New Jersey Administrative Code › Title 8 - HEALTH › Chapter 33C - CERTIFICATE OF NEED AND HEALTHCARE FACILITY LICENSURE: REGIONALIZED PERINATAL SERVICES AND MATERNAL AND CHILD HEALTH CONSORTIA › Subchapter 1 - GENERAL PROVISIONS › Section 8:33C-1.2 - Definitions

Current through Register Vol. 56, No. 14, July 15, 2024
The following words and terms, when used in this chapter, shall
				  have the following meanings:
"Advanced practice nurse" means a licensed registered professional
				  nurse with certification in a specialty requiring expertise in maternal and child
				  health who has been certified by the New Jersey Board of Nursing, in accordance with
				  N.J.A.C. 13:37-7, Certification of Nurse Practitioners/Clinical Nurse
				  Specialists.
"Back transport" means the act of returning patients to the
				  facility to which they were originally admitted or to their local hospital for
				  further care when the problems that required transport to a higher level facility
				  have been resolved and the patient no longer requires such higher level of
				  care.
"Central service facility" means a health care facility, regulated
				  by the Department, providing essential administrative and clerical support services
				  to two or more direct providers of health care services in a region, which may also
				  include some direct provision of health care services.
"Certified nurse midwife" means a registered professional nurse,
				  licensed as such by the New Jersey State Board of Nursing, who is also a graduate of
				  an accredited school certified by the American College of Nurse Midwives, and
				  licensed as such by the New Jersey Board of Medical Examiners as required through
				  N.J.A.C. 13:35-2A.
"Co-managed" means for two or more providers to temporarily share
				  responsibility for a patient's health care.
"Commissioner" means the New Jersey State Commissioner of
				  Health.
"Community Perinatal Center" means a Department-designated
				  Community Perinatal Center-Basic, Community Perinatal Center-Birth Center, Community
				  Perinatal Center-Intensive and Community Perinatal Center-Intermediate
				  collectively.
"Community Perinatal Center-Basic" means a general acute care
				  hospital licensed by the Department in accordance with N.J.A.C. 8:43G, and
				  authorized to provide services to neonates and uncomplicated, low risk maternity
				  patients expected to deliver neonates at least 36 weeks in gestational age and
				  weighing greater than 2,499 grams as well as supportive services to infants returned
				  from Regional or Community Perinatal Center-Intensive facilities, as such services
				  are specified within a formal letter of agreement between the facility and a
				  Regional Perinatal Center.
"Community Perinatal Center-Birth Center" means an ambulatory care
				  facility, or a distinct part of a health care facility separately licensed as an
				  ambulatory care facility, authorized to provide routine prenatal and intrapartal
				  care to low risk maternity patients who are expected to deliver neonates at least 37
				  weeks of gestational age, weighing greater than 2,499 grams, and requiring less than
				  a 24-hour stay following birth.
"Community Perinatal Center-Intensive" means a general acute care
				  hospital, licensed by the Department in accordance with N.J.A.C. 8:43G, and
				  authorized to provide services to neonates and complicated maternity patients who
				  are expected to deliver neonates at least 28 weeks of gestational age and weighing
				  greater than 999 grams, as such services are specified within a formal letter of
				  agreement between the facility and a Regional Perinatal Center.
"Community Perinatal Center-Intermediate" means a general acute
				  care hospital, licensed by the Department in accordance with N.J.A.C. 8:43G, and
				  authorized to provide services to neonates and complicated maternity patients
				  expected to deliver neonates at least 32 weeks of gestational age and weighing
				  greater than 1,499 grams, as such services are specified within a formal letter of
				  agreement between the facility and a Regional Perinatal Center.
"Consultation" means information or guidance provided by a person
				  recognized as a specialist in a particular medical field. This information may be
				  provided via the telephone or through co-management of the high risk maternal-fetal
				  or neonatal patient.
"Consumer/consumer advocacy organization" means an individual who
				  may receive health care services in a specific health care service region, who is
				  not a health care provider and has no fiduciary interest in a health care service;
				  or an agency or organization which is not a health care provider and advocates for
				  consumers.
"Department" means the New Jersey State Department of
				  Health.
