Skilled nursing facility · CMS certification number 125057
Kulana Malama
EWA BEACH, Hawaii · Medicare and Medicaid
Certified beds, as filed in Care Compare: 33
Download this facility’s record (CSV)
A CSV file of this facility’s record: its name and location, its Medicare cost-report finances year by year, its ownership, its inspections, deficiencies and penalties, and the Care Compare provider information — each figure with the worksheet, line and column or file it came from.
In Care Compare’s provider information: Penalties: 1 · Fines: 1 · Fines, total amount: $14,069.00 · Payment denials: 0. The most recent penalty on file: June 18, 2025, Fine, $14,069. Every penalty on file ↓
For this facility: the citable document with full history — $295 · an email when this record changes — $99/month
Finances, as filed
From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.
Cost report for January 1, 2024 to December 31, 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on June 23, 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $14,578,571 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $521,513 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $14,057,058 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $13,760,329 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $296,729 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $780,183 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,076,912 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,076,912 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 66 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 24,156 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicaid (Title XIX) patient days | 10,693 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 547 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 11,240 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicaid discharges | 19 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Total discharges, all components | 19 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, all patients, in days | 591.58 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1429813, read from the public cost report file SNF10FY2024.zip.
Fiscal year 2023, ended December 31, 2023
Cost report for February 1, 2023 to December 31, 2023 — a reporting period of 333 days, on form CMS-2540-10, settled, processed by CMS on August 22, 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,293,617 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,484,007 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,809,610 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,616,992 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,807,382 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $379,342 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,428,040 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,428,040 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 9,096 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 15 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, all patients, in days | 606.4 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1392870, read from the public cost report file SNF10FY2023.zip.
Fiscal year 2021, ended December 31, 2021
Cost report for January 1, 2021 to December 31, 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on September 20, 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,026,337 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $12,314 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $11,014,023 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,550,402 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $463,621 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $316,362 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $779,983 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $752,685 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 10,333 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 13 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, all patients, in days | 794.85 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1332962, read from the public cost report file SNF10FY2021.zip.
Fiscal year 2020, ended December 31, 2020
Cost report for January 1, 2020 to December 31, 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on November 24, 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,626,920 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $372,821 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,254,099 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,444,948 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,190,849 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,446,497 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,255,648 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,233,328 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 9,962 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 14 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, all patients, in days | 711.57 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1305323, read from the public cost report file SNF10FY2020.zip.
Fiscal year 2019, ended December 31, 2019
Cost report for January 1, 2019 to December 31, 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on November 20, 2020.
None of these figures is carried on this report.
CMS report record 1274106, read from the public cost report file SNF10FY2019.zip.
Fiscal year 2018, ended December 31, 2018
Cost report for January 1, 2018 to December 31, 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on August 26, 2019.
None of these figures is carried on this report.
CMS report record 1242285, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2017, ended December 31, 2017
Cost report for January 1, 2017 to December 31, 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on August 29, 2018.
None of these figures is carried on this report.
CMS report record 1210909, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2016, ended December 31, 2016
Cost report for January 1, 2016 to December 31, 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on August 22, 2017.
None of these figures is carried on this report.
CMS report record 1174499, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2015, ended December 31, 2015
Cost report for January 1, 2015 to December 31, 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on August 26, 2016.
None of these figures is carried on this report.
CMS report record 1142775, read from the public cost report file SNF10FY2015.zip.
Fiscal year 2014, ended December 31, 2014
Cost report for January 1, 2014 to December 31, 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on August 25, 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,835,091 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $529,649 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,305,442 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,241,980 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $63,462 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $577,148 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $640,610 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $640,489 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 10,310 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 22 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, all patients, in days | 468.64 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1108713, read from the public cost report file SNF10FY2014.zip.
