Idaho certified family home: certification to care for up to four adults in your own home

What triggers certification in Idaho

Idaho Code 39-3512 applies the CFH chapter to any individual who seeks payment for caring for an elderly person or an adult with a mental illness, developmental disability or physical disability, and who also houses that adult in their primary residence.⁠¹ DHW’s summary is the same: certification is required whenever a paid caregiver provides services to any vulnerable adult living in the caregiver’s home.⁠⁴ A paid caregiver who houses a vulnerable adult without certification commits a misdemeanor, and either the attorney general or the county attorney where the caregiver lives can prosecute.⁠¹ Under the rule, DHW may refer an uncertified home for prosecution and move its residents if their safety is threatened or the operator won’t cooperate in getting certified.⁠²

Payment from a family member still counts as payment. The statutory exemptions are narrow:⁠¹⁠²

• Care in a relative’s home that is wholly privately funded. The vulnerable adult lives in a relative’s primary residence and no part of the payment comes from a publicly funded program. Once Medicaid pays for any of that care, the relative needs certification. “Relative” runs to the third degree: grandparents, aunts, uncles, nieces, nephews, great-grandparents and first cousins, by birth, adoption or marriage.⁠²
• VA medical foster homes that care only for veterans who are not Medicaid recipients. A medical foster home that also takes non-veterans must be certified.
• Housing-only arrangements. Someone who provides only housing, meals, transportation, housekeeping or recreation is outside the rules. Once you help with personal care, medications or supervision, you are covered.
• Licensed health facilities and residential assisted living facilities.

The chapter supersedes any city or county program that licenses or sets standards for CFH providers, so no separate local care license applies.⁠¹ The rule adds that it does not supersede other local regulations.⁠² Remodeling, for example, still needs local building permits (see the house section below).

Two residents, or up to four with a variance

Idaho Code 39-3502 defines a CFH as a home and care provider certified to give housing and care in a family-style setting to one to four residents.⁠¹ Section 39-3505 then sets the working limit: a provider may admit or retain no more than two residents at a time. DHW may grant a variance for up to four.⁠¹

How the variance works, under IDAPA 16.03.19.140:⁠²

• You apply on DHW forms to your regional certifying agent for each resident before admitting a third or fourth person. A variance cannot be moved to another resident or provider.⁠¹⁠²
• DHW weighs each resident’s physical, mental and behavioral history; who else in the household needs your care; your training and experience; obstacles to getting in and out of the home; staffing; residents’ wishes, including roommate approval; total hours of care; and the home’s layout and square footage.
• With three or four residents, you cannot hold a job outside the home unless staff can reach you immediately about resident needs.
• Ongoing training rises from 8 hours a year to 12 hours for three residents and 16 hours for four. For part of a year, the extra hours are prorated at 20 minutes a month for a third resident and 40 minutes a month for a fourth. A resident counts for a month when their admission agreement is in effect for 15 days or more of it.
• The home gets a certifying agent’s inspection at least annually instead of every 24 months. Fire drills move from quarterly to monthly. No sleeping room may hold more than two residents.
• DHW reassesses the variance at least annually, at each proposed third or fourth admission, and whenever a significant factor changes.

Nursing-home-level residents have their own limit. You may care for one resident who needs nursing facility level of care without a variance. Two need a written variance, with signed requests from each resident or representative.⁠² By statute, DHW cannot grant a variance to admit or retain more than two residents who need nursing facility care.⁠¹

A CFH with a variance for more than two residents stays a CFH. Section 39-3505 exempts it from residential care administrator licensing under Title 54, Chapter 16.⁠¹

When you need a RALF license instead

Idaho’s Residential Care or Assisted Living Act covers any facility or residence, however named, that provides supervision, personal assistance, meals and lodging to three or more adults not related to the owner.⁠⁹ The CFH route is closed if you will not live in the house as your primary residence.⁠¹ It is also closed if you want more than four residents, or more than two without a variance. An investor who wants to staff a house with employees is looking at a residential assisted living facility license. That license requires a licensed administrator and a building evaluation.

