu and, critically, construct adjacent, below-market-rate housing to recruit and retain some of the estimated 300 hospital staff, nurses and doctors.
The campus, including a medical office building, would start to go up in two to three years on 30 acres of land Queen’s owns, with it opening perhaps five years from now, according to Queen’s President and CEO Jason Chang.
The project would cost $400 million to $500 million, with possible funding from private investments and philanthropic contributions, Queen’s said.
“What we’re trying to do is create a regional health system for the Big Island, so this is in partnership with our existing hospital, Queen’s North Hawaii Community Hospital,” Chang said. “We’ll be bringing more access, better care and more specialists to the north and west sides of the island.”
Queen’s plans surprised officials at the 94-bed Kona Community Hospital, located south of the Queen’s site closer to Captain Cook.
Hawaii Health Systems Corp., which operates the Kona Community and Kohala hospitals, had been looking to build another hospital closer to the main population center in Kailua-Kona, including potentially on the land where Queen’s plans to build its still-unnamed hospital, said Clayton McGhan, HHSC West Hawaii regional CEO.
Because of the health care needs of the west side of the Big Island, McGhan said he supports Queen’s plans, especially its goal of building workforce housing for hospital staff.
While some refer to the neighbor islands as providing “rural health care,” McGhan said that in Kona, “I actually think we’re remote or frontier health care.”
Based on a needs assessment funded by the state Legislature, West Hawaii’s population is expected to grow 11% over the next decade.
Last year, 22,000 patients were treated in the Kona Community Hospital’s emergency room and the number is on track to jump to 24,000 this year McGhan said.
It has its own helipad and flies about 6,000 patients each month to Queen’s trauma center on Oahu via Hawaii Life Flight medical transport crews. Most are neurological or stroke patients and “traumatic cases,” McGhan said.
But the 50-year-old Kona Community lacks the volume of specialized cases to justify full-time specialists. So it relies on specialists at Queen’s to consult via telemedicine technology on stroke and neurological cases, along with helping with a new electronic medical records system, McGhan said.
A new Queen’s hospital in Kailua-Kona would be welcomed, he said.
“We don’t look at it as competition,” McGhan said. “I know what our community needs. We have to celebrate that because it’s going to meet the community’s demands. The main thing is we’re supportive of any additional resources that would come here.”
Kona community Hospital needs 25 more doctors trained in psychiatric care, cardiology, adult primary care and pediatric specialties, according to McGhan, who applauded Queen’s plan to build 150 condo and apartment units that would be rented to hospital staff at below-market rates, with the option to also buy at below-market prices.
When it’s time to sell, owners would have to sell to another hospital employee at similar rates, Chang said.
McGhan called the concept “fantastic. It’s hard to attract staff here. So we’re going to be supportive of any new workforce housing.”
Gov. Josh Green started his Hawaii medical career at a rural hospital in Kau on the southern end of Hawaii island. As lieutenant governor, he worked weekend ER shifts at Kona Community while running for governor.
“It’s very exciting to see health care weigh in on the need for affordable housing. I’ve always said that housing is health care,” Green said.
For Queen’s, Chang hopes to finish building the housing before the hospital itself opens to ensure it has long-term staffing.
“We believe housing’s such a huge need and you can’t recruit nurses, doctors, technologists, social workers if you don’t,” Chang said.
Because of the difficulty recruiting health care workers — let alone specialists — to the neighbor islands, Queen’s 35-bed North Hawaii Community Hospital relies on traveling nurses and doctors.
It’s hired four full-time oncologists over the last 10 years who all left after a couple of years, Chang said.
“It takes a year to bring someone new in,” he said. “Traveling physicians don’t plan to stay. It’s a real challenge in rural communities. We can’t hire permanent people because they can’t find housing — affordable or just inventory, period. If we don’t address housing ourselves, we’re going to have the same problem.”
By providing below-market-rate condos and apartments, Chang hopes to retain some traveling health care workers for the new hospital.
Queen’s physicians also work closely with medical students at the University of Hawaii’s John A. Burns School of Medicine, including students who already work with patients at Queen’s. They also could rotate through the new hospital, along with one or two post-graduate medical residents every couple of years.
With Queen’s residents, he said, “I just need one or two to stay every few years. That would be fantastic and it makes them appreciate the need for rural health care.”
Many details of the new hospital campus still need to be worked out, such as how many stories the facility would have. But the hospital probably will be around 250,000 square feet in size, Chang said.
The community wants a trauma center and specialists to treat heart attacks and strokes, but West Hawaii doesn’t have the volume of cases to attract or retain “a top-notch cardiologist,” Chang said. “Just treating 30 heart attacks a year, they’re going to leave.”
Instead, the hospital will focus on “diagnostic cardiology, diagnostic neurology — state-of-the-art diagnostics — and general surgery,” he said.
There also will be an emergency room “to stabilize you and fly you to Queen’s.”
For some neighbor-island patients flying to The Queen’s Medical Center in Honolulu on an airplane, it can sometimes take three to four hours between when they call 911, get taken by ambulance to their local hospital, diagnosed, driven by ambulance to an airport, put on a plane to Daniel K. Inouye International Airport and then taken by ambulance to the hospital, Chang said.
“You end up with a massive amount of transfer time,” he said.
Instead, a twin-engine H145 helicopter is scheduled to be delivered to Queen’s in 2026.
It’s being paid for by philanthropists Lynne and Marc Benioff, who have a home on the Big Island. Marc Benioff is co-founder, chairman and CEO of Salesforce and owns Time magazine.
The couple already have donated $5 million, dedicated solely to Hawaii island health care workers, to augment $30 million in state funds to pay off student loans to keep health care workers from leaving Hawaii.
Once the helicopter goes into use at the new hospital, Chang said Hawaii County crews will staff it to fly patients to Queen’s trauma center.
“How do you get somebody to the trauma center, which is Queen’s Medical Center Punchbowl, as fast as you can?” Chang asked. “If you can go rooftop to rooftop, you cut out all that ambulance time.”
Benioff, Chang said, “recognizes that air transport is a real issue.”
Queen’s plans help address the growing need for health care in the area, according to Green.
In a follow-up statement, Green said: “The West Hawaii community truly needs a new hospital as Kona Hospital has aged, and is now further away from the region’s population center. It’s exciting to see Queen’s begin the process of raising capital and building relationships to launch this new facility. There is certainly a pathway for the state to either support or even partner with Queen’s on this project, once all of the stakeholders have come to a consensus on how to move forward.”
