The 10 Worst Nursing Homes in Hawaii

A list of the ten worst skilled nursing homes in Hawaii. Based on the Weighted Health Inspection Score developed by the Centers for Medicare and Medicaid Services.

Compare the Worst Nursing Homes in Hawaii

Every year, thousands of seniors, their families, and friends are faced with the difficult decision of choosing a skilled nursing facility, either because someone is recuperating after a hospital visit or for end-of-life care. This is usually an issue that arises suddenly, and the decision makers are not equipped with the right knowledge and information to make a good decision. Not knowing how to decide, they turn to others for recommendations. Word of mouth, along with geography, are constantly cited as the most important factors in choosing a skilled nursing facility. Choosing a facility with such limited information can lead to significant problems. Not all skilled nursing facilities are the same and the people that you trust to recommend a facility may not know enough about the facility and the alternatives to be a competent guide.

Providing the type of care that residents of skilled nursing facilities require is very difficult. The range of issues that are being treated is vast and the needs cover both people recuperating and recovering as well as those facing end-of-life issues. Residents require significant help with basic daily activities as well as supplemental needs like oxygen and 24/7 monitoring.

To help people who are facing this difficult situation, we have compiled a list of the worst Hawaii skilled nursing facilities and the the best skilled nursing facilities. (We have also compiled the best and worst nursing homes by city for most cities in the United States, links are shown at the bottom on this page.) The lists are based on data provided by The Centers for Medicare & Medicaid (“CMS”) and include information gathered from detailed annual inspections, monthly reporting, complaint histories, deficiency reports and much more.

The list below calls out the worst skilled nursing facilities in Hawaii. For the most part these facilities should be avoided. All the facilities have issues with cleanliness and safety and a large number of the facilities have been flagged by CMS as locations where abuse has either occurred or is highly likely.

Avoiding these facilities may not always be an option either because of geographic, monetary, or occupancy constraints. However, being in a bad nursing home does not mean that the resident will not improve. If you have a loved one in one of these facilities, we encourage you to visit often and to ask that friends and other family visit too. It is well documented that positive outcomes for skilled nursing residents is highly correlated with the number and diversity of people visiting the resident. Being there, getting to know the staff, showing the staff that the resident has people that care about him or her is critical. There may not always be a better option, but your direct involvement can make a difference.

To see a more detailed analysis of the performance on skilled nursing facilities in Hawaii, including staffing, COVID-19 infections, historical occupancy levels and recent trends, look at our detailed analysis page.

Nursing Home Rating
Liliha Healthcare Center
Hale Malamalama
Hale Makua - Kahului
Nuuanu Hale
Aloha Nursing and Rehab Centre
Pu'uwai 'o Makaha
Yukio Okutsu State Veterans Home
Avalon Care Center - Honolulu, LLC
Palolo Chinese Home
2459 10TH AVENUE
Kuakini Geriatric Care, Inc

Nursing Homes with the warning icon () have been flagged by CMS for abuse.

How We Compile Nursing Home Ratings in Hawaii

Every month, we rank all of the skilled nursing facilities in Hawaii. These rankings are based on data provided by The Centers for Medicare & Medicaid measures ("CMS"), including the CMS 5-Star Rating System and the Health Inspection Scores. The list of the Worst Skilled Nursing Facilities in Hawaii is based on the weighted overall health inspection score which is a composite of CMS's three most recent skilled nursing home inspection scores weighted to give the most recent inspection more importance.

The CMS 5-Star Rating System rates skilled nursing facilities from one to five stars, with one star being the lowest and five stars being the highest. The rating system also rates Hawaii nursing homes across five different dimensions including overall rating, health inspection rating, quality measures rating, overall staffing rating, and RN staffing rating (RN is an acronym for Registered Nurse).

