Idaho Statutes Title 39. Health and Safety § 39-3315. Admission records

(a) Name and social security number.

(b) Permanent address if other than the facility.

(c) Marital status and sex.

(d) Birthplace and date of birth.

(e) Name, address and telephone number of responsible agent or agency.

(f) Personal physician or authorized provider.

(g) Admission date.

(h) Results of a physical or health status examination performed by a licensed physician or authorized provider within six (6) months prior to admission.

(i) A list of medications, treatments and diet prescribed for the resident which is signed and dated by the physician or authorized provider giving the order(s).

(j) Religious affiliation if resident chooses to so state.

(k) Interested relatives and friends other than those in paragraph (e) of this subsection. Names, addresses and telephone numbers of family members and/or significant others.

(l) Resident assessment.

(m) The results of any psychosocial evaluations or histories to ensure all resident needs are being met.