Who can be the provider

The certificate goes to an individual, the “care provider,” who is responsible for meeting residents’ needs, maintaining the home and complying with the chapter.⁠¹ The statute and rule add these conditions:⁠¹⁠²

• Live there. The home must be your primary residence. The rule defines that as where you stay at least 30 days in any 60-day period. You cannot be away more than 30 consecutive days while a resident is admitted.
• Control the premises. You or your spouse must show a legal right to occupy the home: a lease, deed or mortgage.
• No other boarders. You cannot charge room or board to anyone who is not a resident, a relative or full-time staff. DHW may grant a variance for a resident’s spouse who does not need personal assistance.
• No child foster care license at the same time, unless DHW grants a variance.
• No guardianship of a resident. You, your relatives and other adults in the home may not be a resident’s legal guardian unless the guardian is the resident’s relative. A variance is possible when DHW finds the guardianship is in the resident’s best interest.
• Sufficient resources to maintain the home and the services you offer.

DHW may deny an application for willful misrepresentation, an Unconditional Denial on any required background check, or a past denial or revocation of a child care, foster care, health facility, RALF or CFH license. Other grounds are a finding that you operated one of those without a license, a court order barring you from operating one, or being under the control of someone with any of those histories.⁠² Part A of the application asks screening questions on all of this. It also asks about any other criminal conviction in the past five years and listing on the child protection, adult protection or sex offender registries or the Medicaid Exclusion List. A “yes” answer means a consultation with a certifying agent.⁠⁵

Background checks for everyone in the household

Before certification, the provider and every adult living in the home, apart from residents, must hold a DHW criminal history and background check clearance affiliated with the CFH program.⁠² DHW’s instructions say to use Pay Code Z6NGS so the clearance attaches to the CFH program.⁠³⁠⁶ Staff and substitute caregivers need a clearance before any unsupervised contact with residents. So do visitors. A child in the home who turns 18 must apply and be fingerprinted within 30 days after the month of the birthday. An adult who plans to move in must do so before moving.⁠²

The check is fingerprint-based. You apply online, then get fingerprinted. As published on 2026-10-12, the Background Check Unit lists a standard fee of $70, and an enhanced check costs $70 plus any fees charged by other states’ child protection registries.⁠⁷ Clearances are renewed every five years for the first 15 consecutive years, then every ten years, and DHW can require a new check at any time.⁠²

Training before you are certified

IDAPA 16.03.19.100 requires training in resident rights, emergency procedures, fire safety (extinguishers, smoke and carbon monoxide detectors) and complaint and inspection procedures. You also need current first aid and adult CPR that includes hands-on skills, and a DHW-approved medications course through an Idaho technical college.⁠² DHW names the course “CFH Basic Medication Awareness and Infection Control,” and the CPR and first aid skills must be demonstrated to a live instructor.⁠³ Licensed practical nurses, registered nurses, physician assistants and physicians are exempt from the medication course.⁠²

Most of the non-clinical topics are covered in New Provider Orientation (NPO). DHW holds it every month. You are enrolled automatically once the Central Revenue Unit confirms payment of your application fee. A training packet arrives by mail at the start of the month.⁠³

After certification, you must document 8 hours of training a year, and your initial training satisfies the first year. When residents are admitted, at least half the hours must cover their specific conditions and diagnoses. For each session, log the topic, source and instructor, hours, whether it was resident-specific, and the date.⁠²

The house: what the certification study checks

A CFH must be in a building intended for residential use, and DHW must approve the home. Remodeling or additions must stay consistent with residential use and comply with local building standards and IDAPA 24.39.30, with any local permits.⁠²

Utility and systems proof is due with the application: written statements dated within the past 12 months from a licensed electrician or electrical inspector, a licensed plumber, and a licensed HVAC technician.⁠²⁠⁶ A private well must test free of bacteria (E. coli and coliform) at an accredited lab at least yearly. A septic tank must have been pumped or the system serviced within the last five years (the rule also accepts a system that is otherwise in good working condition), and a city water or sewer bill is proof for city service.⁠²⁠⁶ You also need homeowner’s or renter’s insurance, and you must keep it current.⁠²

