Above average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
Estimate from public CMS data, current as of October 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Hale Anuenue Restorative Care during CMS and state inspections, most recent first.
The facility failed to provide sufficient nursing staff to meet residents' needs, resulting in long wait times for assistance, accidents, and falls. Multiple residents reported delays, and staffing data confirmed excessively low weekend staffing throughout fiscal year 2023. The Health Information Management Director and the Administrator acknowledged the staffing challenges.
The facility failed to meet residents' dietary needs and preferences, including providing incorrect meal textures, not honoring food allergies and dislikes, and giving regular milk to a lactose-intolerant resident. Staff were unaware of dietary abbreviations, leading to inconsistent meal service.
The facility failed to apply standard infection control precautions, including not providing hand sanitizer to residents before meals and not posting transmission-based precaution signs for a resident with COVID-19. Staff were observed not offering hand sanitizer to residents before meals, and a resident's room lacked proper signage for PPE use.
The facility failed to store, prepare, distribute, and serve food in accordance with professional standards. Uncovered cakes, expired cranberry juice containers, and improperly dated condiments were found. Additionally, a chicken was served at an unsafe temperature, prompting reheating.
The facility failed to ensure proper grooming for a resident and dignified feeding assistance for two residents. One resident was observed with uncombed hair in the dining area, and staff members were seen standing while feeding two other residents, contrary to facility policy.
The facility failed to provide proper notification of transfer or discharge for four residents who were hospitalized. Written notifications were not issued to two residents or their representatives, and notifications were not sent to the State LTC Ombudsman for the other two residents. These deficiencies could affect all residents at the facility who are discharged or transferred.
The facility failed to provide written notification of its bed hold policy to residents or their representatives in cases of hospitalization. For one resident transferred due to a hip fracture and another for a change in care level, the EHRs lacked documentation of written notifications. Staff confirmed that only verbal communication was made.
The facility failed to transmit the MDS data to CMS within 14 days of completion for a resident discharged on 09/29/23. The discharge assessment, completed on 10/04/23, was only transmitted on 01/31/24 after being identified during a review.
The facility failed to develop and implement comprehensive care plans for two residents. One resident's care plan did not include interventions to prevent further decrease in ROM, while another resident's care plan lacked measures to monitor and alleviate edema in her left leg and foot.
A resident with acute urinary retention was subjected to repeated intermittent catheterizations over five days due to an inoperable bladder scanner, leading to delayed diagnosis and treatment of a UTI. The facility did not follow its policy for indwelling catheter use, causing potential trauma and increased infection risk.
A facility failed to ensure a resident received the appropriate treatment and equipment to maintain or improve ROM in her left knee and hand. Despite care plans and physician orders, the resident was observed without the necessary splints, and staff were unaware of their proper application. Documentation was inaccurate, and no explanations were provided for the absence of the splints, affecting the resident's well-being.
A resident with a recent UTI was not provided sufficient fluids when requested. The resident asked for water at 07:15 AM, but the water pitcher was not returned until 08:45 AM, despite a documented risk of dehydration.
Insufficient Nursing Staff
Penalty
Summary
The facility failed to ensure there was sufficient nursing staff to provide nursing and related services to meet the residents' needs safely and in a manner that promotes each resident's rights, in addition to their physical, mental, and psychosocial well-being. Multiple residents reported long wait times for assistance, with some experiencing accidents or attempting to move unassisted due to the delays. For instance, one resident reported waiting 15-20 minutes for assistance, another waited an hour and had an accident in bed, and another fell and hit their head after waiting too long for help. These incidents indicate a consistent issue with staffing levels, particularly during weekends and early mornings, as confirmed by interviews with residents and staff members, including the Health Information Management Director and the Administrator. The facility's staffing data from the Centers for Medicare and Medicaid Services (CMS) Payroll-Based Journal (PBJ) revealed excessively low weekend staffing every quarter of fiscal year 2023. The Health Information Management Director confirmed the accuracy of this data, noting that the facility struggles to maintain adequate staffing levels, especially for Certified Nurse Aides (CNAs). The Director of Nursing and the Administrator also acknowledged the staffing challenges, particularly on weekends, and the difficulty in meeting their staffing ratio goals due to frequent sick calls and overall staff shortages.
