Who licenses homes
The Office of Health Care Assurance licenses health care facilities in Hawaii and does state inspections. It also does Medicare certification surveys for the U.S. Centers for Medicare and Medicaid Services.
Two desks matter for senior care. The Medicare Section covers facilities that can participate in Medicare, including skilled nursing and intermediate care facilities, home health agencies, hospices, and hospitals. The State Licensing Section covers community homes that must be licensed by the State and are outside Medicare. That list includes adult residential care homes, expanded ARCHs, assisted living facilities, developmental disabilities domiciliary homes, therapeutic living programs, and special treatment facilities.
The State Licensing Section also keeps a registry of adult residential care homes and the vacancies in them. OHCA does not answer Medicare insurance questions. Those go to the State Health Insurance Assistance Program, SHIP, at (808) 586-7299.
Adult residential care home (ARCH)
State rules describe an ARCH as a facility that provides 24-hour living accommodations, for a fee, to adults unrelated to the family. Residents need at least some help with daily living, personal care, protection, and health care services. They do not need the professional services of an intermediate, skilled nursing, or acute care facility. Federal facilities are outside this license.
Type I
Five or fewer residents. State law allows a sixth when the Department agrees and the primary caregiver is a certified nurse aide with the required training. The vacancy list describes this home as one to five residents who need minimal help with bathing, dressing, walking, eating, and getting out of bed.
Type II
Six or more residents. The help with daily living is the same idea as Type I. The home is larger, and it has an administrator responsible for staff and residents.
Care in these homes follows a social model: family and community, not a hospital ward. Homes help with personal care, medications as the rules allow, laundry, housekeeping, rides to health appointments, supervision, and activities. A Type I primary caregiver is at least a nurse aide, at least 21, a Hawaii resident, and either lives in the home or arranges a qualified primary caregiver who does.
Expanded ARCH
An expanded ARCH may admit people who need a nursing-home level of care, when a physician or APRN has certified that level. The Department describes the expanded home, on its vacancy legend, as a place for residents who need 24-hour help with ordinary daily living and who may need skilled nursing.
- A Type I expanded ARCH generally serves no more than two nursing-facility-level residents at a time. The Department may allow more.
- A Type II expanded ARCH generally keeps that level of care to 20 percent of licensed capacity. The Department may allow more.
- If someone already lives in the home and later needs that level of care, the Department can allow the person to stay when it is in their interest, after talking with the resident, family, physician, case manager, caregiver, and operator.
- A registered nurse, other than only counting on the licensee, is involved in training and monitoring daily personal and specialized care.
- Primary and substitute caregivers in an expanded ARCH document 12 hours of continuing education a year. In a Type I ARCH, the yearly training floor in the caregiver rule is 6 hours.
On admission, the home keeps a current physician report, orders for diet, medication, specialized care, or activities, evidence of tuberculosis clearance under the Department’s policy, pneumococcal and influenza immunization status as recommended by the ACIP, and a written care plan.
Assisted living facility
Hawaii Administrative Rules Title 11, Chapter 90 created assisted living as its own community residential setting. The purpose written into the rules is a combination of housing, meals, health care services, and personal support, built around three ideas: aging in place, a negotiated plan of care, and managed risk.
The rules describe the building as a complex of dwelling units, with meals provided and staff available 24 hours. Services follow the resident’s own needs. The resident, family, and staff decide together what support will help the person live as independently as they can. The setting is meant for people who feel they can no longer live alone, including people with limited mobility.
A facility is licensed before it admits residents, except a facility run by the federal government. The Department inspects at least every two years for renewal and may enter without notice. The license is posted where residents and visitors can see it. A license runs for at least two years unless it is suspended or revoked. The operator tells the Department 15 days before a change of name, location, ownership, or licensed occupancy.
Admission may not be refused because of race, religion, ancestry, sexual orientation, or national origin. The April 2026 public list includes assisted living facilities on Oʻahu, Hawaiʻi Island, Maui, and Kauaʻi. We link that list below rather than reprinting phone numbers that the Department will update.
Community care foster family home
The Department of Health has regulatory authority over community care foster family homes, case management agencies, and adult day care centers. It has designated Community Ties of America to do the licensing and certification work.
These are small certified homes. The March 2026 roster shows many homes with two or three beds, on Oʻahu and the neighbor islands. They are a usual path when Medicaid community care is paying and a case manager from a case management agency is involved. That is a different door from a private-pay ARCH. Hale Kōkua is not a case management agency.
Community Ties of America, Inc. is at 500 Ala Moana Boulevard, Suite 7-400, Honolulu, HI 96813. Phone (808) 234-5380. Fax (808) 234-5470. The same office takes complaints about these services.
