AZDHS Rules & Regulations

CALL AZDHS (602) 542-1025 ASK FOR RESIDENTIAL LICENSING, SURVEYOR OF THE DAY FOR ALL YOUR ALH QUESTIONS

AZDHS Rules & Regulations Article 1 & 8 (print and have available for staff)

Need Assisantce with your Policies & Procedures?

Contact Dan Stamos with Assisted Living Licenses, Certificates & Training for assistance (not affiliated with INtouch Senior Services) *Recommended
602.384.1146 | Training@ALLCT.com | https://allct.com

Contact Rob Moore with Assisted Living Home Services for assistance (not affiliated with INtouch Senior Services) *Recommended
602.545.4558 | rob@alhservces.com | https://alhservices.net

Contact Gabriela Istrate with for assistance (not affiliated with INtouch Senior Services) *Recommended
602.439.7307 | gabrielagoldenage@cox.net |

FORMS

Please review the forms used with the Arizona Department of Health Services Regulations before implementing them in your Facility. Keep in mind these forms are examples of what you can use, some forms may be out of date.


2021 Minimum Wage Poster (English) Check your local laws if your facility is exempt from Minimum wage

Completed W-9 (Request for Taxpayer Identification Number and Certification), A4 (Employee’s Arizona Withholding Election)

DURABLE HEALTH CARE POWER OF ATTORNEY

DURABLE MENTAL HEALTH CARE POWER OF ATTORNEY

Inspection Records Notice (conspicuously posted)

LIVING WILL (End of Life Care)

PREHOSPITAL MEDICAL CARE DIRECTIVE (DO NOT RESUSCITATE)

Cost of Care
Long Term Care in Arizona pays up to $6000/month

VA Aid & Attendance pays Married Veteran: $2,296 | Single Veteran: $1,937 |Surviving Spouse: $1,245

For Private Pay or ALTCS follow Genworth Cost of Care
Genworth.com


Median Cost Data Tables by Genworth Download
Arizona Long Term Care SystemHealth Care Plans in Arizona

Step 1- Apply for AHCCCS ID >>
Applications may also be submitted to altcsregistration@azahcccs.gov
The DE-101 form is required to begin an application. (Financial Hardship is considered to waive the cost of the application)
Step 2- If Needed Apply for an NPI>>
Step 3- Submit an application directly with a Health Plan

Call (toll-free):
888-621-6880
Fax (toll-free):
(local):
888-507-3313
602-253-6385
Mailing address:
801 E. Jefferson Street, MD 3900
Phoenix, Arizona 85034


If you are contracted with ALTCS and operate a Assisted Living Home please complete this years survey.
2019 ALTCS Survey

American Indian Health Program



Arizona Complete Health-Complete Care Plan
Providers>


Banner-University Family Care
Providers>


Care 1st Health Plan
Providers>




Magellan Complete Care
Providers>





Mercy Care
Providers>




Health Choice Arizona
Providers>



UnitedHealthCare Community plan
Providers>
1-800-334-5283


1-888-788-4408


1-800-582-8686


1-866-560-4042



1-800-424-5891




1-800-624-3879



1-800-322-8670


1-800-348-4058
Website
Member handbook


Website
Member handbook


Website
Member handbook


Website
Member handbook
Email


Website
Member handbook
Email



Website
Member handbook



Website
Member handbook


Website
Member handbook





Provider Application









Provider Application
AzAHP Organizational Data Form
AzAHP Facility Application
 


Provider Application
AzAHP Organizational Credentialing Form (PDF)
AzAHP Facility Application (PDF)
W-9 Form (PDF)


AzAHP Organizational Credentialing Form (PDF)
AzAHP Facility Application (PDF)
W-9 Form (PDF)


Provider Application




Submit a request
include care provider full name, tax ID, service address location(s), and (NPI).
Arizona Department of Veterans’ ServicesVA AID AND ATTENDANCE PROGRAM

Married Veteran: $2,296
Single Veteran: $1,937
Surviving Spouse: $1,245

Comparison of Eligibility and Benefits:
2021 VA Aid and Attendance vs. Arizona Long Term Care System (ALTCS)

Cemeteries
The Arizona State Veterans’ Cemeteries 
provide a lasting final benefit in honor of
Veterans and their families with a final
resting place in appreciation and gratitude for their service and sacrifice to our nation.
Arizona Veterans’ Memorial Cemetery at Camp Navajo

Arizona Veterans’ Memorial Cemetery at Marana

Southern Arizona Veterans’ Cemetery
Step 1 – Request your military service records (including DD214) there are other paid services online
Step 2– Check Eligibility
You may be eligible for this benefit if you get a VA pension and you meet at least one of the requirements listed below.
At least one of these must be true:
You need another person to help you perform daily activities, like bathing, feeding, and dressing, or
You have to stay in bed—or spend a large portion of the day in bed—because of illness, or
You are a patient in a nursing home due to the loss of mental or physical abilities related to a disability, or
Your eyesight is limited (even with glasses or contact lenses you have only 5/200 or less in both eyes; or concentric contraction of the visual field to 5 degrees or less)
Housebound benefits eligibility
You may be eligible for this benefit if you get a VA pension and you spend most of your time in your home because of a permanent disability (a disability that doesn’t go away).
Note: You can’t get Aid and Attendance benefits and Housebound benefits at the same time.
Step 3– Make an Appointment
To make an appointment to see a VBC, call 602-535-1215.
VBCs assist clients by: 
-Educating them on eligibility requirements for benefits
-Processing VA compensation and pension applications
-Appealing VA decisions
-Representing claimants at VA hearings
-Filing for survivor’s benefits
-Applying for discharge upgrades
-Referring claimants to other agencies for potential benefits
-Requesting military service records and certifying DD-214s (discharge paperwork)
-Discussing State Veteran Benefits


Adult Protective Services (APS)What is Abuse, Neglect and Exploitation?

File a Report
By phone:
Monday – Friday:
7:00 a.m. – 7:00 p.m.
Saturday, Sunday and state holidays:
10:00 a.m. – 6:00 p.m.
1-877-SOS-ADULT
(1-877-767-2385)
Online:
The online reporting form is available 24 hours a day, seven days a week.
For life-threatening emergencies, call 911 immediately.
File a Report Online
Abuse can take many forms. Not all abuse is seen with the naked eye. Abuse can take many forms, including:
Physical abuse, including intentional infliction of physical harm and injury
Sexual abuse or sexual assault
Unlawful imprisonment
Neglect is the deprivation of:
Food
Water
Medication
Medical services
Shelter
Cooling
Heating
Supervision
Other services necessary to maintain minimum physical or mental health
Exploitation is the illegal or improper use of an individual or their resources for another person’s profit or advantage. This can include:
Misusing cash, credit cards or bank accounts
Stealing money or household goods and property
Forced panhandling
Prostitution
Abuse, neglect and exploitation can occur for many reasons. Also, individuals can be victimized by friends, family members or strangers.
Renew your ALH Manger License NCIA Board
Approved Manager & Caregiver Training Schools
Ombudsman
ALH Community Assistance Program

Apply to be an Adult Foster Care (Tax Exempt) Foundation of Senior Living
Apply for an Assisted Living Home Arizona Department of Health Services
Help your Resident if they have no Family , POA or Representative Adult Protective Services
Free Adult Day Care Services for ALTCS Residents
Find Referral Specialist & Marketing Options for your Facility

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