Hawaii Department of Health issues $828K fine for unlicensed care home

The state Department of Health has fined Island Promise Homes LLC $828,000 for allegedly operating an adult residential care home without a license, part of a larger effort in recent years to reign in an industry that has skirted health and safety regulations.

State inspectors conducted two unannounced inspections of the home at 94-947 Lumihoahu St. in Waipahu following a complaint. During both investigations, in December 2018 and July 2020, inspectors confirmed that unrelated residents were receiving care at the home, according to a Health Department news release.

Island Promise Homes LLC is owned by Anita Felipe, a registered nurse who operates three licensed adult residential care homes in Honolulu.

Felipe admitted that she was providing care for individuals in the unlicensed facility, according to the Health Department, and records show that four residents who were living in the Waipahu home at the time of the second inspection were transferred to one of Felipe’s licensed care homes later that month. There are currently no other residents at the unlicensed home, according to health officials.

An adult residential care home is defined as any facility that provides full-time accommodations for a fee to unrelated adults, typically seniors, who require assistance with daily living, including health care services. The facilities provide a lower level of care than an intermediate, skilled nursing or acute care facility. Under state law they must be licensed.

Felipe has been fined $1,000 for every day the facility was in operation from April 24, 2018, to July 29, 2020, which amounts to 828 days.

Felipe, who didn’t respond to a request for comment, has 20 days to contest the order and seek a hearing; otherwise, it will become final.

State health officials began cracking down on the senior care homes, often referred to as ARCHs, after state legislators passed Act 148 in 2018, which authorized the Health Department to investigate and enter unlicensed care facilities. Under the law, health care providers who knowingly refer clients to unlicensed homes can also be fined.

At the time, it was estimated that as many as 100 to 200 unlicensed care homes were operating throughout the state under what was being called an “aging in place model.” Operators of the unlicensed homes had been able to circumvent health and safety regulations and annual Health Department inspections, while their clients lacked the consumer protections afforded in licensed homes.

During a legislative hearing in November 2019, licensed care home operators, case managers and long-term care navigators told lawmakers that unlicensed care homes continued to operate despite the passage of Act 148 and that sometimes seniors and their families were unaware that a home wasn’t licensed. Some described a scheme in which an operator with a license would funnel clients to unlicensed homes.

Health officials have fined at least seven adult residential care homes over the past two years and ordered them to stop operating.

There are more than 460 licensed homes operating throughout the state.