Care-facility inspections
How nursing homes and care facilities in Hawaii are inspected, licensed, and held to account.
6 laws · 9 enforcement actions · 5 guides · 3 court decisions
See the details
The laws 6
- HRS §321-1.9, Inspections; visits; state-licensed or state-certified care facilities: the cross-cutting inspection-authority statute requiring DOH to conduct unannounced visits/inspections, including for relicensing or recertification, on a… capitol.hawaii.gov
- HRS §321-15.6, Adult residential care homes; licensing: requires all ARCHs to be licensed, and directs DOH to adopt rules establishing Type I (five or fewer residents; capitol.hawaii.gov
- HRS §321-14.8, Home care agencies; licensing: since July 1, 2010, every home care agency must be licensed by DOH; capitol.hawaii.gov
- HRS §321-13.5, Certified nurse aides; investigations of abuse and neglect: the statutory basis for DOH's certified-nurse-aide abuse/neglect registry actions, requiring rules for investigating abuse, neglect, or misappropriation of a residen… capitol.hawaii.gov
- HRS §321-483, Community care foster family home, authority over and evaluation of (HRS chapter 321, Part XXXVIII): anyone who takes into their household, for a fee, a nursing-facility-level-of-care adult unrelated to the household (a CCFFH)… capitol.hawaii.gov
- HRS §§321-486 through 321-486.2, and 321-487 (HRS chapter 321, Part XXXVIIIA, 'Uncertified or Unlicensed Care Facilities'): DOH's power to investigate reports that a person, entity, home, or living arrangement is operating a care facility w… capitol.hawaii.gov
Know your rights 5
- OHCA Medicare Section guidance, 'Opening a General Health Care Facility': walks an applicant through obtaining a Certificate of Need (or a CON-not-needed letter) from the State Health Planning and Development Agency, then submitting a writt… health.hawaii.gov
- OHCA guidance on HAR chapter 11-106 (Background Checks, effective 2/3/2019): explains that state-licensed applicants/operators and prospective direct-patient-access employees/volunteers of health care facilities must undergo a background ch… health.hawaii.gov
- OHCA's 'Minimum Qualifications for an Adult Residential Care Home (ARCH) License': a provider-facing checklist requiring the applicant to be a Hawaii resident, at least 21 years old, at least a certified nurse aide, have a home/facility mee… health.hawaii.gov
- OHCA's 'Facility Event Reporting Requirements & Guidance for Conducting Investigations' (revised 11/10/2025): current OHCA guidance for long-term care facilities on their duty to report 'Reasonable Suspicion of a Crime' and 'Abuse, Neglect… health.hawaii.gov
- OHCA's 'Home Care Agency License Application' requirements-and-instructions packet: defines 'home care agency' and 'administrator,' and walks an applicant through the full state licensure application process under HAR chapter 11-700. health.hawaii.gov
Enforcement actions 2
- OHCA's 'Kahua Ike' public provider portal — Inspection Summaries tool: a live, searchable named-facility/named-individual inspection index (columns: Facility Name, Facility Type, and year columns 2023–2026), covering every OHCA-regulated ca… portal.ohcaportal.doh.hawaii.gov
- OHCA's 'Kahua Ike' public provider portal — Facility Listings tool: the live, statewide directory of every OHCA-regulated licensee (Assisted Living Facility, Skilled Nursing Facility, Type I/II Adult Residential Care Home, Home Care Agency,… portal.ohcaportal.doh.hawaii.gov
Orders & settlements 7
- Hawaii Administrative Rules (HAR) Title 11, Chapter 94.2 — Nursing Facilities (effective 9/16/2022, 65 pages; health.hawaii.gov
- HAR Title 11, Chapter 100.1 — Adult Residential Care Homes (effective 9/18/2006; repealed and replaced the prior chapters 11-100 and 11-101): the state licensing rules for Type I and Type II ARCHs, administered by OHCA; health.hawaii.gov
- HAR Title 11, Chapter 90 — Assisted Living Facility (effective 8/23/1999): the state licensing rules for Hawaii assisted living facilities, administered by OHCA, covering purpose, definitions, licensing, minimum building/structural requirem… health.hawaii.gov
- HAR Title 11, Chapter 97.1 — Home Health Agencies (effective 9/16/2022; repealed and replaced the prior chapter 11-97): the state licensing rules for Hawaii home health agencies, administered by OHCA. health.hawaii.gov
- HAR Title 11, Chapter 700 — Home Care Agencies (effective 8/10/2018): the state licensing rules for Hawaii home care agencies (personal care/homemaker/respite services), administered by OHCA's State Licensing Section, implementing HRS §321-… health.hawaii.gov
- HAR Title 11, Chapter 96 — Freestanding Adult Day Health Centers (effective 11/22/1991): the state licensing/Medicare-certification rules for adult day health centers, administered by OHCA's Medicare Section. health.hawaii.gov
- HAR Title 17, Chapter 1424 — Licensing of Adult Day Care Centers (effective 10/4/2001): originally a Department of Human Services rule (Subtitle 9, Adult and Community Care Programs); health.hawaii.gov
Court decisions 3
- One Kalakaua Senior Living Association v. Clay, 153 Haw. 232, 529 P.3d 710 (Haw. App. 2023), No. courts.state.hi.us
- Campos v. Marrhey Care Home, LLC, 128 Haw. 405, 289 P.3d 1041 (Haw. App. 2012), No. 29114, decided 2012-09-27 — Hawaii Intermediate Court of Appeals opinion in a dispute involving an elderly resident, Magdalena Campos, who was placed by a c… courtlistener.com
- State v. Bermisa, 104 Haw. 387, 90 P.3d 1256 (Haw. App. 2004), No. 24046, decided 2004-05-07 — Hawaii Intermediate Court of Appeals opinion affirming a manslaughter conviction of defendant-appellant Raquel Bermisa. courtlistener.com
Official notices 3
- OHCA's own home page carries its current provider/public notice on the shift of complaint intake to its new online portal: 'Complaints Effective August 1, 2026, official intake of complaints needs to be made through our "Kahua Ike" public p… health.hawaii.gov
- OHCA Medicare Section's designated 'Notices and Updates for Facilities' bulletin page, currently featuring OHCA's MDS 3.0 update memo to Medicare-certified nursing facilities (effective April 1, 2012) alongside a link to the federal CMS MDS… health.hawaii.gov
- OHCA notice of a legislative licensing-waiver change (Act 091, Session Laws of Hawaii 2019) together with the resulting named-agency list: home care agency licensure is waived, as of this pass, for Easter Seals Hawaii, Full Life, The Arc of… health.hawaii.gov