New Jersey Administrative Code › Title 8 - HEALTH › Chapter 39 - STANDARDS FOR LICENSURE OF LONG-TERM CARE FACILITIES › Subchapter 1 - GENERAL PROVISIONS › Section 8:39-1.2 - 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, unless the context clearly indicates otherwise:
"Actual hours worked" means the hours that a staff member is
				  scheduled to work on the particular shift for which information is being
				  reported.
"Advance directive" means a written statement of a resident's
				  instructions and directions for health care in the event of future decision making
				  incapacity, in accordance with the New Jersey Advance Directives for Health Care
				  Act, N.J.S.A. 26:2H-53 et seq., P.L. 1991, c.201. An advance directive
				  may include a proxy directive, an instruction directive, or both.
"Advanced practice nurse" means a person certified by the New
				  Jersey Board of Nursing in accordance with
				  Section
				  8 or
				  9 of
				  P.L.
				  1991, c.377; amended by
				  P.L.
				  199, c. 85, §6.
"Adverse drug reaction" means any unexpected, unintended,
				  undesired or excessive response to a drug such that it:
1. Requires discontinuing the drug (therapeutic or
				diagnostic);
2. Requires changing the
				drug therapy;
3. Requires modifying the
				dose;
4. Negatively affects prognosis;
				or
5. Results in temporary or permanent
				harm or disability, or death.
"Available" means ready for immediate use (pertaining to
				  equipment) or capable of being reached (pertaining to personnel), unless otherwise
				  defined in these rules.
"Bed" or "licensed bed" means one of the total number of beds for
				  which each licensed long-term care facility is approved for resident care by the
				  Commissioner of the New Jersey State Department of Health and Senior
				  Services.
"Certified nurse aide" means an individual who has satisfied the
				  requirements of N.J.A.C.
				  8:39-43.1(a).
"Cleaning" means the removal by scrubbing and washing, as with
				  hot water, soap or detergent, or vacuuming, of infectious agents and of organic
				  matter from surfaces on which and in which infectious agents may find conditions for
				  surviving or multiplying.
"Cohorting" means the practice of grouping patients who are or are
				  not colonized or infected with the same organism to confine their care to one area
				  and prevent contact with other patients.
"Commissioner" means the Commissioner of the New Jersey
				  Department of Health and Senior Services, or his or her designee.
"Communicable disease" means an illness due to a specific
				  infectious agent or its toxic products which occurs through transmission of that
				  agent or its products from a reservoir to a susceptible host.
"Conspicuously posted" means placed at a location within the
				  facility accessible to and seen by residents and the public.
"Contamination" means the presence of an infectious or toxic
				  agent in the air, on a body surface, or on or in clothes, bedding, instruments,
				  dressings, or other inanimate articles or substances, including water, milk, and
				  food.
"Controlled Dangerous Substances Acts" means the Controlled
				  Substances Act of 1970 (Title II,
				  Public Law
				  91-513) and the New Jersey Controlled Dangerous
				  Substances Act of 1971, N.J.S.A. 24:21-1 et seq.
"Current" means up-to-date, extending to the present time.
"Defibrillator" means a medical device heart monitor and
				  defibrillator that has received approval of its pre-market notification filed
				  pursuant to 21 U.S.C. §
										360(k) from the United States
				  Food and Drug Administration, is capable of recognizing the presence or absence of
				  ventricular fibrillation or rapid ventricular tachycardia, is capable of
				  determining, without intervention by an operator, whether defibrillation should be
				  performed, and upon determining that defibrillation should be performed,
				  automatically charges and requests delivery of an electrical impulse to an
				  individual's heart.
"Department" means the New Jersey Department of Health and Senior
				  Services.
"Dietitian" means a person who possesses a bachelor's degree from
				  an accredited college or university with a major area of concentration in a
				  nutrition-related field of study, and one year of full-time professional experience
				  or graduate-level training in nutrition.
"Direct resident care" means clinical care services provided
				  directly to residents by a registered professional nurse, licensed practical nurse
				  and/or a certified nurse aide and the supervision of those providing clinical care
				  services to residents.
"Disinfection" means the killing of infectious agents outside the
				  body, or organisms transmitting such agents, by chemical and/or physical means,
				  directly applied.
"Documented" means written, signed, and dated. If an identifier
				  such as a master sign-in sheet is used, initials may be used for signing
				  documentation, in accordance with applicable professional standards of
				  practice.
"Drug administration" means a procedure in which a prescribed
				  drug or biological is given to a resident by an authorized person in accordance with
				  all laws and regulations governing such procedures. The complete procedure of
				  administration includes:
1. Removing an
				individual dose from a previously dispensed, properly labeled container (including a
				unit dose container);
2. Verifying it
				with the prescriber's orders;
3. Giving
				the individual dose to the resident;
4.
				Seeing that the resident takes it (if oral); and
5. Recording the required information, including
				the method of administration.
"Drug dispensing" means a procedure entailing the interpretation
				  of the original or direct copy of the prescriber's order for a drug or a biological
				  and, pursuant to that order, the proper selection, measuring, labeling, packaging,
				  and issuance of the drug or biological to a resident or a service unit of the
				  facility, in conformance with all applicable Federal, State, and local rules and
				  regulations.
