reglab/statecodes huggingface dataset:
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.01 - ELIGIBILITY FOR HEALTH CARE ASSISTANCE FOR FAMILIES AND CHILDREN › HEALTH COVERAGE FOR CHILDREN › Section 16.03.01.523 - ACCESS TO OR COVERAGE UNDER OTHER HEALTH PLANS

Current through August 31, 2023
A child is ineligible for coverage under the CHIP plan if
				  they have access to or are enrolled in other health coverage plans as described
				  below: (3-17-22)
01.
Covered by
				Creditable Health Insurance
. The child is covered by creditable health
				insurance at the time of application. (3-17-22)
02.
Eligible for Title XIX
. The
				child is eligible under Idaho's Title XIX State Plan. (3-17-22)
03.
Idaho State Employee Benefit
				Plan
. The child is eligible to receive health insurance benefits under
				Idaho's State employee benefit plan. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.01 - ELIGIBILITY FOR HEALTH CARE ASSISTANCE FOR FAMILIES AND CHILDREN › HEALTH COVERAGE FOR CHILDREN › Section 16.03.01.524 - CONTINUOUS HEALTH CARE ASSISTANCE ELIGIBILITY FOR CHILDREN UNDER AGE NINETEEN

Current through August 31, 2023
Children under age nineteen (19), who are found eligible for
				  health coverage in an initial determination or at renewal, remain eligible for
				  a period of twelve (12) months. The twelve (12) month continuous eligibility
				  period does not apply if, for any reason, eligibility was determined
				  incorrectly. (3-17-22)
01.
Reasons Continuous Eligibility Ends
. Continuous eligibility for
				children ends for one (1) of the following reasons: (3-17-22)
a. The child is no longer an Idaho resident;
				(3-17-22)
b. The child dies;
				(3-17-22)
c. The participant
				requests closure; or (3-17-22)
d.
				The child turns nineteen (19) years of age as defined in Subsection
				010.05 of these rules.
				(3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.01 - ELIGIBILITY FOR HEALTH CARE ASSISTANCE FOR FAMILIES AND CHILDREN › HEALTH COVERAGE FOR CHILDREN › Section 16.03.01.525 - FORMER FOSTER CHILD

Current through August 31, 2023
An individual who is between the age of eighteen (18) and
				  twenty-six (26), who was in foster care in Idaho and became ineligible for
				  Medicaid as a foster child due to age, may receive Medicaid coverage until his
				  twenty-sixth birthday. There are no financial eligibility criteria. The only
				  non-financial criteria are the receipt of foster care services and age.
				  (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.01 - ELIGIBILITY FOR HEALTH CARE ASSISTANCE FOR FAMILIES AND CHILDREN › SPECIAL CIRCUMSTANCES FOR CHILDREN › Section 16.03.01.530 - NEWBORN CHILD DEEMED ELIGIBLE FOR MEDICAID

Current through August 31, 2023
A child is deemed eligible for Medicaid for his first year of
				  life when the following exists. (3-17-22)
01.
Mother Filing an
				Application
. The child is born to a mother who files an application for
				medical assistance. (3-17-22)
02.
Mother Is Eligible for Medicaid
. The mother is eligible for
				Medicaid in the newborn's birth month, including a month of retroactive
				coverage. This includes a mother who qualifies for coverage only for the
				delivery because of her alien status. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.01 - ELIGIBILITY FOR HEALTH CARE ASSISTANCE FOR FAMILIES AND CHILDREN › SPECIAL CIRCUMSTANCES FOR CHILDREN › Section 16.03.01.531 - MINOR PARENT LIVING WITH PARENTS

Current through August 31, 2023
A minor parent is a child under the age of eighteen (18) who
				  is pregnant or has a child. Minor parents who live with their parents may be
				  eligible for Health Care Assistance for themselves and their children. The
				  minor parent's eligibility is determined according to the Section
				  300 of these rules related to tax
				  filing households. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.01 - ELIGIBILITY FOR HEALTH CARE ASSISTANCE FOR FAMILIES AND CHILDREN › SPECIAL CIRCUMSTANCES FOR CHILDREN › Section 16.03.01.532 - RESIDENT OF AN ELIGIBLE INSTITUTION

Current through August 31, 2023
A resident of an eligible institution must meet all
				  nonfinancial and financial criteria of Title XIX, Title XXI, or any other
				  applicable program. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.01 - ELIGIBILITY FOR HEALTH CARE ASSISTANCE FOR FAMILIES AND CHILDREN › SPECIAL CIRCUMSTANCES FOR CHILDREN › Section 16.03.01.533 - CHILDREN WITH SPECIAL CIRCUMSTANCES AND MEDICAID

Current through August 31, 2023
Children who receive foster care or are in adoptive
				  placements are eligible for Medicaid. The children must meet nonfinancial
				  criteria and must meet the financial requirements described for the children's
				  coverage group. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.01 - ELIGIBILITY FOR HEALTH CARE ASSISTANCE FOR FAMILIES AND CHILDREN › SPECIAL CIRCUMSTANCES FOR CHILDREN › Section 16.03.01.535 - TITLE IV-E FOSTER CARE CHILD

