Skilled nursing facility · CMS certification number 125064

THE CHING VILLAS

HONOLULU, Hawaii · Medicare and Medicaid

Certified beds, as filed in Care Compare: 163

Finances, as filed

From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.

Cost report for 1 January 2024 to 31 December 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 29 August 2025.

Revenue and expenses, fiscal year 2024
Figure	As filed	Where it comes from
Total patient revenue	$55,005,436	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$19,834,145	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$35,171,291	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$34,244,873	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$926,418	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$49,115	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$975,533	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $975,533 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2024
Figure	As filed	Where it comes from
Total facility beds, all components	163	CMS-2540-10 worksheet S300001 line 800 column 100
Bed days available, all components	59,658	CMS-2540-10 worksheet S300001 line 800 column 200
Medicare (Title XVIII) patient days	17,713	CMS-2540-10 worksheet S300001 line 800 column 400
Medicaid (Title XIX) patient days	376	CMS-2540-10 worksheet S300001 line 800 column 500
Other-payer patient days	25,042	CMS-2540-10 worksheet S300001 line 800 column 600
Total patient days, all components	43,131	CMS-2540-10 worksheet S300001 line 800 column 700
Medicare discharges	623	CMS-2540-10 worksheet S300001 line 800 column 900
Medicaid discharges	7	CMS-2540-10 worksheet S300001 line 800 column 1000
Other-payer discharges	825	CMS-2540-10 worksheet S300001 line 800 column 1100
Total discharges, all components	1,455	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	28.43	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	53.71	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	29.64	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1436535, read from the public cost report file SNF10FY2024.zip.

Fiscal year 2023, ended 31 December 2023

Cost report for 1 January 2023 to 31 December 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 23 August 2024.

Revenue and expenses, fiscal year 2023
Figure	As filed	Where it comes from
Total patient revenue	$41,655,801	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$16,469,733	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$25,186,068	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$26,379,670	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$1,193,602	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$135,015	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$1,058,587	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$1,058,587 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2023
Figure	As filed	Where it comes from
Total facility beds, all components	163	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	32,119	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	1,229	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	25.39	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	96.14	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	26.13	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1392976, read from the public cost report file SNF10FY2023.zip.

Fiscal year 2022, ended 31 December 2022

Cost report for 1 January 2022 to 31 December 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 29 August 2023.

Revenue and expenses, fiscal year 2022
Figure	As filed	Where it comes from
Total patient revenue	$34,321,002	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$14,759,720	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$19,561,282	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$21,359,056	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$1,797,774	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$20,399	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$1,777,375	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$1,777,375 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2022
Figure	As filed	Where it comes from
Total facility beds, all components	163	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	25,989	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	977	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	24.2	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	53.22	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	26.6	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1363396, read from the public cost report file SNF10FY2022.zip.

Fiscal year 2021, ended 31 December 2021

Cost report for 1 January 2021 to 31 December 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 20 September 2022.

Revenue and expenses, fiscal year 2021
Figure	As filed	Where it comes from
Total patient revenue	$39,742,253	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$18,658,392	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$21,083,861	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$21,483,276	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$399,415	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$117,012	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$282,403	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$282,403 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2021
Figure	As filed	Where it comes from
Total facility beds, all components	116	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	28,599	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	1,012	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	24.79	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	82.57	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	28.26	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1332964, read from the public cost report file SNF10FY2021.zip.

Fiscal year 2020, ended 31 December 2020

Cost report for 1 January 2020 to 31 December 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 3 December 2021.

Revenue and expenses, fiscal year 2020
Figure	As filed	Where it comes from
Total patient revenue	$52,304,300	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$29,074,030	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$23,230,270	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$22,478,769	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$751,501	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$1,269,200	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$2,020,701	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $2,020,701 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2020
Figure	As filed	Where it comes from
Total facility beds, all components	116	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	32,197	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	1,184	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	26.98	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	17.2	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	27.19	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1306141, read from the public cost report file SNF10FY2020.zip.

Fiscal year 2019, ended 31 December 2019

Cost report for 1 January 2019 to 31 December 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 30 October 2020.