"General member" means any individual, facility or organization
				  with an interest in maternal and child health who has joined a Maternal and Child
				  Health Consortium.
"High risk" or "patient who is at risk" means any patient
				  identified with a medical/obstetrical condition requiring more than routine medical
				  or surgical intervention.
"High risk infant follow-up" means a system of screening and
				  tracking infants with potentially serious health problems or at risk for development
				  delays following discharge from the hospital.
"Hospital" means a New Jersey licensed general acute care
				  hospital.
"Hospital provider" means an individual who is a direct provider
				  of a health care service or has administrative responsibility for a New Jersey
				  licensed general acute care hospital or an individual who is employed by a
				  hospital.
"Hospital service area" means those municipalities in an area
				  determined through the most recent patient origin/market share data collected by the
				  Department to meet one or more of the following criteria:
1. The hospital derives five percent or more of total admissions
				  from the municipality;
2. Greater than 20 percent of residents of the municipality who
				  are hospitalized utilize the subject hospital; or
3. The hospital is located within the municipality.
"Infant" means a child from birth to one year of age.
"In-hospital coverage" means a system whereby a licensed
				  practitioner is physically present in the hospital as required by N.J.A.C.
				  8:43G-19.
"Intensive care" means a hospital unit in which special equipment
				  and skilled personnel are concentrated to provide immediate and continuous attention
				  to patients who, because of surgery, shock, trauma, serious injury or life
				  threatening conditions, require intensified comprehensive observation and
				  care.
"Intermediate care" means a hospital unit in which special
				  equipment and personnel are available to care for stable, though ill,
				  patients.
"Intermediate birth weight" means a weight of between 1,500 and
				  2,500 grams at birth.
"Intrapartum" means the period occurring during childbirth or
				  delivery.
"Labor-delivery-recovery-postpartum (LDRP) bed" means a licensed
				  obstetric bed, the primary function of which is to accommodate an obstetrical
				  patient during the entire course of labor, delivery, recovery, and postpartum
				  periods.
"Letter of agreement" means a document between licensed perinatal
				  and pediatric health care providers and an MCHC, or a document between a Regional
				  Perinatal Center and a Community Perinatal Center, developed in cooperation with the
				  MCHC, which defines the relationship between the parties, specifies all tasks to be
				  provided by each party, and is signed by a representative of each party to the
				  agreement who is authorized to bind the party to such an agreement.
"Low birth weight" means a weight of less than 2,500 grams at
				  birth.
"Maternal and Child Health Consortium (MCHC)" means a voluntary
				  formed nonprofit organization which is licensed as a central service facility by the
				  Department as specified in these rules, and incorporated under Section 501(c)(3) of
				  the United States Internal Revenue Code.
"Maternal and child health service region" means a MCHC's
				  designated geographically contiguous perinatal and pediatric service delivery
				  area.
"Maternal-fetal transport" means transport of a high risk pregnant
				  patient (that is, a patient diagnosed with a fetal condition which will require
				  stabilization or resuscitation of the infant during the neonatal period, a patient
				  with a severe maternal illness, and other cases in which care by a perinatologist is
				  required) from one facility to another facility able to provide the appropriate
				  level of care.
"Member in good standing" means a MCHC member that has made timely
				  payment of its financial assessment (based on a budget approved by the Department),
				  in accordance with the MCHC's by-laws.
"Mid-level practitioner" means a certified nurse midwife or
				  advanced practice nurse as set forth in N.J.A.C. 13:35-2A, or a physician assistant
				  as set forth in N.J.A.C. 13:35-2B.
"Neonatal" means the period up to 28 days after birth.
"Neonatal intensive care" means a hospital intensive care unit
				  staffed with specially trained nursing personnel and containing specialized support
				  equipment for treatment of newborn infants who require intensified, comprehensive
				  observation and care exceeding that provided in pediatric acute or newborn nursing
				  units.
"Neonatal transport" means a situation where a team is deployed
				  from one facility to evaluate and stabilize the condition of a neonate at another
				  facility, with the intent of transferring the neonate to the team's facility for a
				  higher level of care, as medically appropriate.
"Neonate" or "newborn" means a child from the moment of birth up
				  to 28 days thereafter.
