21 of the 43 Medicare-certified nursing homes in Hawaii (49%) are chain-owned, and all are listed below. 11 of the 20 graded homes earn an A and 3 earn a D or F. They average 4.37 nursing hours per resident per day, 0.6 hours below the 4.97 for every home in Hawaii. Honoka'a Hospital & Skilled Nursing in Honokaa grades highest at A (99 out of 100).
How chain-owned homes in Hawaii compare
This group set against every nursing home in Hawaii, from the current CMS release.
Honoka'a Hospital & Skilled Nursing runs on state money and a lot of nursing hours. At 5.51 per resident day, it's staffed about 43 percent above the national average, and weekend coverage only dips around 14 percent from its weekday level, a smaller drop than many homes manage. Turnover sits at 24.4 percent against a national 45.8 percent, so the people caring for residents tend to stay. The 14 deficiencies on record include one abuse-related finding, though none rose to harm or jeopardy, and the most recent inspection was in late 2024.
Hilo Benioff Medical Center runs 5.34 nurse hours per resident day, roughly 38% above the national average, and its staffing ratio holds up better than most, weekend hours dip about 14% below weekdays, which is worth knowing if you're planning visits or worrying about coverage on a Sunday. Turnover sits at 30.8%, well under the 45.8% national figure, so the people caring for your family member are more likely to still be there next year. The tradeoff shows up in the inspection record: 23 deficiencies, including one at the harm level and two abuse-related, with the most recent survey in February 2025. State-owned, 52 beds, and quality scores that beat its inspection scores.
The Weinberg Care Center in Kaneohe runs on a nonprofit model with 44 certified beds, and the numbers behind its record hold up under scrutiny. Nurse staffing sits at 4.07 hours per resident day, about 5% above the national average, though weekend coverage dips roughly 11% below its own weekday level, worth asking about if your family visits primarily on Saturdays or Sundays. Staff turnover is 30.8%, notably lower than the 45.8% national figure, which suggests a more stable caregiving team than most homes manage. Inspectors found 19 deficiencies on the current record, none at the harm or jeopardy level and none abuse-related, with the most recent survey completed January 30, 2025. All three CMS star ratings, health inspection, quality measures, and staffing, come in at 5 out of 5.
Kauai Veterans Memorial Hospital is a small state-run home, 20 certified beds, where the caregiver hours per resident run about 26% above the national average, and staff turnover sits at 9.5% against a national 45.8%. That kind of retention is rare, and the quality measures score reflects it. The problem isn't the people; it's the building's history. Twenty-one deficiencies on the current record, two of them serious enough to put residents in harm's way, landed this home in CMS's Special Focus Facility program, and the inspection star tells the same story. Weekend staffing also dips about 11% below weekdays. One fine on record, $34,588. The last inspection was September 2024.
The Ching Villas runs on unusually heavy nurse staffing, 6.46 hours per resident day, roughly two-thirds more than the national average, and that shows up in its five-star staffing rating. Weekend coverage dips about 13% below its own weekday level, so ask how that plays out on a Saturday. Turnover sits at 36.3%, better than the 45.8% national figure, which matters for whether you see the same faces month to month. The catch is the inspection record: 40 deficiencies, though none at harm or jeopardy level and none abuse-related, and the most recent inspection was in January 2026. For-profit, limited liability ownership. Strong care numbers, a long paper trail to read.
Garden Isle Healthcare in Lihue runs on unusually steady staffing for a for-profit home: 4.09 nurse hours per resident day, about 6% above the national average, with weekend coverage dipping only 7% below weekdays. Turnover sits at 31.5% against a national 45.8%, which matters more than any single number here, it means fewer unfamiliar faces on the floor.
The tradeoff shows up in inspections. The current record carries 38 deficiencies, including two tied to abuse, though none rose to harm or jeopardy level, and the most recent survey was in February 2025. Ownership is a for-profit corporation, and CMS gives it 3 of 5 stars on health inspections but 5 of 5 on both quality measures and staffing. Read those together: strong day-to-day care, a longer paper trail of cited problems.