Revenue and expenses, fiscal year 2019
Figure	As filed	Where it comes from
Total patient revenue	$55,842,989	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$31,858,206	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$23,984,783	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$22,074,806	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$1,909,977	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$10,469	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$1,920,446	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $1,920,446 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2019
Figure	As filed	Where it comes from
Total facility beds, all components	116	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	35,475	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	1,339	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	25.59	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	28.5	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	26.49	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1272852, read from the public cost report file SNF10FY2019.zip.

Fiscal year 2018, ended 31 December 2018

Cost report for 1 January 2018 to 31 December 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 31 March 2020.

Revenue and expenses, fiscal year 2018
Figure	As filed	Where it comes from
Total patient revenue	$55,069,035	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$31,974,289	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$23,094,746	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$20,861,184	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$2,233,562	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$108,695	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$2,342,257	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $2,342,257 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2018
Figure	As filed	Where it comes from
Total facility beds, all components	116	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	34,248	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	1,323	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	25.39	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	60.25	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	25.89	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1253420, read from the public cost report file SNF10FY2018.zip.

Fiscal year 2017, ended 31 December 2017

Cost report for 1 January 2017 to 31 December 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 17 April 2019.

Revenue and expenses, fiscal year 2017
Figure	As filed	Where it comes from
Total patient revenue	$48,249,159	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$27,084,610	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$21,164,549	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$19,677,015	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$1,487,534	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$47,747	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$1,535,281	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $1,535,281 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2017
Figure	As filed	Where it comes from
Total facility beds, all components	116	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	32,056	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	1,236	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	25.07	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	33.14	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	25.94	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1222542, read from the public cost report file SNF10FY2017.zip.

Fiscal year 2016, ended 31 December 2016

Cost report for 1 January 2016 to 31 December 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 15 August 2017.

Revenue and expenses, fiscal year 2016
Figure	As filed	Where it comes from
Total patient revenue	$35,285,718	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$20,355,502	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$14,930,216	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$15,581,432	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$651,216	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$1,155	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$650,061	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$650,061 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2016
Figure	As filed	Where it comes from
Total facility beds, all components	116	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	24,393	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	872	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	25.26	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	27.97	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1173264, read from the public cost report file SNF10FY2016.zip.

Fiscal year 2015, ended 31 December 2015

Cost report for 23 July 2015 to 31 December 2015 — a reporting period of 161 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 23 August 2016.

Revenue and expenses, fiscal year 2015
Figure	As filed	Where it comes from
Total patient revenue	$7,044,662	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$4,098,900	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$2,945,762	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$4,854,968	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$1,909,206	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$11	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$1,909,195	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$1,909,195 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2015
Figure	As filed	Where it comes from
Total facility beds, all components	116	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	5,283	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	163	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	27.35	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	32.41	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1142267, read from the public cost report file SNF10FY2015.zip.

Nurse staffing

Nurse staffing hours from the Payroll-Based Journal, quarter by quarter, are on this facility’s staffing page, each quarter with the file it came from.

The staffing record →

Ownership, as filed with CMS

Care Compare

As filed in the CMS file dated 1 August 2026 (Care Compare ownership).