Current through August 31, 2023
A child may be eligible for Medicaid under the Title IV-E
				  foster care program if they meet the eligibility requirements in IDAPA
				  16.06.01, "Child and Family Services," Section
				  425. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.01 - ELIGIBILITY FOR HEALTH CARE ASSISTANCE FOR FAMILIES AND CHILDREN › SPECIAL CIRCUMSTANCES FOR CHILDREN › Section 16.03.01.540 - YOUTH EMPOWERMENT SERVICES (YES) PROGRAM CHILDREN

Current through August 31, 2023
01.
Payments for Children Under
				Eighteen (18) Years of Age with SED
. In accordance with Section
				56-254(2), Idaho
				Code, the Department will make payments for medical assistance for a child
				under eighteen (18) years of age with serious emotional disturbance (SED), as
				defined in Section
				16-2403, Idaho Code, and verified
				by an independent assessment: (3-17-22)
a.
				Whose family income does not exceed three hundred percent (300%) of the federal
				poverty guideline (FPG) as determined using MAGI-based eligibility standards;
				or (3-17-22)
b. Who meets other
				Title XIX Medicaid eligibility standards in accordance with the rules of the
				Department. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.01 - ELIGIBILITY FOR HEALTH CARE ASSISTANCE FOR FAMILIES AND CHILDREN › SPECIAL CIRCUMSTANCES FOR CHILDREN › Section 16.03.01.545 - PRESUMPTIVE ELIGIBILITY FOR CHILDREN AND ADULTS

Current through August 31, 2023
Presumptive eligibility determination for qualifying medical
				  coverage groups can only be provided by a qualified hospital defined in Section
				  011 or these rules.
				  (3-17-22)
01.
Presumptive
				Eligibility Decisions
. Decisions of presumptive eligibility can be made
				for individuals, who meet program requirements for MAGI-based Medicaid
				coverage. (3-17-22)
02.
Presumptive Eligibility Determination
. Presumptive eligibility
				determinations are made by a qualified hospital when an individual receiving
				medical services is not covered by health care insurance and the financial
				assessment by hospital staff indicates the individual is eligible for Medicaid
				Coverage in Idaho. This determination is made by hospital staff through an
				online presumptive application process: (3-17-22)
a. Prior to completion of a full Medicaid
				application; and (3-17-22)
b. Prior
				to a determination being made by the Department on the full application.
				(3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.01 - ELIGIBILITY FOR HEALTH CARE ASSISTANCE FOR FAMILIES AND CHILDREN › SPECIAL CIRCUMSTANCES FOR CHILDREN › Section 16.03.01.546 - QUALIFIED HOSPITAL PRESUMPTIVE ELIGIBILITY PROCESSES

Current through August 31, 2023
A qualified hospital must have a Memorandum of Understanding
				  (MOU) with the Department and follow all standards and processes agreed to in
				  the MOU. (3-17-22)
01.
Acceptance of Application
. The qualified hospital accepts the
				request for services in the same manner as all applications for assistance are
				accepted. (3-17-22)
02.
Standards and Processes
. The presumptive eligibility determination
				must be based on standards and processes provided by the Department.
				(3-17-22)
03.
Assistance to
				Applicant
. The qualified hospital must assist the applicant in
				completing the Department's application process. (3-17-22)
04.
Qualified Hospital Staff
.
				Only qualified hospital staff who are trained in presumptive eligibility
				standards can make a presumptive eligibility determination. (3-17-22)
05.
Notice to Applicant
. The
				qualified hospital or the Department will provide notice to the applicant
				within two business days on the presumptive eligibility determination.
				(3-17-22)
06.
Notice and
				Hearing Rights
. Presumptive eligibility decisions are not appealable and
				do not have hearing rights under the Title XIX Medicaid program.
				(3-17-22)
07.
Number of
				Presumptive Eligibility Periods Allowed
. Only one (1) presumptive
				eligibility period is allowed per applicant in any twelve (12) month period.
				(3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.01 - ELIGIBILITY FOR HEALTH CARE ASSISTANCE FOR FAMILIES AND CHILDREN › CASE MAINTENANCE REQUIREMENTS › Section 16.03.01.600 - ANNUAL ELIGIBILITY RENEWAL

Current through August 31, 2023
Participants must have an annual eligibility review of all
				  eligibility factors. Exceptions to the annual eligibility renewal are listed in
				  Section 601 of these
				  rules. (3-17-22)
01.
Continuing
				Eligibility
. Continuing eligibility is determined using available
				electronic verification sources without participant contact, unless: (3-17-22)
a. Information is not available;
				(3-17-22)
b. Information sources
				provide conflicting information; or (3-17-22)
c. Information is inconsistent with
				information provided by the participant. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.01 - ELIGIBILITY FOR HEALTH CARE ASSISTANCE FOR FAMILIES AND CHILDREN › CASE MAINTENANCE REQUIREMENTS › Section 16.03.01.601 - EXCEPTIONS TO ANNUAL RENEWAL

Current through August 31, 2023
A participant who receives Title XIX or Title XXI through
				  time-limited coverage does not require an annual renewal when the following
				  exists. (3-17-22)
01.
Extended
				Medicaid
. A participant who receives extended Medicaid is eligible as
				provided in Section 420 of these
				rules. (3-17-22)
02.
Pregnant
				Woman
. A participant who receives Medicaid as a Low Income Pregnant
				Woman is eligible as provided in Section
				500 of these rules.
				(3-17-22)
03.
Newborn Child
				of Medicaid-Eligible Mother
. A participant receiving Medicaid as the
				newborn child of a Medicaid-eligible mother is eligible as provided in Section
				530 of these rules.
				(3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.01 - ELIGIBILITY FOR HEALTH CARE ASSISTANCE FOR FAMILIES AND CHILDREN › CASE MAINTENANCE REQUIREMENTS › Section 16.03.01.610 - REPORTING REQUIREMENTS

