State plate · HI
Assisted living in Hawaii
Hawaii licenses assisted living through DOH, Office of Health Care Assurance, under the license types Assisted Living Facility; Adult Residential Care Home Type I/II; Expanded ARCH. Hawaii does not publish a downloadable list with capacity. CDC's 2020 survey estimated 220 residential care communities with 4,700 beds. HUD's active-loan file shows 4 FHA-insured assisted living loans in Hawaii with $68.6 million outstanding as of September 30, 2026.
Licensing
- Licensing agency
- DOH, Office of Health Care Assurance
- License types
- Assisted Living Facility; Adult Residential Care Home Type I/II; Expanded ARCH
- Official program page
- health.hawaii.gov
- Facility list
- ArcGIS (Sept 2026)
Licensing details checked against each agency's site on 2026-10-24. HUD requires a Section 232 assisted living project to be licensed or regulated by the state and have at least 20 beds.
CDC survey profile (2020)
The National Post-acute and Long-term Care Study, run by CDC's National Center for Health Statistics, estimates residential care communities with four or more beds. 2020 is its latest wave with state figures, so these numbers differ from the state's own list.
| Measure | Hawaii | US |
|---|---|---|
| Communities | 220 | 30,600 |
| Beds | 4,700 | 1,197,600 |
| Average beds per community | 21 | 39 |
| For-profit | n/a% | 81.9% |
| Chain affiliated | 46.5% | 61.4% |
| Medicaid certified | 47.1% | 43.6% |
| Dementia-only communities | 12.3% | 10.5% |
| Dementia-only or with a dementia unit | n/a | 20.5% |
| Residents 85 and older | 52.7% | 49.9% |
| Residents with Alzheimer disease or other dementias | 38.4% | 42.1% |
Source: CDC/NCHS, Biennial Overview of Post-acute and Long-term Care (data.cdc.gov). Percentages are of communities, except the resident rows.
HUD Section 232 assisted living loans
- Active FHA loans
- 4
- Outstanding
- $68.6 million
- Median note rate
- 2.67%
- Endorsed since FY2001
- 11
Since fiscal 2001 HUD has endorsed 11 FHA-insured assisted living loans in Hawaii for $222.4 million of original principal, 7 of them for new construction or substantial rehabilitation, and 2 since fiscal 2021. 1 of today's active loans carry a note rate of 5% or more. The active file also lists 1 board and care loans in the state.
| Property (HUD name) | City | Units | Endorsed | Rate | Balance | Matures |
|---|---|---|---|---|---|---|
| Plaza at Pearl CityFHA 14043027 | Pearl City | 158 | Jun 2015 | 2.78% | $32,606,766 | Jul 2055 |
| Regency at PuakeaFHA 14022018 | Lihue | 164 | May 2025 | 5.72% | $18,291,358 | Jun 2060 |
| Regency at HualalaiFHA 14022013 | Kailua Kona | 123 | Aug 2021 | 2.52% | $15,008,012 | Sep 2056 |
| Hale Ku'ikeFHA 14022006 | Honolulu | 26 | Apr 2010 | 2.57% | $2,693,694 | May 2045 |
Active loans: HUD FHA insured mortgages, active, as of September 30, 2026. Endorsements: HUD Office of Healthcare Programs database, data run July 8, 2026. Facility type comes from HUD's endorsement records.
Own or are buying an assisted living or memory care building in Hawaii? See what HUD, Fannie Mae and Freddie Mac would lend against your NOI.
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ALF Atlas is operated by Janover Capital LLC and is not affiliated with HUD, FHA, CDC or any state agency. Methodology.