Map showing the location of AVALON CARE CENTER - HONOLULU, LLC in HONOLULU, Hawaii
1930 KAMEHAMEHA IV RD, HONOLULU, HI, 96819

Overall Score

CMS Five-Star Quality Rating
3/5AverageCMS Five-Star overall rating
  1. Much below average
  2. Below average
  3. Average
  4. Above average
  5. Much above average

Where it ranks

  • HawaiiAbove only 23% of peers41 rated homes · average 3.6★
  • Honolulu CountyAbove only 32% of peers26 rated homes · average 3.5★
  • United StatesAbove only 41% of peers14,574 rated homes · average 3.0★

How the rating is built

  • Health inspectionsStarting point2★−1.0 vs HI avg
  • StaffingCan add or remove a star4★−0.1 vs HI avg
  • Quality measuresCan add or remove a star5★+0.6 vs HI avg

CMS starts from the health inspection stars, then adds or subtracts a star for staffing and for quality measures. Stars are assigned relative to other facilities in the same state.

Ratings & measures

Tap a row to see what it means
Health inspection ratingCMS stars from the last three on-site inspection cycles2★Above only 13% of peersHI avg3.0★U.S. avg2.8★
What is health inspection rating?

Stars assigned from the last three standard surveys and every complaint investigation in that window, weighted toward the most recent and the most serious findings. CMS assigns these stars relative to other facilities in the same state.

Why it matters

It carries the most weight in the overall rating and is the only domain based on what trained inspectors saw on site rather than what the facility reported.

Staffing ratingCMS stars from payroll-reported hours and turnover4★Above only 21% of peersHI avg4.1★U.S. avg2.9★
What is staffing rating?

Nurse and aide hours per resident day from payroll records CMS collects every quarter, adjusted for how much care residents need, plus staff turnover and weekend coverage.

Why it matters

More hours and lower turnover are the strongest predictors of fewer falls, pressure sores, and avoidable hospital stays.

Quality measures ratingCMS stars from clinical outcomes and resident assessments5★Above only 48% of peersHI avg4.4★U.S. avg3.6★
What is quality measures rating?

Clinical outcomes from resident assessments and Medicare claims: falls with injury, pressure ulcers, hospitalizations, antipsychotic use, and more, for both short-stay and long-stay residents.

Why it matters

It shows whether care is working, but part of it comes from the facility’s own assessments, so read it alongside the inspection results.

Total nurse hoursPer resident per day, all nursing staff4.59hrsAbove 53% of peersHI avg4.70Benchmark4.10
What is total nurse hours?

All licensed nurse and aide hours worked, divided by the number of residents, on an average day. Reported from payroll, not self-reported.

Why it matters

Federal research links 4.1 hours a day to fewer avoidable harms. Below about 3 hours, residents wait longer for help with basics like toileting and repositioning.

RN hoursPer resident per day, registered nurses only1.91hrsAbove 80% of peersHI avg1.63Benchmark0.75
What is rn hours?

Registered nurse hours only. RNs assess residents, manage medications, and catch changes in condition; LPNs and aides deliver most hands-on care.

Why it matters

RN coverage is the staffing measure most tied to fewer hospital transfers and infections, and it is where thinly staffed facilities cut first.

Nursing staff turnoverShare of nursing staff who left within a year · lower is better40%Above only 35% of peersHI avg37%RN turnover33%
What is nursing staff turnover?

The share of nursing staff who left within the past year, from the same payroll data.

Why it matters

High turnover means residents are cared for by people who do not know them, and it is one of the strongest predictors of inspection problems.

Fines in the last three yearsCivil money penalties imposed by CMS · lower is better$12,838Above only 44% of peersHI avg$21,335Fines · denials1 · 0
What is fines in the last three years?

Civil money penalties CMS imposed after serious or uncorrected deficiencies, and denials of Medicare payment for new admissions.

Why it matters

Penalties follow the worst inspection findings. A recent fine is the clearest sign that inspectors found real harm.

Inspection history

Last three inspection cycles
53citations
3inspection dates
0actual harm (G–I)
0immediate jeopardy (J–L)
Apr 3, 2025most recent

Citations by monthMar 2023 – Apr 2025

  • No actual harm (D–F)
  • Actual harm (G–I)
  • Immediate jeopardy (J–L)
  • $Fine or payment denial

Click a month or a year to filter the findings below. Arrow keys move between months; Esc clears.

