Oahu Nursing Homes by the CMS Numbers: Ratings, Staffing and Inspections

The overall picture

CMS Care Compare lists 27 Medicare- and Medicaid-certified nursing homes in the City and County of Honolulu, with 2,679 certified beds, in data as of October 1, 2026. They range from small hospital-based units to homes of more than 250 beds.

Ratings are CMS's own, built from health inspections, staffing and quality measures. Hawaii's Office of Health Care Assurance carries out the inspections on CMS's behalf.

Staffing and turnover

Staffing is the measure families should look at hardest. Across Oahu's certified homes the median is 4.65 total nurse staffing hours per resident per day, of which 1.69 are registered nurse hours, from CMS's payroll-based data. The median total nursing-staff turnover is 32.8%.

The table shows the ten largest homes. Every home has its own page in our directory with the full CMS record.

Inspections and deficiencies

The median Oahu home had 9 health deficiencies in its latest standard inspection cycle. A count alone says little: one serious finding about resident harm matters more than several minor ones. Open the CMS inspection report for the homes you are considering and read what was cited, then ask the administrator about it.

Reading staffing numbers

CMS's staffing figures come from payroll-based journal data that nursing homes submit, which is more reliable than self-reported staffing. Total nurse hours per resident per day include registered nurses, licensed practical nurses and nurse aides. A home with high total hours but low RN hours relies more on aides; a home with high turnover may have many agency staff, which can affect continuity. Weekend staffing, also reported by CMS, is often lower and worth asking about.

Compare each home with the island median rather than national figures. Hawaii's labor market and the mix of hospital-based units affect local numbers.

Short stays versus long stays

Many Oahu nursing homes serve both short-stay rehab patients after a hospital admission and long-stay residents. CMS reports quality measures for each group separately. If your parent is going for rehab, look at the short-stay measures; for long-term care, the long-stay ones. Ask the home whether long-term beds are on a different unit and whether Med-QUEST long-term residents are accepted.

Hospital-based units and small homes

Several of Oahu's certified nursing homes are small units inside or attached to hospitals or continuing-care campuses, some with fewer than 50 beds. Their CMS figures can swing more from year to year because a few residents or one inspection change the averages. For small homes, read the inspection report itself and ask about staffing rather than relying on a single rating. Large homes of 150 beds or more have steadier numbers but more variation between units, so ask to see the unit where your parent would live.

Finally, remember that CMS data lags. Inspections happen roughly once a year and staffing data is reported by quarter, so a home that changed management or staff recently may look better or worse than it is today. Ask the administrator what has changed since the last inspection, and whether CMS reports a recent change of ownership; our directory pages flag it when CMS does.

How to use the numbers

Use the data to choose which homes to visit and what to ask, not to make the final decision. A five-star home with a long wait list may be no help this week; a three-star home with strong staffing and a recent clean inspection may be a good choice. Ask every home about agency staff use, night staffing, and which QUEST Integration plans it accepts for long-term stays.

Also consider whether a nursing home is needed at all. In Hawaii, expanded ARCHs and foster family homes can care for people at nursing facility level of care in a home setting. For short-term rehab, a nursing home is usually the right first step; for long-term care, compare both.