Avalon Care Center: Range of Motion Failures - HI
That finding came out of a complaint inspection completed May 22, 2026, at Avalon Care Center at 1930 Kamehameha IV Road in Honolulu. The facility's own Director of Nursing confirmed it.
Range-of-motion therapy, often abbreviated AROM for active range of motion, is among the most basic interventions a nursing home can provide. For residents whose muscles and joints are at risk of stiffening or weakening, consistent movement is what stands between a person who can lift a fork or turn in bed and one who cannot. Six sessions a week is not an incidental recommendation. It is a structured clinical commitment.
The resident identified in the inspection report, referred to only as R1, refused the therapy. That happens. Residents have the right to refuse care. But a refusal is not the end of the clinical story. It is the beginning of a conversation that nursing homes are supposed to have, document, and build a plan around. Did staff explain the consequences? Did they try again at a different time of day? Did they involve a family member or a physician? Did anyone write any of it down?
None of that happened here. The Director of Nursing, interviewed by inspectors at 1:00 in the afternoon on the day of the survey, did not dispute the finding. She confirmed that the exercises should have been carried out. She confirmed that R1's refusals should have been addressed. She confirmed that those refusals should have been documented and built into a care plan.
That acknowledgment is notable. It means this was not a case where the facility pushed back, claimed the therapy had been delivered, or argued the documentation was somewhere else. The Director of Nursing sat across from inspectors and agreed that the facility had not done what it was supposed to do.
The inspection classified the harm level as minimal harm or potential for actual harm, and noted that few residents were affected. Those classifications matter for regulatory purposes, but they can obscure what is actually at stake for the person in the room. A resident who needed mobility therapy six times a week and did not receive it, and whose refusals were never addressed or documented, did not receive the care that was prescribed for them. Whether that resulted in measurable physical decline during the inspection window is a separate question from whether the failure was real.
Avalon Care Center operates under a facility identification number of 125020. The inspection was a complaint survey, meaning someone, whether a resident, a family member, or a staff member, contacted regulators with a concern before inspectors arrived. Complaint surveys are targeted. They go where there is already a reason to look.
The inspection report covers only this deficiency in the available narrative. What it shows is a facility where a prescribed therapy was not delivered consistently, where a resident's repeated refusals generated no documented response, and where the person responsible for nursing oversight confirmed all of it when asked.
R1 needed to move. Six times a week, someone was supposed to help make that happen, and when R1 said no, someone was supposed to figure out why, write it down, and try again. The record shows none of that occurred.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Avalon Care Center - Honolulu, LLC from 2026-05-22 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: This article is based on inspection data downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases inspection reports in bulk; we publish the findings as documented by state surveyors in the official Form CMS-2567 Statement of Deficiencies.
Plan of correction: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to state survey agencies and those responses may not be reflected in CMS data at the time of publication. The absence of a plan of correction in our data does not mean one was not filed. Readers who want information about corrective steps taken are encouraged to contact the facility directly or their state survey agency.
Corrections may have occurred: Inspection reports reflect conditions observed on the date of the survey. Facilities may have implemented corrections, staffing changes, additional training, or other remediation since the report was issued. We report what CMS provides and encourage readers to seek current information from the facility.
Editorial process: Inspection findings are extracted from CMS source documents and synthesized using AI, reviewed for factual accuracy against the original report by our editorial team.
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Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: October 31, 2026 · Our methodology
AVALON CARE CENTER - HONOLULU, LLC in HONOLULU, HI was cited for violations during a health inspection on May 22, 2026.
That finding came out of a complaint inspection completed May 22, 2026, at Avalon Care Center at 1930 Kamehameha IV Road in Honolulu.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.