Adult Day Care Regulations in Arizona

Who regulates adult day care in Arizona

The Arizona Department of Health Services (ADHS), through its Bureau of Residential Facilities Licensing, licenses adult day health care facilities. Under A.R.S. 36-407, no one may operate a health care institution, or any class of one, without a current license from ADHS.

The Arizona Health Care Cost Containment System (AHCCCS), the state Medicaid agency, pays for adult day health services through the Arizona Long Term Care System (ALTCS). AHCCCS policy states that Adult Day Health Facilities are licensed by ADHS.

Types of adult day programs in Arizona

Arizona law defines an adult day health care facility as a facility that provides adult day health services for compensation on a regular basis to five or more adults who are not related to the proprietor (A.R.S. 36-401).

Adult day health services means a program that provides planned care supervision and activities, personal care, personal living skills training, meals and health monitoring in a group setting. Arizona's rules use this one facility type for adult day; they do not set up a separate license category for social adult day programs.

How to get licensed in Arizona

ADHS describes the licensure process in its residential licensure process guide (updated March 2022):

1. Get approval from your city, town or county building codes and permits agency.
2. Complete the ADHS architectural review, which adult day health care facilities must finish before applying.
3. Submit a complete application packet with all supplemental forms, including key personnel records for an administrator, a registered nurse and a nurse.
4. Pass an initial on-site inspection, scheduled after the application is administratively complete. ADHS lists any deficiencies and sets a correction deadline.
5. Receive the license once the facility is in substantial compliance with the rules.

Key requirements

Facility standards are in A.A.C. Title 9, Chapter 10, Article 11, effective November 5, 2019. Key provisions include:

• Administrator: 21 or older. If the administrator is away while participants are present, a designated person 21 or older must be on site.
• Staffing: no numeric ratio, but enough qualified staff whenever participants are present, at least two staff on site when two or more participants attend, and at least one person certified in CPR and first aid at all times.
• Nursing: a registered nurse manages nursing services, and a nurse must be on site daily to give medications and treatments and monitor health.
• Assessment and care plans: a registered nurse completes a comprehensive assessment before the tenth visit or within 30 days of enrollment, and the care plan is reviewed at least every six months.
• Space: at least 40 square feet of indoor activity space per participant, shaded outdoor space, and at least one toilet and one sink for every ten participants.
• Medications: policies approved by a pharmacist, medical practitioner or registered nurse, with locked storage.

Medicaid funding for adult day in Arizona

AHCCCS runs a statewide managed care program under its Section 1115 demonstration, approved for October 14, 2022 through September 30, 2027. The demonstration includes ALTCS.

Under AHCCCS policy 1240-B, adult day health services are covered for ALTCS Elderly and Physical Disability members through ALTCS program contractors. American Indian members living on a reservation receive services through the Tribal ALTCS fee-for-service program. Members living in Behavioral Health Residential Facilities are not eligible, and respite care may substitute when no adult day health facility is available.

Billing basics

Adult day health requires case manager authorization, and services are part of the member's person-centered service plan. For members in an assisted living facility, the contractor or Tribal ALTCS program must give prior approval.

For Tribal ALTCS fee-for-service, the AHCCCS fee-for-service billing manual (revised May 2026) says home and community-based service providers bill on a CMS 1500 claim form. It refers providers to the AHCCCS Medical Coding Resource webpage for service codes and units. Billing for managed care members follows each program contractor's rules.

The AHCCCS EVV page applies electronic visit verification to in-home attendant care, personal care, homemaker, habilitation, respite and home health services. It does not mention adult day health.

Other ways centers are paid

Enrolled veterans who meet VA eligibility and clinical criteria can get Adult Day Health Care through the VA, which may be provided at VA medical centers, State Veterans Homes or community organizations.

Official resources

• ADHS Residential Licensure Process
• A.A.C. R9-10 Article 11: Adult Day Health Care Facilities
• A.R.S. 36-401: Definitions
• AHCCCS Policy 1240-B: Adult Day Health Facilities
• AHCCCS Fee-for-Service Billing Manual: ALTCS Services

Frequently asked questions

Do I need a license to open an adult day center in Arizona?

Yes, if you provide adult day health services for compensation on a regular basis to five or more unrelated adults. ADHS issues the license after architectural review, application review and an on-site inspection.

Does Arizona Medicaid pay for adult day care?

Yes. AHCCCS covers adult day health services for eligible ALTCS members, mainly through ALTCS program contractors, with case manager authorization.

Who inspects adult day centers in Arizona?

The ADHS Bureau of Residential Facilities Licensing conducts the initial on-site inspection before a license is issued.

Is social adult day care regulated in Arizona?

The license covers any facility that provides adult day health services, defined to include supervision, activities, personal care, meals and health monitoring, to five or more unrelated adults for compensation.