Current through August 31, 2023
Changes in family circumstances must be reported to the
				  Department by the tenth of the month following the month in which the change
				  occurred. Report of changes may be made verbally, in writing, through personal
				  contact, telephone, fax, electronic mail, or mail. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.01 - ELIGIBILITY FOR HEALTH CARE ASSISTANCE FOR FAMILIES AND CHILDREN › CASE MAINTENANCE REQUIREMENTS › Section 16.03.01.611 - TYPES OF CHANGES THAT MUST BE REPORTED

Current through August 31, 2023
Changes in circumstances the participant must report are the
				  following: (3-17-22)
01.
Name or
				Address
. A name change for any participant must be reported. A change of
				address or location must be reported. (3-17-22)
02.
Household Composition
.
				Changes in family composition must be reported if a parent or relative
				caretaker receives Medicaid. (3-17-22)
03.
Marital Status
. Marriages or
				divorces of any family member must be reported if a parent or relative
				caretaker receives Medicaid. (3-17-22)
04.
New Social Security Number
.
				A Social Security Number (SSN) that is newly assigned to a Medicaid Health Care
				Assistance program participant must be reported. (3-17-22)
05.
Health Insurance Coverage
.
				Enrollment or disenrollment of a participant in a health insurance plan must be
				reported. (3-17-22)
06.
End
				of Pregnancy
. Pregnant participants must report when pregnancy ends.
				(3-17-22)
07.
Earned
				Income
. Changes in the amount or source of earned income must be
				reported if a parent or relative caretaker receives Title XIX benefits.
				(3-17-22)
08.
Unearned
				Income
. Changes in the amount or source of unearned income must be
				reported if a parent or relative caretaker receives Title XIX benefits.
				(3-17-22)
09.
Support
				Income
. Changes in the amount of spousal support received by an adult
				household member. (3-17-22)
10.
Disability
. A family member who becomes disabled or is no longer
				disabled must be reported if a parent or relative caretaker receives Title XIX
				benefits. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.01 - ELIGIBILITY FOR HEALTH CARE ASSISTANCE FOR FAMILIES AND CHILDREN › CASE MAINTENANCE REQUIREMENTS › Section 16.03.01.620 - NOTICE OF CHANGES IN ELIGIBILITY

Current through August 31, 2023
The Department will notify the participant of changes in his
				  Health Care Assistance. The notice must give the effective date, the reason for
				  the action, the rule that supports the action, and appeal rights.
				  (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.01 - ELIGIBILITY FOR HEALTH CARE ASSISTANCE FOR FAMILIES AND CHILDREN › CASE MAINTENANCE REQUIREMENTS › Section 16.03.01.621 - NOTICE OF CHANGE OF PLAN

Current through August 31, 2023
The Department is allowed to switch a participant from the
				  Medicaid Basic Plan to the Medicaid Enhanced plan within the same month.
				  Advance notice must be given to the participant when there is a decrease in
				  their benefits and he will be switched from the enhanced plan to the basic
				  plan. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.01 - ELIGIBILITY FOR HEALTH CARE ASSISTANCE FOR FAMILIES AND CHILDREN › CASE MAINTENANCE REQUIREMENTS › Section 16.03.01.622 - ADVANCE NOTICE RESPONSIBILITY

Current through August 31, 2023
The Department must notify the participant at least ten (10)
				  calendar days before the effective date of when a reported change results in
				  Health Care Assistance closure. The effective date must allow for a five (5)
				  day mailing period for any notice. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.01 - ELIGIBILITY FOR HEALTH CARE ASSISTANCE FOR FAMILIES AND CHILDREN › CASE MAINTENANCE REQUIREMENTS › Section 16.03.01.623 - ADVANCE NOTICE NOT REQUIRED

Current through August 31, 2023
Advance notice is not required when a condition listed in
				  Subsections 623.01 through
				  623.08 of this rule exists. The
				  participant must be notified no later than the date of the action.
				  (3-17-22)
01.
Death of
				Participant
. The Department has proof of the participant's death.
				(3-17-22)
02.
Participant
				Request
. The participant requests closure in writing.
				(3-17-22)
03.
Participant in
				Institution
. The participant is admitted or committed to an institution.
				Further payments to the participant do not qualify for federal financial
				participation under the state plan. (3-17-22)
04.
Nursing Care
. The
				participant is placed in a nursing facility or Intermediate Care Facility for
				Persons with Intellectual Disabilities (ICF/IID). (3-17-22)
05.
Participant Address Unknown
.
				The participant's whereabouts are unknown. (3-17-22)
06.
Medical Assistance in Another
				State
. A participant is approved for medical assistance in another
				state. (3-17-22)
07.
Eligible
				One Month
. The participant is eligible for aid only during the calendar
				month of his application for aid. (3-17-22)
08.
Retroactive Medicaid
. The
				participant's Title XIX or Title XXI eligibility is for a prior period.
				(3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.01 - ELIGIBILITY FOR HEALTH CARE ASSISTANCE FOR FAMILIES AND CHILDREN › CASE MAINTENANCE REQUIREMENTS › Section 16.03.01.700 - OVERPAYMENTS

