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Guide to Senior Living in Hawaii

Located in the Pacific Ocean, approximately 2,000 miles from the coast of California, Hawaii is the only state outside of North America. Consisting of 137 islands spanning 1,500 miles, Hawaii is home to about 1.4 million people, and 18.4% are aged 65 or older. The elderly population in the state is growing at a rate of 3.6% per year, and predictions show that by 2045, one in four seniors in The Aloha State will be aged 85 or older.

The cost of living in Hawaii is relatively high compared to costs in many mainland states, so seniors in Hawaii can expect to pay care costs that are above the national average. For instance, in Hawaii, the average monthly cost of assisted living care is $4,375, which is $324 higher than the U.S. average. Seniors who need help covering senior living costs can find in-depth information on local, state and federal programs in this guide.

Covid-19 Rules and Restrictions for Hawaii Senior Living Facilities

The following rules and guidelines were obtained from the Hawaii Department of Health: Disease Outbreak Control Division with Reliance on CDC Updates, as well as other state-level government sites. Among others, these rules apply to nursing homes and other forms of long-term care, including assisted living.

This data has been most recently updated on 7/16/20, but keep in mind that COVID-19 is a rapidly evolving crisis, so all of the below information can change at any time. For additional questions and up-to-date information, you can contact your loved one’s senior living facility or your local Area Agency on Aging.

Visiting Loved Ones

Can I visit my relative in person if he/she wants emotional support from me?No (may vary by facility)
Can I visit my relative in person for end-of-life compassion care?Yes
Will my loved one be required to self-quarantine after I visit him or her?No
Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?Yes
Are hairdressers and other non-medical contractors still allowed in senior living facilities?No
Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives?NA
Are visitors being screened for elevated temperatures?Yes
Are visitors being asked questions about health, travel, and potential virus contact?Yes

Outings and Group Activities

Are residents allowed to leave the facility for non-medical reasons?Yes, but it is strongly discouraged
Are residents of senior living facilities who leave and return required to self-quarantine?NA
Are senior living facilities required to cancel all group outings?Yes
Are residents still eating together in the dining hall?Yes, with social distancing
Are facilities still allowed to host group activities within the community?Yes, with social distancing

Safety Measures for Staff & Contractors 

Are staff members and contractors being screened for elevated temperatures?Yes
Are staff members and contractors being tested for Coronavirus?Yes (testing availability may be limited)
Are staff members and contractors being asked questions about health, travel, and potential virus contact?Yes

Safety Measures for Residents 

Are staff members required to regularly screen residents for coronavirus symptoms?Yes
Are residents relied on to screen themselves and self-report potential coronavirus symptoms?No
Are staff members required to take residents’ temperatures?Yes
Are residents being tested for coronavirus?Yes (testing availability varies)

Paying for Senior Living in Hawaii

Assisted living facilities provide accommodation, meals and some care services, making this type of senior care popular among older adults. Seniors who have complex medical needs may require placement in a nursing home, the most expensive type of senior care in Hawaii. In-home services such as a homemaker and home health aide cost more than assisted living and don’t include room and board. Here are the average costs for these care types in Hawaii:


Assisted Living


Home Health Care


In-Home Care


Adult Day Care


Nursing Home Care

The Cost of Assisted Living in Hawaii

According to Genworth Financial’s 2019 Cost of Care Survey, the average monthly cost of assisted living care in Hawaii is $4,375, which is slightly higher than the national average of $4,051 per month.




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The Cost of In-Home Care in Hawaii

Seniors living in Hawaii who need help at home with activities of daily living may want to consider in-home care services. Seniors will find the average cost of in-home care on the big island to be higher than the U.S. average of $4,290 by $810 monthly. For $5,100 each month, aging adults will receive assistance with tasks such as cooking, housekeeping, shopping and personal care.  




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The Cost of Nursing Home Care in Hawaii

Seniors in need of nursing home care in Hawaii will pay a premium to receive this type of care in The Aloha State. At $11,650, the average monthly cost for nursing home care in Hawaii far surpasses the U.S. average of $7,513 by $4,137 per month.




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Financial Assistance for Senior Living in Hawaii


Med-QUEST is Hawaii’s Medicaid program for the elderly, blind and disabled. This managed care program provides low-income seniors with Medicaid-funded medical and nonmedical support services that can include senior living services.

Med-QUEST replaces previous Hawaii Medicaid waivers, consolidating managed care services into a single program. Unlike waivers, there are no enrollment caps on Med-QUEST, so every senior in Hawaii who qualifies for Med-QUEST receives a customized care plan that may include the following:

  • Adult day health services
  • Assisted living services
  • Homemaker and home health services
  • Transportation to local appointments
  • Personal and respite care
  • A personal emergency response system
  • Durable and disposable medical supplies

While Med-QUEST covers costs related to care in a senior living setting, program participants are responsible for their room-and-board costs.