Fire safety and emergency planning

Section 600 of the rule sets the fire rules:⁠²

• Smoke detectors in each sleeping room, each hallway and on every level. CO detectors when the home has fuel-burning appliances or an attached enclosed garage. Part B accepts an electrician’s statement that the home is all-electric, with a detached or open garage, in place of CO alarms.⁠⁶
• A 2.5-pound or larger ABC fire extinguisher on each level. Examine it every three months and have it professionally serviced or replaced every 12 months.
• Exit paths and doorways at least 28 inches wide. Exit-door locks must open from inside without a key.
• Each resident bedroom needs a door or window directly outside. An escape window needs a sill no higher than 44 inches and an opening at least 20 by 24 inches, with a usable window well in a basement.
• No unvented combustion heaters. Portable electric heaters must plug straight into the wall, shut off if tipped, run only under supervision and sit 36 inches from anything combustible.
• Test smoke and CO detectors monthly and keep a log. Replace batteries at least yearly. Have chimneys for wood or pellet stoves professionally cleaned every year.
• If you allow smoking, it is barred in bed and near flammables, and residents may smoke unsupervised only if their plan of service allows it.

You need a written emergency preparedness plan with a floor plan showing two escape routes from each room and an outdoor meeting spot. It must also name who takes the head count, and cover 72 hours sheltering in place, mandatory evacuation to shelters in town and out of town, and your own incapacity.⁠² Review it with each resident at admission and every 12 months. Drills are required at least every three months, at least half of them fire drills, and everyone able must be outside within three minutes.⁠² Part B also requires firearms in the home to be secured, and a backup power source for cell phones if a cell phone is your required phone service.⁠⁶

Applying, in order

DHW’s certification page lays out the sequence.⁠³

1. Submit Application Part A

   Email it to [email protected] or fax it to (208) 239-6250. It asks for household members, the home’s type and ownership, and, if you already have someone in mind, the prospective resident’s diagnoses, daily hours of direct care and payment source (Medicaid or private pay).⁠³⁠⁵

2. Pay the $150 application fee

   After Part A is approved, the Central Revenue Unit mails an invoice. Paying by phone or online adds a 3% convenience fee. If you don’t pay within six months, DHW may terminate the application.⁠¹⁠³⁠⁵

3. Attend New Provider Orientation

   Enrollment is automatic once payment is confirmed. Until you attend, you get an invitation to each month’s session.⁠³

4. Get background check clearances

   for yourself and every other adult in the home, using Pay Code Z6NGS.⁠³

5. Complete first aid and adult CPR

   with a live skills check, and the technical-college medication course.⁠³

6. Collect the inspection statements and household documents

   listed in Part B: electrical, plumbing, HVAC, water, sewer, fire-district proof, chimney, extinguishers, lease or deed, and insurance.⁠⁶

7. Submit Application Part B

   only after NPO and once every item is done. Part B sets your requested certified bed count, up to four, and records substitute caregivers and the conditions you will accept (dementia, developmental disability, mental illness, traumatic brain injury, and so on).⁠⁶ By signing, you agree DHW may list your vacancies, with your name and contact details, on its public website. To stay off the list, you have to lower your certified bed count so you have no vacancies.⁠⁶

8. Pass the initial certification study

   DHW starts it within 30 days of an acceptable application. The study includes a home inspection, an interview with you, interviews with household members if needed, a review of the care needs of others in the household, and, if DHW decides it is necessary, a medical or psychological exam.⁠²

The 12-month deadline is worded two ways. Idaho Code 39-3520 allows termination if the completed application is not in within 12 months of paying the fee. Part B says 12 months from the date you attend New Provider Orientation.⁠¹⁠⁶ DHW does not say which date it applies in practice, so ask your certifying agent in writing when your 12 months start, and plan to finish Part B within 12 months of paying the fee.