Fiscal year 2013, ended December 31, 2013
Cost report for January 1, 2013 to December 31, 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on September 9, 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,780,461 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $496,879 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,283,582 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,104,106 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $179,476 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $436,002 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $615,478 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $605,620 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 10,115 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 30 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, all patients, in days | 337.17 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1077819, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2012, ended December 31, 2012
Cost report for January 1, 2012 to December 31, 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on August 16, 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,815,897 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $711,319 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,104,578 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,100,671 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $3,907 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $167,916 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $171,823 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $165,271 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 90 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 9,938 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 29 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, all patients, in days | 342.69 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1046691, read from the public cost report file SNF10FY2012.zip.
Fiscal year 2011, ended December 31, 2011
Cost report for January 1, 2011 to December 31, 2011 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on January 31, 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,865,636 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $661,337 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,204,299 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,019,809 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $184,490 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $11,410 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $195,900 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $179,347 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 90 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 10,023 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 34 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, all patients, in days | 294.79 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1024359, read from the public cost report file SNF10FY2011.zip.
Fiscal year 2010, ended December 31, 2010
Cost report for January 1, 2010 to December 31, 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on August 1, 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $9,013,480 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,764,761 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $248,719 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $124,977 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $40,359 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $333,337 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 9,984 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 35 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 469 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 340.08 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 285.26 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 414197, read from the public cost report file SNFFY2010.zip.
Fiscal year 2009, ended December 31, 2009
Cost report for January 1, 2009 to December 31, 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on August 2, 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $9,106,580 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,504,404 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $602,176 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $137,695 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $669 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $739,202 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 30 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 787 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 8 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 103.5 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 72.25 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 98.38 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 384551, read from the public cost report file SNFFY2009.zip.
Fiscal year 2008, ended December 31, 2008
Cost report for January 1, 2008 to December 31, 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on August 31, 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $6,181,133 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,182,737 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,001,604 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $90,569 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $3,039 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$914,074 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 90 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 7,465 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 47 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 65.67 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 187.97 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 158.83 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 356000, read from the public cost report file SNFFY2008.zip.
Fiscal year 2007, ended December 31, 2007
Cost report for May 1, 2007 to December 31, 2007 — a reporting period of 244 days, not a full year, on form CMS-2540-96, settled, processed by CMS on November 8, 2010.
None of these figures is carried on this report.
CMS report record 389398, read from the public cost report file SNFFY2007.zip.
Nurse staffing
Nurse staffing hours from the Payroll-Based Journal, quarter by quarter, are on this facility’s staffing page, each quarter with the file it came from.
Ownership, as filed with CMS
Care Compare
As filed in the CMS file dated September 1, 2026 (Care Compare ownership).
| Owner or manager | Role | Type | Ownership percentage | Association |
|---|---|---|---|---|
| PACIFIC SKILLED HEALTHCARE LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | 100% | since 06/30/2022 |
| OLSEN, SPENCER | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | Individual | 73% | since 06/30/2022 |
| SORENSEN, KRISTEN | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | Individual | 13% | since 06/30/2022 |
| ITO, RANDALL | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 02/01/2023 |
| LEFLER, TYRUS | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 09/23/2022 |
| OLSEN, SPENCER | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 09/23/2022 |
| PANG, BRIAN | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 02/01/2023 |
| YOSHIDA, CYNTHIA | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 02/01/2023 |
| ITO, RANDALL | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 02/01/2023 |
| ITO, RANDALL | W-2 MANAGING EMPLOYEE | Individual | NOT APPLICABLE | since 02/01/2023 |
Medicare enrollment
As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of PSH KM LLC (enrollment ID O20230405000474).
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; where the private equity, real estate investment trust or holding company field below has not been filed under the current cycle, it reads “Paused by CMS”.
