Honolulu Senior AdvisorDoes Hawaii license memory care facilities?
No. Hawaii has no separate memory care license; people living with dementia are cared for in licensed assisted living facilities, adult residential care homes, expanded ARCHs, foster family homes and nursing facilities, under the rules for each of those settings.
OHCA's rosters do not flag which buildings run a dementia unit, so any list that claims to show “licensed memory care” on Oahu is drawing that label from marketing rather than from the state. We do not apply it. What the rules do require is relevant: assisted living facilities must be able to provide or arrange services for residents with behavior problems requiring ongoing staff support (HAR 11-90-8), and every care home resident gets a care plan that covers behavioral needs.
Where do people with dementia usually live on Oahu?
Most Oahu residents with moderate dementia who leave home move to a small care home or expanded ARCH, where one primary care giver supervises five or fewer people around the clock; larger assisted living buildings and nursing homes care for others, especially when wandering, falls or medical needs increase.
A small home can be very good for someone who is calmed by routine and a familiar face. It can be a poor fit for a resident who tries to leave, because a house is rarely designed with secured exits and one care giver cannot follow one resident and watch four others. Nursing facilities and some assisted living buildings have secured areas; ask to see them and ask how residents are assessed for them.
What should we ask a care home about dementia care?
Ask how many current residents have dementia, how the care giver handles sundowning and exit-seeking at night, what dementia training the primary and substitute care givers have completed, and at what point the home would ask a resident with dementia to move.
- Ask whether the doors are alarmed and whether residents can reach the street unseen.
- Ask how medication changes are coordinated with the physician, and whether the home uses psychotropic medications to manage behavior.
- For an expanded ARCH, ask the RN case manager how often they visit and what triggers an extra visit.
- Ask to read the home's last OHCA inspection report; it is public under HRS 321-1.8.
Can Med-QUEST pay for dementia care?
Med-QUEST can pay for long-term services and supports for members who meet its financial rules and are assessed at nursing facility level of care, which many people with moderate to advanced dementia are; covered settings include nursing facilities, expanded ARCHs, foster family homes and home and community-based services through a QUEST Integration plan.
Room and board in community settings is the resident's responsibility from their own income. See Med-QUEST long-term care for the details and what to do after a dementia diagnosis.
At a glance
| In Hawaii, dementia care is | In Hawaii, dementia care is not | |
|---|---|---|
| License | Provided under ALF, ARCH, E-ARCH, CCFFH or nursing licenses | A separate state license category |
| Labels | Visible in each facility's own description of its services | Marked on OHCA's rosters |
| Small homes | Often a good fit for calm, routine-driven residents | Usually built with secured exits |
| Payment | Payable by Med-QUEST at nursing facility level of care | Covered by Medicare as long-term custodial care |
Sources include Hawaii Administrative Rules chapters 11-100.1, 11-90 and 11-800, HRS 321-481 and 321-1.8, Office of Health Care Assurance rosters and pages, the 2026 HHS poverty guidelines, CMS, CareScout and VA rate tables as cited above; see our editorial standards.