Owner or manager	Role	Type	Ownership percentage	Association
FIRST HAWAIIAN BANK	5% OR GREATER MORTGAGE INTEREST	Organization	NOT APPLICABLE	since 12/27/2019
DAVIS, DUSTY	ADP OF THE SNF	Individual	NOT APPLICABLE	since 03/14/2022
HATA, RANDALL	ADP OF THE SNF	Individual	NOT APPLICABLE	since 12/15/2014
KISHABA, RICHARD	ADP OF THE SNF	Individual	NOT APPLICABLE	since 12/15/2014
KOP, ARNOLD	ADP OF THE SNF	Individual	NOT APPLICABLE	since 11/01/2023
LO, WESLEY	ADP OF THE SNF	Individual	NOT APPLICABLE	since 01/01/2020
LORE, ANDREW	ADP OF THE SNF	Individual	NOT APPLICABLE	since 02/01/2022
MCCLENNON, PAMELA	ADP OF THE SNF	Individual	NOT APPLICABLE	since 04/01/2025
MORIKUNI, SUANNE	ADP OF THE SNF	Individual	NOT APPLICABLE	since 01/01/2015
OHANA PACIFIC MANAGEMENT COMPANY INC	ADP OF THE SNF	Organization	NOT APPLICABLE	since 11/24/2025
ST. FRANCIS HEALTHCARE SYSTEM	ADP OF THE SNF	Organization	NOT APPLICABLE	since 04/09/2015
OHANA PACIFIC MANAGEMENT COMPANY INC	DIRECT OWNERSHIP INTEREST	Organization	NOT APPLICABLE	since 04/23/2014
KISHABA, RICHARD	INDIRECT OWNERSHIP INTEREST	Individual	NOT APPLICABLE	since 12/15/2014
RICHARD S. KISHABA 2010 DYNASTY TRUST	INDIRECT OWNERSHIP INTEREST	Organization	NOT APPLICABLE	since 07/30/2010
KISHABA, SANDRA	INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF	Individual	NOT APPLICABLE	since 12/01/2025
DAVIS, DUSTY	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 03/14/2022
HATA, RANDALL	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 12/15/2014
KISHABA, RICHARD	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 12/15/2014
KOP, ARNOLD	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 11/01/2023
LO, WESLEY	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 01/01/2020
LORE, ANDREW	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 02/01/2022
MCCLENNON, PAMELA	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 04/01/2025
MORIKUNI, SUANNE	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 01/01/2015
OHANA PACIFIC MANAGEMENT COMPANY INC	OPERATIONAL/MANAGERIAL CONTROL	Organization	NOT APPLICABLE	since 04/23/2014

Medicare enrollment

As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of LILIHA KUPUNA SNF LLC (enrollment ID O20150702002610).

Owner	Individual or organization	Role	Ownership percentage	Association date	Described in the filing as
OHANA PACIFIC MANAGEMENT COMPANY INC	Organization	5% OR GREATER DIRECT OWNERSHIP INTEREST	100	4/23/2014	Private equity company: No Real estate investment trust: No Holding company: Yes
RICHARD S KISHABA	Individual	5% OR GREATER INDIRECT OWNERSHIP INTEREST	10	12/15/2014	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
RICHARD S. KISHABA 2010 DYNASTY TRUST	Organization	5% OR GREATER INDIRECT OWNERSHIP INTEREST	90	7/30/2010	Private equity company: No Real estate investment trust: No Holding company: No
FIRST HAWAIIAN BANK	Organization	5% OR GREATER MORTGAGE INTEREST	100	12/27/2019	Private equity company: No Real estate investment trust: No Holding company: No
ANDREW LORE	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	2/1/2022	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
ARNOLD WH KOP	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	11/1/2023	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
DUSTY DAVIS	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	3/14/2022	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
OHANA PACIFIC MANAGEMENT COMPANY INC	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	11/24/2025	Private equity company: No Real estate investment trust: No Holding company: Yes
PAMELA MCCLENNON	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	4/1/2025	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
RANDALL I HATA	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	12/15/2014	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
RICHARD S KISHABA	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	12/15/2014	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
ST. FRANCIS HEALTHCARE SYSTEM	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	4/9/2015	Private equity company: No Real estate investment trust: No Holding company: No
SUANNE MORIKUNI	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	1/1/2015	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
WESLEY LO	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	1/1/2020	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
OHANA PACIFIC MANAGEMENT COMPANY INC	Organization	DIRECT OWNERSHIP INTEREST	100	4/23/2014	Private equity company: No Real estate investment trust: No Holding company: Yes
RICHARD S KISHABA	Individual	INDIRECT OWNERSHIP INTEREST	10	12/15/2014	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
RICHARD S. KISHABA 2010 DYNASTY TRUST	Organization	INDIRECT OWNERSHIP INTEREST	90	7/30/2010	Private equity company: No Real estate investment trust: No Holding company: No
ANDREW LORE	Individual	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	2/1/2022	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
ARNOLD WH KOP	Individual	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	11/1/2023	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
DUSTY DAVIS	Individual	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	3/14/2022	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
OHANA PACIFIC MANAGEMENT COMPANY INC	Organization	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	4/23/2014	Private equity company: No Real estate investment trust: No Holding company: Yes
PAMELA MCCLENNON	Individual	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	4/1/2025	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
RANDALL I HATA	Individual	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	12/15/2014	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
RICHARD S KISHABA	Individual	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	12/15/2014	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
SUANNE MORIKUNI	Individual	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	1/1/2015	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
WESLEY LO	Individual	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	1/1/2020	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.

