If you're arranging dementia care in Hawaii, the honest starting point is this: the state does not issue a separate memory care license. Its assisted living rule sets no dementia-specific standard either, so the vetting the state doesn't do falls to you. This guide explains how Hawaii actually regulates dementia care, the questions to ask because no rule answers them, what it costs, and who pays.

In This Guide

How Hawaii Regulates Memory Care

When you start calling around, "memory care" gets used as if it were one licensed thing you could shop for and line up side by side. In Hawaii it isn't. The state never created a separate memory-care license, and the rule that governs assisted living doesn't fill that gap either. Knowing that before you tour a single place changes what you look for, because it tells you where the real protection has to come from: from your own questions, not from a state standard you can lean on.

Here's the structure. Assisted living facilities in Hawaii are licensed and inspected by the Hawaii Department of Health Office of Health Care Assurance under Hawaii Administrative Rules Title 11, Chapter 90, with authority from Hawaii Revised Statutes Chapter 321. An assisted living facility provides housing, meals, personal care, and health-related services in a residential setting. The state also licenses smaller community-based options: adult residential care homes (ARCHs) and community care foster family homes (CCFFHs), which serve fewer residents in a home-like setting.

Dementia care happens inside those licensed settings. Some assisted living facilities, ARCHs, and CCFFHs run a secured or specialized dementia program, and that program is where a person with Alzheimer's or another dementia actually lives. But the program isn't separately licensed, because the state has no separate memory-care license to grant.

This is the part families most need to hear plainly. HAR 11-90 does not set out separate requirements for dementia or memory-care units, for secured units, for dementia staff-training hours, or for a memory-care disclosure. Some states require a marketed special care unit to put its dementia approach in writing through a disclosure law. Hawaii has nothing like that. When a Hawaii facility tells you it offers "memory care," there is no state rule defining what that phrase has to mean, no minimum training a caregiver must complete, and no security standard the unit has to meet. The license confirms the facility can operate. It does not confirm the dementia program is what the brochure says it is.

It would be easy to read all that and feel like the floor just dropped out. It hasn't. Good dementia programs exist across Hawaii, and many facilities staff, train, and secure their units well beyond anything a rule would require. The point isn't that Hawaii care is unsafe. The point is that the state isn't doing the checking for you, so the questions a disclosure law would normally answer become questions you have to ask yourself.

Think of it as three things the state leaves to you, each one a fair question to bring on a visit.

What no Hawaii rule sets a standard for What to ask, and what to confirm in writing
Dementia staff training What does dementia-specific training cover, who on staff receives it, how many hours, and do new caregivers complete it before they work alone?
Staffing levels How many residents does one caregiver cover on the day shift, and on nights and weekends, when families aren't around to see?
Security and wandering How is the unit secured, how are exits managed, and what is the plan if a resident with dementia tries to leave or goes missing?
Screening and discharge What conditions would lead the facility to discharge or transfer a resident, so a later move doesn't blindside you?
Care as dementia progresses How often is the care plan reviewed, and what happens when needs outgrow what this setting is licensed to provide?

The staffing and security questions deserve the closest read, because they're the two a marketing tour glosses over most easily. Ask for specific numbers, not reassurance. A program that staffs its memory unit well can tell you its day and night ratios without hesitating. The screening and discharge question matters just as much: families are often caught off guard months in, when a facility decides it can no longer meet a resident's needs and the whole search starts over at the worst possible moment. Get the answers, then ask the facility to put them in writing. A program confident in how it cares for people with dementia won't mind committing its answers to paper.

What It Costs and Who Pays

Cost is usually what families brace for, and in Hawaii there's no softening it: this is among the most expensive states in the country for long-term care, and the CareScout 2025 Cost of Care Survey found it was the state where senior-care costs rose fastest, ranking in the top 10 across all four care settings. There's also no clean single number for memory care specifically, because Hawaii doesn't publish one, and because memory care here is delivered within a licensed facility rather than as a separately surveyed category, the industry surveys that track senior-care prices don't break it out the way they break out assisted living.

Use the assisted-living base as your anchor. Per the CareScout 2025 Cost of Care Survey, the most recent state-level data (released March 2026, from rates collected July through November 2025), assisted-living costs in Hawaii rose 36.9 percent between 2022 and 2025, against a national assisted-living median of about $74,400 a year (roughly $6,200 a month). The survey did not publish a verbatim Hawaii assisted-living dollar figure for 2025, so treat any precise statewide number with caution and confirm with a written quote. Memory care costs more than that base, here as everywhere, because dementia care means more staff time, dementia-specific training, and a setting built for safety. How much more depends on the facility, its size, and how much care your loved one needs.

For context on the upper end, the same survey put a private nursing-home room in Hawaii at about $196,735 a year in 2025, well above the national medians of roughly $114,975 for a semi-private room and $129,575 for a private room. Those are industry-survey medians, not government figures, and costs vary across the islands and rise as care needs grow. Use them to set expectations, then get a specific written quote from any place you're serious about. The advertised figure is almost always a base rate. Ask what it includes, how the facility charges as care needs grow, how it reassesses care as dementia progresses, and how often rates rise.

Paying for it is where families often get caught off guard. Assisted living in Hawaii is largely private-pay, and Medicaid does not pay the room-and-board portion. Hawaii's QUEST Integration program, the state's Medicaid managed-care system, can help cover the care services for residents who qualify, though not the rent and meals. Dementia care runs for years and the bill is steep, so it's worth checking eligibility and planning early rather than assuming the whole cost is yours alone to carry.

