Idaho residential assisted living facility (RALF) license: rules, steps and fees
In Idaho, a facility that gives supervision, personal assistance, meals and lodging to three or more adults not related to the owner needs a residential assisted living facility (RALF) license from the Department of Health and Welfare (DHW). One license type covers every size from three beds up, and every facility must have an administrator licensed by the Division of Occupational and Professional Licenses.
Contents11 sections
Key takeaways
- A RALF license is required once you give supervision, personal assistance, meals and lodging to three or more unrelated adults; operating without one is a misdemeanor punishable by up to six months in jail or a $5,000 fine.14
- Every facility needs an administrator licensed by the Idaho Board of Long-Term Care Administrators: at least 21, a board-approved course, an exam, and 200 to 800 hours of supervised on-site experience depending on education.51314
- The application, filed through DHW's FLARES portal, must include printed policies and procedures, a measured floor plan, proof of site control, fire, electrical and zoning occupancy evidence, and a written request for a building evaluation.1012
- Idaho sets no staff-to-resident ratio. It requires awake overnight staff, a CPR and first-aid certified caregiver in every building at all times, 16 hours of orientation and 8 hours of yearly training.610
- Most of IDAPA 16.03.22 was reissued effective July 1, 2026, after the Legislature rewrote chapter 33 in 2025.210
Quick facts
| Agency | Idaho DHW, Residential Assisted Living Facilities Program (208-364-1962) |
|---|---|
| License threshold | 3 or more unrelated adults |
| Facility license fee | None stated in Idaho Code ch. 33 or the 2026 IDAPA 16.03.22 text; confirm with DHW |
| Administrator license (DOPL, Oct 2026) | $600 initial, $400 biennial renewal |
| First surveys | Within 90 days of licensure, then within 15 months |
| Renewal | Annual report and renewal at least 30 days before expiration |
Administrator fees as published on the DOPL board page, checked 2026-10-12. Statute and rule citations reflect the versions in force on that date.
Does your home or building need a RALF license?
Idaho’s statute defines a “residential care or assisted living facility” as “a facility or residence, however named, operated on either a profit or nonprofit basis for the purpose of providing necessary supervision, personal assistance, meals and lodging to three (3) or more adults not related to the owner.”1 DHW’s program page adds that the residents are adults 18 or older.11
“Personal assistance” is broad. It covers any one of these, provided by facility staff: help with activities of daily living, arranging supportive services, knowing a resident’s general whereabouts, or monitoring residents on the premises for their health, safety and well-being.1 If your plan for three or more adults includes any of those along with meals and lodging, you are in licensing territory.
Two arrangements are outside the act:3
- Housing-only properties. A house, hotel, congregate housing project, retirement home or similar place that limits itself to housing, meals, transportation, housekeeping, or recreational and social activities. The same exemption covers a property whose residents get supportive services from a separately approved Idaho provider, as long as that provider holds no ownership interest in the entity operating the property.
- Care by a relative.
The exemption for outside services does not cover a landlord who owns the care agency in the building. Idaho also treats a place as an unlicensed facility if it is “held out as or represented as, providing care, supervision and services,” or if it accepts or keeps residents who need them.4 Operating unlicensed is a misdemeanor punishable by up to six months in county jail or a fine of up to $5,000. If the county attorney does not act within 30 days, the attorney general may prosecute.4 Under the rule, DHW can also impose civil monetary penalties on a facility operating without a license.10
RALF or certified family home?
For adults living in the caregiver’s own home, Idaho uses a separate program, the certified family home (CFH). The statute allows one to four residents,18 but a CFH may serve only two unless DHW grants a variance.19 If you will live in the home and care for a small number of residents yourself, read the certified family home rules in IDAPA 16.03.19, which DHW administers separately from this program.19 If you plan a staffed building with a licensed administrator, or more than four residents, the RALF license applies.
Idaho has one RALF license with no tiers, so a three-bed house and a 150-bed building hold the same license. Chapter 33 does state a policy favoring small facilities for specific groups: eight beds or fewer for people with developmental or physical disabilities or dementia, and fifteen beds or fewer for people with mental illness.9 That is a development policy, not a separate license class.
