PEARL CITY NURSING HOME
NPI 1124063003
Nursing Facility/Intermediate Care Facility in Pearl City, HI

Q: What is PC Care Corp's NPI number?

The NPI number for PC Care Corp is 1124063003. It was assigned to this organization in the NPPES registry on June 17, 2006. The provider is doing business as Pearl City Nursing Home.

Q: What is PC Care Corp's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

Q: What quality rating does PC Care Corp have?

CMS rates Pearl City Nursing Home 3 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

Q: When was this NPI record last updated?

The NPPES record for PC Care Corp was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 17, 2006CLIA 12D0914311 · Waiver

3/5

Overall Rating

919 LEHUA AVE, PEARL CITY, HI 96782(808) 453-1919(808) 453-1929 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Pearl City Nursing Home NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEARL CITY NURSING HOME (NPI 1124063003) is a healthcare organization registered as a nursing facility/intermediate care facility in Pearl City, Hawaii and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through April 24, 2028 and lists Cynthia L. C. Yoshida, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1124063003

Entity TypeOrganization

Primary Taxonomy313M00000X

Legal Business NamePC CARE CORP

Location Address919 LEHUA AVEPearl City, HI 96782-3328

Mailing Address919 Lehua AvePearl City, HI 96782-3328 · (808) 453-1919 · Fax (808) 453-1929

Phone(808) 453-1919

Fax(808) 453-1929

Organization SubpartYesParent: Ito Family Holdings Corp

Authorized OfficialCynthia L. C. YoshidaChief Financial Officer · (808) 453-1919

Enumeration DateJune 17, 2006

Last NPPES UpdateJuly 21, 2022

✔ NPI 1124063003 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities

Taxonomy Code313M00000X

License✔ Licensed in HI · 49-N

Definition

An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.

919 LEHUA AVE, Pearl City, HI 96782

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Other Names 1

Doing Business AsPearl City Nursing Home

Other Identifiers 2

Other20453-7HI · Hmsa/hmsa 65c Provider #

Medicaid076801-01HI

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 12D0914311

Pearl City Nursing Home · Pearl City, HI

Active · expires Apr 24, 2028

CLIA Number12D0914311

Laboratory TypeSkilled Nursing Facility/Nursing Facility

Certificate Effective DateApril 25, 2026

Certificate Expiration DateApril 24, 2028

Laboratory DirectorMarvin Espiritu

Laboratory Phone(808) 687-3200

Laboratory LocationPearl City Nursing Home919 Lehua Ave, Pearl City, HI 96782

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Pearl City Nursing Home (CMS certification number 125043), from CMS Care Compare.

Pearl City Nursing Home

Nursing home · Pearl City, HI

3/5 CMS Overall Rating

OwnershipFor profit - Corporation

CMS Certification Number125043

Certified Beds122 beds113 residents per day on average

Medicare & Medicaid Participant SinceNovember 17, 1995

Resident & Family CouncilResident council

Automatic sprinkler system

CMS Star Ratings

Quality Measures

Based on a select set of clinical quality measures.

4/5

Long-Stay Quality

Quality of care delivered to long-term residents.

3/5

Short-Stay Quality

Quality of care delivered to short-term and rehabilitation residents.

5/5

Staffing

Based on nursing staff hours relative to resident needs.

4/5

Weighted Health Inspection Score

Lower scores are better; the score summarizes deficiencies found on recent inspections.

Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing

nurse aide 3.09 · LPN 0.66 · RN 1.92

5.68 hrs per resident per day

Weekend Nurse Staffing

4.79 hrs per resident per day

Physical Therapist Staffing

0.14 hrs per resident per day

Nursing Staff Turnover

Share of nursing staff who left the facility within the past year.

38.9%

Registered Nurse Turnover

43.8%

Administrators Who Have Left

In the past year.

Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents

Substantiated Complaints

Fines

1 totaling $57,226.00

Medicare Payment Denials

Total Penalties

Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOHN CORNELIUS DONKERVOET PH.D.

Psychologist (Clinical)