HALE KUPUNA HERITAGE HOME, LLC
NPI 1992792733
Nursing Facility/Intermediate Care Facility in Koloa, HI

Q: What is Hale Kupuna Heritage Home, LLC's NPI number?

The NPI number for Hale Kupuna Heritage Home, LLC is 1992792733. It was assigned to this organization in the NPPES registry on October 5, 2005.

Q: What is Hale Kupuna Heritage Home, LLC's specialty?

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

Q: What quality rating does Hale Kupuna Heritage Home, LLC have?

CMS rates Hale Kupuna Heritage Home, LLC 5 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

Active since October 05, 2005CLIA 12D0697252 · Waiver

5/5

Overall Rating

4297C OMAO RD, KOLOA, HI 96756(808) 742-7591(808) 742-6563 Get Directions Write a Review

NPPES record last updated: October 3, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Hale Kupuna Heritage Home, Llc NPPES

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

HALE KUPUNA HERITAGE HOME, LLC (NPI 1992792733) is a healthcare organization registered as a nursing facility/intermediate care facility in Koloa, Hawaii and active in the NPI registry since October 2005. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Randall Hata, Cfo, as its authorized official.

NPPES Registry Identity

NPI1992792733

Entity TypeOrganization

Primary Taxonomy313M00000X

Legal Business NameHALE KUPUNA HERITAGE HOME, LLC

Location Address4297C OMAO RDKoloa, HI 96756-9624

Mailing Address45-181 Waikalua RdKaneohe, HI 96744-2765 · (808) 247-0003

Phone(808) 742-7591

Fax(808) 742-6563

Organization SubpartNo

Authorized OfficialRandall HataCfo · (808) 247-0003

Enumeration DateOctober 5, 2005

Last NPPES UpdateOctober 3, 2022

NPPES CertifiedOctober 3, 2022

✔ NPI 1992792733 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 · 61-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.

4297C OMAO RD, Koloa, HI 96756

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Other Identifiers 1

Medicaid521030-01HI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HMSA.Insurance ›

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 12D0697252

Hale Kupuna Heritage Home · Koloa, HI

Active · expires Aug 31, 2026

CLIA Number12D0697252

Laboratory TypeSkilled Nursing Facility/Nursing Facility

Certificate Effective DateSeptember 1, 2024

Certificate Expiration DateAugust 31, 2026

Laboratory DirectorJulia Favret

Laboratory Phone(808) 742-7591

Laboratory LocationHale Kupuna Heritage Home4297A Omao Rd, Koloa, HI 96756

CLIA data matches this NPI record on: Name Phone

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 Hale Kupuna Heritage Home, LLC (CMS certification number 125062), from CMS Care Compare.

Hale Kupuna Heritage Home, LLC

Nursing home · Koloa, HI

5/5 CMS Overall Rating

OwnershipFor profit - Limited Liability company

CMS Certification Number125062

Certified Beds84 beds47 residents per day on average

Medicare & Medicaid Participant SinceJune 7, 2011

Resident & Family CouncilResident and family councils

Automatic sprinkler system

CMS Star Ratings

Quality Measures

Based on a select set of clinical quality measures.

5/5

Long-Stay Quality

Quality of care delivered to long-term residents.

5/5

Short-Stay Quality

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

4/5

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.

53.33

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 1.69 · LPN 0.48 · RN 1.21

3.38 hrs per resident per day

Weekend Nurse Staffing

2.9 hrs per resident per day

Physical Therapist Staffing

0.09 hrs per resident per day

Nursing Staff Turnover

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

45.1%

Registered Nurse Turnover

35.7%

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

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.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Hale Kupuna Heritage Home, LLC's NPI number?

The NPI number for Hale Kupuna Heritage Home, LLC is 1992792733. It was assigned to this organization in the NPPES registry on October 5, 2005.

Where is Hale Kupuna Heritage Home, LLC located?

Hale Kupuna Heritage Home, LLC is located at 4297C Omao Rd, Koloa, HI 96756. The listed phone number is (808) 742-7591.

What is Hale Kupuna Heritage Home, LLC's specialty?

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

Does Hale Kupuna Heritage Home, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 12D0697252) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Hale Kupuna Heritage Home, LLC a Medicare-certified nursing home?

Yes. Hale Kupuna Heritage Home, LLC is a Medicare-certified nursing home with 84 certified beds.

What quality rating does Hale Kupuna Heritage Home, LLC have?

CMS rates Hale Kupuna Heritage Home, LLC 5 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

What insurance does Hale Kupuna Heritage Home, LLC accept?

Health plans from HMSA list Hale Kupuna Heritage Home, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Hale Kupuna Heritage Home, LLC was last updated on October 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.