"Drug regimen review" means an individual resident record review
				  conducted by the consultant pharmacist, including, but not limited to, laboratory
				  tests, dietary requirements, physician's or advanced practice nurse's and nurse's
				  clinical notes, physician's or advance practice nurse's orders and progress notes,
				  in order to monitor for potentially significant adverse drug reactions, drug-to-drug
				  and drug-food interactions, allergies, contraindications, rationality of therapy,
				  drug use evaluation, and laboratory test results.
"Epidemic" means the occurrence or outbreak in a facility of one
				  or more cases of an illness in excess of normal expectancy for that illness, derived
				  from a common or propagated source.
"Facility" means a facility or distinct part of a facility
				  licensed by the New Jersey State Department of Health and Senior Services as a
				  long-term care facility.
"Full-time" means relating to a time period established by the
				  facility as a full working week, as defined and specified in the facility's policies
				  and procedures.
"Guardian" means a person appointed by a court of competent
				  jurisdiction to handle the affairs and protect the rights of any resident of the
				  facility.
"Health care facility" means a facility so defined in
				  N.J.S.A.
				  26:2H-1 et seq., and amendments thereto.
"Licensed nursing personnel" (licensed nurse) means registered
				  professional nurses or practical (vocational) nurses licensed by the New Jersey
				  State Board of Nursing.
"Licensed practical nurse" means an individual licensed by the
				  New Jersey Board of Nursing pursuant to
				  N.J.S.A.
				  45:11-27.
"Medication error" means a discrepancy between what the
				  prescriber ordered and what the resident receives. The error may or may not be seen
				  by the (pharmacist) surveyor during an observation of a resident receiving
				  medication. If a medication error is seen by the surveyor during a medication
				  observation pass, it shall be included in determining the medication error
				  rate.
"Medication error rate" is calculated by the following equation:
				  (number of errors observed divided by the opportunities for errors) x 100.
"Monitor" means to observe, watch, or check.
"Number of staff" means the number of registered professional
				  nurses, licensed practical nurses and certified nurse aides who are scheduled to
				  provide and be responsible for direct resident care on a particular shift, which is
				  calculated by dividing the total actual hours worked by each category of staff
				  member by the number of hours in the shift.
1. Actual hours worked includes the hours for each
				category of staff members included in this definition for which they will be
				providing direct resident care during any portion of the shift.
"Pharmacist" means an individual so licensed by the New Jersey
				  State Board of Pharmacy, pursuant to
				  N.J.A.C.
				  13:39-3.
"Physician" means a person licensed to practice medicine by the
				  New Jersey State Board of Medical Examiners, pursuant to
				  N.J.S.A.
				  45:9-1 et seq.
"Reasonable hour" means any time between the hours of 8:00 A.M.
				  and 8:00 P.M. daily.
"Registered professional nurse" means an individual licensed by
				  the New Jersey Board of Nursing pursuant to
				  N.J.S.A.
				  45:11-26.
"Religious and recreational activities" includes any religious,
				  social, or recreational activity that is consistent with the resident's preferences
				  and choosing, regardless of whether the activity is coordinated, offered, provided,
				  or sponsored by facility staff or by an outside activities provider.
"Resident" means a person who resides in the facility and is in
				  need of 24-hour continuous nursing supervision.
"Self administration" means a procedure in which any medication
				  is taken orally, injected, inserted, or topically or otherwise administered by a
				  resident to himself or herself. The complete procedure of self-administration
				  includes:
1. Removing an individual dose
				from a previously dispensed (in accordance with the New Jersey State Board of
				Pharmacy Rules, N.J.A.C. 13:39), labeled container (including a unit dose
				container);
2. Verifying it with the
				directions on the label; and
3. Taking
				orally, injecting, inserting, or topically or otherwise administering the
				medication.
"Shift" means a standardized reporting period, which shall consist
				  of, based on the facility's choice, either three eight-hour periods (day, evening
				  and night) or two 12-hour periods (day and night).
"Signature" means at least the first initial and full surname and
				  title (for example, R.N., L.P.N., D.D.S., M.D., D.O.) of a person, legibly written
				  with his or her own hand. A controlled electronic signature system may be
				  used.
"Social isolation" means a state of isolation wherein a resident
				  of a long-term care facility is unable to engage in social interactions and
				  religious and recreational activities with other facility residents or with family
				  members, friends, and external support systems.
"Staff-to-resident ratio" means a ratio calculated with the
				  numerator being the number of staff for each category of direct resident care staff
				  scheduled to work on a particular shift and the denominator being the number of
				  residents in the facility during that particular shift.
"Supervision" means authoritative procedural guidance by a
				  qualified person for the accomplishment of a function or activity within his or her
				  sphere of competence, with initial direction and periodic on-site inspection of the
				  actual act of accomplishing the function or activity. "Direct supervision" means
				  supervision on the premises within view of the supervisor.
"Unit-of-use" means a system in which drugs are delivered to the
				  resident areas either in single unit packaging, bingo or punch cards, blister or
				  strip packs, or other system where each drug is physically
				  separate.