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.
Position within HI
8 citations — more than 71% 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
The latest survey found 0 citations; the earlier surveys on file averaged 4. With 3 surveys on file this is a direction of travel, not a conclusion.
When is the next survey likely?
Past the typical window (May 2026 to October 2026). Most US facilities have been surveyed by May 2027. This facility’s last Life Safety survey was May 2025. Nursing homes nationally are typically surveyed 13–17 months after the last one (median 14), measured over 19,744 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 about three years in Virginia. How the window is measured
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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 cited for sprinkler inspection and testing in CMS’s current file 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
Compared with the median facility in HI, and nationally. Surveyors differ markedly between states, so the HI figure is the meaningful one.
| Measure | Citations |
|---|---|
| This facility | 8 |
| Median facility in HI | 5 |
| Median facility nationally | 11 |
Survey history
| Survey date | Citations |
|---|---|
| March 31, 2023 | 5 |
| March 7, 2024 | 3 |
| May 1, 2025 | 0 |
Most-cited tags
| Tag | What the surveyor checks | Times cited | Last cited |
|---|---|---|---|
| K-0345 | Have approved installation, maintenance and testing program for fire alarm systems. | 2 | 2024-03-07 |
| K-0918 | Have generator or other power source capable of supplying service within 10 seconds. | 1 | 2023-03-31 |
| K-0353 | Inspect, test, and maintain automatic sprinkler systems. | 1 | 2023-03-31 |
| E-0035 | Provide family notifications of emergency plan. | 1 | 2024-03-07 |
| K-0712 | Have simulated fire drills held at unexpected times. | 1 | 2024-03-07 |
| E-0001 | Establish an Emergency Preparedness Program (EP). | 1 | 2023-03-31 |
| K-0923 | Have proper medical gas storage and administration areas. | 1 | 2023-03-31 |
What the citations cover
- Smoke Deficiencies 3
- Emergency Preparedness Deficiencies 2
- Gas, Vacuum, and Electrical Systems Deficiencies 2
- Miscellaneous Deficiencies 1
| Category | Citations |
|---|---|
| Smoke Deficiencies | 3 |
| Emergency Preparedness Deficiencies | 2 |
| Gas, Vacuum, and Electrical Systems Deficiencies | 2 |
| Miscellaneous Deficiencies | 1 |
Every citation on file
As published by CMS, newest survey first. Descriptions are CMS’s own wording.
March 7, 2024 — 3 citations
| Tag | What the surveyor checks | Status |
|---|---|---|
| E-0035 | Provide family notifications of emergency plan. | Deficient, Provider has date of correction (April 3, 2024) |
| K-0345 | Have approved installation, maintenance and testing program for fire alarm systems. | Deficient, Provider has date of correction (April 3, 2024) |
| K-0712 | Have simulated fire drills held at unexpected times. | Deficient, Provider has date of correction (April 3, 2024) |
March 31, 2023 — 5 citations
| Tag | What the surveyor checks | Status |
|---|---|---|
| E-0001 | Establish an Emergency Preparedness Program (EP). | Deficient, Provider has date of correction (April 21, 2023) |
| K-0345 | Have approved installation, maintenance and testing program for fire alarm systems. | Deficient, Provider has date of correction (June 8, 2023) |
| K-0353 | Inspect, test, and maintain automatic sprinkler systems. | Deficient, Provider has date of correction (June 8, 2023) |
| K-0918 | Have generator or other power source capable of supplying service within 10 seconds. | Deficient, Provider has date of correction (June 8, 2023) |
| K-0923 | Have proper medical gas storage and administration areas. | Deficient, Provider has date of correction (June 8, 2023) |
Reflects the CMS posting of October 1, 2026. Surveys conducted in the last few months may not appear yet.