Types of Facilities


All nursing facilities provide personal care and residential services including room and meals, planned activities and a program to meet social and spiritual needs. Nursing facilities meet high standards set by federal and state regulations. They are are surveyed by specially designated state agencies on a yearly basis to confirm that these standards are being maintained.

In Hawaii’s facilities the level of care required by patients is often even higher than in comparable mainland facilities. This high “acuity” of Hawaii’s nursing facility patients has been noted by health care professionals for many years and is due, in part, to the shortage of long term care beds in Hawaii. This shortage has, over the years, resulted in sicker patients being admitted to those beds which are available. In addition, Hawaii has a long tradition of health care being delivered in outpatient and home settings. This applies to long term care, as well as physician and hospital services.

Following are the three major types of nursing facilities. Those designated at SNF and ICF may be licensed to participate in government health programs: Medicare and Medicaid. Those facilities designated as care homes receive state and private funding only.

Skilled Nursing Facilities (SNF): provide continuous 24-hour nursing care for convalescent and/or critically or chronically ill residents. RNs, LPNs and Certified Nurse Aides provide care and services prescribed by physicians with emphasis on medical nursing care. Physical, occupational and other therapies are offered as prescribed by the patient’s physician.

Intermediate Care Facilities (ICF): provide less intensive nursing care than that which is typically found in an SNF; however, many ICF patients may require higher levels of care to assist them with the activities of daily living. ICF services include 24-hour nursing care along with rehabilitative and social services and physical, occupational and other therapies as prescribed by the patient’s physician.

Care Homes (ARCH)
: adult residential care homes provide for the social and daily needs of individuals rather than medical needs. Residents are usually people who are functionally semi-independent, but need assistance in the activities of daily living. Dietary and housekeeping, social and recreational programs and medical monitoring are the primary functions of these facilities. ARCHs are designated as Type I or Type II. Type I care homes are limited to 5 or fewer residents in a family home. Type II care homes are institutional settings and may care for as many as 50 to 60 residents.