Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record

Palolo Chinese Home

HONOLULU, HI · 113 certified beds · Last Life Safety survey May 1, 2025

CMS Certification Number 125059 · first certified June 2008

Ownership

Independently operated (no chain recorded by CMS) · For profit - Corporation

No change of ownership on CMS record since January 1, 2016, when the records begin.

8
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
1
Tags cited more than once
Across separate surveys
6
Inspection & testing records
Of the citations on file

Position within HI

8 citations — more than 81% of the 43 certified nursing homes in HI. Compared within HI rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated

Improvingfewer citations at the latest survey than at its earlier surveys in the window.

The latest survey found 0 citations; the earlier surveys in the window averaged 4. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

The window is open now: May 2026 to October 2026. This facility’s last Life Safety survey was May 2025. Nursing homes nationally are typically surveyed 12–17 months after the last one (median 14), measured over 19,385 consecutive surveys in the last two years of CMS records. HI has too few recent surveys to measure on its own, so the national interval is used.

A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to three years in Maryland. How the window is measured

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Which alerts

1 inspection-and-testing tag has been cited here at more than one survey. Nationally, that pattern is common: about three quarters of cited facilities have at least one repeated tag, and half of the facilities ever cited for sprinkler inspection and testing are cited for it again. A repeat is usually a recordkeeping gap rather than a new hazard.

Emergency preparedness

2 of the 8 citations on file are Emergency Preparedness E-tags. E-tags are cited under 42 CFR §483.73 and concern the emergency plan, training, drills, communications and supplies. Nationally about half of certified facilities have at least one. The Emergency Preparedness Index

Physical environment (health survey)

8 physical-environment citations on the health survey. Cited by the health surveyors under Appendix PP, not the Life Safety Code surveyor: equipment in safe operating condition, the call system, bed rails, pest control, hazards, the environment. Counted separately from the 8 Life Safety citations above. The Physical Environment Index

  • F-0584 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.
  • F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  • F-0880 Provide and implement an infection prevention and control program.
  • F-0908 Keep all essential equipment working safely.

How that compares

Citations on file over three years

Compared with the median facility in HI, and nationally. Surveyors differ markedly between states, so the HI figure is the meaningful one.

This facility8HI median4National median11
Citations on file over three years, compared
MeasureCitations
This facility8
Median facility in HI4
Median facility nationally11

Survey history

Citations at each Life Safety survey
52023-0332024-0302025-05
Citations at each Life Safety survey
Survey dateCitations
March 31, 20235
March 7, 20243
May 1, 20250

Most-cited tags

Most-cited tags at this facility
K-03452K-09181E-00351K-03531K-07121E-00011K-09231
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0345Have approved installation, maintenance and testing program for fire alarm systems.22024-03-07
K-0918Have generator or other power source capable of supplying service within 10 seconds.12023-03-31
E-0035Provide family notifications of emergency plan.12024-03-07
K-0353Inspect, test, and maintain automatic sprinkler systems.12023-03-31
K-0712Have simulated fire drills held at unexpected times.12024-03-07
E-0001Establish an Emergency Preparedness Program (EP).12023-03-31
K-0923Have proper medical gas storage and administration areas.12023-03-31

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 3
  • Emergency Preparedness Deficiencies 2
  • Gas, Vacuum, and Electrical Systems Deficiencies 2
  • Miscellaneous Deficiencies 1
Citations by CMS category
CategoryCitations
Smoke Deficiencies3
Emergency Preparedness Deficiencies2
Gas, Vacuum, and Electrical Systems Deficiencies2
Miscellaneous Deficiencies1

Every citation on file

As published by CMS, newest survey first. Descriptions are CMS’s own wording.

March 7, 2024 — 3 citations

Citations issued on March 7, 2024
TagWhat the surveyor checksStatus
E-0035Provide family notifications of emergency plan.Deficient, Provider has date of correction (April 3, 2024)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (April 3, 2024)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (April 3, 2024)

March 31, 2023 — 5 citations

Citations issued on March 31, 2023
TagWhat the surveyor checksStatus
E-0001Establish an Emergency Preparedness Program (EP).Deficient, Provider has date of correction (April 21, 2023)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (June 8, 2023)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (June 8, 2023)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (June 8, 2023)
K-0923Have proper medical gas storage and administration areas.Deficient, Provider has date of correction (June 8, 2023)

Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.