Changes in ownership

1 May 2026: SUANNE MORIKUNI no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: STEPHEN BREWER no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: RICHARD S KISHABA no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: RICHARD S KISHABA no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: RANDALL I HATA no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: DUSTY DAVIS no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: FIRST HAWAIIAN BANK appears as 5% OR GREATER MORTGAGE INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: SUANNE MORIKUNI appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: SUANNE MORIKUNI appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: ARNOLD WH KOP appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: ARNOLD WH KOP appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: PAMELA MCCLENNON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: PAMELA MCCLENNON appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: ANDREW LORE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: ANDREW LORE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: WESLEY LO appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: WESLEY LO appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: RICHARD S KISHABA appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: RICHARD S KISHABA appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: RICHARD S KISHABA appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: RICHARD S KISHABA appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: RANDALL I HATA appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: RANDALL I HATA appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: OHANA PACIFIC MANAGEMENT COMPANY INC appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: OHANA PACIFIC MANAGEMENT COMPANY INC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: OHANA PACIFIC MANAGEMENT COMPANY INC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: ST. FRANCIS HEALTHCARE SYSTEM appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: RICHARD S. KISHABA 2010 DYNASTY TRUST appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: RICHARD S. KISHABA 2010 DYNASTY TRUST appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: DUSTY DAVIS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: DUSTY DAVIS appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 August 2023: SUANNE MORIKUNI no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
1 August 2023: PATRICIA SCHULER no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
1 August 2023: DUSTY DAVIS no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
1 August 2023: SUANNE MORIKUNI appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
1 August 2023: STEPHEN BREWER appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
1 August 2023: DUSTY DAVIS appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv

Recent changes on this record

1 May 2026: SUANNE MORIKUNI no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: STEPHEN BREWER no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: RICHARD S KISHABA no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: RICHARD S KISHABA no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: RANDALL I HATA no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: DUSTY DAVIS no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: FIRST HAWAIIAN BANK appears as 5% OR GREATER MORTGAGE INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: SUANNE MORIKUNI appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: SUANNE MORIKUNI appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: ARNOLD WH KOP appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: ARNOLD WH KOP appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: PAMELA MCCLENNON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: PAMELA MCCLENNON appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: ANDREW LORE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: ANDREW LORE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: WESLEY LO appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: WESLEY LO appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: RICHARD S KISHABA appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: RICHARD S KISHABA appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: RICHARD S KISHABA appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: RICHARD S KISHABA appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: RANDALL I HATA appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: RANDALL I HATA appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: OHANA PACIFIC MANAGEMENT COMPANY INC appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: OHANA PACIFIC MANAGEMENT COMPANY INC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: OHANA PACIFIC MANAGEMENT COMPANY INC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: ST. FRANCIS HEALTHCARE SYSTEM appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: RICHARD S. KISHABA 2010 DYNASTY TRUST appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: RICHARD S. KISHABA 2010 DYNASTY TRUST appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: DUSTY DAVIS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
1 May 2026: DUSTY DAVIS appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
29 August 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
23 August 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
29 August 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
1 August 2023: SUANNE MORIKUNI no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
1 August 2023: PATRICIA SCHULER no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
1 August 2023: DUSTY DAVIS no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
1 August 2023: SUANNE MORIKUNI appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
1 August 2023: STEPHEN BREWER appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
1 August 2023: DUSTY DAVIS appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv

Inspections

Inspection cycle	Health inspection	Fire safety inspection	Health deficiencies	Fire safety deficiencies
1	16 January 2026	16 January 2026	13	0
2	13 December 2024	13 December 2024	15	1
3	22 December 2023	22 December 2023	12	3

From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.