Current through August 31, 2023
Health Care Assistance overpayments occur when a participant
				  receives benefits during a month he was not eligible. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.01 - ELIGIBILITY FOR HEALTH CARE ASSISTANCE FOR FAMILIES AND CHILDREN › CASE MAINTENANCE REQUIREMENTS › Section 16.03.01.701 - RECOVERY OF OVERPAYMENTS

Current through August 31, 2023
All Health Care Assistance overpayments are subject to
				  recovery. Overpayments are recovered by direct payment from the participant.
				  (3-17-22)
01.
Notice of
				Overpayment
. The participant must be informed of the Health Care
				Assistance overpayment and appeal rights. (3-17-22)
02.
Notice of Recovery
. The
				participant must be informed when his Health Care Assistance overpayment is
				fully recovered. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.02 - SKILLED NURSING FACILITIES › Section 16.03.02.000 - LEGAL AUTHORITY

Current through August 31, 2023
The Idaho Legislature has delegated to the Board of Health and
				Welfare the responsibility to establish and enforce rules to promote safe and
				adequate treatment of individuals within a Skilled Nursing Facility under
				Sections 39-1306,
				39-1307,
				39-1307A, and
				39-1307B, Idaho Code.
				(3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.02 - SKILLED NURSING FACILITIES › Section 16.03.02.001 - TITLE AND SCOPE

Current through August 31, 2023
01.
Title
. These rules are titled, IDAPA 16, Title 03, Chapter 02,
			 "Skilled Nursing Facilities." (3-17-22)
02.
Scope
. These rules establish
			 regulations and standards for the provision of adequate care and licensure of
			 Skilled Nursing Facilities in the state of Idaho. These rules are expressly
			 intended for the benefit of all skilled nursing residents. To this end, the
			 Idaho State Board of Health and Welfare may issue variances to these rules
			 under standards and procedures established by the Board. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.02 - SKILLED NURSING FACILITIES › Section 16.03.02.009 - CRIMINAL HISTORY AND BACKGROUND CHECK REQUIREMENTS

Current through August 31, 2023
01.
Criminal History and Background
			 Check
. A skilled nursing facility must complete a criminal history and
			 background check on employees and contractors hired or contracted with after
			 October 1, 2007, who have direct patient access to residents in the skilled
			 nursing facility. A Department check conducted under IDAPA 16.05.06, "Criminal
			 History and Background Checks," satisfies this requirement. Other criminal
			 history and background checks may be accepted provided they meet the criteria
			 in Subsection 009.02 of
			 this rule and the entity conducting the check issues written findings. The
			 entity must provide a copy of these written findings to both the facility and
			 the employee. (3-17-22)
02.
Scope of a Criminal History and Background Check
. The criminal
			 history and background check must, at a minimum, be a fingerprint-based
			 criminal history and background check that includes a search of the following
			 record sources: (3-17-22)
a. Federal Bureau
			 of Investigation (FBI); (3-17-22)
b. Idaho State Police Bureau of Criminal
			 Identification; (3-17-22)
c. Sexual
			 Offender Registry; (3-17-22)
d.
			 Office of Inspector General List of Excluded Individuals and Entities; and
			 (3-17-22)
e. Nurse Aide Registry.
			 (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.02 - SKILLED NURSING FACILITIES › Section 16.03.02.010 - DEFINITIONS

Current through August 31, 2023
For the purposes of these rules the following terms are used,
				as defined herein: (3-17-22)
01.
Administrator
. The person delegated the responsibility for
			 management of a facility by the legal owner, employed as a full-time
			 administrator in each facility, and licensed by the state of Idaho. The
			 administrator and legal owner may be the same individual. (3-17-22)
02.
Advanced Practice Registered
			 Nurse
. A licensed registered nurse having specialized skills, knowledge
			 and experience who is authorized under the Idaho Board of Nursing rules to
			 provide certain health services in addition to those performed by licensed
			 registered nurses (R.N.). (3-17-22)
03.
Board
. The Idaho State Board
			 of Health and Welfare. (3-17-22)
04.
Change of Ownership
. The
			 sale, purchase, exchange, or lease of an existing facility by the present owner
			 or operator to a new owner or operator. (3-17-22)
05.
Charge Nurse
. One (1) or
			 more licensed nurse(s) who has direct responsibility for nursing services in an
			 operating unit or physical subdivision of a facility during one (1) eight (8)
			 hour shift, to be provided by herself and by any other licensed nurse or
			 auxiliary personnel under her immediate charge. (3-17-22)
06.
Department
. The Idaho
			 Department of Health and Welfare. (3-17-22)
07.
Director
. The Director of
			 the Department of Health and Welfare or designee. (3-17-22)
08.
Director of Nursing Services
			 (DNS)
. A licensed registered nurse currently licensed by the state of
			 Idaho and qualified by training and experience. (3-17-22)
09.
Existing Facility
. A nursing
			 home currently licensed. (3-17-22)
10.
Governmental Unit
. The state
			 of Idaho, any county, municipality, or other political subdivision, or any
			 department, division, board or other agency thereof. (3-17-22)
11.
Hospital Licensing Act
. The
			 act set out in Sections
			 39-1301 through
			 39-1314, Idaho Code.
			 (3-17-22)
12.
Licensee
. The person or organization to whom a license is issued.
			 (3-17-22)
13.
Licensing
			 Agency
. The Department of Health and Welfare. (3-17-22)
14.
Licensed Nursing Personnel
.
			 A licensed registered nurse (R.N.) or licensed practical nurse (L.P.N.)
			 currently licensed by the Idaho State Board of Nursing. (3-17-22)
15.
New Construction
. (3-17-22)
a. New buildings to be used as a facility.
			 (3-17-22)
b. Additions to existing
			 buildings and/or added bed capacity. (3-17-22)
c. Conversion of existing buildings or
			 portions thereof for use as a facility. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.02 - SKILLED NURSING FACILITIES › Section 16.03.02.050 - LICENSURE