Failure to Meet Residents' Dietary Needs and Preferences
Penalty
Summary
The facility failed to ensure residents' dietary needs and preferences were met, leading to multiple deficiencies. One resident reported not receiving milk with her breakfast despite requesting it 30 minutes prior. Additionally, she did not receive her preferred dinner choices on two separate occasions, receiving the wrong meal each time. The facility's policy on honoring individual food preferences was not followed, resulting in dissatisfaction with the dining experience. Another deficiency involved staff members not being aware of residents' special dietary texture needs. A family member reported that a resident with a moist minced diet due to a choking incident was inconsistently given various diet textures, including regular, chopped, minced, and pureed. Interviews with staff revealed a lack of knowledge about dietary abbreviations, indicating a failure to ensure that residents received the correct diet texture as prescribed. Further deficiencies were observed with another resident who had documented allergies and dislikes, including chocolate and ground meat. Despite this, the resident received meals containing chocolate and ground meat multiple times. Additionally, a resident who was lactose intolerant reported receiving regular milk instead of almond milk on several occasions, leading to gastrointestinal distress. These incidents highlight the facility's failure to adhere to residents' dietary preferences and needs, as documented in their dietary forms.
Infection Control Deficiencies
Penalty
Summary
The facility failed to apply standard infection control precautions to ensure the health and safety of its residents, staff, and visitors. On multiple occasions, staff did not provide hand sanitizer or hand wipes to residents before meals. For instance, an Activities Aide did not offer hand sanitizer to a resident in a wheelchair before breakfast, and the Registered Nurse confirmed that while staff should provide hand sanitizer, it was not consistently done. The Administrator acknowledged the need for correction, and the Infection Preventionist confirmed that hand sanitizer should be given to residents before meals, especially since they are now eating in their units due to COVID-19. Additionally, dietary staff did not offer hand sanitizer to residents before lunch, and a total of 19 residents were observed dining without being offered hand sanitizer or the opportunity to wash their hands. The facility also failed to implement proper transmission-based precautions for a resident with an active case of COVID-19. A resident's room did not have signs posted outside to notify staff and visitors of the need to use personal protective equipment (PPE) before entering. A Registered Nurse was unaware of the missing signage and only taped the sign up after being informed. These lapses in infection control practices were observed and confirmed through interviews with staff and residents, highlighting significant deficiencies in the facility's infection prevention and control program.
Failure to Adhere to Food Safety Standards
Penalty
Summary
The facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety. During an initial kitchen tour, 19 uncovered cakes were observed in the walk-in refrigerator, which the Dietary Manager (DM) acknowledged should have been covered. Additionally, expired cranberry cocktail juice containers were found in a nourishment room, both on the shelf and in the refrigerator, which the DM discarded upon discovery. Furthermore, the temperature of a regular chicken was found to be 127 degrees Fahrenheit, below the safe holding temperature of 135 degrees Fahrenheit, prompting the DM to reheat it in the steamer. In another observation, the nourishment room contained various condiments, including grape jellies, honey, breakfast syrups, and peanut butters, all of which lacked use-by or expiration dates. The Director of Nursing (DON) confirmed that there was no way to determine if these condiments were expired and stated that staff should have dated them. These findings indicate a failure to adhere to the facility's policy and procedure for food safety, which requires maintaining hot foods at temperatures of 135 degrees Fahrenheit or above and ensuring all food items are properly dated to prevent the use of expired products.
