New Jersey Administrative Code › Title 8 - HEALTH › Chapter 33H - CERTIFICATE OF NEED: POLICY MANUAL FOR LONG TERM CARE SERVICES › Subchapter 1 - GENERAL PROVISIONS › Section 8:33H-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:
"Aging in place" means a process whereby individuals remain in
				  their living environment despite the physical and/or mental decline and growing
				  needs for supportive services that may occur in the course of aging. For aging in
				  place to occur, services are added, increased, or adjusted to compensate for the
				  person's physical and/or mental decline.
"Applicant" means an individual, a partnership, a limited
				  liability partnership, a corporation (including associations and joint-stock
				  companies, a limited liability corporation, a State, or a political subdivision
				  (including a municipal corporation) of a State that will be the licensed operator of
				  the proposed service, facility or equipment, which will have overall responsibility
				  for the health care service to be provided.
"Assisted living" means a coordinated array of supportive personal
				  and health services, available 24 hours per day, to residents who have been assessed
				  to need these services, including residents who require formal long-term care.
				  Assisted living promotes resident self-direction and participation in decisions that
				  emphasize independence, individuality, privacy, dignity, and homelike
				  surroundings.
"Assisted living program" means the provision of or arrangement
				  for meals and assisted living services, when needed, to the tenants (also known as
				  residents) of publicly subsidized housing which because of any Federal, State, or
				  local housing laws, regulations or requirements cannot become licensed as an
				  assisted living residence. An assisted living program may also provide staff
				  resources and other services to a licensed assisted living residence and a licensed
				  comprehensive personal care home.
"Assisted living program provider" means an organization licensed
				  by the New Jersey Department of Health , in accordance with N.J.A.C. 8:36, to
				  provide all services required of an assisted living program.
"Assisted living residence" means a facility which is licensed by
				  the Department, in accordance with N.J.A.C. 8:36, to provide apartment-style housing
				  and congregate dining and to assure that assisted living services are available when
				  needed, to four or more adult persons unrelated to the proprietor. Apartment units
				  offer, at a minimum, one unfurnished room, a private bathroom, a kitchenette, and a
				  lockable door on the unit entrance.
"Commissioner" means the State Commissioner of Health .
"Comprehensive personal care home" means a facility which is
				  licensed by the Department, in accordance with N.J.A.C. 8:36, to provide room and
				  board and to assure that assisted living services are available when needed, to four
				  or more adults unrelated to the proprietor. Residential units in comprehensive
				  personal care homes house no more than two residents and have a lockable door on the
				  unit entrance.
"Continuing care retirement community" means the provision of
				  lodging and nursing, medical, or other related services at the same or another
				  location to an individual pursuant to an agreement effective for the life of the
				  individual or for a period greater than one year, including mutually terminable
				  contracts, and in consideration of the payment of an entrance fee with or without
				  other periodic charges. A fee which is less than the sum of the regular periodic
				  charges for one year of residency is not considered an entrance fee. For Certificate
				  of Need exemption purposes, a new or proposed community which will have fewer than
				  four independent living units per nursing facility bed, or an existing community
				  which proposes to construct additional nursing facility beds which will be utilized
				  by persons who have not paid the entrance fee, is not a continuing care retirement
				  community. The required four to one ratio shall be maintained at all times. Beds
				  licensed as assisted living residence, comprehensive personal care home or
				  residential health care may be counted in the numerator of this ratio, at the
				  discretion of the applicant.
"Deficiency" means a finding or findings by the Department that a
				  facility is not in compliance with applicable State licensure requirements and/or
				  Federal requirements for a health care facility. A deficiency remains valid unless
				  overruled by the Commissioner of Health or a judicial appeal process.
"Department" means the New Jersey State Department of Health
				  .
"Direct admission Medicaid patient" or "resident" means an
				  individual who is admitted to a long-term care bed as a Medicaid eligible patient,
				  or a private paying patient who will spend down to Medicaid eligibility within 180
				  days of placement in the long-term care bed.
