Renewal license application for a health care institution - azdhs 2026

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The document is a renewal license application for health care institutions in Arizona, detailing required information about the institution, its owner, and operational details. It includes sections for institutional classification, accreditation status, ownership structure, and necessary documentation for compliance with state regulations.

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Click ‘Get Form’ to open the Renewal license application in the editor.
Begin by filling out the Health Care Institution Information section. Enter the name, license number, mailing address, and contact details accurately.
Select the appropriate class or subclass of your health care institution from the provided options. Ensure you understand each category to select correctly.
Detail your institution's scope of practice and operational hours. This information is crucial for compliance and should be filled out clearly.
In the Owner Information section, provide complete details about the owner, including their name, address, and business structure. If applicable, list all partners or corporate officers.
Answer questions regarding any past licensing issues honestly. This transparency is vital for your application’s success.
Complete the Statutory Agent section with accurate contact information for service of process.
Fill in details for the Chief Administrative Officer and ensure all signatures are obtained as required before submission.

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What does AZDHS stand for?

The Arizona Department of Health Services (DHS), Bureau of Medical Facilities Licensing, licenses and certifies medical health care institutions (includes Architectural Reviews) and providers of medical services. Types of medical facilities licensed by DHS include home health agencies.

What type of accreditation does an assisted living facility need?

CARF International accredits assisted living communities. The accreditation process requires the community to follow a rigorous set of standards based on industry trends and to undergo an on-site survey to determine its conformance to those standards.

Who runs an assisted living facility?

Assisted living facilities (ALFs) may be owned by a range of entities, from large corporations to individuals to nonprofit organizations.

Are assisted living facilities federally regulated?

To assist low-income residents with the cost of room and board, some states and local governments may have state or local-only funded programs, with eligibility based on financial need. In general, ALFs and similar residential settings are not regulated by the federal government.

Who licenses assisted living facilities in Arizona?

The Division of Public Health Licensing Services, Bureau of Residential Facilities Licensing, licenses assisted living facilities (ALFs).

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