Assisted living communities in Idaho must follow the state's comprehensive laws regarding senior care to stay in operation. Some of these laws are highlighted below.

Assisted Living Service Plan Requirements

All residents in assisted living communities must have a written agreement with the home that covers the minimum information required by Idaho law. This includes an overview of any services that will be provided, staffing patterns and qualifications, a breakdown of the community's rates for services and supplies, a plan for resident funds management, description of the conditions needed for emergency transfers and the responsibilities of the resident.

Assisted living homes are required to perform an assessment to determine the needs of each resident. This assessment should cover any ADL support needed and include the level and frequency of support necessary, health services required, any agreement for medication assistance, behavioral symptoms along with interventions for each symptom, and any physician's orders for the resident. Once the assessment is complete, a service agreement is negotiated based on the results.

Assisted Living Admission Requirements

Assisted living homes may not admit residents who require care the community is not licensed to provide. This could include ongoing skilled nursing services, the use of physical restraints, intravenous therapy, tracheotomy care and syringe feeding. Residents who have needs that are incompatible with other residents, whether emotional, physical or social, may not be admitted, especially if they demonstrate they are a danger to themselves or others. Any resident who requires ambulatory assistance must reside on the ground floor unless certain fire safety rules are met.

Assisted Living Scope of Care

All assisted living communities must be able to provide basic services to residents, such as necessary supervision, assistance with activities of daily living (ADLs), medication assistance and monitoring, first aid, emergency interventions, outside service coordination and basic housekeeping that includes laundry. If necessary, residents can contract with third parties for additional services.

Assisted Living Medicaid Policy

Idaho Medicaid offers programs to pay for seniors' personal services at any location, including an assisted living facility, as long as they are not in a nursing home. The two Medicaid programs offered are the HCBS Aged and Disabled waiver and the Personal Care Services program. Neither program pays for meals or room and board as both are limited to personal services.

Assisted Living Facility Requirements

Idaho does not require apartment-style units for residents, but no more than two residents may share a single unit if licensed after July 1, 1991. Assisted living communities licensed before that date can house up to four residents in one unit. The home must provide at least one toilet for every six residents housed within the facility.

Meals in assisted living facilities are also regulated. Therapeutic diets require an order from an authorized provider or the resident's physician. A therapeutic diet menu plan must be approved with the date and a signature from a licensed dietitian. Food selections must be provided with the resident's habits, preferences and physical abilities in mind. Communities are required to offer snacks between meals and at bedtime.

Medication Management Regulations

Residents have the options of self-administering their medications, requesting assistance or having them administered. Staff who are unlicensed can help with self-administration provided they complete a course covering medication assistance and are designated to do so by a licensed nurse. Only a licensed nurse may administer medication or check medication regimens, which should be done on a quarterly basis.

All medications must be received in blister packs or medisets and must be filled by a licensed nurse or a pharmacy. For residents who display behavioral issues, the community must attempt intervention without drugs before psychotropic drugs are used. Should any resident demonstrate behavior that may require psychotropic drugs, possible side effects and need for the medication must be monitored.

Staffing Requirements

Every assisted living community must have a dedicated administrator on staff unless approved for a variance allowing an administrator to oversee multiple residences. The administrator is required to be on site long enough to ensure the safety of residents and confirm that care is adequate. Each community must have a licensed nurse on staff to handle administering medications and delegating staff for assistance with self-administered medications. Additional staff must be trained to provide services to residents. At least one direct-care staff member who is certified in first aid and cardiopulmonary resuscitation must be on site at all times.

Assisted living communities with a license for no more than 15 beds must have at least one trained and qualified staff member available during sleeping hours. If any resident requires night care or is unable to call for assistance, on-site staff must be awake. For communities licensed for more than 15 beds, staff is required to be awake during sleeping hours. If detached units house residents, at least one trained staff member must be present in each of those buildings.

Staff Training Requirements

Staff members at assisted living communities are prohibited from providing unsupervised personal assistance to residents until the completion of a 16-hour job-related orientation. All staff members are required to complete eight hours of job-related continuing training annually except licensed administrators, who must complete 12 hours of continuing education each year.

If the community is admitting residents who have been diagnosed with traumatic brain injury, mental illness or a developmental disability, staff must receive targeted training that covers the specialized needs of those residents.

Background Checks for ALF Staff in Idaho

All employees or contractors with direct access to residents must submit to a thorough criminal history and background check. This check must be conducted using a fingerprint search through the Federal Bureau of Investigations, Nurse Aide Registry, National Criminal History Background Check System and any other relevant state registries.

Requirements for Reporting Abuse

Idaho has an extensive list of mandated reporters for elder abuse, including medical professionals, any employees of a health facility, ombudsmen for the elderly, social workers, law enforcement and professional caregivers. Reporting is required if there is reasonable evidence that a senior has been abused, neglected or exploited. Nursing facilities and their employees report directly to the Department of Health and Welfare while others must report to the Idaho Commission on Aging. If an act of suspected abuse results in serious injury or death, a report must be made to the appropriate law enforcement agency.