Current through August 31, 2023
01.
General Requirements
. Before
			 any person either directly or indirectly operates a facility, they must make an
			 application for and receive a valid license for operation of the facility, and
			 no resident must be admitted or cared for in a facility that is required under
			 Idaho law to be licensed, until a license is obtained. (3-17-22)
a. The facility and all related buildings
			 associated with the operation of the facility, as well as all records required
			 under these rules, must be accessible at any reasonable time to authorized
			 representatives of the Department for the purpose of inspection, with or
			 without prior notice. (3-17-22)
b.
			 Before any building is constructed or altered for use as a facility, written
			 approval of construction or alteration of plans must be obtained from the
			 Department. (3-17-22)
c.
			 Information received by the licensing agency through filed reports, inspection,
			 or as otherwise authorized under this law, must not be disclosed publicly in
			 such a manner as to identify individual residents except in a proceeding
			 involving the question of licensure. Public disclosure of information obtained
			 by the licensing agency for the purposes of this law must be governed by rules,
			 regulations, and minimum standards adopted by the Board.
			 (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.02 - SKILLED NURSING FACILITIES › Section 16.03.02.100 - ADMINISTRATION

Current through August 31, 2023
01.
Governing Body
. Each
			 facility must be organized and administered under one (1) authority which may
			 be a proprietorship, partnership, association, corporation, or governmental
			 unit. The following requirements must be met: (3-17-22)
a. That the true name and current address for
			 each person or business entity having a five percent (5%) or more direct, or
			 indirect, ownership interest in the facility is supplied to the Department at
			 the time of licensure application or preceding any change in ownership.
			 (3-17-22)
b. That the names,
			 addresses, and titles of offices held by all members of the facility's
			 governing authority are submitted to the Department. (3-17-22)
c. That a copy of the lease (if a building or
			 buildings are leased to a person or persons to operate as a facility) showing
			 clearly in the context which party to the agreement is to be held responsible
			 for the maintenance and upkeep of the property to meet minimum standards is
			 available for review by the Department. Terms of the financial arrangement may
			 be omitted from the copy of the lease available to the Department.
			 (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.02 - SKILLED NURSING FACILITIES › Section 16.03.02.105 - PERSONNEL

Current through August 31, 2023
01.
Daily Work Schedules
. Daily
			 work schedules must be maintained that reflect: (3-17-22)
a. Personnel on duty at any given time for
			 the previous three (3) months; (3-17-22)
b. The first and last names of each employee,
			 including professional designation (R.N., L.P.N., etc.) and position; and
			 (3-17-22)
c. Any adjustments made
			 to the schedule. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.02 - SKILLED NURSING FACILITIES › Section 16.03.02.106 - FIRE AND LIFE SAFETY

Current through August 31, 2023
Facilities must meet general requirements for the fire and life
				safety standards for a health care facility as follows: (3-17-22)
01.
General Requirements
.
			 General requirements for the fire and life safety standards for a health care
			 facility are as follows: (3-17-22)
a. The
			 facility must be structurally sound, maintained, and equipped to assure the
			 safety of residents, employees, and the public. (3-17-22)
b. Where natural or man-made hazards are
			 present on the premises, that the facility must provide suitable fences,
			 guards, and/or railings to isolate the hazard from the resident's environment.
			 (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.02 - SKILLED NURSING FACILITIES › Section 16.03.02.107 - DIETARY SERVICE

Current through August 31, 2023
The following requirements must be met: (3-17-22)
01.
Approved Diet Manual
. A
			 current diet manual approved by the Department and available in the kitchen
			 (the Idaho Diet Manual is approved by the Department). (3-17-22)
02.
Preparation and Correction of
			 Menus
. That menus are prepared at least a week in advance and corrected
			 to conform with food actually served (items not served deleted and food
			 actually served written in.) The corrected copy of the menu and diet plan is to
			 be dated and kept on file for thirty (30) days. (3-17-22)
03.
Variety and Adequacy of
			 Food
. That menus provide a sufficient variety of foods in adequate
			 amounts at each meal. Menus are to be different for the same days each week and
			 adjusted for seasonal changes. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.02 - SKILLED NURSING FACILITIES › Section 16.03.02.108 - ENVIRONMENTAL SANITATION