Failure to Ensure Resident Dignity in Grooming and Feeding Assistance
Penalty
Summary
The facility failed to protect and promote the quality of life for three residents by not ensuring proper grooming and dignified feeding assistance. Resident 74 was observed on two separate occasions with uncombed hair while seated in the common dining area, despite being unable to perform grooming tasks independently. This was confirmed by a Certified Nurse Aide who acknowledged that the resident's hair should have been groomed before being brought out of her room. The resident's care plan indicated a need for extensive to total assistance with personal hygiene, which was not adhered to in this instance. Additionally, staff members were observed standing while providing feeding assistance to two other residents, which is against the facility's policy for promoting dignity. A Registered Dietician was seen standing while feeding Resident 41, despite a chair being available in the room. Similarly, an Activities Aide was observed standing while assisting Resident 12 with feeding in the activities room. Both staff members acknowledged that they should have been seated while providing assistance. The Director of Nursing confirmed that staff should sit while assisting residents with eating to maintain their dignity.
Failure to Provide Proper Notification of Transfer/Discharge
Penalty
Summary
The facility failed to provide proper notification of transfer or discharge for four residents who were hospitalized. Specifically, the facility did not issue written notifications of transfer or discharge to two of the residents or their representatives and failed to send notifications to the Office of the State Long Term Care Ombudsman (LTCO) for the other two residents. For Resident 15, who was hospitalized for gastrointestinal bleeding, there was no written notice of the transfer/discharge found in her electronic health record (EHR), and the provided notice was not signed by her family representative. Similarly, Resident 24, who was transferred to the emergency room for a hip fracture requiring surgery, did not have documentation of written notification in his EHR, and the notice form lacked a signature verifying receipt by the resident or his representative. Additionally, the facility did not send written notifications to the State Long Term Care Ombudsman for Residents 12 and 9, who were transferred to acute care hospitals for changes in their levels of care. Resident 12's EHR lacked documentation of the notification, and the facility's Social Service staff confirmed that the notification was not sent. Similarly, Resident 9's EHR also lacked documentation of the notification, and the same Social Service staff confirmed that the notification was not sent. These deficiencies have the potential to affect all residents at the facility who are discharged or transferred.
Failure to Provide Written Bed Hold Policy Notification
Penalty
Summary
The facility failed to provide written notification of its bed hold policy to residents or their representatives in cases of hospitalization. For Resident 24, who was transferred to the emergency room due to a left hip fracture requiring surgery, the Electronic Health Record (EHR) did not document that a written copy of the bed hold policy was given or sent to the resident or their representative. An interview with Social Services confirmed that only a phone call was made. Similarly, for Resident 12, who was transferred to an acute care hospital for a change in her level of care, the EHR lacked documentation of written notification of the bed hold policy. The Health Information Management Director confirmed that the facility's process involved only verbal communication of the policy, without sending written notifications.
Failure to Transmit MDS Data Timely
Penalty
Summary
The facility failed to electronically transmit the minimum data set (MDS) data to the Centers for Medicare and Medicaid Services (CMS) System within 14 days of its completion following the discharge of Resident 70. Resident 70 was discharged on 09/29/23, and the discharge assessment was documented as completed on 10/04/23. However, during a review on 01/31/24, it was found that the assessment had not been transmitted. The Minimum Data Set Coordinator (MDSC) confirmed that the discharge assessment had not been transmitted and provided documentation showing it was only transmitted and accepted on 01/31/24.
Failure to Implement Comprehensive Care Plans
Penalty
Summary
The facility did not ensure that comprehensive person-centered care plans were developed and/or implemented for two residents. For one resident, the facility failed to implement interventions from the comprehensive care plan to help increase and/or prevent further decrease in the range of motion (ROM) of her left knee and hand. This was based on observation, interview, and record review, indicating a lack of adherence to the care plan designed to address the resident's mobility needs. Another resident was observed with edema in her left leg and foot, which was not addressed in her care plan. The resident had a history of a displaced midcervical fracture of the left femur and a left artificial hip joint. Despite the swelling being noted by staff, there were no documented interventions in the care plan to monitor or alleviate the edema. This oversight was confirmed through interviews with the resident and a registered nurse, as well as a review of the resident's electronic health record.
