facebook tracking How are Hawaii hospitals doing financially? Margins, losses and charity care

How are Hawaii hospitals doing financially?

Operating margins, losses, charity care, beds and staff for 24 Hawaii hospitals, from the cost reports they file with Medicare, compared with the rest of the U.S.

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Lost money on patient care
70%
Hawaii16 of 23 with a full-year margin
United States55%

Hospitals whose patient care cost more than it brought in, in their latest full-year report — more than the national share.

Typical operating margin
-11.0%

The median Hawaii hospital kept -11.0% of its patient revenue after operating costs, against -1.6% nationally (#46 of 50 states). Excludes donations and investment income.

Charity care
$28.9 million

The cost of free or discounted care Hawaii hospitals gave patients who qualified, in their latest full-year reports: 0.1% of the U.S. total of $35.6 billion.

Beds and staff
2,653 beds

16,649 full-time-equivalent employees across 24 hospitals with a cost report.

Most charity care in Hawaii

Charity care is reported at cost, not at list prices. The share is charity care as a part of the hospital's operating expenses.

Kaiser Foundation Hospital Honolulu $5.3 million 1.2% of expenses · FY Dec 2024 The Queens Medical Center Honolulu $4.7 million 0.3% of expenses · FY Jun 2025 Straub Clinic and Hospital Honolulu $4.0 million 0.6% of expenses · FY Jun 2025 Castle Medical Center Kailua $3.2 million 1.2% of expenses · FY Dec 2024 Kona Community Hospital Kealakekua $2.8 million 1.7% of expenses · FY Jun 2025 Pali Momi Medical Center Aiea $2.5 million 0.7% of expenses · FY Jun 2025

Biggest losses on patient care

The lowest operating margins among Hawaii hospitals with a full-year report. A negative margin means patient care cost more than it brought in; donations, grants and investments can still cover the gap.

Leahi Hospital Honolulu -82.7% -$13.8 million on $16.7 million patient revenue Kohala Hospital Kapaau -53.9% -$8.5 million on $15.7 million patient revenue Lanai Community Hospital Lanai City -39.9% -$2.3 million on $5.6 million patient revenue Kona Community Hospital Kealakekua -38.1% -$45.1 million on $118.3 million patient revenue Kula Hospital Kula -37.6% -$11.3 million on $30.1 million patient revenue Kau Hospital Pahala -35.8% -$17.9 million on $49.9 million patient revenue

Every Hawaii hospital's finances

Latest fiscal year each hospital reported. Reports marked "partial year" cover only part of a year (for example after a change of owner) and are left out of the state totals. Click a column to sort.

Hospital Beds Patient revenue Operating margin Charity care
The Queens Medical CenterHonolulu · FY Jun 2025 · 4,964 staff 762 $1.6 billion 0.1% $4.7 million
Straub Clinic and HospitalHonolulu · FY Jun 2025 · 1,604 staff 159 $590.3 million -7.0% $4.0 million
Kaiser Foundation HospitalHonolulu · FY Dec 2024 · 1,241 staff 225 $463.3 million 5.6% $5.3 million
Kapiolani Med Ctr for WomenHonolulu · FY Jun 2025 · 1,222 staff 253 $451.1 million 2.6% –
Maui Memorial Medical CenterWailuku · FY Dec 2024 · 1,280 staff 219 $359.6 million 2.2% $2.1 million
Pali Momi Medical CenterAiea · FY Jun 2025 · 998 staff 118 $349.4 million -2.3% $2.5 million
Hilo Medical CenterHilo · FY Jun 2025 · 1,358 staff 194 $316.8 million -18.1% $39,000
Castle Medical CenterKailua · FY Dec 2024 · 824 staff 142 $239.2 million -10.4% $3.2 million
Wilcox Memorial HospitalLihue · FY Jun 2025 · 441 staff 72 $156.3 million -9.1% $1.1 million
Kuakini Medical CenterHonolulu · FY Jun 2025 · 703 staff 170 $152.6 million -25.4% $157,000
Kona Community HospitalKealakekua · FY Jun 2025 · 494 staff 83 $118.3 million -38.1% $2.8 million
North Hawaii Community HospitalKamuela · FY Jun 2025 · 271 staff 33 $109.5 million 0.1% $330,000
Kauai Veterans Memorial HospitalWaimea · FY Jun 2025 · 270 staff 25 $55.6 million -22.9% $21,000
Kau HospitalPahala · FY Jun 2025 · 86 staff 21 $49.9 million -35.8% $2,000
Rehab Hospital of the PacificHonolulu · FY Sep 2024 · 294 staff 82 $48.6 million -11.0% –
Samuel Mahelona Memorial HospitalKapaa · FY Jun 2025 · 90 staff 5 $46.4 million -20.6% $128,000
Kula HospitalKula · FY Dec 2024 · 88 staff 9 $30.1 million -37.6% –
Honoka'a Hospital and Skilled NursingHonokaa · FY Jun 2025 · 77 staff 11 $27.5 million 1.5% –
Kahuku Medical CenterKahuku · FY Jun 2025 · 143 staff 21 $24.4 million -21.5% $62,000
Molokai General HospitalKaunakakai · FY Jun 2025 · 61 staff 15 $23.6 million 5.8% $255,000
Leahi HospitalHonolulu · FY Jun 2025 5 $16.7 million -82.7% –
Kohala HospitalKapaau · FY Jun 2025 · 119 staff 25 $15.7 million -53.9% $2.2 million
Lanai Community HospitalLanai City · FY Dec 2024 · 22 staff 4 $5.6 million -39.9% $3,000
Shriners Hospital for ChildrenHonolulu · FY Dec 2024 – – – –