Deficiencies cited

40 deficiencies on file, newest inspection first

Inspection date	Inspection type	Tag	Category	What was cited	Scope and severity	Complaint	Corrected	Correction date
16 January 2026	Health	F 0552	Resident Rights Deficiencies	Ensure that residents are fully informed and understand their health status, care and treatments.	D	No	Deficient, Provider has date of correction	20 February 2026
16 January 2026	Health	F 0656	Resident Assessment and Care Planning Deficiencies	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.	D	Yes	Deficient, Provider has date of correction	20 February 2026
16 January 2026	Health	F 0684	Quality of Life and Care Deficiencies	Provide appropriate treatment and care according to orders, resident’s preferences and goals.	D	No	Deficient, Provider has date of correction	20 February 2026
16 January 2026	Health	F 0689	Quality of Life and Care Deficiencies	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.	D	Yes	Deficient, Provider has date of correction	20 February 2026
16 January 2026	Health	F 0690	Quality of Life and Care Deficiencies	Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.	D	No	Deficient, Provider has date of correction	20 February 2026
16 January 2026	Health	F 0761	Pharmacy Service Deficiencies	Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.	D	No	Deficient, Provider has date of correction	20 February 2026
16 January 2026	Health	F 0812	Nutrition and Dietary Deficiencies	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	E	No	Deficient, Provider has date of correction	20 February 2026
16 January 2026	Health	F 0825	Quality of Life and Care Deficiencies	Provide or get specialized rehabilitative services as required for a resident.	E	No	Deficient, Provider has date of correction	20 February 2026
9 October 2025	Health	F 0580	Resident Rights Deficiencies	Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.	E	Yes	Deficient, Provider has date of correction	16 December 2025
9 October 2025	Health	F 0684	Quality of Life and Care Deficiencies	Provide appropriate treatment and care according to orders, resident’s preferences and goals.	D	Yes	Deficient, Provider has date of correction	16 December 2025
9 October 2025	Health	F 0755	Pharmacy Service Deficiencies	Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.	D	Yes	Deficient, Provider has date of correction	16 December 2025
9 October 2025	Health	F 0842	Resident Assessment and Care Planning Deficiencies	Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.	E	Yes	Deficient, Provider has date of correction	16 December 2025
9 October 2025	Health	F 0880	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	D	Yes	Deficient, Provider has date of correction	16 December 2025
13 December 2024	Health	F 0550	Resident Rights Deficiencies	Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.	D	No	Deficient, Provider has date of correction	23 January 2025
13 December 2024	Health	F 0561	Resident Rights Deficiencies	Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.	E	No	Deficient, Provider has date of correction	23 January 2025
13 December 2024	Health	F 0583	Resident Rights Deficiencies	Keep residents' personal and medical records private and confidential.	D	No	Deficient, Provider has date of correction	23 January 2025
13 December 2024	Health	F 0622	Resident Rights Deficiencies	Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.	D	No	Deficient, Provider has date of correction	23 January 2025
13 December 2024	Health	F 0656	Resident Assessment and Care Planning Deficiencies	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.	D	No	Deficient, Provider has date of correction	23 January 2025
13 December 2024	Health	F 0657	Resident Assessment and Care Planning Deficiencies	Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.	D	No	Deficient, Provider has date of correction	23 January 2025
13 December 2024	Health	F 0684	Quality of Life and Care Deficiencies	Provide appropriate treatment and care according to orders, resident’s preferences and goals.	D	No	Deficient, Provider has date of correction	24 January 2025
13 December 2024	Health	F 0693	Quality of Life and Care Deficiencies	Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.	D	No	Deficient, Provider has date of correction	23 January 2025
13 December 2024	Health	F 0695	Quality of Life and Care Deficiencies	Provide safe and appropriate respiratory care for a resident when needed.	D	No	Deficient, Provider has date of correction	23 January 2025
