Publication
Significant Rule Changes Ahead for Arizona Assisted Living Facilities Providing Memory Care and Directed Care Services
By Terry Roman, Allison Davis, and Claudia E. Stedman
On April 8, 2024, Governor Katie Hobbs signed HB 2764 into law. Among other things, this law added A.R.S. § 36-405.03(A), which requires the Arizona Department of Health Services (the Department) to establish rule standards for assisted living facilities that are licensed to provide memory care1 and directed care services.2
In response to the mandate set forth in A.R.S. § 36-405.03(A), the Department drafted a series of proposed rules regarding memory care service standards and training requirements for staff members, managers, and providers of licensed facilities.
The proposed rules cover the following topics:
- Training standards for memory care services for staff and contractors who work in facilities licensed to provide directed care (including a minimum number of hours of training), with the training program to be approved by the Department;
- During an investigation or compliance survey, the Department will require facilities to provide evidence of minimum training standards, and demonstrate that staff and providers have met those minimum training requirements;
- Creates a new definition for “memory care services” and a new sub-category on assisted living facility license applications;
- Creates additional policy and procedure requirements for assisted living facilities licensed to provide memory care services;
- Requires intake paperwork and bi-annual certification by a medical provider that a resident’s stay in a given memory care facility is appropriate;
- Requires facilities to maintain certain signage and visual clues, as well as methods to prevent elopement;
- Imposes civil monetary penalties of up to $1,000 per resident each day the violation or deficiency occurs;
- Outlines an enforcement matrix listing potential consequences if a facility is found to be in violation of the Department’s rules;
- Imposes a $1,000 per visit monitoring fee if the Department believes that monitoring is necessary due to repeat deficiencies or if the Department feels there is a threat of harm to residents.
Significantly, while the Department’s proposed rules create a new category on licensing applications for assisted living facilities who wish to provide memory care services after June 30, 2025, current guidance is unclear as to whether existing licensees will need to update or supplement their license to comply with this new application requirement. The Department is actively meeting to discuss what documentation, if any, existing licensees providing memory care services will need to provide to the Department to demonstrate compliance with this new licensing requirement. In the coming months, existing licensees should be on the lookout for additional guidance from the Department regarding supplemental application or documentation requirements indicating that they provide memory care services and comply with the Department’s rules.
The proposed rules will take effect on July 1, 2025, and the changes are expected to have a significant impact on licensees, providers, and staff. Licensed facilities should consider discussing these forthcoming changes with legal counsel in advance of July 1, 2025, to ensure compliance with the rules.
Snell & Wilmer’s healthcare services group is actively monitoring developments with respect to the Department’s proposed rules.
Footnotes
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Memory care services are “services that support individuals with dementia and other progressive and neurodegenerative brain disorders, including specialized environmental features, care planning, directed care services, medication administration services, specialized accommodations, activity programming or other services required by the department in rule.” See A.R.S. § 36-405.03(D).
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Directed care services are “programs and services, including supervisory and personal care services, that are provided to persons who are incapable of recognizing danger, summoning assistance, expressing need or making basic care decisions.” See A.R.S. § 36-401(16).
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