The facility must provide each resident with at least the minimum food and nutritional needs in accordance with the
Recommended Dietary Allowances established by the Food and Nutrition Board of the National Academy of
Sciences. These recommendations are found in the Idaho Diet Manual incorporated by reference in Section 004 of
these rules. The menu must be adjusted for age, sex, and activity as approved by a registered dietitian.
01. Menu. The facility must have a menu planned or approved, and signed and dated by a registered
dietitian prior to being served to any resident. The planned menu must meet nutritional standards.
a. Menus will provide a sufficient variety of foods in adequate amounts at each meal;
b. Food selections must include foods that are served in the community and in season. Food selections
and textures should account for residents’ preferences, food habits, and physical abilities.
c. The current weekly menu must be posted in a facility common area; and
d. The facility must serve the planned menu. If substitutions are made, the menu must be modified to
reflect the substitutions.
02. Therapeutic Diets. The facility must have a therapeutic diet menu planned or approved, and
signed and dated by a registered dietitian prior to being served to any resident.
a. The therapeutic diet planned menu, if possible, must meet nutritional standards;
b. The therapeutic diet menu must be planned as close to a regular diet as possible; and
c. The facility must have for each resident on a therapeutic diet, an order from a physician or
authorized provider.
03. Facilities Licensed for Sixteen Beds or Less. In facilities licensed for sixteen (16) beds or less,
menus must be planned in writing at least one (1) week in advance.
04. Facilities Licensed for Seventeen Beds or More. Facilities licensed for seventeen (17) beds or
a. Develop and implement a cycle menu which covers a minimum of two (2) seasons and is four (4) to
five (5) weeks in length;
b. Follow standardized recipes; and
c. Have available in the kitchen a current copy of the Idaho Food Code and Idaho Diet Manual.
455. FOOD SUPPLY.
The facility must maintain a seven (7) day supply of nonperishable foods and a two (2) day supply of perishable
foods. The facility’s kitchen must have the types and amounts of food to be served readily available to meet all
planned menus during that time.
01. Food Preparation. Foods must be prepared by methods that conserve nutritional value, flavor, and
appearance.
02. Frequency of Meals. Food must be offered throughout the day, as follows:
a. To provide residents at least three (3) meals daily, at regular times comparable to normal mealtimes
in the community;
b. To ensure no more than fourteen (14) hours between a substantial evening meal and breakfast;
c. Ensure that residents who are not in the facility for the noon meal are offered a substantial evening
meal; and (
d. Offer snacks and fluids between meals and at bedtime.
03. Food Preparation Area. Any areas used for food preparation must be maintained as follows:
a. No live animals or fowl will be kept or maintained in the food service preparation or service area;
and
b. Food preparation and service areas cannot be used as living quarters for staff.
04. Disposable Items. The facility will not use single-use items except in unusual circumstances for a
short period of time or for special events.
510. REQUIREMENTS TO PROTECT RESIDENTS FROM ABUSE.
The administrator must ensure that policies and procedures are developed and implemented to ensure that all
residents are free from abuse. These policies and procedures should be posted in a conspicuous place in the facility,
shared with new residents, families upon admission, all residents annually thereafter, and made available upon
request.
515. REQUIREMENTS TO PROTECT RESIDENTS FROM EXPLOITATION.
The administrator must ensure that policies and procedures are developed and implemented to ensure that all
residents are free from exploitation. These policies and procedures should be posted in a conspicuous place in the
facility, shared with new residents, families upon admission, all residents annually thereafter, and made available
upon request.
520. REQUIREMENTS TO PROTECT RESIDENTS FROM INADEQUATE CARE.
The administrator must ensure that policies and procedures are developed and implemented to ensure that all
residents are free from inadequate care. These policies and procedures should be posted in a conspicuous place in the
facility, shared with new residents, families upon admission, all residents annually thereafter, and made available
upon request.
525. REQUIREMENTS TO PROTECT RESIDENTS FROM NEGLECT.
The administrator must ensure that policies and procedures are developed and implemented to ensure that all
residents are free from neglect. These policies and procedures should be posted in a conspicuous place in the facility,
shared with new residents, families upon admission, all residents annually thereafter, and made available upon
request.
