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Health Inspection

Avalon Care Center - Honolulu, Llc

June 4, 2026 · Honolulu, HI · 1930 Kamehameha Iv Rd
Citations 3
CMS Rating 2/5
Beds 108
Provider ID 125020
Healthcare Facility
Avalon Care Center - Honolulu, Llc
Honolulu, HI  ·  View full profile →
Source Document
Official CMS Inspection Report (Medicare.gov)
Downloaded from CMS/Medicare.gov. Reflects what state inspectors documented and does not include the facility's plan of correction, which is submitted separately. Facilities may have taken corrective actions since this report was released.
Inspection Summary

AVALON CARE CENTER - HONOLULU, LLC in HONOLULU, HI — inspection on June 4, 2026.

Found 3 citations. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

Inspection Findings

FF0550
Resident Rights Deficiencies

Review of facility policy titled Resident Rights, Respect and Dignity with a revision date of 09/20/22 stated, .1.

The resident has a right to be treated with respect and dignity.

Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided.

For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.

LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER TITLE (X6) DATE REPRESENTATIVE'S SIGNATURE

125020 06/04/2026

Avalon Care Center - Honolulu, LLC 1930 Kamehameha IV Rd Honolulu, HI 96819

catheter care, and appropriate care to prevent urinary tract infections.

catheter to prevent urinary tract infection for 1 of 2 residents (Resident (R) 144) sampled. As a result

06/03/26 at 08:29 AM, observed Resident (R) R144 seated in a wheelchair in the entrance of the resident's assigned room. R144's catheter bag was out of the privacy bag (approximately the bottom third of the catheter bag bag) and was resting directly on the floor, along with the tubing. R144 moved the wheelchair and ran over the exposed catheter bag.

Alerted Registered Nurse (RN) 15 of the situation. RN15 secured the catheter bag and tubing off the floor.

Inquired with RN15 if it was okay for the catheter bag and tubing to be in direct contact with the floor. RN15 confirmed appropriate treatment/care of the catheter bag and tubing was to ensure it was not in direct contact with the floor.

125020 06/04/2026

Avalon Care Center - Honolulu, LLC 1930 Kamehameha IV Rd Honolulu, HI 96819

checked.

This deficient practice could potentially put residents at risk of contamination that receive

station 1C medication cart was checked and a pill cutter, located in the top drawer of the medication cart, was observed to have large amounts of white/brown sediments in the interior portion of the cutter.

The Registered Nurse (RN) 6 administering medications from this cart was concurrently interviewed. RN6 confirmed seeing the white and brown sediments in the pill cutter and stated it was from not cleaning it. RN6 also stated that the cutter should be cleaned after each use.

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in HONOLULU, HI, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from AVALON CARE CENTER - HONOLULU, LLC or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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About This Inspection Report

Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.

Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.

Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.