13 December 2024	Health	F 0697	Quality of Life and Care Deficiencies	Provide safe, appropriate pain management for a resident who requires such services.	D	No	Deficient, Provider has date of correction	23 January 2025
13 December 2024	Health	F 0698	Quality of Life and Care Deficiencies	Provide safe, appropriate dialysis care/services for a resident who requires such services.	D	No	Deficient, Provider has date of correction	23 January 2025
13 December 2024	Health	F 0755	Pharmacy Service Deficiencies	Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.	D	No	Deficient, Provider has date of correction	23 January 2025
13 December 2024	Health	F 0761	Pharmacy Service Deficiencies	Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.	D	No	Deficient, Provider has date of correction	23 January 2025
13 December 2024	Health	F 0812	Nutrition and Dietary Deficiencies	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	E	No	Deficient, Provider has date of correction	23 January 2025
13 December 2024	Health	F 0880	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	D	No	Deficient, Provider has date of correction	23 January 2025
23 May 2024	Health	F 0684	Quality of Life and Care Deficiencies	Provide appropriate treatment and care according to orders, resident’s preferences and goals.	D	Yes	Deficient, Provider has date of correction	7 June 2024
22 December 2023	Health	F 0550	Resident Rights Deficiencies	Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.	D	No	Deficient, Provider has date of correction	31 January 2024
22 December 2023	Health	F 0641	Resident Assessment and Care Planning Deficiencies	Ensure each resident receives an accurate assessment.	D	No	Deficient, Provider has date of correction	31 January 2024
22 December 2023	Health	F 0657	Resident Assessment and Care Planning Deficiencies	Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.	D	No	Deficient, Provider has date of correction	31 January 2024
22 December 2023	Health	F 0689	Quality of Life and Care Deficiencies	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.	D	Yes	Deficient, Provider has date of correction	31 January 2024
22 December 2023	Health	F 0755	Pharmacy Service Deficiencies	Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.	D	No	Deficient, Provider has date of correction	31 January 2024
22 December 2023	Health	F 0760	Pharmacy Service Deficiencies	Ensure that residents are free from significant medication errors.	D	No	Deficient, Provider has date of correction	31 January 2024
22 December 2023	Health	F 0761	Pharmacy Service Deficiencies	Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.	D	No	Deficient, Provider has date of correction	31 January 2024
22 December 2023	Health	F 0803	Nutrition and Dietary Deficiencies	Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.	D	No	Deficient, Provider has date of correction	31 January 2024
22 December 2023	Health	F 0880	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	D	No	Deficient, Provider has date of correction	31 January 2024
22 December 2023	Health	F 0883	Infection Control Deficiencies	Develop and implement policies and procedures for flu and pneumonia vaccinations.	D	No	Deficient, Provider has date of correction	31 January 2024
22 December 2023	Health	F 0921	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.	D	No	Deficient, Provider has date of correction	31 January 2024

From the Care Compare health citations file NH_HealthCitations_Aug2026.csv, processed on 1 August 2026.

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Care Compare provider information

Field	As filed
Provider Type	Medicare and Medicaid
Ownership Type	For profit - Limited Liability company
Legal Business Name	LILIHA KUPUNA SNF LLC
Date First Approved to Provide Medicare and Medicaid Services	2015-07-23
Provider Resides in Hospital	N
Continuing Care Retirement Community	N
Urban	Y
County/Parish	Honolulu
Telephone Number	8085476000
Chain Name	OHANA PACIFIC MANAGEMENT CO.
Chain ID	382
Provider Changed Ownership in Last 12 Months	N
With a Resident and Family Council	Resident
Automatic Sprinkler Systems in All Required Areas	Yes
Number of Certified Beds	163
Average Number of Residents per Day	144.5
Overall Rating	4
Health Inspection Rating	3
QM Rating	4
Long-Stay QM Rating	5
Short-Stay QM Rating	4
Processing Date	2026-08-01

From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on 1 August 2026.

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