Current through August 31, 2023
The following requirements must be met: (3-17-22)
01.
Water Supply
. An approved
			 public or municipal water supply is used wherever available. (3-17-22)
a. In areas where an approved public or
			 municipal water supply is not available, a private water supply is provided,
			 and meets the standards approved by the Department. (3-17-22)
b. If water is from a private supply, water
			 samples are submitted to the Department through the district public health
			 laboratory for bacteriological examination at least once every three (3)
			 months. Monthly bacteriological examinations are recommended. Copies of the
			 laboratory reports are kept on file in the facility by the administrator.
			 (3-17-22)
c. There is sufficient
			 amount of water under adequate pressure to meet the sanitary requirements of
			 the facility at all times. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.02 - SKILLED NURSING FACILITIES › Section 16.03.02.120 - EXISTING BUILDINGS

Current through August 31, 2023
These standards must be applied to all currently licensed
				health care facilities. Any minor alterations, repairs, and maintenance must
				meet these standards. In the event of a change in ownership of a facility, the
				entire facility must meet these standards prior to issuance of a new license.
				(3-17-22)
01.
Codes and
			 Standards
. Construction features of all existing facilities must be in
			 accordance with applicable local, state, national codes, standards, and
			 regulations in effect at the time of adoption of these rules. (3-17-22)
a. In the event of a conflict of requirement
			 between the codes, the most restrictive apply. (3-17-22)
b. In addition, existing facilities are to
			 comply with applicable fire and life safety codes and standards as set forth in
			 Section 106.
			 (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.02 - SKILLED NURSING FACILITIES › Section 16.03.02.121 - NEW CONSTRUCTION STANDARDS

Current through August 31, 2023
The following requirements must be met: (3-17-22)
01.
Plans, Specifications, and
			 Inspections
. New facility construction or any addition, conversion, or
			 renovation of an existing facility is governed by the following rules:
			 (3-17-22)
a. Prior to commencing work
			 pertaining to construction of new buildings, any additions, structural changes
			 to existing facilities, or conversion of buildings to be used as a facility,
			 plans and specifications must be submitted to, and approved by, the Department
			 to assure compliance with the applicable construction standards, codes, rules,
			 and regulations. (3-17-22)
b. The
			 plans and specifications must be prepared by, or executed under, the immediate
			 supervision of a licensed architect registered in the state of Idaho. The
			 employment of an architect may be waived by the Department in certain minor
			 alterations. (3-17-22)
c.
			 Preliminary plans must be submitted and include at least the following:
			 (3-17-22)
i. The assignment of all spaces,
			 size of areas and rooms, and indicated in outline the fixed and movable
			 equipment and furniture. (3-17-22)
ii. The plans are drawn at a scale
			 sufficiently large to clearly present the proposed design, but not less than a
			 scale of one-eighth inch (1/8") equals one foot (1'). (3-17-22)
iii. The drawings include a plan for each
			 floor, including the basement or ground floor with approach or site plan,
			 showing roads, parking areas, sidewalks, etc. (3-17-22)
iv. The total floor area and number of beds
			 are computed and noted on the drawings. (3-17-22)
v. Outline specifications provide a general
			 description of the construction, including interior finishes, acoustical
			 material, its extent and type and heating, electrical, and ventilation systems.
			 (3-17-22)
d. Before
			 commencing construction, the working drawings must be developed in close
			 cooperation with, and approved by, the Department and other appropriate
			 agencies with the following. (3-17-22)
i.
			 Working drawings and specifications are prepared so that clear, distinct prints
			 may be obtained, accurately dimensioned, and include all necessary explanatory
			 notes, schedules, legends, and stamped with the licensed architect's seal.
			 (3-17-22)
ii. Working drawings are
			 complete and adequate for contract purposes. Separate drawings are prepared for
			 each of the following branches of work: architectural, mechanical and
			 electrical. (3-17-22)
e.
			 Prior to occupancy, the facility must be inspected and approved by the
			 licensing agency. The agency will be notified at least two (2) weeks prior to
			 completion in order to schedule a final inspection.
			 (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.02 - SKILLED NURSING FACILITIES › Section 16.03.02.122 - FURNISHINGS AND EQUIPMENT

Current through August 31, 2023
01.
Furnishings - Resident Living Rooms and Bedrooms
. Living rooms for
			 residents' use must be provided with a sufficient number of reading lamps,
			 tables, chairs, or sofas of satisfactory design for age and condition of the
			 residents. The following requirements must be met: (3-17-22)
a. Each resident is provided with their own
			 bed that is at least thirty-six (36) inches wide, have a head and a footboard,
			 be substantially constructed, and in good repair. Roll-away type beds, cots,
			 folding beds, double beds, or Hollywood-type beds are not to be used.
			 (3-17-22)
b. Each bed is provided
			 with satisfactory type springs in good repair and a clean, comfortable mattress
			 at least five (5) inches thick, (four (4) inches if of foam rubber construction
			 and four and one-half (4-1/2) inches if of innerspring type) and standard in
			 size for the bed. (3-17-22)
c. Each
			 resident is provided with an individual rack with towel and washcloth.
			 (3-17-22)
d. In addition to basic
			 resident care equipment, each resident is provided an individual reading light,
			 bedside cabinet with drawer, comfortable chair, and storage space for clothing
			 and other possessions. (3-17-22)
e.
			 Each resident is provided with a cup and a covered pitcher of fresh water (or
			 the equivalent) at the bedside if the resident needs assistance to ambulate but
			 is able to drink without assistance. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.02 - SKILLED NURSING FACILITIES › Section 16.03.02.152 - SOCIAL SERVICES