To qualify for Med-QUEST, seniors must:

  • Be 65 or older, or qualify for Medicaid due to disability
  • Have a monthly income of $1,224 or less from all sources, including employment and pensions
  • Two spouses applying together can have a joint monthly income of $1,653 or less
  • Have no more than $2,000 worth of countable assets (individual), or $3,000 (couple applying together)

Contact: Hawaii seniors can learn more about Med-QUEST by calling the Med-QUEST customer service line at 1-800-316-8005.

VA Pension Top-Up Programs

The U.S. Department of Veterans Affairs administers two benefits programs that can help eligible seniors cover senior living costs.

VA Aid and Attendance benefits and VA Housebound allowance are VA pension top-up programs. These programs give qualified vets, dependents and survivors an increased monthly pension payment.

To qualify for either Aid and Attendance or Housebound, applicants must be deemed eligible for the regular VA pension. Applicants cannot combine benefits from both of these programs.

For the Housebound allowance, VA pension recipients must have a permanent disability assessed at 100% disabling according to VA guidelines. As a result of this permanent disability, applicants must be largely restricted to their residence, which can be a senior living facility.

VA pension beneficiaries who have one disability rated by the VA at 100% and at least one additional disability rated at 60% or greater can also apply for the Housebound allowance.

For Aid and Attendance, applicants have to meet at least one of the following criteria:

  • Live in a nursing home
  • Need help with activities of daily living such as grooming, eating and moving around their home
  • Have a visual field of 5 degrees or less or corrected vision of 5/200 or worse
  • Be restricted to bed as a result of a disability or chronic illness

Contact: For more information on Aid and Attendance and Housebound, contact the nearest VA benefits office or call the nearest Office of Veterans’ Services.

Senior Living Laws and Regulations in Hawaii

Note: All these rules typically apply to non-clinical senior living facilities, such as independent living, assisted living, and memory care facilities. Nursing homes and other senior living facilities with a clinical setting may have additional or slightly different requirements and regulations.

Senior living facilities in Hawaii are regulated by state law in order to ensure all senior living residents are treated with care, respect and the appropriate level of support. The Department of Health, State Licensing Section overseas licensing and inspection of ALFs, and all facilities must comply with state regulations regarding service delivery, staffing and accommodations. These are some of the rules that apply to all licensed ALFs in Hawaii.

Admissions Requirements

In Hawaii, there are no clear limitations on resident admissions to senior living facilities. Individual ALFs have the discretion to admit or decline any resident who has medical needs or behaviors that might not be safely managed at the facility.

Residents who exhibit behaviors that pose a threat to themselves, other residents or ALF staff may be discharged upon receiving written notice from the ALF administrator.

Scope of Care

Senior living facilities are geared toward seniors and people with disabilities who are unable to live independently but who don’t need around-the-clock skilled nursing care.

Every licensed ALF in Hawaii must provide, or arrange for:

  • 24-hour on-site direct care staff
  • Three meals daily plus snacks, including dietary modifications to accommodate medical needs and personal preferences as determined by a licensed dietitian
  • Laundry services for residents who can’t do their own laundry
  • Assistance with activities of daily living such as grooming, toileting, bathing, eating and dressing
  • Routine health monitoring by a licensed registered nurse or delegated unlicensed staff
  • Opportunities for individual and group socialization, including age-appropriate recreational programming
  • Transpiration to local medical appointments
  • Barber or beauty care services
  • Ancillary medical services such as dental care, occupational and physical therapy, and podiatry
  • Social work services
  • A personal fund account for each resident
  • Behavioral support and intervention
  • A private apartment unit measuring at least 220 square feet plus a bathroom with a sink, shower and toilet
  • Resident apartments must have a refrigerator and at least one appliance to cook food

Medication Management

Every licensed ALF in Hawaii must have written policies regarding self-management and medication administration. Facilities can help residents take prescription medications under the direct or indirect supervision of a registered nurse. Any medications administered by facility staff or self-administered by residents must be reviewed by a registered nurse or physician every 90 days or less.


Although there are no state regulations regarding staffing ratios in Hawaii’s senior living facilities, ALFs are required to employ direct care staff who have complied with current tuberculosis clearance standards. Staff must also be trained in basic first aid and CPR and complete at least six hours of in-service training each year. A registered nurse must be available to train and supervise staff and conduct resident assessments.

Facility administrators are required to have a minimum of two years of experience as a manager of a health care, personal care or housing organization. Administrators also need to complete the ALF administrator’s course or equivalent training.

