The Terminology Confusion
Arizona families use 'nursing home' and 'skilled nursing facility' (SNF) interchangeably, but the terms describe different funding and care contexts. 'Skilled nursing facility' as a funding concept refers specifically to Medicare Part A-certified short-term rehabilitation and medically complex post-acute care following a qualifying hospital stay. 'Nursing home' as commonly used refers to long-term custodial care — 24-hour nursing care of someone who cannot live independently and whose condition is not expected to improve significantly with rehabilitation.
Understanding which context you are in determines what Medicare, ALTCS, and private pay will cover.
Skilled Nursing: The Medicare-Covered Short-Term Stay
Medicare Part A covers skilled nursing facility care following a qualifying inpatient hospital stay of at least 3 days. Coverage in 2026: days 1–20 at 100% of the Medicare-approved amount; days 21–100 at a co-pay of $204.00/day; after day 100, Medicare pays nothing.
To qualify, the care must be 'skilled' — requiring the training of a licensed nurse or therapist. Medicare does not cover 'custodial care' — help with ADLs like bathing or dressing — when that is the only service needed.
In Phoenix, Medicare-certified SNFs are distributed throughout the metro, with concentrations near each major hospital system. After choosing a SNF for Medicare-covered rehabilitation, the question of long-term placement begins — because the Medicare benefit ends when skilled care needs are no longer required or day 100 is reached.
Long-Term Nursing Home Care: ALTCS and Private Pay
Long-term nursing home care is funded primarily by ALTCS (Arizona Medicaid for long-term care) and private pay in Arizona. Medicare does not pay for long-term custodial nursing home care.
ALTCS covers nursing home care for eligible Arizona residents — income below $2,829/month (or with a Miller Trust), assets below $2,000, and meeting the nursing home level of care criteria (higher than the assisted living level). ALTCS-accepting nursing homes in Maricopa County are distributed throughout the metro.
Private-pay nursing home rates in Phoenix range from $8,000 to $13,500/month for a semi-private room and $9,500 to $15,000/month for a private room — significantly higher than assisted living costs.
How to Evaluate Phoenix Nursing Homes
Medicare's Care Compare tool (medicare.gov/care-compare) is the starting point for nursing home evaluation in Phoenix. The tool provides ratings for health inspections, staffing levels, quality measures, and an overall composite. The staffing rating is the metric most predictive of care quality — facilities with higher RN hours per resident day consistently outperform those with lower staffing.
For ALTCS placements specifically, ask whether the facility participates in ALTCS and what the current ALTCS bed availability is. Facilities that participate in both Medicare (short-term rehab) and ALTCS (long-term) are generally preferable for continuity — the patient can transition from Medicare to ALTCS coverage without physically moving.
Our Phoenix advisors work with families navigating both the short-term SNF choice following hospitalization and the longer-term nursing home decision.