Current through August 31, 2023
The facility must provide for the identification of the social
				and emotional needs of the residents either directly or through arrangements
				with an outside resource and provide means to meet the needs identified.
				Sufficient staff must be provided to implement the program as follows:
				(3-17-22)
01.
Licensed Social
			 Worker
. That a social worker is licensed by the state of Idaho as a
			 social worker or who receives regular consultation from such a qualified social
			 worker. (3-17-22)
02.
Outside Resources
. That if the facility does not provide the services
			 directly but arranges with an outside resource to provide the services, a
			 facility staff member is designated in writing as a liaison person.
			 (3-17-22)
03.
Identify and
			 Implement Programs
. That the facility ensures that identification of
			 needs and implementation of programs meets the needs and appropriate record
			 keeping is accomplished. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.02 - SKILLED NURSING FACILITIES › Section 16.03.02.154 - PHYSICIAN SERVICES

Current through August 31, 2023
The following standards must be met: (3-17-22)
01.
Physician Supervision
. That
			 each resident is under the direct and continuing supervision of a physician of
			 their own choice licensed by the Idaho Board of Medicine. (3-17-22)
02.
Necessary Medical
			 Information
. That the physician provides the facility with medical
			 information necessary to care for the resident that includes at least a current
			 history and physical or medical findings completed made no longer than five (5)
			 days prior to admission or within forty-eight (48) hours after admission. The
			 information includes diagnosis, medical findings, activity limitations, and
			 rehabilitation potential. (3-17-22)
03.
Physician's Plan of Care
.
			 That a physician's plan of care is provided to the facility upon admission of
			 the resident that reflects medication orders, treatments, diet orders, activity
			 level approved, and any other directives to the facility for the care of the
			 resident. (3-17-22)
04.
Plan
			 of Care Review
. That the physician's plan of care for the resident is
			 reviewed by the physician as follows: (3-17-22)
a. Every thirty (30) to sixty (60) days for
			 skilled care residents depending upon the visit schedule authorized.
			 (3-17-22)
b. The plan of care is
			 reordered with any changes included by the physician and signed and dated by
			 the physician at the time of the review. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.02 - SKILLED NURSING FACILITIES › Section 16.03.02.200 - NURSING SERVICES

Current through August 31, 2023
The following requirements must be met: (3-17-22)
01.
Director of Nursing Services
			 (DNS)
. A licensed registered nurse currently licensed by the state of
			 Idaho and qualified by training and experience is designated DNS in each SNF
			 and is responsible and accountable for the following: (3-17-22)
a. Participating in the development and
			 implementation of resident care policies; (3-17-22)
b. Developing and/or maintaining goals and
			 objectives of nursing service, standards of nursing practice, and nursing
			 policy and procedures manuals; (3-17-22)
c. Assisting in the screening and selection
			 of prospective residents in terms of their needs, and the services available in
			 the facility; (3-17-22)
d.
			 Observing and evaluating the condition of each resident and developing a
			 written, individualized patient care plan that is based upon an assessment of
			 the needs of each resident, and that is kept current through review and
			 revision; (3-17-22)
e. Recommending
			 to the administrator the numbers and categories of nursing and auxiliary
			 personnel to be employed and participating in their recruitment, selection,
			 training, supervision, evaluation, counseling, discipline, and termination when
			 necessary. Developing written job descriptions for all nursing and auxiliary
			 personnel; (3-17-22)
f. Planning
			 and coordinating orientation programs for new nursing and auxiliary personnel,
			 as well as a formal, coordinated in-service education program for all nursing
			 personnel; (3-17-22)
g. Preparing
			 daily work schedule for nursing and auxiliary personnel that includes names of
			 employees, professional designation, hours worked, and daily patient census;
			 and (3-17-22)
h. Coordinating the
			 nursing service with related resident care services;
			 (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.02 - SKILLED NURSING FACILITIES › Section 16.03.02.201 - PHARMACY SERVICES

Current through August 31, 2023
The following requirements must be met: (3-17-22)
01.
Pharmacy Service
. That each
			 SNF has a written agreement with a pharmacist licensed by the state of Idaho to
			 direct, supervise, and be responsible for pharmacy service in the facility and
			 for coordinating services when more than one (1) supplier of medications is
			 utilized by the facility. (3-17-22)
02.
Care of General Medications
.
			 That the care and handling of medications is conducted in the following manner:
			 (3-17-22)
a. Medications are administered to
			 residents of the SNF only on the order of a person authorized by law in Idaho
			 to prescribe medications. This order is recorded on the resident's medical
			 record, dated and signed by the ordering physician, dentist or nurse
			 practitioner. (3-17-22)
b. All
			 telephone and verbal orders are taken by licensed nurses, pharmacists and
			 physicians only, and recorded on the resident's clinical record, dated and
			 signed by the person taking the order. Telephone and verbal orders are
			 countersigned by the ordering physician, dentist or nurse practitioner within
			 seven (7) days. (3-17-22)
c. No
			 person other than licensed nursing personnel and physicians administer
			 medications. This does not include execution of duties of inhalation therapists
			 as ordered by the attending physician. (3-17-22)
d. Nursing service personnel do not package
			 or repackage, bottle or label any medication, in whole or in part.
			 (3-17-22)
e. Prescription
			 medication is administered only to the resident whose name appears on the
			 prescription legend. (3-17-22)
f.
			 All medications are labeled with the original prescription legend including the
			 name and address of the pharmacy, resident's name, physician's name,
			 prescription number, original date and refill date, dosage unit, number of
			 dosage units, and instructions for use and drug name. (Exception: See Unit Dose
			 System.) (3-17-22)
g. No alteration
			 or replacement of original prescription legend is allowed. (3-17-22)
h. Prescription renewal or refill is made
			 only under physician's, dentist's, or nurse practitioner's authorization.
			 (3-17-22)
i. Drugs dispensed meet
			 the standards established by the United States Pharmacopeia, the National
			 Formulary, New Drugs, the Idaho Board of Pharmacy, and the U.S. Food and Drug
			 Administration. (3-17-22)
j. All
			 medications in the facility are maintained in a locked cabinet with the key for
			 the lock carried only by licensed nursing personnel and/or the pharmacist.
			 (3-17-22)
k. Poisons and toxic
			 chemicals are stored in separate locked areas apart from medications.
			 (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.02 - SKILLED NURSING FACILITIES › Section 16.03.02.202 - PET THERAPY

