Assisted Living in Hawaii

Agency: Department of Health, Office of Health Care Assurance
Phone: (808) 586-4080
Website: www.state.hi.us/doh/resource/ohca

An assisted living facility consists of a building complex offering dwelling units to individuals and services to allow residents to maintain an independent assisted living lifestyle.

Facility Scope of Care:
The facility must provide 24-hour on-site direct care staff to meet the needs of the residents; services to assist residents in performing all activities of daily living; and nursing assessment, health monitoring, and routine nursing tasks.

Move-In/Move-Out Requirements:
There are no specific limitations on the admission of residents unless otherwise indicated by restrictions placed through the County Building Department review. A resident must receive a written 14-day notice of discharge if his or her behavior imposes an imminent danger to him/herself or others, or if the facility cannot meet the resident's needs for services. Guidelines have been developed through a work group of providers and the department. The proposed amendments to the Chapter rules address these requirements.

Resident Assessment:
There is no specific resident assessment form required. However, the facility staff must conduct a comprehensive assessment of each resident's needs, plan and implement responsive services, maintain and update resident records as needed, and periodically update the plan. The plan should include the resident's level of involvement; support principles of dignity, privacy, choice, individuality, independence, and a home-like environment; and should include significant others who participate in the delivery of services. Guidelines have been developed by a work group comprised of providers and the department.

Medication Management:
The facility must have medication management policies related to self-medication and the administration of medication

Physical Plant Requirements:
Facilities must provide each resident with an apartment unit with the following: a bathroom, refrigerator, and cooking capacity, including a sink; a unit that is a minimum of 220 square feet, not including the bathroom; a cooking capacity that may be removed or disconnected depending on the individual needs of the resident; a separate and complete bathroom with a sink, shower, and toilet; accommodations for the physically challenged and wheelchair-bound persons, as needed; a call system monitored 24-hours per day by staff; and wiring for telephones and televisions.

Life Safety:
Facilities must meet requirements set forth by county building occupancy and fire codes. The level of compliance for fire rating is determined by both the number of residents occupying a facility and whether residents are ambulatory, self preserving, or wheelchair bound. All counties are currently adopting International Building Code standards, and county fire authorities are reviewing their respective fire codes in an effort to be consistent.

Staffing Requirements:
Licensed staff shall be available seven days a week.

Staff Education Training:
All facility staff must complete orientation and a minimum of six hours annually of regularly scheduled in-service training.

Medicaid Policy and Reimbursements:
A Medicaid home and community-based services waiver covers nursing services in assisted living facilities for residents that are Medicaid eligible.