In addition to the 5-Star Rating System, CMS provides numerical metrics that summarize:

  • Health Inspection Domain. The health inspection rating is based on the three most recent standard surveys for each nursing home, results from any complaint investigations during the most recent three-year period, and any repeat revisits needed to verify that required corrections have brought the facility back into compliance. CMS calculates a weighted deficiency score based on points assigned to health deficiencies identified in each active provider’s current health inspection survey and the two prior surveys (including revisits), as well as deficiency findings from the most recent three years of complaint investigations. More recent surveys are weighted more heavily than older surveys: the most recent period (cycle 1) is assigned a weighting factor of 1/2, the previous period (cycle 2) has a weighting factor of 1/3, and the second prior survey (cycle 3) has a weighting factor of 1/6. The weighted time period scores are then summed to create the survey score for each facility.
  • Staffing Domain. Using multiple reporting methods, CMS calculates the amount of time that the nursing staff spends with residents. This is measured across multiple dimensions, one each for three different levels of nursing, including Registered Nurses (“RNs”), Licensed Practical Nurses (“LPNs”), and Certified Nursing Assistants (“CNAs”), plus one metric that totals all contributions. These metrics are expressed in hours per resident per day. CMS also provides state-level and national averages for the metrics to allow for additional comparisons.
  • Quality Measures Domain. A set of quality measures (QMs) has been developed from MDS-based indicators to describe the quality of care provided in nursing homes. These measures address a broad range of functioning and health status in multiple care areas. The facility rating for the QM domain is based on performance on a subset of 11 (out of 18) of the QMs. Ratings for the QM domain are calculated using the three most recent quarters for which data are available. This time period specification was selected to increase the number of assessments available for calculating the QM rating, increasing the stability of estimates and reducing the number of facilities that do not have enough data to report QM ratings.
  • Abuse Flag. Abuse is always a concern in skilled nursing facilities. To highlight the issue, CMS has extracted this feature as its own flag. Facilities with an actual abuse event or where the potential for abuse has been shown for the past two years are flagged. The Health Inspection Score is capped at 2-stars for nursing homes that have been flagged for abuse.

Skilled nursing facilities that are new and do not have at least two surveys completed are not rated by CMS. These facilities may have health inspection scores that can be used to evaluate the facility.

One complication in Hawaii nursing home inspections is the COVID-19 pandemic. Although inspections should be performed every 12 months, COVID has decreased this frequency. While CMS admits that only in “rare cases” do these inspections increase to 15 months, our analysis suggests that this time frame may be even longer. This report shows that the time between inspections is now just under 500 days (more than sixteen months). There are now hundreds of skilled nursing homes in the United States that have not been inspected in more than 24 months. This list shows the skilled nursing homes with the longest period since being inspected. According to the CMS data, these homes have not been inspected since 2018!

Skilled Nursing Home Abuse in Hawaii

Abuse is always going to be an issue with skilled nursing facilities. Skilled nursing facility residents need help with so many basic things and they are suffering, confused, and frustrated. If you are the friend or relative of a nursing home resident, we guarantee that you will be constantly fretting about whether your loved one is receiving proper and timely care. Abuse feels like a violation of your trust, but it happens. CMS actively monitors nursing homes not just for actual abuse but also for indicators that suggest that abuse might be occurring. Homes where abuse has either occurred or might be occurring are flagged. A very high percentage of the worst skilled nursing facilities in Hawaii have been flagged for abuse. We have marked these facilities both on the list of the worst skilled nursing facilities and on the detailed page for each of the facilities.

How to Report a Nursing Homes in Hawaii

If you run into an issue at a Hawaii nursing home, there are a few steps you can take to make sure the issue is reported. First, speak with the immediate staff. If the problem is not solved, speak with a director or administrator, doctor, or any other employee of a high level.

As required by Medicare and Medicaid, reports and complaints must go through a grievance procedure. Per the Center for Medicare & Medicaid Services, a grievance is “an expression of dissatisfaction (other than an organization determination) with any aspect of the operations, activities, or behavior of a Medicare health plan, or its providers, regardless of whether remedial action is requested”. All grievances must be filed in writing or verbally within 60 days of the event prompting the grievance.

