The board of American Samoa's LBJ Hospital hopes a new direction of fiscal prudence will encourage the territorial government to help with the hospital's financial difficulties.
The hospital has a debt of about 15 million US dollars, including an outstanding 5.7 million dollar loan from the territorial government from 2003.
The board chairman, Charles Warren, says while it's unlikely that the government would forgive LBJ's debt, it has told the board to show it a plan that the hospital will be able to eliminate cash flow shortages in future.
Mr Warren says the new cost-cutting plan may involve unpopular developments like staff cuts.
"We've had some very productive meetings this week already. They like the plan we showed to the governor, the cost-cutting plans and revenue enhancement. He likes all the features, and you know, their revenue is tight also, but it looks like there might be a way for them to come to the assistance of LBJ on the basis to allow us to kind of wipe the slate clean and roll forward."
Mr Warren says the board has directed management to analyse its services to see what is affordable on an ongoing basis.