The state's first skilled nursing facility designed specifically for medically fragile children and their families opened in 'Ewa this month, filling a niche in the community.

With alphabet carpeting, stone pathways, forest animals, a castle, a billowy cloud ceiling and a giant beanstalk that appears to reach into the sky dominating the center of its atrium, the 30-bed Kulana Malama looks more like a fancy play center than a medical facility.

But then, that's the whole point of the $20 million Emerald Forest-themed center, which is aimed at those who don't need to be in a hospital but aren't ready for a home setting.

"We're trying to make it as child-friendly as possible," said Paul Bursey, Kulana Malama's nursing director.

While there are several other skilled nursing homes in Hawai'i that accept children, they are primarily geared for elder care. Kulana Malama, which held its grand opening yesterday, is taking only those under 21.

"Children's growth and development needs are a big piece of the whole medical situation that they may be in," Bursey said. "It's important that they have as normal a growing-up phase even though they're medically unwell. That's why the place looks the way it looks because we're trying to create the visual stimulus as well as the other type of stimulus."

The dramatic interior decorating of the facility masks its state-of-the-art technical features that can aid those needing everything from ventilators to aquatic therapy equipment.

The 21,000-square-foot children's residence, which carry about the same dimensions as a football field, contains seven, four-bed units and two studio apartments designed to accommodate families learning to adjust to a home- care living situation.

Kulana Malama has two doctors on staff and can accommodate up to 30 medically fragile children at a time.

Willow Morton, vice president of hospital operations at Kapi'olani Medical Center for Women & Children, said there has long been a big need for a facility like Kulana Malama in Hawai'i.

"We do have some children with very complex medical conditions and it sometimes takes a long time for them to get to a stable enough status where they can be cared for by their parents at home," she said. "These are kids who might be on ventilators, have to be fed on special tubes, have zillions of medications or need 24-hour constant monitoring."

While they may be recovering, they are not necessarily ill, she said.

Gordon Ito, owner and chief executive officer of Kulana Malama, said a marketing study "showed us there were a number of children in the hospital that needed to get out of the hospital, that a great number of children were inappropriately placed there because there was no place else to go."

Additionally, he said, Kulana Malama is designed to aid families in need of respite from the 24-hour care of medically fragile children. A second phase of the facility is expected to address the need for other types of pediatric services in the fast-growing 'Ewa region, Ito said.

Reach Gordon Y.K. Pang at gpang@honoluluadvertiser.com.