Figures as reported to CMS (Hospital Provider Cost Report), not audited statements. Operating margin = net income from patient care ÷ net patient revenue; it excludes investment income, donations and grants. Charity care is the cost of free or discounted care for patients who qualify under the hospital's financial assistance policy. How to read these figures.

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How Hawaii compares with other states

Median operating margin of each state's hospitals (patient care only)

AK5.0% ME-3.0% VT-20.7% NH-0.5% WA-5.0% ID-3.2% MT-6.0% ND-10.5% MN-2.5% IL-2.3% WI3.2% MI0.0% NY-12.8% RI-14.7% MA-9.0% OR-6.4% NV4.0% WY-8.0% SD-0.8% IA-0.2% IN0.7% OH1.5% PA0.1% NJ-0.7% CT-7.9% CA-3.1% UT9.7% CO-3.1% NE-4.7% MO-3.7% KY4.0% WV-0.4% VA7.7% MD-3.7% DE3.3% AZ3.5% NM4.4% KS-15.3% AR-10.0% TN1.5% NC4.8% SC9.5% OK-5.6% LA-3.8% MS-3.8% AL-10.6% GA0.4% HI-11.0% TX1.2% FL7.6%

Median operating margin in nearby states:

Arizona · 3.5% All states

Questions about Hawaii hospital finances

How many Hawaii hospitals lose money?

16 of 23 Hawaii hospitals (70%) reported a loss on patient care in their latest full-year Medicare cost report, compared with 55% nationwide. The median operating margin was -11.0%, lower than the U.S. median of -1.6%. The operating margin leaves out donations, investment income and grants, so some of these hospitals still end the year in the black.

Which Hawaii hospitals provide the most charity care?

Hawaii hospitals reported $28.9 million in charity care (the cost of free or discounted care for patients who qualify) in their latest full-year reports. The largest amounts came from Kaiser Foundation Hospital ($5.3 million), The Queens Medical Center ($4.7 million), Straub Clinic and Hospital ($4.0 million), Castle Medical Center ($3.2 million), Kona Community Hospital ($2.8 million).

How do Hawaii hospitals compare with other states?

Hawaii ranks 46 of 50 states by the median operating margin of its hospitals (1 = highest). A larger share of its hospitals lost money on patient care than the U.S. as a whole (70% vs 55%).

What is the largest hospital in Hawaii by revenue?

The Queens Medical Center in Honolulu reported the most net patient revenue: $1.6 billion in its latest full-year cost report, with 762 beds and an operating margin of 0.1%.

What is an operating margin?

It is how much a hospital keeps from patient care after paying its operating costs, as a share of its patient revenue. A margin of 5% means the hospital kept 5 cents of every dollar it earned from patients; a negative margin means patient care cost more than it brought in. It excludes donations, investment income and grants.

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Source: CMS Hospital Provider Cost Report (data.cms.gov), latest report per hospital. About the data.