Eviction From Care Homes

Residents of a care home or assisted living facility may have their lease terminated, but there are certain laws that protect residents from being removed when there is no cause.

Can someone who resides in a care home be evicted?

Yes, although the process is called “termination,” rather than eviction, because landlord/tenant law does not apply to care homes.

The difference between an “eviction” and a “termination” is a significant one:

• If a landlord wants to end a residential tenant’s “rental agreement” (or “lease”), then the landlord must ask a court of law to enter an eviction judgment against the tenant. Only a judge can evict a tenant.
• However, if a care home wishes to end a resident’s “residency agreement,” and either discharge the resident or transfer the resident elsewhere, then the care home can do so on their own. No court or judge is involved.

When can a care home terminate residency of a person?

It depends on a number of different factors, including what kind of care home it is.

If the care home is a “nursing facility,” then both Arizona state law and United States federal law, including provisions of the Nursing Home Reform Act of 1987 apply.

However, if the care home is an “assisted living facility,” then only Arizona state law applies.

What is a “nursing facility” under federal law?

Residents of nursing facilities have more protections than residents of assisted living facilities. Under federal law, a “nursing facility” is an institution that primarily provides:

• skilled nursing care and related services for people who require medical or nursing care,
• rehabilitation services for the rehabilitation of people who injured, disabled, or sick, OR
• on a regular basis, health-related care and services to people who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, AND
• is not primarily for the care and treatment of mental diseases.

Nursing facilities are regulated by, among other federal statutes, 42 U.S.C. § 1396r, which sets out the rules for when and how nursing facilities either must or may terminate a person’s residency.

When may a nursing facility terminate someone’s residency?

Under 42 U.S.C. § 1396r(c)(2)(A),(B), a nursing facility may terminate a person’s residency ONLY if:

• The facility can no longer meet the resident’s needs and welfare, as documented by the resident’s physician;
• The resident’s health has improved sufficiently, as documented by the resident’s physician, so that they no longer need the services the facility provides;

• The resident’s presence in the facility threatens other people’s safety, as documented by the facility;
• The resident’s presence in the facility threatens other people’s health, as documented by a physician; OR
• The resident has not paid required fees or charges, unless they are awaiting a determination of their eligibility for medical assistance.

If a nursing facility intends to terminate someone’s residency on any of these bases, it must provide the resident (or the resident’s representative) with at least 30 days’ advance written notice.

What is a “nursing care institution” under state law?

Under Arizona state law, a “nursing care institution” is a health care institution that provides inpatient beds or resident beds and nursing services to people who need continuous nursing services but don’t require hospital care or direct daily care from a physician. A.R.S. § 36-401(34).

Nursing care homes are regulated by Title 9, Chapter 10, Article 4 of the Arizona Administrative Code (A.A.C.), which sets out the rules for when and how nursing care institutions either must or may terminate a person’s residency.

When must a nursing care institution terminate someone’s residency?

Under A.A.C. R9-10-408(A)(1), a nursing care institution must terminate a person’s residency if:

• The nursing care institution isn’t authorized or able to meet the resident’s needs, as documented by a physician; OR
• The resident’s behavior is a threat to the health or safety of the resident or other people at the nursing care institution, as documented by a physician.

When may a nursing care institution terminate someone’s residency?

Under A.A.C. R9-10-408(B), a nursing care institution may terminate a person’s residency if the resident (or the resident’s representative) hasn’t paid required fees or charges even after receiving a 30-day written notice, including an explanation of the resident’s right to appeal.

What is an “assisted living facility” under state law?

Under Arizona state law, an “assisted living facility” is a residential care institution that provides or contracts to provide supervisory care services, personal care services, or directed care services on a continuous basis. A.R.S. § 36-401(9)

Assisted living facilities are regulated by Title 9, Chapter 10, Article 8 of the Arizona Administrative Code (A.A.C.), which sets out the rules for when and how assisted living facilities either must or may terminate a person’s residency.

The federal rules regarding “nursing facilities” do not apply to assisted living facilities.

When must an assisted living facility terminate someone’s residency?

Under A.A.C. R9-10-807(C), an assisted living facility must terminate a person’s residency if:

• The resident comes to require continuous medical services, nursing services, or behavioral health services;
• The primary condition for which the resident needs assisted living services is a behavioral health issue;

• The services the resident needs are not within the facility’s scope of services and a home health agency or hospice service agency is not involved in the resident’s care;
• The facility does not have the ability to provide the services the resident needs; OR The resident requires restraints, including the use of bedrails.

When may an assisted living facility terminate someone's residency?

Under A.A.C. R9-10-807(G), an assisted living facility may terminate a person’s residency if:

• The resident exhibits behavior that is an immediate threat to the health and safety of the resident or other people in the assisted living facility, as documented by a physician. If this happens, then the person’s residency can be terminated immediately, without advance notice;
• The resident (or their representative) hasn’t paid required fees or charges even after receiving a 14-day written notice; OR
• The management of the facility decides for any reason that they no longer wish to house the resident, so long as they give the resident (or their representative) a 30-day written notice.

If an assistant living facility wishes to terminate a person’s residency, the written notice of termination must provide:

• The date of the notice;
• The specific reason why the residency is being terminated;
• The facility’s policy regarding the refunding of fees, charges, or deposits;
• A statement of the fees, charges, or deposits to be refunded to the resident; AND
• Contact information for the Long-Term Care Ombudsman Program.

If a care home terminates or threatens to terminate a residency in violation of state and/or federal law, what can the resident (or the resident’s representative) do?

What is the Long-Term Care Ombudsman Program?

The Long-Term Care Ombudsman Program (LTCOP) investigates and works to resolve complaints made by people who reside in care homes; educates residents, families, care home staff, and communities about long-term care issues and services; promotes and advocates for residents’ rights; and helps residents obtain needed services.

Who can make a complaint to the LTCOP?

Anyone who resides in a nursing facility, an assisted living facility, or an adult foster care home in the state of Arizona (or their representative) can make a complaint to the LTCOP. The contact information for the LTCOP’s local offices are as follows:

Maricopa County

Area Agency on Aging, Region One

Apache, Coconino, Navajo, and Yavapai Counties

Northern Arizona Council on Aging

Navajo Nation

Navajo Area Agency on Aging

(602) 542-6454 or (602) 542-6432

Pima County

Pima Council on Aging

La Paz, Mohave, and Yuma Counties

Western Arizona Council on Aging

Inter-Tribal Council of Arizona

(Serving 21 Tribal Nations)

Pinal and Gila Counties

Pinal-Gila Council for Senior Citizens

Cochise, Graham, Greenlee, and Santa Cruz Counties

Southeastern Arizona Governments Organization

(520) 432-2528, ext. 206

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This website has been prepared for general information purposes only. The information on this website is not legal advice. Legal advice is dependent upon the specific circumstances of each situation. Also, the law may vary from state-to-state or county-to-county, so that some information in this website may not be correct for your situation. Finally, the information contained on this website is not guaranteed to be up to date. Therefore, the information contained in this website cannot replace the advice of competent legal counsel licensed in your jurisdiction.