05/29/2026
Arizona licenses three tiers of elder residential care. Oversight gets weaker as the home gets smaller.
The smallest tier is 1,711 assisted living homes at 10 beds or fewer. No federal counterpart. No CMS star rating. No public comparison database equivalent to Care Compare. Just AZ Care Check.
The AZ Auditor General's May 2022 report: ADHS downgraded 98% of nursing-home complaints and didn't investigate 75% of them. That's the same agency that's the sole oversight for the smallest tier.
One Mesa facility racked up 148 ADHS citations across three years before the AG filed racketeering charges. The licensing system didn't catch it. Investigative journalism did.
Full investigation with the three-tier framing and the Heritage Village receivership case:
https://azlawnow.com/investigations/arizona-adult-care-homes-serious-violations/