SKILLED NURSING SERVICES PROVIDER IN ARIZONA
- Fatumata Kaba
- Jul 2
- 4 min read
DELIVERING PROFESSIONAL MEDICAL CARE TO SUPPORT HEALTH, SAFETY, AND INDEPENDENCE IN HOME AND COMMUNITY SETTINGS
Skilled Nursing Services in Arizona deliver medically necessary care provided by licensed nurses to individuals with chronic conditions, disabilities, or significant health needs. These services are authorized under Arizona’s Home and Community-Based Services (HCBS) Medicaid Waiver programs and the Arizona Long Term Care System (ALTCS), aiming to maintain health and prevent unnecessary hospitalization or institutionalization.
1. GOVERNING AGENCIES
Agency: Arizona Health Care Cost Containment System (AHCCCS)
Role: Oversees Medicaid enrollment, service authorization, and reimbursement for Skilled Nursing Services
Agency: Arizona Department of Economic Security (DES) – Division of Developmental Disabilities (DDD) (for DDD members)
Role: Coordinates skilled nursing supports for individuals with developmental disabilities
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight ensuring that skilled nursing services comply with Medicaid HCBS guidelines
2. SKILLED NURSING SERVICE OVERVIEW
Skilled Nursing Services provide clinical interventions based on physician orders, designed to address specific health conditions and promote individual health, wellness, and stability.
Approved providers may deliver:
Medication administration and complex medication management
Wound care and treatment of pressure ulcers
Tracheostomy care and ventilator support
Catheter care and management
Gastrostomy (G-tube) care and enteral nutrition
Diabetes management, including insulin administration
Chronic disease monitoring and clinical assessments
Training caregivers on health support procedures
Coordination with physicians, therapists, and case managers
Services must be provided by licensed nurses (Registered Nurses [RNs] or Licensed Practical Nurses [LPNs]) and comply with an individualized person-centered service plan.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Arizona Corporation Commission
Obtain EIN from the IRS and NPI (Type 2)
Employ licensed RNs and/or LPNs with active Arizona Board of Nursing licenses
Secure malpractice insurance and liability coverage
Develop clinical protocols and policies aligned with Arizona nursing standards
Ensure compliance with HIPAA and Medicaid documentation standards
4. AHCCCS/DDD PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Request Skilled Nursing Provider application materials from AHCCCS or DDD
(Recommended) Attend Medicaid or HCBS provider orientation sessions
Application and Documentation Submission:
Submit business documents, staffing rosters, clinical service descriptions, and liability insurance proof
Provide sample nursing care plans, incident reporting protocols, and emergency procedures
Submit background checks and licensing verification for all clinical staff
Program Readiness Review:
AHCCCS and/or DDD review staffing qualifications, policies, and operational readiness
May require demonstration of clinical documentation systems and quality assurance processes
Approval & Medicaid Enrollment:
Upon approval, complete Medicaid enrollment with AHCCCS
Contract with Medicaid Managed Care Organizations (MCOs) and/or DDD for service delivery
Configure billing systems and Medicaid claims processes
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License
IRS EIN confirmation
NPI confirmation
RN and/or LPN licensure verification
Liability insurance and malpractice coverage proof
Policy & Procedure Manual including:
Participant intake and clinical assessment protocols
Skilled service documentation procedures
Medication administration policies
Emergency medical response and reporting procedures
Resident/client rights, HIPAA privacy compliance, and informed consent policies
Staff background checks, credentials, and continuing education records
Incident tracking, infection control policies, and quality assurance systems
Medicaid billing, service authorization, and claim tracking systems
6. STAFFING REQUIREMENTS
Role: Nursing Supervisor (RN)Requirements: Active Arizona RN license, supervisory experience in clinical care settings, Medicaid familiarity
Role: Skilled Nurse (RN or LPN)Requirements: Current Arizona nursing license, CPR certification, background check clearance
All staff must complete:
Medicaid HCBS and DDD service documentation training
Emergency preparedness and infection control training
Annual continuing education and skills competency assessments
Training in person-centered planning and client rights protection
7. MEDICAID WAIVER SERVICES
The following Arizona Medicaid Waivers authorize Skilled Nursing Services:
Arizona Long Term Care System (ALTCS) – Elderly and Physically Disabled (EPD) Program
ALTCS – Developmental Disabilities (DD) Program
HCBS Waivers under AHCCCS and DDD programs
Approved providers may deliver:
In-home or facility-based skilled nursing interventions
Clinical assessments and ongoing health monitoring
Training for family members and caregivers
Participation in interdisciplinary care team meetings and service plan updates
8. TIMELINE TO LAUNCH
Phase: Business Formation and Initial Setup
Timeline: 2–3 weeks
Phase: AHCCCS/DDD Application and Readiness Review
Timeline: 60–90 days
Phase: Staff Hiring, Training, and Clinical Protocol Finalization
Timeline: 30–45 days
Phase: MCO Contracting and Medicaid Claims Configuration
Timeline: 45–60 days
9. CONTACT INFORMATION
Arizona Health Care Cost Containment System (AHCCCS)
Website: https://www.azahcccs.gov/
Arizona Department of Economic Security – Division of Developmental Disabilities (DDD)
Arizona Medicaid Provider Enrollment Portal

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — ARIZONA SKILLED NURSING PROVIDER
WCG supports healthcare entrepreneurs, clinicians, and home health agencies in launching Medicaid-compliant Skilled Nursing Services under Arizona’s HCBS Waiver programs and ALTCS.
Scope of Work:
Business registration and EIN/NPI setup
AHCCCS/DDD provider application and documentation support
Development of Skilled Nursing Policy & Procedure Manual
Staff credentialing, tracking, and clinical documentation templates
Medicaid enrollment, MCO contracting, and billing configuration
Website, domain, and email setup
Client intake and care plan documentation packets
Emergency response and incident reporting templates
Quality assurance and compliance management tools
Referral networking and clinical service expansion strategies
Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.
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