Nursing Homes in Arizona
With year-round warm weather, a low cost of living and favorable tax rates for seniors, Arizona is the most popular state after Florida for retirement. Seniors account for 18.3% of the population, with roughly 1.35 million residents over the age of 65. The state offers access to world-class health care facilities such as the Mayo Clinic in Phoenix, and seniors have a variety of living options available depending on their level of independence and the medical care required.
Nursing homes offer seniors and family members peace of mind by providing access to medical supervision and care in a homelike environment. According to the Kaiser Family Foundation, 10,699 people reside in Arizona's 142 registered nursing homes as of 2022. The average monthly cost of nursing home care in Arizona is $6,540 for a semiprivate room and $8,030 for a private room, though costs vary depending on the medical services required.
The following guide provides information on long-term nursing home care and how medical assistance programs such as Medicare and Medicaid can help cover the costs. It is intended to help seniors and caregivers better understand eligibility for government assistance programs as well as the application process and services covered.
Popular Cities in Arizona
Cost of Arizona Nursing Homes
The average cost of nursing homes in Arizona is $192 per day. This is higher than the national average which is $228 per day.
Can You Use Medicaid to Pay for Nursing Home Care in Arizona?
Arizona Medicaid covers the costs associated with long-term nursing home care for Arizona residents who meet financial and medical eligibility requirements. Nearly 2.3 million Arizonans are enrolled in Medicaid and CHIP, representing an increase of 90.65% since 2013. Of those, 5 out of 9 nursing home residents receive Medicaid benefits to cover the cost of their care. While benefits vary according to the long-term care setting (such as a nursing home, adult day care or assisted living), Arizona Medicaid covers medical care, appointments, dental service, medical equipment and medication administration.
Arizona Medicaid is managed by the Arizona Health Care Cost Containment System (AHCCCS). Nursing home care and other services for the elderly and individuals with disabilities are managed through a subsection of AHCCCS, the Arizona Long-Term Care System (ALTCS). Unlike other states, ALTCS uses a managed care model in which anyone who meets eligibility requirements is entitled to benefits. Aside from care services in a facility, ALTCS offers community and home-based services, including personal attendants, home health care and coordination with providers.
Eligibility for Medicaid in Arizona
Seniors over age 65 or adults with blindness or a registered disability are eligible for Arizona Medicaid if they meet certain financial criteria. Because Arizona Medicaid functions as an entitlement program, those who are determined to require long-term institutional or nursing home care receive benefits upon acceptance into ALTCS without restriction due to a participation cap or waiting list. Arizona Medicaid is three-pronged, covering institutional or nursing home care, home or community-based services and regular Medicaid services (for the aged, blind and disabled).
To be financially eligible for nursing home Medicaid, a single individual must demonstrate an income of less than $2,742 per month, with less than $2,000 in assets. If both an individual and their spouse are applying for nursing home Medicaid, each must earn below $2,742 for a total monthly income of less than $5,484 with no more than $4,000 in combined assets.
| Income Limits* | Asset Limits | |
|---|---|---|
| Single Person | $2,742 | $2,000 |
| Married (both spouses applying) | $5,484 ($2,742 per spouse) | $4,000 ($2,000 per spouse) |
| Married (one spouse applying) | $2,742 | $2,000 ($148,620 for nonapplicant) |
*Per month
Aside from financial need, applicants must also meet certain legal criteria to be eligible for Arizona Medicaid, including citizenship, residency and immigration status. Medicaid applicants need to demonstrate:
- Arizona residency
- Status as a U.S. citizen or permanent legal resident
- Medical need
Applying for Medicaid in Arizona
Eligible Arizona residents can choose to apply for Medicaid online, over the phone or by mail. Applicants may apply online through the Health-e-Arizona Plus portal for regular Medicaid, or by printing the online application and mailing it to 801 East Jefferson Street, MD 3900, Phoenix, Arizona, 85034. Completed applications can also be taken to a local ALTCS office.
Those who want to apply for long-term care coverage under ALTCS can call (888) 621-6880 or visit a local office.
