Hawaii PBJ Nursing Home StaffingHawaii PBJ Staffing
Hawaii's statewide staffing ratio is 4.63 HPRD in Q1 2026. Hawaii's statewide staffing ratio is up (+0.18) since Q1 2025. This level is above the national ratio of 3.75 HPRD and ranks #3 out of 51 states.
- Q2 2025: 4.45
- Q3 2025: 4.63
- Q4 2025: 4.47
- Q1 2026: 4.63
Staffing hours per resident day for Hawaii, calculated by PBJ320 from CMS’s quarterly PBJ nurse staffing files.
Hawaii
Direct staff excludes Admin/DON. Direct staff excludes Admin/DON.
Hawaii
Hawaii
Hawaii
Explore Hawaii
PBJ320 High-risk facilities in Hawaii
7 facilities flagged for staffing or quality concerns.
| Facility | City | CMS ratings | Risk flags | Total HPRD |
|---|---|---|---|---|
| Ann Pearl Nursing FacilityKaneohe | Kaneohe | SFF cand.c. | 4.01 HPRD | |
| Avalon Care Center - Honolulu, LLCHonolulu | Honolulu | SFF cand.c. | 4.62 HPRD | |
| Hale MalamalamaHonolulu | Honolulu | SFF cand.c. | 4.18 HPRD | |
| Hale Nani Rehabilitation and Nursing CenterHonolulu | Honolulu | SFF | 3.69 HPRD | |
| Islands Skilled Nursing & RehabilitationHonolulu | Honolulu | SFF cand.c.1★ | 5.67 HPRD |
Staffing snapshot
Latest state staffing metrics for Hawaii.
| Metric | Hawaii | CMS Region 9CMS Region 9 includes American Samoa, Arizona, California, FM, Guam, Hawaii, MH, the Northern Mariana Islands, Nevada, and PW.Regional figures are calculated from facility-level data using the same methodology as the state figures. | U.S. | State rankRanks compare the 50 states and D.C. by the displayed metric value. A higher or lower rank is not inherently positive or negative for every metric, including contract staffing share and rural-facility share. |
|---|---|---|---|---|
| Total Nurse Staffing HPRD | 4.63 | 4.30-0.34 vs HI | 3.75-0.89 vs HI | #3 of 51 |
| Direct Care Nurse HPRD | 4.27 | 4.03-0.24 vs HI | 3.48-0.80 vs HI | #3 of 51 |
| RN HPRD | 1.60 | 0.63-0.96 vs HI | 0.62-0.97 vs HI | #2 of 51 |
| RN Direct Care HPRD | 1.27 | 0.50-0.77 vs HI | 0.44-0.83 vs HI | #2 of 51 |
| Nurse Aide HPRD | 2.67 | 2.55-0.12 vs HI | 2.26-0.41 vs HI | #6 of 51 |
| Contract Staff Percentage | 6.9% | 2.5%-4.3 pts vs HI | 5.3%-1.5 pts vs HI | #18 of 51 |
| Median Case-Mix HPRD (Acuity) | — | 3.86 | 3.74 | #23 of 51 |
| Rural Facilities (Share) | 28% | 5%-23.0 pts vs HI | 27%-0.6 pts vs HI | #29 of 51 |
State rank reflects the displayed value, not necessarily stronger or weaker performance.
Ownership groups in Hawaii
Most facilities linked in CMS owner data (Hawaii).
Ownership changes in Hawaii
8 ownership changes at 8 Hawaii facilities · 01/01/2016 – 02/01/2026.
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How these figures are calculatedMethods, definitions, and data sources
Staffing from CMS Payroll-Based Journal (PBJ) public nurse files (2017–2026), plus Provider Information (September 2026 processing snapshot) and chain data where shown. State staffing context via March 2022 compendium. Methodology · PBJ guide.
Metrics
- Hours Per Resident Day (HPRD): Total staff hours ÷ average residents. Example: 350 hours for 100 residents = 3.5 HPRD.
- Direct Care (excl. Admin, DON): Hours per resident day for direct care staff only (RN, LPN, CNA, NAtrn, MedAide), excluding administrative and supervisory roles.
- Contract Staff %: Share of hours provided by contract staff.
- Census: Average number of residents during the period.
Note: Some states set minimums (e.g., NJ, CA, NY at 3.5 HPRD); a federal 3.48 minimum was recently overturned (2025). A 2001 federal study linked 4.1 HPRD to better outcomes in that study. Staffing needs vary by resident acuity (case-mix), day, and shift. Estimates on PBJ Takeaway assume roughly 60% of staff are CNAs.
Data transparency
The PBJ Dashboard pulls directly from CMS data and is carefully vetted for accuracy. Still, sometimes a bug sneaks into the jelly. That could mean: a systemic CMS data reporting issue (e.g., Q2 2017 contract staffing, missing data in 2020 due to COVID) or there could be a coding error on our part. If you spot something that looks off, please let me know via the contact form so I can set things right.
Trend charts omit quarters with implausible submitted HPRD (total/direct below 0.25; RN, LPN, and aide use role floors and neighbor-quarter rules). Full criteria.
Rankings, within-state percentiles, CMS flags (including abuse icon): How metrics are calculated.