"Financially feasible" means revenues exceed expenses during or
				  before the third year subsequent to implementation of a certificate of need-approved
				  project.
"General long-term care bed" means a long-term care bed for which
				  there is no restriction imposed by statute (for example, subacute long-term care),
				  certificate of need approval requirements (for example, pediatric long-term care,
				  specialized long-term ventilator care, specialized long-term care of residents with
				  severe behavior management problems) or stipulations and/or licensure standards that
				  would limit the type of nursing home resident who may occupy the bed or the type of
				  nursing home care which may be provided to the occupant of the bed.
"Hospice" means a program, which is licensed by the New Jersey
				  State Department of Health to provide palliative services to terminally ill persons
				  in the person's home or place of residence, including medical, nursing, social work,
				  volunteer, and counseling services.
"Hospital-based subacute long term care unit" means a unit located
				  within an acute care general hospital which utilizes licensed long-term care beds to
				  provide subacute care for patients.
"Long-term care" means a wide range of personal care,
				  psycho-social, nursing, and other supportive services for people with functional
				  limitations due to chronic--and frequently degenerative--physical or cognitive
				  disorders. Long-term care services range from in-home assistance provided by family
				  members or a home care agency to nursing home care.
"Medicaid-eligible patient" means, for the purpose of this
				  chapter, a person who has received a determination of medical and financial
				  eligibility for Medicaid coverage, or a person who qualifies medically and
				  financially for Medicaid but who does not apply for Medicaid coverage, or a person
				  whose care is paid for through General Assistance funds.
"Nursing home" or "nursing facility" means a facility that is
				  licensed by the Department to provide health care under medical supervision and
				  continuous nursing care for 24 or more consecutive hours to two or more patients who
				  do not require the degree of care and treatment which a hospital provides and who,
				  because of their physical or mental condition, require continuous nursing care and
				  services above the level of room and board.
"Nursing home-level care" means care provided to individuals who
				  have chronic medical condition(s) resulting in moderate to severe impairments in
				  physical, behavioral, cognitive, and/or psychosocial functioning. The need for
				  nursing home-level care and services is determined by a registered nurse and
				  identified in a plan of care, in accordance with
				  8:36-7.1 "Nursing home-level care"
				  includes, but is not limited to, partial or total assistance with activities of
				  daily living (for example, bathing, dressing, eating, toileting, mobility),
				  assistance with self-administering or administration of medications, and provision
				  of treatments and periodic reassessments as directed by the plan of care. It may
				  also include the provision of physiotherapy, occupational therapy, therapeutic
				  counseling, and other rehabilitative services as indicated by the individual's
				  medical condition.
"Pediatric long-term care" means a facility, distinct nursing
				  unit, or program which is dedicated for occupancy by patients under age 20.
"Planning regions for pediatric and specialized long term care
				  beds/services," unless otherwise specifically defined in the certificate of need
				  call published in the New Jersey Register, means the counties in the following three
				  regions:
1. Region 1: Morris, Sussex, Passaic, Hunterdon, Mercer,
				  Middlesex, Somerset and Warren Counties;
2. Region 2: Bergen, Essex, Union and Hudson Counties;
3. Region 3: Atlantic, Burlington, Camden, Cape May, Cumberland,
				  Gloucester, Monmouth, Ocean and Salem Counties.
"Project" means the construction, renovation, and/or related
				  activities which are required in order to implement a certificate of need.
"Respite care" means a service that provides a brief period of
				  relief from caregiving responsibilities for the family members and friends of
				  individuals who require long-term care. It may be offered either on an outpatient
				  basis, for example, in the form of adult day health care, or an inpatient basis, for
				  example, in the form of residential health care.
"Specialized long-term care" means a program of care provided in
				  licensed long-term care beds for residents who require technically complex treatment
				  with life supporting equipment or who have serious problems accessing appropriate
				  nursing home care due to the specialized treatment required by their medical
				  diagnoses and level of functional limitation.
"Statewide restricted admissions facility" means a non-profit
				  nursing home owned and operated by a religious or fraternal organization that serves
				  only members of that organization and their immediate families.