What Information You Will Need
- Proof of citizenship or legal residency
- Social Security card
- Copy of birth certificate
- Name, address and contact information for a landlord or neighbor
- A signed statement verifying household members and address from a nonrelative
- Proof of income (pay stubs or equivalent from the current and previous month)
- Proof of unemployment, if applicable
- Verification of medical insurance other than Medicaid, including Medicare
Additional Medicaid Support & Resources in Arizona
Applicants have access to several free resources to better understand the qualification requirements and application process for Arizona Medicaid. The following organizations offer free support to answer questions or guide applicants through the process.
| Contact | Service | |
|---|---|---|
| Health-e-Arizona PLUS | (855) 432-7587 | HEA PLUS is the portal established by Arizona's Department of Economic Security for residents to apply for and manage their benefits through AHCCCS, Medicaid, SNAP or TANF. Individuals can apply online by registering on the portal or by calling 1-855-HEA-PLUS. |
| Arizona Association of Area Agencies on Aging | (928) 298-2574 | Area Agencies on Aging (AAAs) are regional help centers that assist seniors in locating and applying for local and statewide assistance programs. Their mission is to "lead Arizona in aging successfully through innovative resources, collaborations and advocacy." |
| Arizona Health Care Cost Containment System | (602) 417-4000 or (800) 654-8713 (from outside Maricopa County) | The AHCCCS is the managing agency for Arizona's Medicaid program. In addition to Medicaid, the AHCCCS manages ALTCS and a variety of other mental and behavioral health initiatives across a diverse spectrum of beneficiary groups. The agency provides two dedicated hotlines — one for calls from within Maricopa County and one for all others. |
Can You Use Medicare to Pay for Nursing Home Care in Arizona?
Medicare provides limited coverage for short-term stays in a skilled nursing facility following a hospital stay, but seniors must meet a number of specific requirements. This benefit is available to beneficiaries who have been hospitalized for at least three days, excluding the date of discharge, so it's most valuable for those who are recovering from an injury, illness, or surgery.
Once seniors meet the hospitalization requirement, Medicare will pay for up to 100 days of skilled nursing per benefit period. The first 20 days are covered in full. Starting on day 21, beneficiaries must pay a daily coinsurance rate. After day 100, seniors are responsible for the entire cost.
What Does Medicare Cover?
Medicare covers a number of specific services, including:
- Meals
- A semiprivate room
- Medications
- Skilled nursing
- Physical therapy
- Occupational therapy
- Speech therapy
- Audiologist care
- Medical supplies
- Medical social services
- Nutritional counseling
- Ambulance transportation
What Isn't Covered by Medicare?
Medicare does not cover long-term custodial care that addresses seniors' day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.
For more information about Medicare and when it covers Nursing Home Care, read our Guide to Nursing Homes.
Medicare Support & Resources in Arizona
While original Medicare might not cover prescriptions or the use of certain medical equipment, it helps over 1.4 million Arizona seniors lower their monthly medical costs. The following organizations provide free, up-to-date advice for seniors choosing a Medicare plan that will fulfill their lifestyle and health care needs.
| Contact | Service | |
|---|---|---|
| Arizona Area Agencies on Aging (Region One) | (888) 783-7500 | The Area Agency on Aging, Region One is a nonprofit providing comprehensive health services for older adults in Maricopa County including assistance with Medicare enrollment. AAAs across the state offer several programs to help older adults remain independent and employ counselors to help seniors understand their Medicare benefits. |
| Arizona SHIP | (800) 432-4040 | The Arizona State Health Insurance Assistance Program (SHIP) offers counseling free of cost to individuals and caregivers regarding Medicare and Medicaid Plus insurance plans. SHIP's volunteers provide unbiased advice for those either new to Medicare or wishing to better understand their plan options. |
| Arizona Department of Economic Security | (877) 600-2722 | The Arizona Department of Economic Security (DES) is the umbrella agency for Arizona SHIP and Arizona Senior Medicare Patrol (SMP). Their website contains resources to reach both agencies as well as a hotline to answer general questions about Medicare enrollment and benefits. |
| Arizona Senior Medicare Patrol | (800) 432-4040 | The Arizona SMP is a network of trained volunteers who educate Medicare beneficiaries on how to protect themselves against health care fraud. In the event of any suspicious activity in which a beneficiary is not comfortable calling their provider, an SMP volunteer can be reached via their helpline to provide guidance. |
| Arizona Rx Card | Contact with online form | Arizona Rx Card is a statewide prescription assistance program offering Arizona residents up to 80% savings on their prescriptions, regardless of age. Medicaid members are eligible to save on medications not covered by Medicare Part D without needing to fill out additional claims or enrollment forms. |
Other Financial Assistance Options for Nursing Home Care in Arizona
While Medicaid and Medicare are two of the most common programs used to pay for Nursing Home Care, there are other financial assistance options available, depending on your unique situation.
