American Samoa's LBJ Medical Center is cutting spending after a drop in revenues, unpaid debts and a fall in funding from the federal government.
The medical center's chief executive, Mike Gerstenberger, says in the quarter to the end of December, it lost one million US dollars from its 2013 budget and the previous administration had cut the entire 10 million dollars proposed for the off-island medical referral programme.
Additionally, there is no word on the 1.25 million dollars the hospital is to receive from the two-percent wage tax and 1.35 million dollars was lost in federal funding due to a fall in the numbers having their health care services paid for by Medicaid.
Mr Gerstenberger says the hospital has implemented steps to address the shortfall by freezing 71 vacant positions and cutting overtime.
It will also reduce utility costs, stop capital spending, put a cap on educational travel expenses and stop covering cell phone costs.