01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-04-30 | 14 | 2025-04-30 | 0 |
| Cycle 2 | 2024-05-16 | 21 | 2024-05-16 | 0 |
| Cycle 3 | 2023-05-25 | 29 | 2023-05-25 | 1 |
CMS CCN 1250672026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Islands Skilled Nursing & Rehabilitation
1205 Alexander Street · Honolulu, HI 96826 · Honolulu County
Certified beds42CMS provider file
Recent citation rows65current CMS citation release
Penalty rows1current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
65 rows in the current release
1 rows carry G–L scope/severity codes; 0 carry J–L. 15 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-04-30 · HEALTHF0550Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Correction field: Deficient, Provider has date of correction · 2025-06-272025-04-30 · HEALTHF0584Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor 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.
Correction field: Deficient, Provider has date of correction · 2025-06-272025-04-30 · HEALTHF0641Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2025-06-272025-04-30 · HEALTHF0655Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Correction field: Deficient, Provider has date of correction · 2025-06-272025-04-30 · HEALTHF0656Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has date of correction · 2025-06-272025-04-30 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2025-06-272025-04-30 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2025-06-272025-04-30 · HEALTHF0756Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Correction field: Deficient, Provider has date of correction · 2025-06-272025-04-30 · HEALTHF0761Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure 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.
Correction field: Deficient, Provider has date of correction · 2025-06-272025-04-30 · HEALTHF0812Severity D · isolated; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2025-06-272025-04-30 · HEALTHF0842Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Correction field: Deficient, Provider has date of correction · 2025-06-272025-04-30 · HEALTHF0851Severity F · widespread; potential for more than minimal harm
Administration Deficiencies
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
Correction field: Deficient, Provider has date of correction · 2025-06-272025-04-30 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2025-06-272025-04-30 · HEALTHF0921Severity F · widespread; potential for more than minimal harm
Environmental Deficiencies
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Correction field: Deficient, Provider has date of correction · 2025-06-272024-07-18 · HEALTHF0622Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.
Correction field: Deficient, Provider has date of correction · 2024-09-05 · complaint2024-07-18 · HEALTHF0623Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Correction field: Deficient, Provider has date of correction · 2024-09-05 · complaint2024-07-18 · HEALTHF0626Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Permit a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy.
Correction field: Deficient, Provider has date of correction · 2024-09-05 · complaint2024-07-18 · HEALTHF0657Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Correction field: Deficient, Provider has date of correction · 2024-09-05 · complaint2024-07-18 · HEALTHF0713Severity D · isolated; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Provide or arrange emergency care by a doctor 24 hours a day.
Correction field: Deficient, Provider has date of correction · 2024-09-05 · complaint2024-07-18 · HEALTHF0726Severity G · isolated actual harm
Nursing and Physician Services Deficiencies
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Correction field: Deficient, Provider has date of correction · 2024-09-13 · complaint2024-05-16 · HEALTHF0550Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Correction field: Deficient, Provider has date of correction · 2024-07-012024-05-16 · HEALTHF0551Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Give the resident's representative the ability to exercise the resident's rights.
Correction field: Deficient, Provider has date of correction · 2024-06-302024-05-16 · HEALTHF0582Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Correction field: Deficient, Provider has date of correction · 2024-06-302024-05-16 · HEALTHF0609Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Correction field: Deficient, Provider has date of correction · 2024-07-12 · complaint03 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| 2024-05-16 | Fine | $89,206 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- PACIFIC HEALTHCARE VENTURES LLCOrganization · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 12/31/2020
- ACCORD HOLDINGS, LLCOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTEREST100% · since 12/31/2020
- LACKNER, CHRISTOPHERIndividual · CORPORATE OFFICERNOT APPLICABLE · since 02/26/2020
- SMITH, NICOLEIndividual · CORPORATE OFFICERNOT APPLICABLE · since 02/26/2020
- MANUMALEUNA, EATHYNIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 07/24/2023
- YAZAWA, KIYOTAKAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 09/01/2019
- ACCORD HOLDINGS, LLCOrganization · GENERAL PARTNERSHIP INTERESTNOT APPLICABLE · since 12/31/2020
- ACCORD HOLDINGS, LLCOrganization · LIMITED PARTNERSHIP INTERESTNOT APPLICABLE · since 12/31/2020
- ACCORD HOLDINGS, LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 02/19/2025
- MANUMALEUNA, EATHYNIndividual · ADP OF THE SNFNOT APPLICABLE · since 02/19/2025
- YAZAWA, KIYOTAKAIndividual · ADP OF THE SNFNOT APPLICABLE · since 09/01/2019
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours5.67per resident day
RN hours2.89per resident day
Weekend nurse hours4.99per resident day
Staff turnover40.0%CMS reported field
06 / LOCAL RECORDS
Open the Honolulu ledger →Other published facilities nearby
15 Craigside45 beds · CMS overall 5/55 citation rowsArcadia Retirement Residence91 beds · CMS overall 4/543 citation rowsAvalon Care Center - Honolulu, Llc108 beds · CMS overall 2/561 citation rowsHale Malamalama40 beds · CMS overall 2/552 citation rowsHale Nani Rehabilitation And Nursing Center288 beds · CMS overall —/5107 citation rowsHi'Olani Care Center At Kahala Nui20 beds · CMS overall 5/526 citation rowsKalakaua Gardens49 beds · CMS overall 2/560 citation rowsKuakini Geriatric Care, Inc187 beds · CMS overall 1/560 citation rows