Hale Anuenue runs on a paradox: the numbers that predict daily care are strong, and the ones that predict trouble are not. Staffing sits at 3.60 hours per resident day, a bit under the national 3.86, but turnover is 16.2% against a national 45.8%, a stable crew that knows the residents, even if the shifts are a touch thin and weekends run about 11% lighter than weekdays. The alarm is the inspection record: 28 deficiencies, two at harm or jeopardy level, three tied to abuse, with the last visit in February 2024. Federal quality measures score 5/5, yet inspectors keep finding serious problems.
Leahi Hospital is state-run, and that shows in the numbers that matter most: turnover sits at 17.7% against a national average of 45.8%, so the people caring for residents tend to stay. Nurse staffing runs 4.55 hours per resident day, roughly 18% above the national figure, though weekends drop about 20% below the home's own weekday level, worth asking about if your family visits on Saturdays. Eighteen deficiencies are on the current record, four tied to abuse, but none rose to harm or jeopardy, and the last inspection was recent, in July 2025.
Life Care Center of Hilo runs 252 certified beds under corporate ownership, and its inspection record is mixed: 41 deficiencies on the current record, including one at the harm or jeopardy level and five tied to abuse. That's a real flag worth asking about directly. Staffing sits at 3.79 nurse hours per resident day, slightly under the national average, and weekend coverage drops about 14% below its own weekday levels, so care may thin out on Saturdays and Sundays. Turnover, though, is 30.3%, well below the national 45.8%, meaning the crew tends to stay. Last full inspection was December 2023, and fines total $13,065.
Pu'uwai 'O Makaha runs on a for-profit LLC structure with 93 certified beds, and its nurse staffing sits at 4.26 hours per resident day, roughly 10% above the national average of 3.86. That cushion matters, though weekends dip about 14% below the home's own weekday levels, so coverage isn't perfectly even across the week. Annual turnover of 27.6% is well under the national 45.8%, which suggests a steadier workforce than most places. The tradeoff shows up in its record: 37 deficiencies, two serious enough to reach harm or jeopardy level, and one fine of $65,455. No abuse citations appear, and the last inspection was July 2025.
Ka Punawai Ola runs a tale of two ratings. Its staffing sits at 4.02 nurse hours per resident day, a bit above the national average, and turnover of 34.6% is well below the national 45.8%, people here tend to stay. But the health inspection side tells a different story: 38 deficiencies on record, two of them at harm or jeopardy level and one abuse-related, with a 2/5 inspection star and $13,343 in fines.
Weekend staffing also drops about 12% below weekday levels. The last inspection was in April 2025, so the record is current. A for-profit corporation operates the 120-bed home. Strong quality measures and staffing don't erase that inspection history, read the deficiency details before deciding.
Maluhia is state-run, and its 4.14 nurse hours per resident day sit about 7% above the national average, but weekends run roughly 26% thinner than weekdays, which matters if your family visits then. Staff turnover is 29.6%, well below the 45.8% national figure, so the people caring for your relative are more likely to still be there next year. The record isn't spotless: 20 deficiencies, one at harm level, two tied to abuse, plus a single $8,278 fine. The most recent inspection was July 2025. Strong marks across all three CMS categories, real but limited findings underneath.
Yukio Okutsu State Veterans Home runs on a state government budget, which shows in the staffing: 4.64 nurse hours per resident day, roughly 20% above the national average. Weekends dip about 12% below its own weekday levels, so coverage isn't perfectly even. The trouble sits in the inspection record, 39 deficiencies, three serious enough to reach harm or jeopardy level, plus one fine of $13,049. Staff turnover of 60.3% is well above the 45.8% national figure, which matters for a 95-bed home where residents rely on consistent caregivers. Quality measures score well, but the last inspection was November 2024, and the deficiency count is the number families should ask about directly.
Hale Kupuna Heritage Home runs on strong staffing, 4.17 nurse hours per resident day, roughly 8% above the national average, and that's the main reason it earns top marks on CMS's staffing measure. Turnover sits at 29.5%, well below the national 45.8%, so the people caring for residents tend to stay. The tradeoff shows up in its record: 25 deficiencies, including one at the harm level and three tied to abuse, plus a $16,350 fine. Weekend staffing also drops about 11% from weekday levels, which is worth asking about. Its last inspection was March 2026, so the picture is current.
