Nursing Home Complaints in Hawaii: Where Families File

When a parent, spouse, or other relative lives in a nursing home, families often notice problems first. It might be a bedsore that was not treated, a fall nobody explained, missed medication, weight loss, or a resident who seems afraid of a staff member. Knowing where to report a concern can help it get looked at quickly.

Hawaii has several offices that play different roles. Some inspect and license facilities. Some advocate for residents. Some investigate abuse or neglect of vulnerable adults. This guide explains, in general terms, who does what, and when a lawyer may help.

If someone is in danger right now

If a resident faces an emergency, such as a serious injury, a medical crisis, or a threat of violence, call 911 first. Reports to state agencies are important, but they are not a substitute for emergency help.

The Office of Health Care Assurance

The Hawaii Department of Health's Office of Health Care Assurance (OHCA) handles state licensing for health care facilities in Hawaii. According to its website, OHCA conducts on-site state licensing surveys, which are inspections, and Medicare certification surveys on behalf of the federal Centers for Medicare & Medicaid Services.

OHCA's licensing work covers skilled nursing and intermediate care facilities, as well as community settings such as adult residential care homes and assisted living facilities.

OHCA's site says that, effective August 1, 2026, official complaints must be filed through its "Kahua Ike" public portal. The link is on the OHCA home page. When you file, describe what happened, when, and who was involved, and keep a copy or confirmation of what you submitted.

OHCA's page also notes that complaints about community care foster family homes, case management agencies, and adult day care centers go to Community Ties of America, which OHCA has designated to handle licensing for those settings.

The Long-Term Care Ombudsman

Hawaii's Executive Office on Aging runs the Long-Term Care Ombudsman Program. According to the office, the program provides information, outreach, and advocacy for residents of long-term care facilities. If you have a problem, complaint, or question about services at a facility, you can contact the ombudsman. The office lists contact details on its website.

An ombudsman works for the resident. That is different from an inspection agency. An ombudsman can help a resident speak up, understand their rights, and work with the facility to resolve concerns. The program also trains volunteers who visit licensed long-term care settings.

Adult Protective Services

Hawaii's Department of Human Services runs Adult Protective Services (APS). According to the department, APS provides crisis intervention, investigation, and emergency services for vulnerable adults who are reported to be abused, neglected, or financially exploited by others, or seriously endangered due to self-neglect. Services are provided without regard to income.

APS is often the right place when you believe a specific person has harmed a resident, for example by hitting, threatening, or taking money from them.

Which office should you contact?

Situations overlap, and it is sometimes appropriate to contact more than one office. As a general guide:

• Care problems at the facility level, such as staffing, cleanliness, or repeated failures to follow care plans, often fit OHCA's licensing role.
• Help speaking up or resolving a concern with the facility often fits the ombudsman.
• Abuse, neglect, or financial exploitation of a vulnerable adult by a person often fits APS.

If you are unsure, ask any of these offices where the report belongs. They can usually point you in the right direction.

Document what you see

Good records make any report or claim easier to review. Consider keeping:

• A dated log of visits, observations, and conversations with staff
• Photos of injuries or conditions, if the resident agrees and it is lawful to take them
• Names and roles of staff you spoke with
• Copies of care plans, medication lists, and incident reports you receive
• Copies or confirmations of complaints you filed and any replies

Ask the facility for records in writing. If you hold a power of attorney or are the resident's legal representative, bring a copy when you ask.

When a lawyer may help

A government complaint and a legal claim are separate. An inspection can lead to findings against a facility, but it does not by itself pay for a resident's losses. A lawyer who handles nursing home neglect or medical negligence cases can review whether a civil claim may be possible, which deadlines apply, and what evidence matters.

Lawyers in this area often look at falls, pressure injuries, dehydration, medication errors, and abuse. Some cases are handled on a contingency fee, where the lawyer is paid a share of any recovery. Ask how case costs are handled and get the agreement in writing.

You can browse lawyers in Hawaii or read about the medical malpractice practice area, which often overlaps with nursing home cases. The Hawaii State Bar Association offers a Lawyer Referral and Information Service. Always check a lawyer's license before you sign.

Questions to ask a lawyer

• Should we file a complaint with OHCA, APS, or both before calling you?
• What records should we request from the facility now?
• Which deadline applies to a possible claim?
• Have you handled cases against long-term care facilities in Hawaii?
• How do you charge, and who pays case costs?

Frequently asked questions

Can I complain anonymously?

Policies differ by office. Ask the office when you contact it how it handles your name and information.

Does a complaint mean the facility did something wrong?

No. A complaint starts a review. The office decides what, if anything, it finds.

Should I move my relative first?

That depends on safety and care needs. If you are worried about immediate safety, act on that first and talk with the resident's doctor.

Is the ombudsman the same as a lawyer?

No. The ombudsman advocates for residents, but does not represent them in court. A lawyer can advise on legal claims.

General information, not legal advice. Laws change and every case is different — talk to a licensed Hawaii attorney about your situation.