Apr 3, 202518 citationsCycle 1worst F · no actual harm
  1. F756Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.Pharmacy ServiceD · isolatedCorrected May 16, 2025
  2. F759Ensure medication error rates are not 5 percent or greater.Pharmacy ServiceD · isolatedCorrected May 16, 2025
  3. F761Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.Pharmacy ServiceD · isolatedCorrected May 16, 2025
  4. F880Provide and implement an infection prevention and control program.Infection ControlF · widespreadCorrected May 16, 2025
  5. Provide appropriate treatment and care according to orders, resident’s preferences and goals.Quality of Life and CareD · isolatedCorrected May 16, 2025
  6. F558Reasonably accommodate the needs and preferences of each resident.Resident RightsE · patternCorrected May 16, 2025
  7. F583Keep residents' personal and medical records private and confidential.Resident RightsD · isolatedCorrected May 16, 2025
  8. F641Ensure each resident receives an accurate assessment.Resident Assessment and Care PlanningD · isolatedCorrected May 16, 2025
  9. F655Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedResident Assessment and Care PlanningD · isolatedCorrected May 16, 2025
  10. F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Resident Assessment and Care PlanningD · isolatedCorrected May 16, 2025
  11. F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.Resident Assessment and Care PlanningD · isolatedCorrected May 16, 2025
  12. F679Provide activities to meet all resident's needs.Quality of Life and CareD · isolatedCorrected May 16, 2025
  13. F688Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.Quality of Life and CareD · isolatedCorrected May 16, 2025
  14. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareD · isolatedCorrected May 16, 2025
  15. F695Provide safe and appropriate respiratory care for a resident when needed.Quality of Life and CareD · isolatedCorrected May 16, 2025
  16. F698Provide safe, appropriate dialysis care/services for a resident who requires such services.Quality of Life and CareD · isolatedCorrected May 16, 2025
  17. F725Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.Nursing and Physician ServicesE · patternCorrected May 16, 2025
  18. F755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.Pharmacy ServiceD · isolatedCorrected May 16, 2025
Apr 5, 202418 citationsCycle 2worst F · no actual harm
  1. F842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.Resident Assessment and Care PlanningD · isolatedCorrected May 7, 2024
  2. Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.Resident RightsE · patternCorrected May 7, 2024
  3. Provide appropriate treatment and care according to orders, resident’s preferences and goals.Quality of Life and CareD · isolatedCorrected May 7, 2024
  4. F641Ensure each resident receives an accurate assessment.Resident Assessment and Care PlanningD · isolatedCorrected May 7, 2024
  5. F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.Resident RightsD · isolatedCorrected May 7, 2024
  6. F568Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.Resident RightsD · isolatedCorrected May 7, 2024
  7. F578Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.Resident RightsE · patternCorrected May 7, 2024
  8. F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Resident Assessment and Care PlanningD · isolatedCorrected May 7, 2024
  9. F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.Resident Assessment and Care PlanningD · isolatedCorrected May 7, 2024
  10. F688Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.Quality of Life and CareD · isolatedCorrected May 7, 2024
  11. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareD · isolatedCorrected May 7, 2024
  12. F697Provide safe, appropriate pain management for a resident who requires such services.Quality of Life and CareE · patternCorrected May 7, 2024
  13. F726Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.Nursing and Physician ServicesD · isolatedCorrected May 7, 2024
  14. F761Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.Pharmacy ServiceD · isolatedCorrected May 7, 2024
  15. F880Provide and implement an infection prevention and control program.Infection ControlF · widespreadCorrected May 7, 2024
  16. F908Keep all essential equipment working safely.EnvironmentalD · isolatedCorrected May 7, 2024
  17. F584Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.Resident RightsD · isolatedCorrected May 7, 2024
  18. F623Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.Resident RightsE · patternCorrected May 7, 2024
Mar 17, 202317 citationsCycle 3worst F · no actual harm$12,838
  1. F908Keep all essential equipment working safely.EnvironmentalE · patternCorrected May 1, 2023
  2. F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.Resident RightsE · patternCorrected May 1, 2023
  3. F578Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.Resident RightsD · isolatedCorrected May 1, 2023
  4. F584Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.Resident RightsD · isolatedCorrected May 1, 2023
  5. F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected May 1, 2023
  6. F623Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.Resident RightsF · widespreadCorrected May 1, 2023
  7. F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Resident Assessment and Care PlanningD · isolatedCorrected May 1, 2023
  8. F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.Resident Assessment and Care PlanningD · isolatedCorrected May 1, 2023
  9. F676Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.Quality of Life and CareD · isolatedCorrected May 1, 2023
  10. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareD · isolatedCorrected May 1, 2023
  11. F726Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.Nursing and Physician ServicesD · isolatedCorrected May 1, 2023
  12. F732Post nurse staffing information every day.Nursing and Physician ServicesE · patternCorrected May 1, 2023
  13. F761Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.Pharmacy ServiceE · patternCorrected May 1, 2023
  14. Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.Resident RightsF · widespreadCorrected May 1, 2023
  15. F804Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.Nutrition and DietaryD · isolatedCorrected May 1, 2023
  16. F842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.Resident Assessment and Care PlanningD · isolatedCorrected May 1, 2023
  17. F880Provide and implement an infection prevention and control program.Infection ControlF · widespreadCorrected May 1, 2023