"Neonatologist" means a physician who is board certified in
				  pediatrics with a certification in neonatology from the American Board of
				  Pediatrics, Sub-Board of Neonatal/Perinatal Medicine or the American Osteopathic
				  Board of Pediatrics, Sub-Board of Neonatology.
"Non-hospital provider" means an individual who is a health care
				  provider or has administrative responsibility for a health care facility but is not
				  employed by a hospital.
"Obstetrician" means a physician who is certified, or eligible for
				  certification by the American Board of Obstetrics and Gynecology, Inc., or the
				  American Osteopathic Board of Obstetrics and Gynecology.
"On-call coverage" means a system whereby a licensed practitioner
				  is readily available to be at the facility within 30 minutes of initial contact as
				  described in N.J.A.C. 8:43G-19.
"Pediatrician" means a physician who is certified or eligible for
				  certification by the American Board of Pediatrics or the American Osteopathic Board
				  of Pediatrics.
"Perinatal" means the period from the 20th week of gestation
				  through the neonatal period.
"Perinatologist" means a physician who is board certified in
				  obstetrics/gynecology with additional certification in maternal-fetal medicine from
				  the American Board of Obstetrics and Gynecology, Inc., Division of Maternal-Fetal
				  Medicine or the American Osteopathic Board of Obstetrics, Sub-Board of
				  Maternal-Fetal Medicine.
"Postpartum" means the period up to, and including, six weeks
				  following birth.
"Preconceptional care" means assessing an individual for risk
				  factors and counseling the individual prior to pregnancy.
"Prenatal (antepartal)" means the period of fetal development
				  prior to birth.
"Provider" means an individual who is a provider of health care
				  either directly through the provision or administration of health services or
				  indirectly by having a fiduciary interest in such services.
"Referral" means a situation where the attending physician
				  transfers the responsibility of the patient's care to a physician specializing in
				  either neonatal or maternal-fetal medicine at the Regional Perinatal Center. Such a
				  transfer of responsibility can consist of consultation only with the attending
				  physician retaining care responsibility or continued management by the Regional
				  Perinatal Center through delivery.
"Regional Perinatal Center" means a general acute care hospital
				  which is designated and licensed to provide care to high risk mothers and neonates.
				  Such a facility provides consultation, referral, transport and follow-up to other
				  members of its Maternal and Child Health Consortium.
"Regional perinatal and pediatric plan" means the five-year plan
				  developed and updated annually by the existing or proposed MCHC, which describes how
				  prenatal, intrapartum, newborn and infant follow-up services and pediatric services
				  are delivered in the maternal and child health service region, as well as strategies
				  for improving services.
"Regional transport system" means a system developed by the MCHC
				  which includes written policies and procedures for the triage of mothers and/or
				  infants to the most appropriate level of care in accordance with formal letters of
				  agreement.
"Regionalized services" means services which are planned and
				  delivered within a specific geographic zone for the best use of financial and
				  medical resources such as staffing, equipment, facilities, education and expertise
				  to coordinate appropriate quality health care to a specific population.
"Risk reduction services" means specific perinatal addiction
				  prevention and intervention services which may be provided individually or on a
				  regional basis.
"Risk reduction specialist" means a registered professional nurse,
				  a licensed or certified social worker, or other professional in a maternal and child
				  health addiction-related field who has specialized training and experience in
				  perinatal addiction.
"Total quality improvement program" means an ongoing and
				  systematic process designed to review, measure and evaluate quality of care and
				  perinatal and pediatric outcomes.
"Transfer" means a temporary or permanent shift in responsibility
				  for a patient's health care management from one provider to another.
"Transport" means the process whereby the attending physician or
				  certified nurse midwife at the Birth Center or Community Perinatal Center determines
				  that the status of the patient has become acutely high risk and arranges for the
				  transfer of the patient to a higher level facility, and includes maternal-fetal
				  and/or neonatal transport.
"Ventilatory support" means the application of positive pressure
				  ventilation and oxygen through mechanical devices, including continuous positive
				  airway pressure (CPAP).
"Very low birth weight" means a weight of less than 1,500 grams at
				  birth.