WAILUKU, Maui — Malulani Health & Medical Center officials said yesterday they are confident they will be able to hire the staffing they need for a new 150-bed hospital in Kihei despite a critical nursing shortage nationwide.

The proposed hospital, under review by the Tri-Isle Subarea Health Council as part of a certificate of need, or CON, approval process, is projecting a payroll of 456 employees in its first year, expanding to 834 by its third year.

Malulani official Dr. Ron Kwon said he has been contacted by a number of physicians, nurses and other healthcare professionals who want to practice at the new state-of-the-art hospital, planned for 40 acres off the Lipoa Parkway. Kwon and other physicians and nurses who testified Friday and yesterday said they expect Malulani to attract staff who want to work at a cutting-edge facility while enjoying Maui's lifestyle.

But some health council members, as well as Maui Memorial Medical Center officials opposing Malulani's CON application, remained skeptical. Maui Memorial Nursing Director Stacey Arakawa said vigorous recruiting efforts that have stretched from the Philippines to the Mainland and Canada have failed to meet the constant demand for nurses. About 10 percent of the hospital's 600-plus nursing and related positions are vacant, she said, with Maui Memorial's total job vacancy rate running at 20 percent.

Arakawa said many of the nurses and other staff who are attracted to the generous wage and benefit package offered by the public hospital do an about-face when confronted with Maui's high cost of living.

Dr. Lee Miyasato of Maui Radiology Associates, which contracts with Maui Memorial, on Friday expressed concern that two hospitals could actually drive away physicians because the patient pool would be split. He said he left the Big Island precisely because there were too many hospitals serving the relatively small North Hawai'i community. He said in order to stay at the top of their game, doctors need a substantial and steady caseload.

Jim Shannon, vice president of development for Triad Hospitals Inc. of Plano, Texas, a partner in the Malulani project, said his company dealt with the staffing issue while building nine new hospitals. He said many of their hires have been doctors and nurses who left public hospitals because they were disenchanted with the level of care and facilities. Others were former hospital staff who had been working in medical offices and wanted to return to a large facility, particularly one that offered the latest in medical care.

Shannon said Triad also has funded nursing instructor positions at local colleges and offered scholarships and internships to encourage more students to enter the healthcare field.

Malulani Health & Medical Center is being developed by the nonprofit Malulani Health Systems Inc. and the for-profit Triad Hospitals Inc. The partnership estimates it will cost $212 million to build a full-service healthcare campus whose major components include a comprehensive imaging center, open-heart surgery capabilities not now available on Maui, an emergency department and a heliport.

All patient rooms would be private, with 110 set aside for medical/surgical cases, 25 for critical care, 10 for labor and delivery, and five for neonatal intensive care, also not now available on the island.

Malulani promises a "combination of the best of Western, Native Hawaiian, complementary, alternative and Eastern medical philosophies" to provide patients and their families "a choice in accessing all forms of health services, while reflecting the cultural diversity of Maui County."

Maui is the only major island in the state served by a single acute-care hospital. The 202-bed Maui Memorial Medical Center is part of the quasi-public Hawai'i Health Systems Corp. that is subsidized by the state.

Maui Memorial officials say Malulani would have a "potentially disastrous impact" on the hospital, which would lose an estimated $55 million annually to the new facility. A second hospital would create duplicated services and dilute the patient pool, opponents claim, weakening overall medical services islandwide and possibly forcing Maui Memorial to drop unprofitable services, such as psychiatric care, already one of the county's major healthcare shortcomings.

In addition to staffing, members of the health council expressed concern about the relationship between Triad and the nonprofit Malulani group. Triad would have 80 percent ownership of the medical center. Council Chairman John Ornellas said he was wary of placing his trust in a publicly traded Mainland company controlled by a board that must answer to stockholders.

Shannon responded that even though Malulani would be only a 20 percent partner, the nonprofit entity would control half the seats on the hospital's board of directors, ensuring local control, even in the unlikely event Triad sells its ownership share.

He said local control also would ensure the new hospital serves all patients, not just the wealthy residents in the neighboring resort and retirement communities of Wailea and Makena.

Maui Memorial officials have said there is a significant risk Malulani will "cherry pick" the rich patients and leave the poor and uninsured to the public facility.

Reach Christie Wilson at cwilson@honoluluadvertiser.com.