Homes where the federal record contains at least one of the following: a CMS abuse icon, Special Focus
Facility status or candidacy, or a citation scored at actual harm or immediate jeopardy. Ordered with
Special Focus homes first.
Read this as a prompt, not a verdict. A citation can be years old and the management
responsible may have gone. It means you ask what happened and what changed, and you get a specific answer
before you sign anything.
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.
Kuakini Geriatric Care is a 187-bed nonprofit in Honolulu with a serious split in its record. The staffing numbers aren't the problem: 3.43 nurse hours per resident day sits about 11% under the national average, but turnover is 26.1% against a national 45.8%, and CMS gives staffing four stars. The inspection side is where it falls apart, 55 deficiencies on the current record, three at harm or jeopardy level and two tied to abuse, plus $83,236 in fines. CMS has placed it in the Special Focus Facility program, which is reserved for the homes with the most persistent problems.
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.
Hale Malamalama runs 40 beds in Honolulu under corporate for-profit ownership, and its staffing numbers are genuinely above average, 4.18 nurse hours per resident day against a national 3.86, though weekend coverage dips about 10% below its own weekday level. Turnover sits at 51.2%, higher than the 45.8% national figure. What pulls the picture down is the inspection record: 43 deficiencies, three at harm or jeopardy level and three abuse-related, with $87,032 in fines and a spot in CMS's Special Focus Facility program, which is reserved for homes with a persistent pattern of serious problems. The last inspection was September 27, 2024. Strong quality scores don't cancel out that history.
Nurse staffing here runs 5.67 hours per resident day, about 47% above the national average of 3.86, which is a real point in its favor, and turnover at 40% is slightly better than the 45.8% norm. But weekends dip roughly 12% below the home's own weekday coverage, so the care you see on a Tuesday isn't guaranteed on a Sunday. The inspection record is the problem: 56 deficiencies, including one at the harm level and three tied to abuse, plus an $89,206 fine, against a 1-out-of-5 health inspection rating. The last inspection was May 2026. Strong staffing can't offset that pattern on its own.