Honolulu Senior AdvisorBy Honolulu Senior Advisor Care Team · September 2, 2026
Hawaii law (HRS 321-1.8) puts state inspection reports for care homes, expanded ARCHs and assisted living online. We matched at least one 2023-2026 report to 412 of Oahu's 455 licensed care homes. Read the cited rule, the finding and the plan of correction, and look for repeats across years.
Why Hawaii's reports are worth your ten minutes
Most states make families request inspection reports in writing. Hawaii is different: since 2015, HRS 321-1.8 has required the Department of Health to post the state licensing inspection reports for adult residential care homes, expanded ARCHs, assisted living facilities, foster family homes and adult day care centers on its website. That makes the Office of Health Care Assurance's inspection page one of the most useful free tools an Oahu family has.
When we matched OHCA's index against the April 2026 care home roster, 412 of 455 licensed Oahu care homes had at least one report posted for 2023 through 2026. For the rest, the home may be newly licensed, listed under a slightly different name, or between required inspections. In each case the home has to keep its last report on file and show it to you.
The reports are scanned documents, often several pages long, and the format is the same across most homes. Once you know where to look, you can read one in about ten minutes.
The four parts of a report
Each report has a header, a list of rules cited, the inspector's findings under each rule, and the facility's plan of correction. Here is what each tells you.
| Part | What it shows | What to look for |
|---|---|---|
| Header | Facility name, license number, inspection date and type (annual, initial, follow-up, complaint) | That the license number matches the roster and the visit type |
| Rule cited | The Hawaii Administrative Rules section, such as HAR 11-100.1 for care homes | Look up the section to see what it requires |
| Finding | What the inspector saw, with resident details redacted | Whether it involved a resident's care or only paperwork |
| Plan of correction | What the facility will change and by when | A specific fix with a date, not a general promise |
A report with no deficiencies is short: a header and a statement that none were found. OHCA's own file names sometimes say so; we flag those on our roster, but always open the file to be sure. We counted 27 care homes whose most recent posted file is labelled that way.
Which findings matter most
Not every citation is equal. A missing signature on a training log matters less than a medication given at the wrong dose or a care plan that does not match a resident's needs. When you read a report, sort the findings into three groups: resident care (medications, falls, nutrition, care plans), safety (fire drills, exits, water temperature) and paperwork (records, training logs, postings).
Resident-care findings deserve a direct question on your visit. Ask the primary care giver what happened and what changed. A good care giver will answer plainly. Safety findings are worth checking yourself during the visit: is the exit clear, is the smoke alarm working. Paperwork findings matter mainly if they repeat.
Repeats are the real signal
The single most useful thing you can do is compare two years. A care home cited once for medication records and never again probably fixed the problem. A home cited for the same rule in 2024, 2025 and 2026 has a pattern. OHCA's index lets you open each year's report from the same row, so this takes a few extra minutes.
Also note years marked Not Required. Some homes are licensed for two years and do not need an annual inspection, so a gap is not automatically a warning. Years marked Initial show a newly licensed home; there is less history to judge, so lean more on references and the care giver's experience.
A short example of reading two years side by side
Suppose a five-bed expanded home has a 2024 report citing HAR 11-100.1 for a medication record that did not match the physician's order, with a plan of correction promising a new checklist and retraining for the substitute care giver. The 2025 report cites a fire drill that was not documented and nothing about medications. That pattern suggests the medication problem was fixed and the new finding is a paperwork lapse worth a question but not a deal-breaker.
Now suppose the 2025 report cites the same medication rule again, this time with a resident receiving a dose late on two days. That repeat is the most important thing in either report, and it deserves a direct conversation with the primary care giver and the RN case manager before you go further.
Questions to bring to the visit
Bring the report with you. Ask the care giver to walk you through what was cited and what changed. Ask who gives medications when the primary care giver is out, how the home checks medication orders after a hospital stay, and how often the case manager visits. Ask whether there have been any complaint investigations since the last report; the home may not be required to tell you, but a straight answer is a good sign.
If the home is an expanded ARCH, ask the RN case manager the same questions separately. The two answers should match.
What a report cannot tell you
An inspection is a snapshot. It cannot tell you how the home runs on a Sunday night, how the substitute care giver handles a fall, or whether your parent will get along with the other residents. That is what visits are for. Visit once by appointment and again at a mealtime, and ask to meet whoever covers when the primary care giver is out.
If you see something on a visit that worries you, the complaint route is OHCA's Kahua Ike portal, and suspected abuse goes to Adult Protective Services at (808) 832-5115.
Frequently asked questions
Where are Oahu care home inspection reports posted?
On the Office of Health Care Assurance's Healthcare Facilities Inspection Reports page, searchable by facility name, for inspections on or after January 1, 2015.
Does a report with deficiencies mean a home is bad?
No. Look at what was cited, whether it involved resident care, and whether the same rule is cited again in later years.
What if I can't find a home's report?
Ask the home for it. The rules require facilities to keep their inspection summaries on file and show them on request.
How often are care homes inspected?
Hawaii licenses care homes for one year or another period set by the department; some are licensed for two years, so the index shows Not Required for years without a required inspection.