Staffing

From quarterly payroll reports

Hours per resident per day

  • All nursing staffRNs, LPNs and aides combined4.59hrsAbove 53% of peers−0.11 vs HI avg
  • Registered nursesRN hours only1.91hrsAbove 80% of peers+0.28 vs HI avg
  • Licensed practical nursesLPN hours0.20hrs
  • Nurse aidesCNA hours2.49hrs
  • Weekend nursingAll staff on Saturdays and Sundays4.10hrs
  • Hawaii average
  • Research benchmark (4.10 total, 0.75 RN)

Turnover & capacity

  • Nursing staff turnoverShare who left within a year · lower is better40%Above only 35% of peersHI avg 37%
  • RN turnoverRegistered nurses only33%Not ranked by CMS
  • Administrators who leftIn the past year0Stable leadership
  • Occupancy108 certified beds · ~98 residents a day91%Above 73% of peersHI avg 82%

Fines & penalties

Roughly the past three years

Enforcement summary

  • $12,838In fines
  • 1Fine
  • 0Payment denials
  • $21,335HI avg in fines
Above only 44% of peersFewer fines than 44% of rated homes in Hawaii

Actions on record

  1. Mar 17, 2023Civil money penalty$12,838

Ownership

As filed with CMS

Structure

Ownership type
For profit - Corporation
Chain
Avalon Health Care13 facilities in the chain3.5★ chain average
Certification
Medicare and Medicaid
Location type
Urban
Ownership change
None in the last 12 months

People and entities on file

Direct owners (5%+)
  • Avalon of Hawaii LLC
Indirect owners (5%+)
  • Avalon Care LLC
  • Avalon Health Care, INC.
  • Avalon Holding, INC.
  • Hyrum a Kirton Individual Tr
  • K-Team LLC
  • Spencer K Kirton Individual Tr
  • The Byron a Kirton Individual Tr
  • Byron Kirton
  • +2 more
Operational or managerial control
  • Avalon Health Care Management, INC.
  • Avalon Health Care, INC.
  • Bernadette Ben
  • Patricia Blanchette
  • Maria Borisevich
  • Alan Hash
  • Kaiulani Kaalekahi
  • Hyrum Kirton
  • +1 more
Corporate directors
  • David Dangerfield
  • Byron Kirton
  • Charles Kirton
  • Hyrum Kirton
  • Spencer Kirton
  • Robert Woltil
Corporate officers
  • Maria Borisevich
  • Alan Hash
  • Charles Kirton
  • Hyrum Kirton
  • Nicole Smith

Person Organization

Sources & notes

Public data, updated quarterly

Data sources

  • CMS Care Compare · Provider InformationStar ratings, staffing hours, turnover, penalties and flags · processed February 2026.
  • CMS Health CitationsEvery deficiency from the last three inspection cycles, with scope, severity and inspection cycle.
  • CMS Penalties and Ownership filesCivil money penalties, payment denials, and the owners and managers on file.

Notes

  • CMS Certification Number 125020 · 1930 KAMEHAMEHA IV RD, HONOLULU, HI, 96819.
  • Percentiles compare this facility with every rated nursing home in Hawaii and Honolulu County. Turnover and fines are inverted so a high percentile is always good.
  • This is an informational summary of public data, not medical, legal, or placement advice. Facilities cannot pay to change it; a facility that believes a record is wrong can dispute it with CMS.

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