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| PACIFIC SKILLED HEALTHCARE LLC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 6/30/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| AARON MAYER | Individual | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 15 | 6/30/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KRISTEN SORENSEN | Individual | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 12.5 | 6/30/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| SPENCER E OLSEN | Individual | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 72.5 | 6/30/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| BRIAN PANG | Individual | CORPORATE OFFICER | 0 | 2/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| CYNTHIA LC YOSHIDA | Individual | CORPORATE OFFICER | 0 | 2/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| RANDALL H ITO | Individual | CORPORATE OFFICER | 0 | 2/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| SPENCER E OLSEN | Individual | CORPORATE OFFICER | 0 | 9/23/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| TYRUS LEFLER | Individual | CORPORATE OFFICER | 0 | 9/23/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| RANDALL H ITO | Individual | OPERATIONAL/MANAGERIAL CONTROL | 100 | 2/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| RANDALL H ITO | Individual | W-2 MANAGING EMPLOYEE | 100 | 2/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
Changes in ownership
- September 15, 2023: RANDALL H ITO no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: RANDALL H ITO no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: RANDALL H ITO no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: MAEDENE S WAKABAYASHI no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: SHERRY LOO no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: BRIAN PANG no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: ROBYN R MCKINNEY no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: BYRON Y AOKI no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: BYRON Y AOKI no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: ITO FAMILY HOLDINGS CORP no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: CYNTHIA LC YOSHIDA no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: AARON MAYER (5% OR GREATER INDIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on September 15, 2023; associated with this enrollment since June 30, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: KRISTEN SORENSEN (5% OR GREATER INDIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on September 15, 2023; associated with this enrollment since June 30, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: RANDALL H ITO (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on September 15, 2023; associated with this enrollment since February 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: RANDALL H ITO (W-2 MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on September 15, 2023; associated with this enrollment since February 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: RANDALL H ITO (OFFICER) first listed in CMS’s Medicare enrollment ownership file on September 15, 2023; associated with this enrollment since February 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: PACIFIC SKILLED HEALTHCARE LLC (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on September 15, 2023; associated with this enrollment since June 30, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: TYRUS LEFLER (OFFICER) first listed in CMS’s Medicare enrollment ownership file on September 15, 2023; associated with this enrollment since September 23, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: BRIAN PANG (OFFICER) first listed in CMS’s Medicare enrollment ownership file on September 15, 2023; associated with this enrollment since February 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: SPENCER E OLSEN (OFFICER) first listed in CMS’s Medicare enrollment ownership file on September 15, 2023; associated with this enrollment since September 23, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: SPENCER E OLSEN (5% OR GREATER INDIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on September 15, 2023; associated with this enrollment since June 30, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: CYNTHIA LC YOSHIDA (OFFICER) first listed in CMS’s Medicare enrollment ownership file on September 15, 2023; associated with this enrollment since February 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
Recent changes on this record
- September 26, 2025: A deficiency was cited under tag F 0812, scope and severity D. NH_HealthCitations_Sep2026_2.csv
- September 26, 2025: A deficiency was cited under tag F 0550, scope and severity D. NH_HealthCitations_Sep2026_2.csv
- September 26, 2025: A deficiency was cited under tag F 0880, scope and severity E. NH_HealthCitations_Sep2026_2.csv
- September 26, 2025: An inspection was recorded in inspection cycle 1. NH_SurveySummary_Sep2026_2.csv
- June 23, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- August 22, 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- October 31, 2023: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2022.zip
