Honolulu Senior AdvisorWhat laws govern senior care homes on Oahu?
Hawaii state law governs them: the Department of Health licenses adult residential care homes and expanded ARCHs under HAR chapter 11-100.1, assisted living facilities under chapter 11-90 and community care foster family homes under HRS 321-481 and chapter 11-800, with federal CMS rules layered on certified nursing homes.
Last verified: October 2026The Office of Health Care Assurance licenses and inspects these settings; for foster family homes, case management agencies and adult day care centers it works through its designee, Community Ties of America. The City and County of Honolulu does not license care settings.
How is Hawaii's system different from the mainland?
Hawaii relies on small licensed homes far more than the mainland does: care homes of five or fewer residents and two- or three-bed foster family homes care for most Oahu residents who need long-term help, expanded ARCHs can keep residents at nursing facility level of care, and the island has only a handful of licensed assisted living buildings.
On the state's rosters that works out to 455 licensed care homes, 1,111 certified foster family homes and 14 assisted living facilities on Oahu. Hawaii also has no separate memory care license.
Where do Oahu families report problems?
Licensing complaints go to the Office of Health Care Assurance through its Kahua Ike portal (Community Ties of America at (808) 234-5380 for foster family homes and adult day care); suspected abuse goes to Adult Protective Services at (808) 832-5115 or apsreport.hawaii.gov; and residents can get free advocacy from the long-term care ombudsman at (808) 586-7268.
The guides below explain each step, with the rule behind it.
Hawaii Rules guides
How Hawaii licenses adult residential care homes
What an adult residential care home is under HAR 11-100.1, the difference between Type I and Type II, who the primary care giver must be, and how many ARCHs Oahu has.
Read →Expanded ARCHs: nursing-level care in a family home
How Hawaii's expanded adult residential care homes (E-ARCH) serve residents at nursing facility level of care, the two-resident and 20% limits, and the RN case manager rule.
Read →Community care foster family homes, explained
How Hawaii's community care foster family homes care for two or three adults at nursing facility level of care, the Medicaid bed rule, caregiver requirements, and how many there are on Oahu.
Read →How Hawaii licenses assisted living
What Hawaii requires of a licensed assisted living facility: private units of 220 square feet, 24-hour staff, service plans, inspections every two years, and how few there are on Oahu.
Read →Memory care in Hawaii: what the license does and doesn't say
Hawaii has no separate memory care license. How assisted living, care homes, expanded ARCHs and nursing homes care for people with dementia on Oahu, and what to ask.
Read →How to find and read a Hawaii inspection report
Where Hawaii posts care home, assisted living and nursing home inspection reports, what HRS 321-1.8 requires them to include, and how to read a statement of deficiencies.
Read →How to check a Hawaii care license
Step by step: confirming an Oahu care home, expanded ARCH, assisted living facility or foster family home is licensed or certified, reading the roster, and red flags.
Read →Where to report problems and abuse on Oahu
Where Oahu families file complaints about care homes, assisted living and nursing homes (OHCA's Kahua Ike portal, CTA), and how to report abuse to Adult Protective Services or reach the ombudsman.
Read →Who can be the care giver? Hawaii's qualification rules
The training, experience and residency rules for primary and substitute care givers in Hawaii ARCHs, expanded ARCHs and foster family homes, and what to verify.
Read →At a glance
| Hawaii's rules do | Hawaii's rules do not | |
|---|---|---|
| Care homes | License Type I (5 or fewer) and Type II (6+) ARCHs | Require a licensed nurse to live in the home |
| Nursing-level care | Allow it in expanded ARCHs and foster family homes | Limit it to nursing homes |
| Memory care | Require care plans covering behavior | Create a separate memory care license |
| Transparency | Require inspection reports to be posted online | Rate or rank facilities |