550. REQUIREMENTS FOR RESIDENTS’ RIGHTS.
The administrator must ensure that policies and procedures are developed and implemented to ensure that residents’
rights are observed, promoted, and protected.
01. Resident Records. Upon request, a resident or others authorized by law, must be provided
immediate access to information in their record, and copies of information within two (2) business days. The facility
must maintain and keep current a record for each resident that contains the information specified in Section 330 of
these rules and Section 39-3316, Idaho Code.
02. Privacy. Each resident must be ensured the right to privacy with accommodations, medical and
other treatment, written and telephone communications, visits, and meetings of family and resident groups.
03. Humane Care and Environment.
a. Each resident has the right to humane care and a humane environment, including the following:
i. The right to a diet that is consistent with any religious or health-related restrictions;
ii. The right to refuse a restricted diet; and
iii. The right to a safe and sanitary living environment.
b. Each resident has the right to be treated with dignity and respect, including:
i. The right to be treated in a courteous manner by staff;
ii. The right to receive a response from the facility to any request of the resident within a reasonable
time; and
iii. The right to be communicated with, orally or in writing, in a language they understand. If the
resident’s knowledge of English or the predominant language of the facility is inadequate for comprehension, a
means to communicate in a language familiar to the resident must be available and implemented. There are many
possible methods such as bilingual staff, electronic communication devices, or family and friends to translate. The
method implemented must ensure the resident’s right to confidentiality, if the resident desires.
04. Personal Possessions. Each resident has the right to:
a. Wear their own clothing;
b. Determine their own dress or hair style;
c. Retain and use their own personal property in their own living area so as to maintain individuality
and personal dignity; and
d. Be provided a separate storage area in their own living area and at least one (1) locked cabinet or
drawer for keeping personal property.
05. Personal Funds. Residents whose board and care is paid for by public assistance will retain, for
their personal use, the difference between their total income and the applicable board and care allowance established
by Department rules. A facility must not require a resident to deposit their personal funds with the facility.
06. Management of Personal Funds. Upon a facility’s acceptance of written authorization of a
resident, the facility must manage and account for the personal funds of the resident deposited with the facility as
follows:
a. The facility must deposit any amount of a resident’s personal funds more than five (5) times the
personal needs allowance in an interest-bearing account (or accounts) that is separate from any of the facility’s
operating accounts and credit all interest earned on such separate account to the account. The facility must maintain
any other personal funds in a non-interest-bearing account or petty cash fund;
b. The facility must ensure a full and complete separate accounting of each resident’s personal funds,
maintain a written record of all financial transactions involving each resident’s personal funds deposited with the
facility, and afford the resident (or a legal representative of the resident) reasonable access to such record; and
(7-1-20)T
c. Upon the death of a resident with such an account, the facility must promptly convey the resident’s
personal funds (and a final accounting of such funds) to the individual administering the resident’s estate. For clients
of the Department, the remaining balance of funds must be refunded to the Department.
07. Access and Visitation Rights. Each facility must permit:
a. Immediate access to any resident by any representative of the Department, by the local ombudsman
for the elderly or their designees, or by the resident’s physician or authorized provider;
b. Immediate access to a resident, subject to the resident’s right to deny or withdraw consent at any
time, by the resident’s immediate family, significant other, or representative;
c. Immediate access to a resident, subject to reasonable restrictions and the resident’s right to deny or
withdraw consent at any time, by others who are visiting with the consent of the resident; and
d. Reasonable access to a resident by any entity or individual that provides health, social, legal, or
other services to the resident, subject to the resident’s right to deny or withdraw consent at any time.
08. Employment. Each resident must have the right to refuse to perform services for the facility except
as contracted for by the resident and the administrator of the facility. If the resident is hired by the facility to perform
services as an employee of the facility, the wage paid to the resident must be consistent with state and federal law.
09. Confidentiality. Each resident must have the right to confidentiality of personal and clinical
records.
10. Freedom from Abuse, Neglect, and Restraints. Each resident must have the right to be free from
physical, mental, or sexual abuse, neglect, corporal punishment, involuntary seclusion, and any physical or chemical
restraints.
11. Freedom of Religion. Each resident must have the right to practice the religion of their choice or to
abstain from religious practice. Residents must also be free from the imposition of the religious practices of others.