| How to Apply | How It Works | |
|---|---|---|
| Aid and Attendance | Learn more and apply online at va.gov. | Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for skilled nursing care. |
| Reverse Mortgages | Learn more about your options and how to apply at ftc.gov. | If you own a home, you may be able to use a reverse mortgage to help pay for nursing care. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. This type of funding can be especially useful for married couples when only one partner needs nursing care, as the other residents of the home may continue living there. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan. |
| Long-Term Care (LTC) Insurance | Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov. | Seniors who already have long-term care insurance may be covered for skilled nursing care. Most policies cover at least a portion of the cost of nursing home care, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not be eligible to sign up for a LTC insurance policy. |
Nursing Home Laws and Regulations in Arizona
| Licensing Requirements | The Arizona Administrative Code requires that all nursing homes carry valid licenses, which must be renewed annually. The state reserves the right to suspend or revoke the licenses of facilities that don’t comply with conditions set forth in Title 9, Chapter 10, Article 4. |
| Staffing Requirements | Nursing home staff members must hold valid licenses for employment and pass a background check to receive a fingerprint clearance card. While Arizona doesn't set a required staff-to-resident ratio, nursing homes are required to provide adequate staffing to ensure resident safety 24/7. |
| Staff Training Requirements | Nursing home staff administrators must ensure that all new staff and volunteers receive onboarding and in-service training. Staff caregivers must complete a CPR course and receive relevant first-aid training. |
| Admission Restrictions | All prospective residents must complete a medical evaluation by a registered nurse prior to being admitted to a nursing home. Those with needs that require treatment beyond the scope of what the nursing home is licensed to provide are not to be admitted. |
| Care Planning Requirements | Skilled nursing facilities must complete a service plan within 14 days of admission and include a description of the resident's medical condition, treatment requirements, frequency of services and medication regimen. Plans must be reviewed at least every 3 months depending on the type of care. |
| Dietary and Nutritional Services Requirements | Nursing facilities must provide three meals per day and snacks in line with federal dietary guidelines, plus accommodate any special diets as outlined in residents' individual care plans. For those who need it, facilities must provide adaptive eating equipment. |
| Specialized Rehabilitative Services | There is no mandated requirement for skilled nursing facilities to provide rehabilitative or restorative services; however, those that admit residents with an assessed need can make these services available through licensed third-party providers. |
| Medication and Pharmaceutical Services | Nursing home facilities may only administer medications as per the direction of a resident's licensed physician. Residents may self-administer medications as specified in their individual care plan, and a licensed pharmacist must review their medications quarterly. |
| Activities Requirements | Nursing facilities are required to employ a qualified coordinator to organize and manage social and recreational activities, which must stimulate cognitive activity and overall function. Each facility must display a calendar of events in a prominent location. |
| Infection Control Requirements | Arizona skilled nursing facilities are required to follow a set of protocols to manage the spread of infection and communicable diseases. Protocols must outline procedures for hand washing, personal protective equipment, quarantine and the proper disposal of hazardous or medical waste. |
| Medicaid Coverage | Arizona Medicaid covers nursing home care as part of the Arizona Long-Term Care System, which is operated by the Arizona Health Care Cost Containment System. Residents must demonstrate both a medical condition and financial need in order to be eligible. |
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