Inappropriate Management of Acute Urinary Retention
Penalty
Summary
The facility did not ensure that a resident with acute urinary retention received appropriate treatment and services. The resident, an elderly female admitted following a hip fracture, was observed to be extremely somnolent, with a very poor appetite, and non-responsive to staff and family. On multiple occasions, the resident was catheterized intermittently over a period of five days, with outputs ranging from 80 to 950 milliliters of dark, foul-smelling urine. Despite these observations, a urinalysis to test for a UTI was not conducted until three days after the initial catheterization, leading to a delayed diagnosis and treatment of a UTI with oral antibiotics. The facility's bladder scanner was inoperable during this period, which contributed to the decision to perform routine intermittent catheterizations without knowing the exact volume of retained urine. The Director of Nursing confirmed that the facility began routine intermittent catheterizations due to the inoperable bladder scanner and lack of knowledge about the urine retention volume. The physician stated that had the bladder scanner been operational, the orders would have been modified to catheterize as needed based on specific urine retention volumes. The physician also noted that there was no indication of an infection initially, which is why a urinalysis was not ordered until later. The facility's policy for indwelling urinary catheter management indicates that an indwelling catheter should be used for acute urinary retention, but this was not followed, leading to repeated intermittent catheterizations and potential trauma to the resident's urethra and increased risk of UTIs.
Failure to Provide Appropriate ROM Treatment
Penalty
Summary
The facility failed to ensure that a resident received the appropriate treatment, equipment, and services to maintain or improve the range of motion (ROM) in her left knee and hand. The resident, a [AGE] year-old female with diagnoses including hemiplegia and hemiparesis following a stroke, as well as contractures in her left hand and knee, was observed multiple times without the prescribed supportive devices or splints. Despite the care plan and physician orders specifying the use of these splints, they were not applied as required, and there was no documentation explaining their absence. Observations revealed that the resident's left wrist was severely contracted, and the splints were either missing or incorrectly applied to the wrong limb. Interviews with staff indicated a lack of awareness and proper documentation regarding the application of the splints. A CNA was unsure about the correct splint for the resident's hand and had never seen a splint on the resident's left knee. An LPN confirmed that the splints should be documented on the Treatment Administration Record (TAR) if applied, and any deviations should be noted in the progress notes. However, the TAR contained inaccurate information, and there were no progress notes explaining the absence of the splints. This deficiency hindered the resident from reaching her highest practicable well-being and had the potential to affect all residents with ROM deficits in the facility.
Failure to Provide Sufficient Fluids
Penalty
Summary
The facility failed to ensure that Resident 52 was offered sufficient fluid when requested to maintain proper hydration and health. Resident 52, who was admitted with a diagnosis including a Urinary Tract Infection (UTI), reported asking for water at approximately 07:15 AM. A staff member took her water pitcher but did not return it. At 08:41 AM, during an observation and interview, Resident 52 mentioned to CNA 10 that she had asked for water again. CNA 10 returned with the water pitcher at 08:45 AM. The resident's care plan documented a risk of dehydration related to the recent UTI.
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Illustrative
What surveyors actually found near you
We read the 23 citations issued within 25 miles in the last 12 months — and tell you exactly what happened, in plain English, matched to your record.
Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
Illustrative
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Illustrative
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Nursing homes near Hilo
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Hilo Benioff Medical Center | 0 mi | ★★★★★ | 0 | 0 |
| Yukio Okutsu State Veterans Home | 0 mi | ★★★★★ | 0 | 0 |
| Legacy Hilo Rehabilitation & Nursing Center | 0.9 mi | ★★★★★ | 15 | 0 |
| Life Care Center Of Hilo | 2.7 mi | ★★★★★ | 8 | 0 |
| Honoka'a Hospital & Skilled Nursing | 34.1 mi | ★★★★★ | 0 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release October 2026) and official state health department websites.