What changed in 2025 and 2026
The Legislature rewrote much of the Residential Care or Assisted Living Act in 2025 (2025 Session Laws ch. 208), and section 39-3340 on licensing was amended again in 2026 (ch. 251).21 DHW then reissued most sections of IDAPA 16.03.22 with an effective date of July 1, 2026.10 For a new operator, the changes that matter most are:
- Inspection schedule in statute. The initial survey must happen within 90 days of licensure, and a licensure survey within 15 months after that. Scheduled inspections, including fire life safety inspections, come with at least 30 days’ notice. Complaint surveys are unannounced.7
- Accreditation instead of routine surveys. DHW must accept an accreditation commission’s survey in place of regular compliance inspections if the commission’s standards meet or exceed Idaho’s, the facility submits its accreditation reports with its renewal, and the results are public.7
- Self-inspection for top-rated facilities. Facilities with a gold or silver rating investigate complaints that do not involve health or safety themselves and send DHW their findings.7
- Easier operator changes. When a new operator or lessee takes over a licensed building, an Idaho operator that already runs at least one facility does not resubmit policies and procedures. No fire life safety inspection is required before the license issues; the inspection happens within 180 days.2
- Administrator licensing moved. Administrators are now licensed under the Long-Term Care Administrators Act (Idaho Code Title 54, chapter 16, added in 2025 and amended in 2026). It is administered by a combined Board of Long-Term Care Administrators that also licenses nursing home administrators.1315
Hire or become a licensed administrator first
DHW will not license a facility without one: the application must include a copy of the administrator’s license and criminal history background check.10 Each facility must employ at least one administrator licensed by the Division of Occupational and Professional Licenses (DOPL). One administrator may cover up to three facilities and hand all day-to-day work to on-site managers.25
To sit for the residential care administrator exam, a candidate must be at least 21 and complete a board-approved course in residential care facility administration. The candidate must also meet one of these education and experience combinations, with all experience gained on site in a residential care facility under a licensed administrator:13
| Education | Supervised on-site experience |
|---|---|
| High school diploma or equivalent | 800 hours |
| Associate degree | 400 hours |
| Bachelor’s degree | 200 hours |
The board can accept other practical experience in place of these combinations.13 The board rule, effective July 1, 2026, sets out the rest:14
- Pass the applicable NAB exam or another board-approved exam.
- Complete the Certification Program for Residential Care Facility Administrators run by the Idaho Health Care Association, or an equivalent course the board approves.
- Get your own DHW criminal background check and include the results. The board does not submit fingerprint cards for applicants.
A licensed nursing home administrator can get the residential license by passing the residential care exam. The exam is waived for someone with at least one year of leadership or management experience in a residential care or nursing home facility within the past five years.14 Renewal requires 12 hours of continuing education every 24 months.14
As published on 2026-10-12, DOPL charges $600 for the initial residential care administrator license (application fee included), $200 for an annual renewal or $400 for a biennial one, and $200 for a provisional permit.15
The administrator’s statutory duties shape the policies you will write. They include investigating every accident, incident, complaint or allegation of abuse, neglect or exploitation and writing up the findings within 30 calendar days, and being reachable at all times. The administrator must also make sure no one under 17 gives hands-on care or supervision unless they have completed a CNA course.5 Reportable incidents go to the licensing agency within one business day, and a change of administrator must be reported in writing within three business days.5
Site, building and fire safety
Idaho requires a facility to be in an area that is “accessible to supportive services” and free of conditions that would endanger residents.17 Local approvals come before state review. Construction drawings for new construction, a change of occupancy, additions or renovations must be signed and stamped by an Idaho-licensed architect or engineer and go to DHW after local authorities approve them. DHW must approve the drawings before any work starts.10 All new construction and conversions need audible and visual fire alarm notification devices in every common area and resident room, whatever the facility’s size.10
The physical standards in IDAPA 16.03.22 section 250 include:10
| Item | Requirement |
|---|---|
| Sleeping room occupancy | No more than 2 residents per room |
| Sleeping room size, built after Jan. 1, 2021 | At least 100 sq ft per resident, single or shared |
| Sleeping room size, older buildings | 100 sq ft single; 80 sq ft per resident shared |
| Common space | At least 30 sq ft per licensed bed for dining, recreation, bathing and living; halls and entries don’t count |
| Closets | At least 4 usable sq ft per resident, with doors |
| Windowsills (existing buildings) | Operable sill no higher than 44 inches |
| Hot water at resident fixtures | 105°F to 120°F |
| Accessibility | New construction meets ADA Accessibility Guidelines |
