Based on interviews, medical record review and document review, the facility failed to assure that all nursing staff possessed the competencies and skill sets necessary to provide nursing care to meet residents' needs in a safe manner. Specifically, the licensed staff did not demonstrate 1) competency to perform and document neurological (neuro) assessments on a Resident whose baseline was neurologically impaired, 2) competency to identify a medical emergency that required timely response and transfer to a higher level of care, and 3) critical thinking to recognize the need to conduct and document a thorough physical and neurological assessment after a fall with potential head/neck injury, to determine if the Resident could be safely transferred from the floor to the bed. …
F726 citations in Hawaii
Competent nursing staff · 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.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Hawaii cites F726 more often than its own record predicts
1.70 times the share F726 takes of citations nationally.
Of every deficiency written in Hawaii in 2025, this is the portion that was F726.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Hawaii surveyors wrote
F726 findings written in Hawaii, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
Based on interviews, document and record review, the facility nursing staff did not demonstrate the competency and skill set to provide one Resident (R)1 the services needed to safely care for him. Specifically, when R1 had ongoing symptoms that were not his baseline requiring additional intervention, they did not implement the process to obtain emergency physician services when unable to reach the on call provider. In addition, nursing applied a scopolamine patch (used to control secretions) on R1, that was not ordered by the physician. The patch may have resulted in significant side effects. As a result of these deficiencies, R1 suffered harm and experienced hallucinations, and increased heart rate. He as ultimately transferred to acute care facility, where he was admitted . …
Based on record review and interviews, the facility failed to ensure licensed nursing staff demonstrated the appropriate competencies and skill set to perform a timely, thorough, and accurate skin assessment for one of one resident (Resident (R) 70) reviewed for abuse. Specifically, staff were aware that R70 had a large bruise on left hip and thigh, first observed on 07/30/25, but an initial assessment was not conducted, and subsequent skin assessments did not document the presence, location, size, characteristics and/or progression of the bruise. …
The short window
Recent years
| Year | Share of Hawaii citations | vs expected |
|---|---|---|
| 2023 | 2.11% | 3.45× |
| 2024 | 3.54% | 5.37× |
| 2025 | 1.02% | 1.70× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Hawaii surveyors cite →
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