Selling a skilled nursing facility in Hawaii

Hawaii at a glance

Hawaii has 43 Medicare- and Medicaid-certified skilled nursing facilities with 4,248 certified beds, and on average 80.9% of those beds are occupied, above the national average of 80.3%.

Source: CMS Provider Information file, August 2026. The full Hawaii picture, rates and every building are on SNFRadar, the market record we built and publish free.

What a buyer reads first in Hawaii

The numbers a buyer pulls before the first call, for the typical Hawaii building against the nation. Your own building's are on its SNFRadar page.

Sources: CMS Provider Information file, August 2026 (occupancy, staffing, turnover, star ratings: averages across certified buildings); Medicare cost reports (full-year filings), as SNFRadar compares them (medians, the same figures each building's SNFRadar page is compared against).

What moves value in Hawaii

Occupancy. 80.9% of Hawaii's certified beds are occupied, in line with the national 80.3%, so a building's own census against its county's is what separates it.

Payer mix and the Medicaid rate. Medicaid pays for 65% of resident days in the median Hawaii building, close to the national 66%. Small shifts between Medicaid and Medicare census move value, which is why buyers ask for census by payer, month by month. Hawaii's Medicaid rate files are on SNFRadar.

Revenue and margin. Net patient revenue runs $591 per patient day in the median Hawaii filing, above the national $373, and the median net margin is 12.3% against 3.6%. Buyers here can price on the cash flow a building already earns.

Staffing. Hawaii's buildings average 4.97 nurse staffing hours per resident per day, more than the national 3.86, and nurse turnover runs 36.4% a year against 45.8%. A stable staff is easier to show here, and buyers notice a building that is the exception.

Inspection record. 56% of Hawaii buildings are rated four or five stars by Medicare and 29% one or two, against 40% and 41% nationally. With strong ratings common here, a weak one stands out, and buyers will ask for the plan of correction before they price.

Size and ownership type. The average Hawaii building has 99 certified beds, against 107 nationally. 60% are for-profit, 21% non-profit and 19% government, and 49% are part of a chain.

Where the beds are

Hawaii's largest counties by certified beds. Each opens that county's buildings on SNFRadar.

How a sale works

1. A first call. What you want from the sale, and when. No listing, no blast.
2. A value from the record. Your building's own numbers and the trades around it. How valuation works
3. Vetted buyers under confidentiality, bidding against each other, not against you.
4. Letter of intent, then the purchase agreement and the operations transfer agreement. The full process
5. Change of ownership. Hawaii's licensure filings plus Medicare and Medicaid, timed so billing does not stop. CHOW and Medicaid

Our recent closings

All five closings, with the press coverage they drew.

Questions owners ask