Bathrooms must be reachable without going through another resident’s room. Each toilet and bathroom needs solid walls, and inside bathrooms without an operable window need mechanical ventilation to the outside.10 Every resident must have access to a call system, and the rule states that the call system “cannot be a substitute for supervision.”10 If you accept residents with cognitive impairment who have a history of elopement, the interior and the yard must be secure.10
The fire and life safety rules require quarterly fire drills, with at least one drill per shift each year. Any fire or fire alarm activation (other than false alarms, testing or drills) must be reported to DHW within 15 days. If the alarm or sprinkler system is out of service for more than four hours in 24, you must notify the local jurisdiction and either evacuate or run a documented fire watch.10 The rule also bans using power strips for medical equipment or appliances, or plugged into each other.10
The application, in the order it comes together
Applications, annual reports, reportable incidents and administrator changes all go through DHW’s FLARES provider portal. DHW publishes short videos on submitting an application in FLARES.12 The steps below follow IDAPA 16.03.22 section 110.10
Register the name
The facility must use a distinctive name registered with the Idaho Secretary of State, and the application needs a copy of the Certificate of Assumed Business Name.10
Secure the building
Attach the purchase agreement, lease or deed, plus a detailed floor plan with every room measured, or the architectural drawings.10
Collect local occupancy evidence
You need evidence that the building is in a lawful fire district (or that a fire authority will respond), that the wiring meets current electrical code, and that the building meets local zoning and fire codes for the occupancy.10
Request the building evaluation in writing
Send DHW the building’s address and the name and phone number of the person who should receive the evaluation report.10
Submit the administrator’s credentials
Include a copy of the administrator’s license and criminal history background check.10
Submit printed policies and procedures
The complete set must be printed (see the next section).10
DHW issues the license once the application shows compliance with the rules.10 It will not review an application from someone who has an enforcement action pending against an Idaho license they hold.10 A license cannot be transferred. A change of building ownership, new construction or a conversion needs its own license before the facility opens.2 Minor ownership changes in existing buildings must be reported within 60 days.2
DHW’s licensing page lays out the order this way: request access to the FLARES portal, complete and submit the application, submit policies and procedures (those selected for review can take up to 90 days, depending on how fast you answer comments), then DHW’s Fire Life Safety staff schedule an on-site building evaluation and send a correction letter. After you fix those items and request a final evaluation, DHW does a last review of the application materials and issues the license.20
Neither chapter 33, the 2026 text of IDAPA 16.03.22 nor DHW’s licensing page states a facility license fee. An earlier version of the rule (2023 archive) required a $500 initial building evaluation fee with the evaluation request, and the 2026 text of section 110 no longer includes it.10 Ask the RALF Program (208-364-1962, [email protected]) in writing whether any application, license or building-evaluation fee applies before you budget.11
DHW publishes a list of consultants on its additional resources page.12
Policies DHW expects in the application
The rule lists the written policies a facility must develop and implement. These are what you submit in step 6:10
- Admissions. The services you offer, and criteria for admission, discharge and transfer. You may admit only residents whose needs your staff, numbers and skills can meet.
- Resident funds. How you manage and protect funds. When a resident leaves, you keep only room and board prorated to the end of the 30-day notice, plus any damage or cleaning charges in the admission agreement.
- Resident safety. Accidents, incidents and abuse allegations; medical and psychiatric emergencies; resident absence; changes in health status; care duties from ADLs to telephone access; behavior management; physical plant maintenance and testing; hazardous materials; and smoking rules. Smoking in bed is always banned.
- Emergency preparedness. A plan for fire, explosion and natural disaster, plus written agreements with two separate locations where residents can go if the building cannot be reoccupied.
- Activities. A written activity policy.
- Hourly adult care. Optional. A RALF may serve day participants who don’t live there, but it needs policies, records of services, and staffing based on the whole facility.
Admission agreements have fixed contents.10 They must list staffing patterns, medication responsibilities, billing and refund practices, and the rule that either party gives 30 days’ written notice before a move-out. After an emergency discharge or death, you may charge at most 15 days of prorated rent. Before admission, the facility assesses each resident, including a pre-admission nursing assessment.10 For residents who are not DHW clients, that assessment and the negotiated service agreement set the rate. Any change in billing practices needs 30 days’ notice.8
Staffing, nursing and training
Idaho does not set a staff-to-resident ratio. The statute requires enough trained staff “to fully meet the needs of its residents” during all hours in each resident’s service plan.6 The rule then adds fixed minimums:10
- Staff must be up, awake and immediately available during residents’ sleeping hours.
- Each detached building or unit must have at least one staff member present whenever residents are there.
- At least one direct care worker certified in first aid and CPR must be in each building or unit at all times.