12. Control and Receipt of Health-Related Services. Each resident must have the right to control
their receipt of health-related services, including:
a. The right to retain the services of their own personal physician, dentist, and other health care
professionals;
b. The right to select the pharmacy or pharmacist of their choice so long as it meets the statute and
rules governing residential assisted living and the policies and procedures of the residential assisted living facility;
c. The right to confidentiality and privacy concerning their medical or dental condition and treatment;
and
d. The right to refuse medical services based on informed decision making. Refusal of treatment does
not relieve the facility of its obligations under this chapter.
i. The facility must document the resident and their legal guardian have been informed of the
consequences of the refusal; and
ii. The facility must document that the resident’s physician or authorized provider has been notified of
the resident’s refusal.
13. Grievances. Each resident must have the right to voice grievances with respect to treatment or care
that is, or fails to be, furnished, without threat of retaliation for voicing the grievances and the right to prompt efforts
by the facility to resolve grievances the resident may have, including those with respect to the behavior of other
residents.
14. Participation in Resident and Family Groups. Each resident must have the right to organize and
participate in resident groups in the facility and the right of the resident’s family to meet in the facility with the
families of other residents in the facility.
15. Participation in Other Activities. Each resident must have the right to participate in social,
religious, and community activities that do not interfere with the rights of other residents in the facility. (3-20-20)T
16. Examination of Survey Results. Each resident must have the right to examine, upon reasonable
request, the results of the most recent survey of the facility conducted by the Licensing Agency and any plan of
correction in effect.
17. Access by Advocates and Representatives. A residential assisted living facility must permit
advocates and representatives of community legal service programs, whose purposes include rendering assistance
without charge to residents, to have access to the facility at reasonable times in order to: (7-1-20)T
a. Visit, talk with, and make personal, social, and legal services available to all residents; (3-20-20)T
b. Inform residents of their rights and entitlements, and their corresponding obligations, under state,
federal, and local laws by distribution of educational materials and discussion in groups and with individuals;
c. Assist residents in asserting their legal rights regarding claims for public assistance, medical
assistance, and social security benefits, and in all other matters in which residents are aggrieved, that may be provided
individually, or in a group basis, and may include organizational activity, counseling, and litigation; (7-1-20)T
d. Engage in all other methods of assisting, advising, and representing residents so as to extend to
them the full enjoyment of their rights;
e. Communicate privately and without restrictions with any resident who consents to the
communication; and
f. Observe all common areas of the facility.
18. Access by Protection and Advocacy System. A residential assisted living facility must permit
advocates and representatives of the protection and advocacy system designated by the governor under 29 U.S.C.
794e, 42 U.S.C. Section 15043, and 42 U.S.C. Section 10801 et seq., access to residents, facilities, and records in
accordance with applicable federal statutes and regulations.
19. Access by the Long-Term Care Ombudsman. A residential assisted living facility must permit
advocates and representatives of the long-term care ombudsman program pursuant to 42 U.S.C. Section 3058,
Section 67-5009, Idaho Code, and IDAPA 15.01.03, “Rules Governing the Ombudsman for the Elderly Program,”
access to residents, facilities, and records in accordance with applicable federal and state law, rules, and regulations.
20. Transfer or Discharge. Each resident must have the right to be transferred or discharged only for
medical reasons, for their welfare or that of other residents, or for nonpayment for their stay. In non-emergency
conditions, the resident must be given at least thirty (30) calendar days notice of discharge. A resident has the right to
appeal any involuntary discharge.
21. Citizenship Rights. Each resident has the right to be encouraged and assisted to exercise rights as a
citizen, including the right to be informed and to vote.
22. Advance Directives. Each resident has the right to be informed, in writing, regarding the
formulation of an advance directive as provided under Section 39-4510, Idaho Code.
23. Fee Changes. Each resident has the right to written notice of any fee change not less than thirty
(30) days prior to the proposed effective date of the fee change, except:
a. When a resident needs additional care, services, or supplies, the facility must provide to the resident
or the resident’s legal guardian or conservator written notice within five (5) days of any fee change taking place;
b. The resident and the resident’s legal guardian or conservator must be given the opportunity to agree
to an amended NSA. If the two parties do not reach an agreement on the proposed fee change, the facility is entitled
to charge the changed rate after five (5) days have elapsed from the date of the facility’s written notice.