How to Vet a Hawaii Memory-Care Setting

You don't have to become an expert in dementia care to make a sound decision. Because the state isn't setting the bar, you set it, with your questions and with what you confirm in writing.

1
Step 1

Confirm the license with OHCA, not just the facility

Every assisted living facility, ARCH, and CCFFH has to hold a valid license to operate, issued by the Hawaii Department of Health Office of Health Care Assurance. Confirm it with the agency directly, and remember the license proves the setting can operate, not that its dementia program meets any particular standard.

2
Step 2

Pin down dementia training in specifics

No Hawaii rule sets a training requirement, so ask what the training covers, how many hours, who receives it, and whether new caregivers finish it before working alone. Specific answers are a good sign; vague reassurance isn't.

3
Step 3

Get the staffing ratios for every shift

Ask how many residents one caregiver covers during the day, and again at night and on weekends. The gap between those numbers often tells you more than the daytime tour ever will.

4
Step 4

Walk the security and ask the wandering plan

See how exits are managed and how the space is built to keep a resident who may wander safe, then ask exactly what the facility does if someone tries to leave or goes missing.

5
Step 5

Read the screening, discharge, and cost terms before you sign

Know what would force a move, get a written breakdown of the base rate and what memory care adds, and bring the contract home to read the refund and discharge terms without a salesperson in the room.

Tour at least a couple of places. The goal isn't a flawless one. It's a setting whose license you've verified with the state, whose staffing and training answers you've gotten in specifics, and whose promises you've put in writing, since the state won't do that for you.

Frequently Asked Questions

Is there a memory care license in Hawaii?

No. Hawaii doesn't issue a separate memory care license. Dementia care is delivered inside settings already licensed by the Hawaii Department of Health Office of Health Care Assurance, such as an assisted living facility, an adult residential care home, or a community care foster family home. The assisted living rule, HAR 11-90, sets no separate requirements for dementia units, secured units, training hours, or disclosure, so a "memory care" label carries no state-defined meaning.

Does Hawaii require dementia training for memory-care staff?

No. HAR 11-90 sets no dementia staff-training hours, and Hawaii has no separate rule that does. Many facilities train their dementia-care staff well anyway, but because the state doesn't require it, you have to ask each facility what its training covers, how many hours it runs, who gets it, and whether new staff finish it before working alone, then confirm the answer in writing.

How do I check that a Hawaii facility really offers memory care?

Confirm the facility's license with the Hawaii Department of Health Office of Health Care Assurance rather than relying on how the place markets itself. Then, because no state rule defines what its dementia program must include, ask directly about staffing ratios, security and wandering plans, and dementia training, and get those answers in writing before you commit.

How much does memory care cost in Hawaii?

There's no reliable single statewide figure for memory care alone, and CareScout's 2025 survey did not publish a verbatim Hawaii assisted-living dollar amount. Use the national assisted-living median as a floor for expectations, about $74,400 a year ($6,200 a month) in 2025, knowing Hawaii runs well above the national figures and its assisted-living costs rose 36.9% from 2022 to 2025, and expect memory care to run higher still because of the added staff time, dementia training, and secured setting it requires. The advertised rate is usually a base that rises as care needs grow, so get a written breakdown from any place you're considering.

Does Hawaii Medicaid pay for memory care?

Largely, assisted living in Hawaii is private-pay, and Medicaid does not pay the room-and-board portion. Hawaii's QUEST Integration program can help cover the care services for residents who qualify, but not the rent and meals. Because an assisted living facility may not provide skilled nursing care, a resident with heavier medical needs may eventually move to a nursing home, where Medicaid's nursing-facility coverage can apply for those who qualify. It's worth checking eligibility early rather than assuming the entire bill is private-pay.

Learn More

Care TypesMemory Care by StateMemory care is specialized assisted living for dementia. What it costs, who pays (Medicare doesn't), and how the rules change by state, with a guide to yours. Care TypesAssisted Living in HawaiiAssisted living in Hawaii is among the nation's costliest and rising fast. How OHCA licenses it, what care costs, and what Med-QUEST does and doesn't cover. Care TypesNursing Homes in HawaiiNursing homes in Hawaii in 2026: a private room runs about $196,735/year, among the highest in the nation. What it costs, who pays, and how to vet a facility. Care TypesHome Care vs. Home Health in HawaiiHome care vs. home health in Hawaii: home health is skilled, OHCA-licensed care Medicare covers; home care is non-medical help it won't. That decides who pays. Care TypesCost of Senior Care in HawaiiWhat senior care costs in Hawaii in 2026: a private nursing-home room reached about $196,735 a year, the highest in the U.S. See every setting and how to pay. Care TypesAssisted Living vs. Nursing Home in HawaiiAssisted living vs. a nursing home in Hawaii comes down to level of care and who pays. Med-QUEST covers nursing-home care, not assisted-living room and board. Care TypesAssisted Living vs. Memory Care in HawaiiAssisted living vs. memory care in Hawaii: cognition and safety drive the choice. Hawaii's care costs rank among the nation's highest; memory care costs more.
CaregiverCaregiver Burnout: Signs and SupportHow to recognize caregiver burnout, why it happens, and what actually helps, from respite care to evidence-based programs like REACH II and Powerful Tools. MedicaidMedicaid Planning StrategiesSee which assets you keep, how the 5-year look-back works, and the legal moves that qualify you for Medicaid long-term care without losing the house.

Find personalized help vetting a Hawaii dementia setting the state doesn't set a standard for at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.