Current through August 31, 2023
The following requirements must be met: (3-17-22)
01.
Policies and Procedures
.
			 That policies and procedures are developed by the facility concerning the
			 admission of pets through a visitation program or on a permanent basis.
			 (3-17-22)
02.
Type of Pet
			 Allowed
. That the types of pets allowed are as follows: (3-17-22)
a. Only domesticated household pets (dogs,
			 cats, birds, fish, hamsters, etc.) are permitted. Exotic pets and wild animals,
			 even though trained, are not be permitted due to the high potential for spread
			 of disease and injury to residents or staff. These include, but are not limited
			 to, iguanas, snakes and other reptiles, monkeys, raccoons and skunks. Turtles
			 are not permitted in the facility. (3-17-22)
b. If animals that are prohibited as
			 designated in Subsection
			 202.02.a. of these rules are
			 brought in for visitation, they are kept on a leash and under the control of
			 the trainer at all times. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.02 - SKILLED NURSING FACILITIES › Section 16.03.02.203 - RESIDENT RECORDS

Current through August 31, 2023
The facility maintains medical records for all residents in
				accordance with accepted professional standards and practices. The following
				requirements must be met: (3-17-22)
01.
Responsible Staff
. That the
			 administrator designates a staff member the responsibility for the accurate
			 maintenance of medical records. If this person is not a Registered Health
			 Information Administrator (RHIA) or a Registered Health Information Technician
			 (RHIT), consultation from such a qualified individual is provided periodically
			 to the designated staff person. (3-17-22)
02.
Individual Medical Record
.
			 That an individual medical record is maintained for each admission with all
			 entries kept current, dated, and signed. (3-17-22)
03.
Confidentiality
. That the
			 facility safeguards medical record information against loss, destruction, and
			 unauthorized use. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.02 - SKILLED NURSING FACILITIES › Section 16.03.02.204 - DAY CARE SERVICES

Current through August 31, 2023
Day care services may be provided for up to twelve (12) hours
				per day as determined by facility policy. If provided, it cannot interfere with
				the regular services to facility residents. The following requirements must be
				met: (3-17-22)
01.
Staffing
. That the facility provides additional staff depending
			 upon the number of day care participants with the following: (3-17-22)
a. Assure that in-house facility residents
			 are provided the nursing hours per resident per day as described in Subsection
			 200.02.c. (3-17-22)
b. Assure that the day care participants
			 receive the services necessary to meet their needs.
			 (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.02 - SKILLED NURSING FACILITIES › Section 16.03.02.205 - CHILD CARE CENTERS

Current through August 31, 2023
The following requirements must be met: (3-17-22)
01.
Policies and Procedures
.
			 That any facility that permits a child care center adjacent to or attached to
			 the skilled nursing facility establishes well-defined written and implemented
			 policies and procedures pertaining to the relationship between the child care
			 center and the SNF. These include, but are not limited to infection control and
			 prevention of disease transmission. (3-17-22)
02.
Day Care Licensure
. That any
			 day care home or day care center for children, as defined under Basic Day Care
			 License Act, Sections
			 39-1101 through
			 39-1117, Idaho Code, either
			 attached as a distinct part or as a separate facility on the premises of the
			 SNF facility is licensed separately by the appropriate state or local licensing
			 agency. (3-17-22)
03.
Day
			 Care Compliance
. That every child day care home or center complies with
			 the Idaho Department of Health and Welfare Rules, IDAPA 16.02.10, "Idaho
			 Reportable Diseases." (3-17-22)
04.
Day Care Staff
. That each child day care home or center is staffed
			 appropriately to meet the needs of the children cared for as a completely
			 separate staff from those employees of the SNF facility. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.02 - SKILLED NURSING FACILITIES › Section 16.03.02.301 - RESPITE CARE SERVICES

Current through August 31, 2023
If the SNF offers respite care to relieve families or other
				individuals, there must be policies and procedures written and implemented
				regarding the program. The following requirements must be met: (3-17-22)
01.
Admissions
. That respite
			 care residents are admitted to the facility in the same manner as any other
			 admission that includes, but is not limited to: (3-17-22)
a. Authorization by a physician.
			 (3-17-22)
b. Current medical and
			 other information sufficient to allow the facility to safely care for the
			 resident. (3-17-22)
c. Medication
			 and treatment orders signed and dated by the resident's attending physician.
			 (3-17-22)