Fees as published on 2026-10-12

Prepaid monthly fees are refunded for any month you operate fewer than 15 days, and may be refunded when you close voluntarily or under enforcement. Nothing is refunded for a retroactive closure.⁠²

DHW approves every resident before move-in

The statute makes all admissions subject to DHW approval.⁠¹ Before a prospective resident moves in, you send the regional certifying agent:⁠²

• Their name, gender and birth date, and the planned move-in date.
• A history and physical from a healthcare professional, done within the past 12 months. For a private-pay resident, you also need the professional’s statement that CFH care is appropriate.
• Their medication and treatment list, plus contacts for their healthcare professionals and representative.
• Any plan of service from a healthcare setting within the past six months.

DHW answers within five business days. Emergency admissions without approval are allowed only after hours, when you cannot reach DHW. You notify the agent by the next business day and complete the regular process within two business days.⁠²

At admission, you and the resident sign a written admission agreement. It must cover monthly room and board, with any care charges listed separately; 30 days’ notice of rate changes; whether you will manage the resident’s money; how much liability coverage your insurance carries and whether it covers the resident’s belongings; and eviction and appeal protections. For eviction, the agreement either adopts Idaho landlord-tenant law (Title 6, Chapter 3) or uses DHW’s version of the agreement.⁠² Either side may end the agreement with 30 days’ written notice. You can give three days’ notice only for nonpayment, violating a written condition of the admission agreement, or drug activity on the premises.⁠²

For publicly funded residents, DHW does the needs assessment. For private-pay residents, you must complete a uniform assessment within 14 days of admission. Each resident’s plan of service must be signed within 14 days and reviewed at least every 12 months.⁠²

Running the home day to day

Room and board. You provide the room, utilities, laundry, a phone, supplies, access to the living room, dining area and kitchen, and breakfast, lunch and dinner every day.⁠² You must also arrange transportation to community, recreational and religious activities within 25 miles when a resident asks 24 hours ahead.⁠²

Medications. You need written medication policies. Staff assist only as a healthcare professional has ordered. A resident may self-administer only with the professional’s written approval.⁠² A pill organizer you fill yourself can be filled no more than seven days ahead. Doses go within 20 minutes of the scheduled time. Narcotics are counted monthly, and discarded drugs are logged with a witness. Only licensed professionals may administer medications or perform nursing tasks.⁠²

Residents’ money. If you or anyone in the household handles a resident’s funds or acts as their payee, you need a separate bank account for each resident, with no commingling and receipts for purchases over $10. Personal loans to residents from the household are prohibited unless they come from the resident’s own relative.⁠² Publicly funded residents must keep at least the CFH basic needs allowance set in IDAPA 16.03.05, so your total charges are capped accordingly.⁠²

Reports. You must report the following:⁠¹⁠²

• Within 4 hours: abuse or neglect that caused death or serious injury, to law enforcement.
• Immediately: suspected abuse, neglect or exploitation, to the Idaho Commission on Aging or an Area Agency on Aging.
• Within 24 hours: a resident’s death or disappearance, to your certifying agent.
• Within 3 business days: an ER or urgent care visit, a hospital admission, contact from adult protective services or police, or a fire where an extinguisher was used or 9-1-1 was called.
• Immediately: any discharge, new criminal conviction or investigation involving anyone in the household.

Backup care. A substitute caregiver can run your home for up to 30 consecutive days. They need current first aid and CPR, a cleared background check and the medication course, and you must keep staffing at your usual level.⁠² With DHW approval, a resident can stay at another CFH, called alternate care, for up to 30 consecutive days. Someone giving “incidental supervision” only, with no care, can cover up to 10 hours a week, never more than six hours in a row.⁠²

Hourly adult care. A CFH may offer hourly adult day care (adult day health) under a written policy. The policy must meet the Medicaid provider agreement’s adult day terms, keep attendance records and run monthly drills.⁠²

Records. Keep admission records in the home for two years after discharge, and ongoing records for two years.⁠²

Inspections, annual renewal and enforcement

A full certificate lasts no more than 12 months, and DHW’s renewal page says providers must recertify every year with an Annual Renewal Application.⁠²⁠³ The first home inspection comes the year after the initial study, then at least every 24 months, or yearly with a variance.⁠² Inspections other than the initial study may be unannounced. DHW’s recertification checklist says residents must be home for the survey.⁠²⁠³ In years without an inspection, DHW may do a desk review instead. You send in current CPR cards, well and septic reports, extinguisher records, detector logs, drill records, training logs and proof of insurance at least 30 days before the certificate expires.⁠²