To report a Hawaii nursing home for quality of care, go through a grievance procedure through your Medicare or Medicaid plan. You can also go through the Beneficiary and Family Centered Care-Quality Improvement Organizations (BFCC-QIO). These groups serve to help with complaints made regarding the quality of care by Medicare providers. You can also choose to go through both Medicare and a BFCC-QIO.

Worst Nursing Homes in the Largest Hawaii Cities

All of the following nursing homes have been given a Weighted Health Inspection Score by the Centers for Medicare and Medicaid Services. Every year, nursing homes in Hawaii go through an unannounced inspection performed by independent state examiners. These examiners look at factors such as cleanliness, hazards, and safety to perform the inspection. Points are given to nursing homes based on their deficiency in a certain category. Thus, a higher Weighted All Cycles Score means more problems and lower quality of care.

The list below ranks the homes with the highest (worst) weighted scores. The score is shown next to the facility name. The list also shows the two most recent deficiencies for each of the nursing homes.

Worst Nursing Homes in Honolulu

  • Liliha Healthcare Center (291.833)
    • Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. (2023-07-31)
    • Give residents a notice of rights, rules, services and charges. (2023-07-31)
  • Hale Malamalama (230.667)
    • Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. (2023-12-06)
    • Ensure that residents are fully informed and understand their health status, care and treatments. (2023-12-06)
  • Nuuanu Hale (165.667)
    • Have elevators that firefighters can control in the event of a fire. (2024-03-18)
    • Provide family notifications of emergency plan. (2024-03-18)
  • Avalon Care Center - Honolulu, LLC (122.667)
    • Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. (2024-05-07)
    • Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home. (2024-05-07)
  • Palolo Chinese Home (116.667)
    • Inspect, test, and maintain automatic sprinkler systems. (2023-06-08)
    • Have approved installation, maintenance and testing program for fire alarm systems. (2023-06-08)
  • Kuakini Geriatric Care, Inc (114.667)
    • Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. (2024-04-08)
    • Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. (2024-02-29)
  • The Care Center of Honolulu (99.667)
    • Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. (2023-10-05)
    • Meet other general requirements. (2023-09-28)
  • Hale Nani Rehabilitation and Nursing Center (92.667)
    • Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. (2023-10-27)
    • Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. (2023-10-27)
  • Islands Skilled Nursing and Rehabilitation (90)
    • Develop and implement policies and procedures for flu and pneumonia vaccinations. (2023-09-25)
    • Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. (2023-09-25)
  • Arcadia Retirement Residence (88.333)
    • Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. (2023-12-15)
    • Give the resident's representative the ability to exercise the resident's rights. (2023-12-15)

Worst Nursing Homes in East Honolulu

Worst Nursing Homes in Pearl City

  • Pearl City Nursing Home (74.667)
    • Install corridor and hallway doors that block smoke. (2024-05-31)
    • Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. (2024-05-10)

Worst Nursing Homes in Hilo

  • Yukio Okutsu State Veterans Home (122.667)
    • Notify the resident or the resident?s representative in writing how long the nursing home will hold the resident?s bed in cases of transfer to a hospital or therapeutic leave. (2023-12-11)
    • Ensure each resident receives an accurate assessment. (2023-12-11)
  • Hale Anuenue Restorative Care (85.333)
    • Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. (2024-03-18)
    • Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. (2024-03-18)
  • Life Care Center of Hilo (84.667)
    • Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. (2024-01-15)
    • Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. (2024-01-15)
  • Legacy Hilo Rehabilitation and Nursing Center (58.333)
    • Reasonably accommodate the needs and preferences of each resident. (2023-12-08)
    • Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. (2023-12-08)
  • Hilo Medical Center (24)
    • Have properly located and lighted "Exit" signs. (2024-03-26)
    • Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements. (2024-03-26)

Worst Nursing Homes in Waipahu

Worst Skilled Nursing Homes in Other States

See the worst skilled nursing homes in other states:

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