Arizona's five care settings
- In-home care. Either through ALTCS (for Medicaid-eligible) or private pay ($28-$38/hour). AZ has a robust home-care market.
- Adult Care Home (ACH). Small residential facilities, typically up to 10 residents, often in a house. AZ has more of these than most states; many are family-owned operations. Costs $2,500-$5,000/month. Provides personal care, meals, supervision.
- Assisted Living Facility (ALF). Larger residential AL (typically 50-200+ residents). $4,000- $7,000/month range in AZ.
- Memory Care. Specialized AL for residents with dementia. AZ added a new licensure subclass in 2025 with tighter standards.
- Skilled Nursing Facility (SNF). $7,800- $9,500/month statewide.
The Adult Care Home market
AZ’s Adult Care Home category is regulated under AAC R9-10-401 et seq. as a distinct setting from larger ALFs. ACHs:1
- Limited to 10 residents (typically 6-10)
- Often family-owned, smaller scale, more personal
- Lower cost than larger ALFs in most cases
- Higher staff-to-resident ratio possible because of the small scale
- Less amenity-rich than larger ALFs (no swimming pool, no on-site beauty salon, etc.)
- Subject to AZ DHS Bureau of Residential Facilities Licensing inspection
Many AZ families choose an ACH over a larger ALF for the more personal feel and lower cost. The trade-off: less clinical depth, fewer activities, and (in some cases) less stability if the owner-operator sells or retires.
Cost-of-care by AZ metro
Approximate 2024 medians (Genworth Cost of Care 2024):2
- Phoenix metro: nursing home? semi-private ~$7,800/month; ALF ~$5,000/month; ACH ~$3,500/month
- Tucson metro: nursing home semi-private ~$7,200/month; ALF ~$4,300/month; ACH ~$3,000/month
- Flagstaff / Northern AZ: nursing home ~$7,400/month; ALF ~$4,500/month
The new 2025 memory-care licensure subclass
Arizona added a new memory-care licensure subclass in 2025 with tighter standards for facilities providing dementia- specific care. Key requirements:
- Enhanced staffing ratios for memory-care wings
- Specific dementia-trained staff certifications
- Secured exits and elopement-prevention protocols
- Programming designed for cognitive impairment
Existing AL facilities providing memory care under previous licensure must transition to the new subclass over a phased period. When evaluating an AZ memory-care facility, verify current licensure status.
How to evaluate an AZ facility
- Check the facility’s licenseat AZ DHS azdhs.gov — verify ACH vs ALF, current status, recent inspections
- For SNFs, cross-reference CMS Care Compare
- For ACHs, talk to current resident families — small scale means word-of-mouth is more informative than reviews
- Visit at least twice, including once unannounced
- Read the contract carefully for ACH- specific terms about owner transitions and care escalations