A scaled-back version of a long-planned health care campus at the developing suburban Koa Ridge community in Central Oahu is moving forward under a new partnership.

Wahiawa General Hospital recently announced that it has partnered with The Queen’s Health Systems to develop what has long been described as an integral piece of the 576-acre community master-planned by developer Castle & Cooke Hawaii between Waipio and Mililani.

Queen’s will build and operate the medical facilities at Koa Ridge, and has yet to determine a detailed scope of the project.

However, the plan no longer includes a hospital with an emergency room and other services as a replacement for Wahiawa General as had been envisioned for roughly two decades.

Also, the footprint of the campus will be 40% smaller: 16.5 acres instead of 28 acres.

Land no longer planned for health care facilities will be used by Castle & Cooke to develop a senior rental housing project and entry-level single-family homes.

The revamped health care campus would still be a big endeavor. Facilities are envisioned to serve a broad region, including Waipahu, Mililani, Wahiawa and the North Shore.

Construction is estimated to cost over $200 million. Project leaders estimate that building the facilities could begin in two years or so.

“Everything is in place right now,” said Duke Aiona, an attorney representing the partnership team that includes a private equity investor in addition to the two nonprofit health care providers. “We can’t wait to get this going. It’s going to happen.”

Under the partnership, Wahiawa General will receive the 16.5 acres from Castle & Cooke as part of a long-standing donation agreement.

Queen’s will build and operate the facilities and will also help finance the project.

Jason Chang, president of The Queen’s Medical Center, said primary health care along with pediatric and geriatric medicine will be offered at Koa Ridge along with specialty care that can include cardiology and oncology. But more detailed plans, including facility size and staffing, have yet to be produced.

“Right now we don’t know specifically what we’re going to build,” he said.

Chang said Queen’s is assessing how to best serve health care needs of nearby communities and future Koa Ridge residents.

Part of that assessment includes looking at data to see where patients visiting other Queen’s facilities are coming from and what their needs are.

“We’re trying to be scientific about the approach and what we need to invest in,” Chang said.

Another part of the analysis will look at what things complement but don’t compete with Wahiawa General and existing Queen’s facilities that include a recently acquired family practice with six physicians in Haleiwa and Mililani.

“The spirit is not to compete with each other,” Chang said. “It is to partner to improve health care.”

The new plan was prompted in part by chronic financial challenges of Wahiawa General, which traces its history to a hospital established in a school building in 1944 and today runs a 53-bed acute-care facility and a long-term care facility with 107 beds.

Wahiawa General’s prior plan for Koa Ridge was to provide comprehensive primary and secondary medical services including an acute-care hospital with more than 100 beds, an emergency room, a skilled-nursing facility with 100 to 150 beds, diagnostic imaging and labora­- tory testing.

This plan was a significant factor in Castle & Cooke obtaining land-use approvals to develop Koa Ridge with 3,500 homes on former pineapple plantation land, and was projected to create 1,100 jobs while allowing Wahiawa General to replace its 64-year-old medical complex with a modern, larger facility.

“Central Oahu needs a new hospital ASAP at the Koa Ridge site,” R. Don Olden, the hospital’s then-CEO, stated in 2013.

However, Wahiawa General has struggled for years with financial difficulties that led the nonprofit to obtain state subsidies and search for another entity to take over its operations or team up to provide services.

In recent years Hawaii Pacific Health — operator of Kapiolani Medical Center for Women & Children, Pali Momi Medical Center and Straub Clinic & Hospital on Oahu — considered an acquisition. Wahiawa General also contemplated becoming part of the state-owned Hawaii Health Systems Corp.

To develop the health care complex at Koa Ridge, Wahiawa General has explored working with Queen’s, Hawaii Pacific, Castle Medical Center and Sutter Health.

Recently, the partnership agreement with Queen’s was reached following discussions that stretch back to mid-2019.

Brian Cunningham, Wahiawa General’s CEO, deferred comment to Aiona, who said the hospital’s nonprofit ownership association is happy to partner with Queen’s.

“We’re very excited about this,” Aiona said.

Koa Ridge has been planned by Castle & Cooke since the mid-1990s, and overcame numerous challenges that included two Hawaii Supreme Court cases and three rounds of state land-use hearings contested by community and environmental groups.

The developer began construction in 2017 laying groundwork for homes, the medical complex, a hotel, an elementary school, a light industrial park, stores, restaurants, parks and a 7.5-mile pedestrian trail.

Castle & Cooke delivered its first home in November. Finishing Koa Ridge is estimated to take about a decade.