The State publishes caregiver names and home addresses on that roster. We link the official file. We do not copy those home addresses onto this website.
How to read a vacancy list
The State Licensing Section publishes a combined ARCH and expanded ARCH vacancy report, by area and in alphabetical order. The legend on the Department’s site uses these marks:
- ARCH I
- Minimal help with daily living. Licensed for 1 to 5 residents.
- ARCH II
- The same help. Licensed for 6 or more residents.
- EXP
- 24-hour help with daily living, and skilled nursing may be needed. Capacity 1 to 5.
- ARCH II-Exp
- The same expanded care. Capacity greater than 6.
- MALE (vac) / FEMALE (vac)
- How many openings are for men, and how many for women.
- CAP
- Licensed capacity.
- DIET
- S means a special diet is approved. R means a regular diet.
- WHC
- Y means the home is approved for a wheelchair. N means it is not.
- FULLY
- The resident walks without another person and without a cane or walker.
- AMB
- The resident walks with a cane, walker, or similar device.
A mark on the list is the license. It is still worth a visit. Approvals change, and a bed can fill the same week the report is printed.
What it takes to apply for an ARCH
The Department’s qualifications sheet, last revised in 2019 on the copy posted to the site, says an applicant must:
- Be a resident of the State of Hawaii.
- Be at least 21.
- Be at least a nurse aide.
- Have a home that meets Hawaii Administrative Rules Title 11, Chapter 100.1.
- Finish Department-approved ARCH training. Modules older than five years have to be taken again.
- Have at least one year of full-time nurse aide work, or the equivalent, in a state-licensed intermediate care facility, skilled nursing facility, home health agency, or hospital.
- Be able to practice resident care in a social model, with family and community at the center.
- Show enough English to carry out the program and comply with Chapter 100.1.
- Meet the rest of Chapter 100.1, which is the binding rule.
The sheet names these training programs: Kapiʻolani Community College, (808) 734-9211, with nurse aide modules at (808) 734-9305; Leeward Community College, (808) 455-0477, when enrollment is large enough; Hawaiʻi Community College, (808) 974-7560; and Kauaʻi Community College, (808) 245-8225. The modules cover ARCH activities, diseases, diet and medications, helping therapies and behavior, and regulations, accounts, and community resources.
Before the application, an operator can request a courtesy plan review and send one 11-by-17-inch floor plan drawn to scale. A second courtesy review can be requested. The application itself is free and is available after the teaching modules. For a walk-in, the sheet says Room 337 at the Kapolei office.
The licensing rule also expects county building and zoning compliance, fire code compliance, sanitation, the owner’s written permission if the house is rented or on leased land, a budget that shows the home can operate, and written policies for staffing, visiting, emergencies, and records. The licensee, primary caregiver, family members in the home who have access, and substitute caregivers need documented evidence of no felony or abuse conviction. The financial papers use an estimated 60 percent occupancy.
A paper copy of Chapter 100.1 was listed at $15 by cashier’s check or money order to the State of Hawaii, mailed to the Kapolei office. The same sheet says a free copy is available from the Department online. Use the current instructions on the qualifications PDF, because that web address is old.
RCFE, RAL, and the Hawaii names
In California, assisted living and board-and-care homes for people 60 and older are licensed as a Residential Care Facility for the Elderly, an RCFE. The license is non-medical: room, meals, supervision, help with medicines, and help with bathing, dressing, eating, and transferring. People in the trade often call a small one, about four to six beds, residential assisted living or a board-and-care home. The license name is still RCFE.
Hawaii does not issue an RCFE or an RAL license. A family leaving that kind of home is usually looking at an ARCH, an expanded ARCH if the care has reached nursing-home level, an assisted living facility if they want a larger residence, or a community care foster family home if Medicaid will be the payer. We explain that on the first call. Always confirm a home's license with the State Licensing Section.
A skilled nursing facility is a further step, and it sits with the Medicare Section, not with the ARCH rules. If that is the level a physician is describing, we say so.
Offices, hours, and complaints
State Licensing Section, Office of Health Care Assurance. 601 Kamokila Boulevard, Room 361, Kapolei, Hawaii 96707. Phone (808) 692-7400. Office hours on the ARCH qualifications sheet are 7:45 a.m. to 4:30 p.m., Monday through Friday.
As of August 1, 2026, the Department asks the public to file complaints through the Kahua Ike portal. Licensed facilities also use the Hawaii Background Check System for staff checks. Both links are in the source list.
Background, a complaint, or a license application is a State matter. We will help a family find the right phone number. We do not inspect homes and we do not decide a license.