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 Keep in mind these forms are examples of what you can use, some forms may be out of date.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)
| 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 System | Health 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 Website Member handbook 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’ Services | VA 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. |
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