Choosing a nursing home in Hawaii involves unique considerations shaped by its island geography and diverse cultural fabric. While O'ahu, and Honolulu in particular, offers the largest concentration of facilities with specialized services, neighbor islands like Maui, Kaua'i, and Hawai'i Island provide essential care close to home for local communities. This guide helps you navigate the distinct aspects of long-term care in the Aloha State, from understanding higher costs to the importance of 'ohana (family) involvement in care.
Care in an island setting
Nursing homes in Hawaii provide skilled nursing and rehabilitative care, but often with a strong emphasis on community and cultural values. The isolation of the islands means facilities must be self-reliant, with limited options for transferring residents to highly specialized care on the mainland. For this reason, many homes strive to manage a wide range of medical conditions locally. Assisted living is a growing but still limited option in Hawaii compared to the mainland.
What to look for in a Hawaiian facility
- Island-Specific Resources: Check the Hawaii Department of Health's Office of Health Care Assurance for facility licenses, inspection reports, and complaint history.
- Proximity to Family: On islands, distance can be a significant barrier. Choosing a facility near family support is crucial for visitation and advocacy.
- Cultural Competence: Look for facilities that incorporate local culture, foods, and activities, and have staff who are familiar with island lifestyles and languages.
- Emergency Preparedness: Inquire about disaster and tsunami evacuation plans, generator capacity, and protocols for natural events.
Understanding the cost of care
Hawaii has one of the highest costs of long-term care in the nation. While Medicare covers short-term rehab, long-term care is often paid for through a combination of private funds, long-term care insurance, and for those who qualify, Hawaii Medicaid (QUEST Integration). The financial eligibility requirements are strict, so advanced planning is highly recommended. Veterans should explore benefits available through the VA.
Steps for your search in Hawaii
- Focus your search on a specific island to manage logistical challenges.
- Use state resources to create a shortlist of facilities and review their latest survey reports.
- If possible, visit in person to assess the environment and meet with the administrative and clinical staff.
- Have a detailed discussion about all costs, payment plans, and the facility's policy on Medicaid.
Use the list of Hawaiian islands and cities below to begin your search. Starting with a specific location is the most effective way to navigate the unique long-term care landscape in Hawaii.