Hawaii Nursing Homes: Violations, Fines and Worst Records

Hawaii leads the nation at number 1, averaging 3.7 stars over 43 nursing homes. The 3.0 national average falls short, based on Medicare data from federal agency CMS. Per resident each day, state facilities average 4.97 nursing staff hours, placing number 3 nationally and topping the 3.86 U.S. level. Registered nurses supply 1.75 hours of that daily care, versus 0.69 hours across the nation. Hawaii sees 36.4% of nursing staff leave over a year, versus 45.8% nationwide.

During the three most recent inspection cycles, inspectors wrote 1,464 citations against Hawaii facilities, with 51 involving immediate danger or harm to residents. In Hawaii, infection control and prevention is the most-cited rule at 92, while supervision and accident hazards top harm-level findings at 18. The federal Special Focus Facility program counts Hale Nani Rehabilitation and Nursing Center as Hawaii's 1 home. It tracks facilities with past serious inspection problems, and 5 additional Hawaii homes are candidates. In Honolulu, Islands Skilled Nursing & Rehabilitation received an $89,206 fine in May 2024, part of $831,590 in total federal fines across 21 homes statewide.

State licensing results from 2015 onward are posted on the Healthcare Facilities Inspection Reports (Office of Health Care Assurance) page. That page covers violations and correction plans for Hawaii care homes, assisted living, and also other long-term care facilities. For Hawaii's Medicare-certified nursing facilities, that state page links to Medicare Care Compare (formerly Nursing Home Compare). There, each Hawaii home's page links to its own federal statement of deficiencies. The official report, Form CMS-2567, lists every rule violation inspectors cited.

Unsafe care in a Hawaii facility can be reported by families to the Hawaii Department of Health, Office of Health Care Assurance at 808-692-7420, and 15.8% of all Hawaii citations come from complaint visits. Residents and relatives can also call the Hawaii Long-Term Care Ombudsman Program at 586-7268 (Oahu). It is an advocate office within the Hawaii State Department of Health, Executive Office on Aging. Suspected neglect or abuse of a vulnerable adult in Hawaii can also be reported to Adult Protective Services by calling (808) 832-5115.