Editor’s note: This is the first in a new Civil Beat series called Data Dive, in which we take a snapshot of data and explore what it means to Hawaii.
Each year, longterm nursing facilities are inspected to ensure residents are getting adequate care, the right medications at the right time, enough time with staff, and that the overall environment is up to required standards of care, among other things.
If the inspection, conducted by the state, finds shortcomings, these “deficiencies” are reported to the federal Center for Medicare and Medicaid Services.
CMS then uses that information to create an for each facility. The numbers are considered an indicator of the quality of patient care and staffing.
What’s The News?
In Hawaii, the average number of deficiencies reported in nursing homes increased between 2019 and 2023, from 7.4 per facility in 2019 to 11.7 in 2023. The rate in Hawaii rose above the national average in 2020 and remained there at the end of 2023.
Some National Context
The average number of nursing home deficiencies across the country increased from 17% to 26% between 2019 and 2023. The 2023 Hawaii average of 11.7 is 10th place nationally — alongside Virginia — and just behind Missouri and Massachusetts both with an average of 11.8.
And the severity of those reported deficiencies has also increased since 2015, including those that could cause actual harm or pose immediate jeopardy to resident health and safety.
Behind The Increase: Lack Of Staffing
Over the five-year period, care hours provided by registered nurses fell by 21% and nurse-aid hours by 10%. Gaps were filled in part by licensed practical nurses, who face fewer training requirements than RNs.
The average number of nurse hours per resident in Hawaii remains higher than the national average. Nationwide, there's been a decline in the number of hours of resident care during and after the Covid-19 pandemic, which has alarmed experts.
Hawaii's Nursing Home Watchdog Weighs In
Hawaii’s Office of Healthcare Assurance said the rise in average deficiencies reported here are linked to Covid-19. New federal infection control guidelines were implemented during the pandemic, leading to an increase in deficiency reports as surveyors in Hawaii ensured facilities were complying with the new standards.
The Takeaway
Other states like Washington and Arizona saw their average nursing facility deficiencies fall in 2023.
When available, data from 2024 should begin to show whether average deficiencies in Hawaii’s nursing homes are falling now the pandemic has subsided.
Additional Resources
allows you to search by facility name.
lists the last four years of reports.
lays out all nursing home inspections and violations and is very user-friendly.
Data Sources: Centers for Medicare and Medicaid Services, Nursing Home Compare, Kaiser Family Foundation.
Civil Beat’s community health coverage is supported by the , and .
