Tucson Senior AdvisorBy Tucson Senior Advisor Care Team · October 20, 2026
149 of Pima County's 310 active assisted living facilities have at least one ADHS enforcement action listed for the last three years (271 actions in all, most closed). Read the inspection behind each action before deciding.
What counts as an enforcement action?
An enforcement action is a formal step ADHS takes beyond citing deficiencies, such as assessing a civil money penalty, entering a consent agreement, or issuing a notice of intent to revoke a license. AZ Care Check keeps a three-year list for each facility with the action number, decision date, status and whether it arose from an inspection.
Most actions in Pima County arose from inspections. They are not secret: the inspection that triggered the action is usually in the same record.
How common are enforcement actions in Pima County?
On October 30, 2026, 149 active facilities had at least one action listed: 117 homes and 32 centers. 30 facilities had three or more.
| Status shown on AZ Care Check | Actions |
|---|---|
| Closed (Complete) | 262 |
| Finalized | 9 |
| Decision year | Actions |
|---|---|
| 2023 | 10 |
| 2024 | 94 |
| 2025 | 77 |
| 2026 | 90 |
What do the statuses mean?
Closed (Complete) means the action has run its course, for example a penalty paid or a consent agreement fulfilled. Finalized means the decision has been made and recorded. An action that is closed is still part of the record for three years, which is the point: it lets families see a facility's recent history, not just its current status.
How should a family weigh an enforcement action?
Weigh it by what caused it and what happened afterward. An action tied to a resident injury or a failure to supervise is serious; an action tied to administrative lapses such as late paperwork is less so. Look at the inspections after the action: a run of clean inspections suggests the problem was fixed, while repeat citations for the same rule suggest it was not.
Ownership changes matter too. A facility under new ownership may carry a predecessor's record, and the new owner's first inspections tell you more.
What questions should you ask the manager?
Ask what led to the action, what changed in staffing or procedures, and who was responsible then versus now. Ask to see the plan of correction. A manager who answers plainly is a good sign; one who dismisses the record as unfair is not.
If you have concerns about a facility where a parent already lives, the Pima Council on Aging ombudsman program at (520) 790-7262 can advise you confidentially.
How does an enforcement action show up for families?
On AZ Care Check, the enforcement list sits beside the inspection history, with an action number, a decision date and a status. On our directory, the same information appears as a count in the enforcement column for every Pima County facility and as a table on each facility profile, so families can sort by it before they start opening individual records.
A count alone is crude. A large center that has served thousands of residents over three years will accumulate more actions than a home with ten beds, so read counts as a reason to look closer rather than as a ranking.
What happens after ADHS issues an enforcement action?
Depending on the action, the facility may pay a civil money penalty, follow the terms of a consent or settlement agreement, or face a hearing. Later inspections then check whether the problems were corrected, and a facility that keeps failing can face stronger steps, up to revocation of its license.
For residents already living in a facility under an enforcement action, little changes day to day, but it is a good time for families to visit more often, attend care-plan meetings and keep notes of any concerns.
An enforcement action: what it is and is not
| It is | It is not | |
|---|---|---|
| Meaning | a formal ADHS step beyond a citation | a license revocation in most cases |
| Window | last three years on AZ Care Check | a lifetime record |
| Status 'Closed' | the action ran its course | a deleted record |
Frequently asked questions
Does an enforcement action mean a facility is unsafe today?
Not necessarily. Many actions are closed and were followed by clean inspections. Read the inspection that led to the action and the inspections after it to judge whether the problem was fixed.
How far back does AZ Care Check show enforcement?
AZ Care Check shows enforcement actions from the last three years for each facility. Older actions are not listed there, though inspection history may go back further.
Can ADHS close an assisted living facility?
ADHS can move to revoke a license, and Pima County records show notices of intent to revoke that were resolved by settlement agreements. Revocation is rare compared with citations and civil penalties.
Who can I talk to about a facility's record?
The long-term care ombudsman at Pima Council on Aging, (520) 790-7262, can talk through concerns confidentially. For a new violation, file a complaint with ADHS; for abuse or neglect, call Adult Protective Services at 1-877-SOS-ADULT (1-877-767-2385).
Do enforcement actions affect ALTCS contracts?
AZ Care Check does not show health plan contracts, and the plans set their own network standards. If you are choosing a facility as an ALTCS member, ask the plan's case manager whether the facility is in good standing with the plan.