Every employee and contractor with direct resident access needs a DHW criminal history and background check. While results are pending, a new hire may work only under a cleared employee and may not be alone with a resident.10 New staff complete at least 16 hours of job-related orientation before giving unsupervised personal assistance, within 30 days of hire. Orientation covers resident rights, abuse reporting, your policies and the population you serve. Each employee then needs at least 8 hours of training every year.10
Aides who help with medications must first complete a medication assistance course from an Idaho community college or a DHW-approved curriculum. The facility nurse must then delegate the task to each aide individually, after a skill demonstration.10 The licensed nurse does the pre-admission assessment, visits at least every 90 days for quarterly assessments, and reassesses residents when their condition changes.10 Medications must be locked, controlled substances counted daily, and discontinued drugs removed within 30 days.10
A RALF may not keep residents who need nursing facility care, except for short exceptional stays allowed by rule.6 If you don’t carry professional liability insurance, you must tell employees in writing when you hire them.6
Surveys, renewal and enforcement
After the initial survey (within 90 days of licensure) and the first licensure survey (within 15 months), the rule sets the schedule by your record.710 A facility with no core-issue deficiencies in two consecutive licensure surveys is inspected at least every 36 months. A facility with core issues is inspected at least every 15 months.10 Core issues are abuse, neglect, exploitation, inadequate care, an inoperable fire detection or suppression system with no fire watch, and denying surveyors access.1 Other deficiencies must be fixed within 30 calendar days of the exit conference (or you tell DHW within those 30 days that you cannot), and they need no plan of correction.710
Renewal requires an annual report and a renewal application at least 30 days before the license expires. The license stays in force while DHW acts on a timely renewal.10
Civil monetary penalties are $10 per day per deficiency, multiplied by the number of occupied licensed beds. The rule caps them over any 90-day period:10
| Occupied beds | Cap for repeat deficiencies |
|---|---|
| 3-4 | $2,880 |
| 5-50 | $6,400 |
| 51-100 | $10,800 |
| 101-150 | $17,600 |
| 151 or more | $29,200 |
DHW can also issue a provisional license with conditions, limit admissions, require a consultant, or appoint temporary management.10
Getting paid by Idaho Medicaid
For residents who are DHW clients, the department assesses their service needs, and that assessment sets the facility’s reimbursement rate.8 To serve Medicaid residents under the Aged and Disabled Waiver, a new RALF must first be trained by the Bureau of Long Term Care’s Quality Assurance Specialist. The training comes before the enrollment application is approved and before you provide any waiver services. To schedule it, call 877-799-4430. Enrollment forms are on idmedicaid.com.16 DHW’s pages and chapter 33 do not publish a RALF waiver rate: section 39-3303 says only that the department’s assessment determines the rate.8 Ask the Bureau of Long Term Care at 877-799-4430 which rate schedule applies to a new RALF before you count on Medicaid revenue.16
Other Idaho care licenses: child care providers caring for seven or more children need the Idaho basic daycare license. All Idaho guides are listed on the Idaho state page.
Sources
- 1
- 2 Idaho Legislature, Idaho Code 39-3340 (Licensing) Checked 12 Oct 2026 · Back to text ↑
- 3 Idaho Legislature, Idaho Code 39-3351 (Exemptions) Checked 12 Oct 2026 · Back to text ↑
- 4
- 5
- 6
- 7 Idaho Legislature, Idaho Code 39-3355A (Inspections) Checked 12 Oct 2026 · Back to text ↑
- 8 Idaho Legislature, Idaho Code 39-3303 (Payment levels) Checked 12 Oct 2026 · Back to text ↑
- 9 Idaho Legislature, Idaho Code 39-3304 (Types of facilities) Checked 12 Oct 2026 · Back to text ↑
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19 Idaho Department of Health and Welfare, IDAPA 16.03.19, Certified Family Homes Checked 12 Oct 2026 · Back to text ↑
- 20
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Related guides
Idaho and neighboring states
Compare all 51| State | License | Who needs it | State fee |
|---|---|---|---|
| Idaho (this guide) | Residential Assisted Living Facility (RALF) license | 3 or more unrelated adults given supervision, care, meals and lodging | None stated in Idaho Code ch. 33 or the 2026 IDAPA 16.03.22 text; confirm with DHW |
| Washington | Assisted Living Facility License | Housing and care for 7 or more residents | $381 per bed, every year |
| Oregon | Assisted Living Facility (ALF) license; Residential Care Facility (RCF) license | 6 or more residents; ALF private units, RCF shared or private units | $2,000 (1-15 beds) to $6,000 (151+ beds) |
| Nevada | Residential Facility for Groups (RFG) license (includes assisted living facilities) | 3+ aged, infirm or disabled residents given food, shelter and assistance | $2,386 + $200 per bed ($35 per bed if paid under $1,000/month) |
| Utah | Assisted Living Facility License (Type I or Type II) | 2 or more unrelated residents; classes of 2-5, 6-16 and 17+ | Application fee per license category, per-bed capacity fee, plan review and inspection fees; amounts are in the DLBC fee schedule (ask OL) |
| Wyoming | Assisted living facility license | Dwelling giving limited nursing, personal and boarding care to unrelated adults | $250 (1-25 beds), $500 (26-50), $1,000 (51+) |
| Montana | Assisted Living Facility license | Group residence with personal care and 24-hour supervision; no minimum | See guide |
Shortened from each state's guide and our 51-state table, as of each guide's last review. Fees are the state's own; local permits and background checks cost extra.