Moving? Notify the certifying agent at least 30 days before you move and submit a new application with inspection reports for the new house. DHW can then issue a temporary certificate for up to 60 days.⁠² To close voluntarily, give residents and the agent 30 days’ written notice.⁠²

When DHW finds violations, it notifies you within 30 days. You may be allowed up to 14 days to submit a plan of correction, and fixes must be completed within 30 days. Statements of deficiencies are available to the public on written request.⁠² Enforcement options include provisional certification, a ban on all admissions or on residents with a specific diagnosis, summary suspension with resident transfer, and revocation.⁠² Revocation is available for even a single “core issue” deficiency. Core issues include abuse, neglect, exploitation, inadequate care, inoperable fire detection without a fire watch, and operating without required background clearances. Failing to pay the certification fee is also grounds for revocation.⁠¹⁠²

Medicaid and private-pay residents

DHW says residents may qualify for Medicaid to pay the provider for care, and residents who don’t qualify pay privately or through insurance. Every resident pays the monthly room and board set in the admission agreement.⁠⁴ Adult residential care is an Aged and Disabled Waiver service overseen by DHW’s Bureau of Long Term Care. Enrolling as a Medicaid provider is a separate step from certification. New CFH providers must be trained by a BLTC Quality Assurance Specialist before their Medicaid application is approved and before serving waiver participants. To schedule, call 877-799-4430 or email [email protected].⁠³⁠⁸ Enrollment forms are on idmedicaid.com.⁠⁸

Recent changes to the law

The current Chapter 35 dates from 2024 (Session Laws ch. 63), when the definitions and the rulemaking section, 39-3505, were enacted in their present form.⁠¹ Senate Bill 1015 of 2025, which mainly rewrote hospital licensing and repealed Idaho’s home health agency licensing chapter, amended 39-3501 and 39-3505 only to correct code references.⁠¹⁰ The 39-3505 history also lists a separate 2025 amendment (ch. 98, sec. 7), and the legislature’s statute page does not say what it changed; the SB 1015 amendment is the one at ch. 122.⁠¹⁠¹⁰ The text of 39-3505 as published on 2026-10-12 is what this guide relies on, and you can ask the agency whether any rule change followed. Every section of IDAPA 16.03.19 checked for this guide carries a 3-28-23 effective date.⁠²

Sources

1. 1
   Idaho Legislature, Idaho Code Title 39, Chapter 35: Idaho Certified Family Homes (ss. 39-3501 to 39-3554) Checked 12 Oct 2026 · Back to text ↑
2. 2
   Idaho Office of the Administrative Rules Coordinator, IDAPA 16.03.19: Certified Family Homes Checked 12 Oct 2026 · Back to text ↑
3. 3
   Idaho Department of Health and Welfare, Certified Family Homes: Certification and Recertification Checked 12 Oct 2026 · Back to text ↑
4. 4
   Idaho Department of Health and Welfare, Certified Family Homes Checked 12 Oct 2026 · Back to text ↑
5. 5
   Idaho Department of Health and Welfare, Certified Family Home Initial Application Part A Checked 12 Oct 2026 · Back to text ↑
6. 6
   Idaho Department of Health and Welfare, Certified Family Home Application Part B Checked 12 Oct 2026 · Back to text ↑
7. 7
   Idaho Department of Health and Welfare, Fingerprinting and Background Checks (Background Check Unit) Checked 12 Oct 2026 · Back to text ↑
8. 8
   Idaho Department of Health and Welfare, Long-Term Care Provider Enrollment and General Information Checked 12 Oct 2026 · Back to text ↑
9. 9
   Idaho Legislature, Idaho Code 39-3302: Definitions (Residential Care or Assisted Living Act) Checked 12 Oct 2026 · Back to text ↑
10. 10
    Idaho Legislature, Senate Bill 1015 (2025): Hospitals and home health agencies Checked 12 Oct 2026 · Back to text ↑

Was this information accurate? Report an errorPrint or save as PDF