Hawaii Senior Living Free Resources

Hawaii Agencies

Executive Office on Aging

The Hawaii Department of Health, Executive Office on Aging, is a state government agency that coordinates statewide aging and caregiver support services. The Office oversees a number of programs and services for seniors and their families, including the Senior Medicare Patrol, a volunteer-based program that works to reduce Medicare fraud.

The Office also operates the Hawaii State Health Insurance Program, a free health insurance education and counseling program, and the Long-Term Care Ombudsman Program, which works to ensure the safety and well-being of seniors living in long-term care facilities.

Contact: Call 1-808-586-0100 to reach the Executive Office on Aging.

Area Agencies on Aging in Hawaii

Established under the federal Older Americans Act, Area Agencies on Aging are nonprofit agencies that are responsible for the planning, development and delivery of services to seniors and their caregivers statewide. There are four regional AAAs in Hawaii, in Kauai, Honolulu, Maui and Hawaii county, that provide free and low-cost services such as Medicaid counseling, information on local supports for seniors, transportation and financial assistance. Seniors can connect with their local AAA by calling the AAA info line at (808) 586-4400.

Kauai Agency on Elderly AffairsPiʻikoi Building4444 Rice Street, Suite 330Lihue, Kauai, Hawaii, 96766(808) 241-4470
Honolulu Elderly Affairs Division925 Dillingham, Suite 200Honolulu, Hawaii 96817(808) 768-7705
Maui County Office on Aging95 Mahalani Street, Room 20Wailuku, HI 96793(808) 270-7774
Hawaii County Office of Aging1055 Kinoole StreetHilo, HI 96720(808) 961-8626

Veterans Affairs Offices in Hawaii

Veterans, dependents and survivors can learn about local, state and federal benefits and services for vets and their families by contacting the State of Hawaii’s Office of Veterans’ Services. The Office provides free advocacy and assistance with VA benefits claims, including the Aid and Attendance benefit and the Housebound allowance. Vets and their families can also contact the Office to obtain free certified copies of vital statistics forms, service records and burial assistance.

Social Security Offices in Hawaii

Social Security can provide low-income seniors with monthly cash benefits, which they can use toward their senior living costs. Seniors in Hawaii can contact one of the three Social Security Administration offices, located in Honolulu, Kapolei and Lihue, or phone the SSA at 1-800-772-1213.

Hilo Social Security Office 96720111 E Puainako StHilo, HI 96720(800) 772-1213
Honolulu Social Security Office 96850300 Ala Moana BlvdHonolulu, HI 96850(800) 772-1213
Kapolei Social Security Office 96707970 Manawai StreetKapolei, HI 96707(800) 772-1213
Lihue Social Security Office 967664334 Rice StreetLihue, HI 96766(800) 772-1213
Wailuku Social Security Office 967932200 Main StreetWailuku, HI 96793(800) 772-1213

Frequently Asked Questions

How much does assisted living cost in Hawaii?

The statewide median cost of assisted living in Hawaii is $4,375. Actual costs may be higher or lower than the state median, depending on the location, services and amenities offered.

Are there financial assistance programs for assisted living in Hawaii?

Yes. Seniors in Hawaii who meet the financial criteria for Medicaid enrollment and who need assisted living services may be eligible for Med-QUEST, Hawaii’s Medicaid managed care program. Vets, dependents and survivors may also qualify for one of two VA pension top-up programs, Aid and Attendance, and Housebound.

What are “Activities of Daily Living”?

Activities of Daily Living are fundamental daily self-care tasks. These tasks generally include eating, bathing, getting dressed, grooming, taking prescription medications, keeping up with basic housekeeping and moving around. As people age, they may experience physical and cognitive deterioration that makes performing ADLs independently difficult.

What types of amenities are commonly in Assisted Living Communities?

In addition to providing seniors with room and board, 24-hour on-site staff and nonmedical support, assisted living communities often offer a variety of amenities. Communal dining rooms, living rooms and access to outdoor space such as a patio, gardens or terrace is common, and many facilities also have exercise rooms, guest suites and private dining rooms that can be reserved for family celebrations. Some large assisted living communities also feature swimming pools, off-leash dog areas, resident gardens, games rooms and movie theaters.

What is the difference between assisted living and independent living?

Independent living is a type of senior care geared toward those who don’t require help with activities of daily living, and who want to live a carefree lifestyle. Independent living communities usually provide housekeeping, laundry and recreational amenities, and some communities offer meal programs.

By comparison, assisted living is suitable for seniors who need daily assistance with tasks such as getting dressed, grooming and transferring, but who don’t need the level of medical care offered in a nursing home. While independent living is the least restrictive type of senior care, assisted living is generally seen as the level of care between independent living and nursing home care.

The Top Cities for Senior Living in Hawaii

Learn more about the cost of senior living in the top Hawaii cities. Additionally, find reviews and information about assisted living facilities and other senior living communities across the state.

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