Life Care Center of Kona runs a for-profit operation with 94 certified beds and a mixed record. Nurse staffing sits at 3.77 hours per resident day, slightly below the national average, and weekend coverage drops about 13% from weekday levels, worth asking about if your family visits mainly on Saturdays and Sundays. Staff turnover is 38.5%, which is actually better than the national average of 45.8%, so the team here may be more stable than at many homes. The bigger concern is the inspection history: 44 deficiencies on record, including 2 at the harm or jeopardy level and 3 related to abuse, with a $27,612 fine and a 2-out-of-5 health inspection rating. The most recent inspection was September 2024.
Kauai Care Center sits in Waimea with 53 certified beds and for-profit individual ownership. Its 4.03 nurse hours per resident day run about 4% above the national average, though weekends dip roughly 13% below its own weekday staffing, so coverage isn't perfectly even across the week. Annual turnover of 45.5% lands almost exactly at the national figure of 45.8%. The current record shows 23 deficiencies, none at harm or jeopardy level, but one is abuse-related, and the last inspection was in April 2024. CMS gives it 3 stars for health inspections, 3 for quality measures, and 4 for staffing. The staffing is the strongest piece here; the inspection history is the part worth asking about directly.
Legacy Hilo Rehabilitation & Nursing Center is a for-profit home with 100 certified beds in Hilo, and the numbers tell a story worth reading carefully. Federal inspectors have logged 34 deficiencies against it, including one at the harm level and one tied to abuse, and the home sits in CMS's Special Focus Facility program, a designation reserved for homes with a persistent pattern of poor care. Staffing runs slightly below the national average at 3.72 hours per resident day, weekend coverage drops about 14% below weekdays, and annual turnover hits 62.3% against a national 45.8%. Its last inspection was February 27, 2026. One $16,350 fine is on record.
Hale Nani runs 288 certified beds under for-profit LLC ownership, and its nurse staffing sits at 3.69 hours per resident day, roughly 5% under the national average of 3.86. Weekends drop about 12% below its own weekday coverage, so the thinnest shifts land when families tend to visit. Turnover is 32.4%, actually better than the 45.8% national figure, which suggests the problem isn't retention. It's the record: 96 deficiencies, one at harm or jeopardy level, eight tied to abuse, and a $27,885 fine. CMS has placed it in the Special Focus Facility program, reserved for homes with a persistent pattern of poor care. The most recent inspection was May 1, 2026.
Avalon Care Center in Honolulu runs on more nurse hours than most places, 4.62 per resident day, roughly a fifth above the national average, and weekend coverage dips only about 10% from its weekday staffing, which is a smaller drop than many homes show. Turnover sits at 40%, below the national 45.8%. The 41 deficiencies on record sound like a lot until you see none are at the harm or jeopardy level and none involve abuse, and its last inspection was recent, in June 2026. This is a for-profit corporate home with strong quality measure scores, steady staffing, and a clean serious-deficiency record, the kind of profile where the numbers hold up under scrutiny.
Ann Pearl runs a nonprofit-style staffing level inside a for-profit corporate structure: 4.01 nurse hours per resident day, roughly 4% above the national average, with weekend coverage dipping about 10% below its own weekday numbers. That staffing strength is doing a lot of work against a much rougher record elsewhere. The current inspection history shows 46 deficiencies, including 3 at harm or jeopardy level and 6 tied to abuse, plus a $23,520 fine and a place in CMS's Special Focus Facility program, a designation reserved for homes with a pattern of serious, repeated problems. Turnover sits at 46.2%, essentially the national rate, and the last inspection was February 2025. Strong aides, serious compliance concerns.
Frequently asked questions
How many chain-owned nursing homes are there in Hawaii?
There are 21 chain-owned Medicare-certified nursing homes in Hawaii, 49% of the 43 nursing homes there.
Are chain-owned nursing homes better staffed?
In Hawaii they average 4.37 total nursing hours per resident per day, against 4.97 for all nursing homes in Hawaii, a difference of -0.6 hours. Staff turnover averages 33.7% against 36.4%.
Which chain-owned nursing home grades best in Hawaii?