- September 15, 2023: RANDALL H ITO no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: RANDALL H ITO no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: RANDALL H ITO no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: MAEDENE S WAKABAYASHI no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: SHERRY LOO no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: BRIAN PANG no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: ROBYN R MCKINNEY no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: BYRON Y AOKI no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: BYRON Y AOKI no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: ITO FAMILY HOLDINGS CORP no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: CYNTHIA LC YOSHIDA no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: AARON MAYER (5% OR GREATER INDIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on September 15, 2023; associated with this enrollment since June 30, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: KRISTEN SORENSEN (5% OR GREATER INDIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on September 15, 2023; associated with this enrollment since June 30, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: RANDALL H ITO (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on September 15, 2023; associated with this enrollment since February 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: RANDALL H ITO (W-2 MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on September 15, 2023; associated with this enrollment since February 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: RANDALL H ITO (OFFICER) first listed in CMS’s Medicare enrollment ownership file on September 15, 2023; associated with this enrollment since February 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: PACIFIC SKILLED HEALTHCARE LLC (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on September 15, 2023; associated with this enrollment since June 30, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: TYRUS LEFLER (OFFICER) first listed in CMS’s Medicare enrollment ownership file on September 15, 2023; associated with this enrollment since September 23, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: BRIAN PANG (OFFICER) first listed in CMS’s Medicare enrollment ownership file on September 15, 2023; associated with this enrollment since February 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: SPENCER E OLSEN (OFFICER) first listed in CMS’s Medicare enrollment ownership file on September 15, 2023; associated with this enrollment since September 23, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: SPENCER E OLSEN (5% OR GREATER INDIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on September 15, 2023; associated with this enrollment since June 30, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: CYNTHIA LC YOSHIDA (OFFICER) first listed in CMS’s Medicare enrollment ownership file on September 15, 2023; associated with this enrollment since February 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 20, 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- November 24, 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
- November 20, 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
- August 26, 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
- August 29, 2018: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
- August 22, 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
- August 26, 2016: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
- August 25, 2015: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
- September 9, 2014: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2013.zip
- August 16, 2013: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2012.zip
- January 31, 2013: A cost report was filed for fiscal year 2011, on form CMS-2540-10. SNF10FY2011.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | September 26, 2025 | September 26, 2025 | 4 | 0 |
| 2 | June 6, 2024 | June 6, 2024 | 13 | 0 |
| 3 | June 23, 2023 | June 23, 2023 | 6 | 0 |
| 3 | July 15, 2022 | July 15, 2022 | 5 | 0 |
From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.
Deficiencies cited
28 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| September 26, 2025 | Health | F 0550 | Resident Rights Deficiencies | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | No | Deficient, Provider has date of correction | November 30, 2025 |
| September 26, 2025 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | D | No | Deficient, Provider has date of correction | November 30, 2025 |
| September 26, 2025 | Health | F 0842 | 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. | D | Yes | Deficient, Provider has date of correction | November 7, 2025 |
| September 26, 2025 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | E | No | Deficient, Provider has date of correction | November 7, 2025 |
| June 18, 2025 | Health | F 0656 | 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. | D | Yes | Deficient, Provider has date of correction | June 20, 2025 |
| June 18, 2025 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Yes | Past Non-Compliance | March 30, 2025 |
| June 18, 2025 | Health | F 0713 | Nursing and Physician Services Deficiencies | Provide or arrange emergency care by a doctor 24 hours a day. | D | Yes | Deficient, Provider has date of correction | June 20, 2025 |
| June 18, 2025 | Health | F 0726 | 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. | J | Yes | Deficient, Provider has date of correction | June 20, 2025 |
| June 18, 2025 | Health | F 0867 | Administration Deficiencies | Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | D | Yes | Deficient, Provider has date of correction | June 20, 2025 |
