Elder care in Hawaii

Data Insights

Hawaii is served by 42 CMS-certified nursing homes operating a combined 4,248 licensed beds, alongside 16 Medicare-certified home health agencies. Statewide, nursing homes average 3.6 out of 5 stars on the CMS overall quality rating, with component averages of 3.0 for health inspections, 4.1 for nurse staffing, and 4.4 for quality measures. Counties within the state vary significantly — urban metros typically host more facilities but also more competition, while rural counties may have fewer choices within driving distance of family caregivers.

Elder-care pricing stacks vary substantially by setting, level of medical care, and whether the service is delivered at home, in a community, or in a skilled facility. According to the CareScout 2025 Cost of Care Survey, statewide medians in Hawaii are: home health aide services $7,817/mo ($93,808/yr), adult day health care $2,551/mo, assisted living $12,096/mo ($145,155/yr), a semi-private nursing home room $15,473/mo ($185,679/yr), a private nursing home room $16,395/mo. These are median figures — actual prices vary by metro area, provider, and whether the resident requires a memory-care or specialty unit.

Payment sources in Hawaii mirror the national pattern: Medicare covers short-term skilled care after a qualifying hospital stay (up to 100 days with co-pays beginning day 21), while Medicaid — through each state's waiver program — is the largest long-term-stay payer for residents who meet income and asset limits. Veterans' benefits and long-term-care insurance supplement private-pay options for those who qualify. Families weighing options typically compare CMS star ratings, inspection history, staffing hours per resident day, distance from caregivers, and monthly cost against their projected length of stay. County-level pages below break the state into local care markets for more targeted comparison.

The figures above come directly from the U.S. Centers for Medicare \& Medicaid Services Nursing Home Compare dataset for federal quality ratings, combined with the CareScout 2025 Cost of Care Survey of more than 15,000 elder-care providers nationwide and U.S. Census American Community Survey income data. Cost figures are monthly medians, refreshed annually with each new CareScout release; quality ratings are refreshed quarterly from the CMS Provider Information File. Read these state and county medians as benchmarks, then verify current rates with individual providers and consult care managers before making placement decisions. See our methodology for source vintage. Median figures above represent the middle of the cost distribution: half of providers charge less, half charge more, and price spreads within a metro area can exceed thirty percent. Where Genworth and CareScout publish overlapping numbers, the more recent CareScout survey takes precedence; both organizations use the same survey methodology developed by the federal Department of Health and Human Services Administration for Community Living, so cross-year comparisons are valid back to 2004 when the survey was first standardized.