| June 6, 2024 | Health | F 0550 | Resident Rights Deficiencies | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | No | Deficient, Provider has date of correction | July 28, 2024 |
| June 6, 2024 | Health | F 0584 | 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. | D | No | Deficient, Provider has date of correction | July 28, 2024 |
| June 6, 2024 | Health | F 0661 | Resident Assessment and Care Planning Deficiencies | Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. | D | No | Deficient, Provider has date of correction | July 28, 2024 |
| June 6, 2024 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | No | Deficient, Provider has date of correction | July 28, 2024 |
| June 6, 2024 | Health | F 0760 | Pharmacy Service Deficiencies | Ensure that residents are free from significant medication errors. | D | No | Past Non-Compliance | January 7, 2024 |
| June 6, 2024 | Health | F 0791 | Quality of Life and Care Deficiencies | Provide or obtain dental services for each resident. | D | No | Deficient, Provider has date of correction | July 28, 2024 |
| June 6, 2024 | Health | F 0842 | 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. | D | No | Deficient, Provider has date of correction | July 28, 2024 |
| June 6, 2024 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | No | Deficient, Provider has date of correction | July 28, 2024 |
| June 23, 2023 | Health | F 0656 | 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. | D | No | Deficient, Provider has date of correction | July 14, 2023 |
| June 23, 2023 | Health | F 0693 | Quality of Life and Care Deficiencies | Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. | D | No | Deficient, Provider has date of correction | July 14, 2023 |
| June 23, 2023 | Health | F 0761 | 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. | D | No | Deficient, Provider has date of correction | July 14, 2023 |
| June 23, 2023 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | F | No | Deficient, Provider has date of correction | July 14, 2023 |
| June 23, 2023 | Health | F 0887 | Infection Control Deficiencies | Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. | D | No | Deficient, Provider has date of correction | July 14, 2023 |
| June 23, 2023 | Health | F 0908 | Environmental Deficiencies | Keep all essential equipment working safely. | E | No | Deficient, Provider has date of correction | July 14, 2023 |
| July 15, 2022 | Health | F 0550 | Resident Rights Deficiencies | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | No | Deficient, Provider has date of correction | August 26, 2022 |
| July 15, 2022 | Health | F 0609 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | E | No | Deficient, Provider has date of correction | August 26, 2022 |
| July 15, 2022 | Health | F 0623 | 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. | E | No | Deficient, Provider has date of correction | August 26, 2022 |
| July 15, 2022 | Health | F 0625 | Resident Rights Deficiencies | Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave. | D | No | Deficient, Provider has date of correction | August 26, 2022 |
| July 15, 2022 | Health | F 0761 | 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. | E | No | Deficient, Provider has date of correction | August 26, 2022 |
From the Care Compare health citations file NH_HealthCitations_Sep2026_2.csv, processed on September 1, 2026.
Penalties
| Penalty date | Type | Fine amount | Payment denial began | Payment denial, days | Fine ID |
|---|---|---|---|---|---|
| June 18, 2025 | Fine | $14,069 | 134198 |
From the Care Compare penalties file NH_Penalties_Sep2026_2.csv, processed on September 1, 2026.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare and Medicaid |
| Ownership Type | For profit - Limited Liability company |
| Legal Business Name | PSH KM LLC |
| Date First Approved to Provide Medicare and Medicaid Services | 2007-05-01 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Honolulu |
| Telephone Number | 8086811200 |
| Provider Changed Ownership in Last 12 Months | N |
| With a Resident and Family Council | None |
| Automatic Sprinkler Systems in All Required Areas | Yes |
| Number of Certified Beds | 33 |
| Average Number of Residents per Day | 33.5 |
| Overall Rating | 5 |
| Health Inspection Rating | 4 |
| QM Rating | 5 |
| Long-Stay QM Rating | 5 |
| Processing Date | 2026-08-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on August 1, 2026.
Get an email when this record changes
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The facility alert follows this one record: a cost report filed or a figure on one changed, an inspection, a deficiency or a penalty recorded, an owner added or removed. The certification number arrives filled in.
On September 26, 2025: A deficiency was cited under tag F 0812, scope and severity D. That is one line of the alert.
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The citable document for Kulana Malama
This page shows the record as it stands today. The report is the citable document: the same figures with the cell each came from, and beyond this page — five facilities of a similar size in Hawaii at the same fiscal year, listed by name; every change on the record rather than the recent ones below; the inspection and staffing history in blocks of their own; and a citation block naming every CMS file it was read from.
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Every figure on this page is printed as it appears in the CMS file named beside it. A figure that does not match its file? Tell us on the corrections page, quoting certification number 125057.