New Jersey Administrative Code › Title 8 - HEALTH › Chapter 39 - STANDARDS FOR LICENSURE OF LONG-TERM CARE FACILITIES › Subchapter 47 - SUBACUTE CARE UNIT IN AN ACUTE CARE GENERAL HOSPITAL › Section 8:39-47.4 - Licensure requirements

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Prior to receiving a
				license and prior to the initial licensure survey by representatives of the
				Department, the hospital-based subacute care unit shall develop written clinical
				admission criteria and utilization review protocols as described in this section.
1. A resident of a long-term care facility who is
				admitted to, and discharged from, an acute care hospital shall not, upon discharge
				from the hospital, be admitted to the hospital-based subacute care unit, unless the
				long-term care facility is unable to readmit the resident within 24 hours after
				written notification to the long-term care facility that the resident is to be
				discharged from the hospital. In this case, the patient shall be discharged to the
				long-term care facility of origin as soon as such facility is able to readmit the
				individual. The hospital-based subacute care unit shall, on a daily basis, document
				in the patient's medical record the continuing inability of the long-term care
				facility of origin to readmit the patient.
2. The hospital shall identify clinical admission
				criteria for its hospital-based subacute care unit which shall include:
i. Prospective clinical admission criteria;
				and
ii. Clinical exclusion
				criteria.
3. The hospital
				shall specify within the clinical admission criteria that the hospital-based
				subacute care unit is intended for patients who will need post-acute care for eight
				days or fewer.
4. Except as provided in
				(a)5 below, patients shall be admitted to the hospital-based subacute care unit on
				the recommendation of the attending physician, if such admission is in accordance
				with the written clinical admission and exclusion criteria.
5. Except as set forth at (a)6 below, the
				hospital-based subacute care unit shall not admit a clinically stable patient with
				one of the diagnoses listed at (a)5i below and meeting all of the criteria for
				inpatient rehabilitation hospital care listed at (a)5ii below.
i. Nonadmissible diagnostic categories shall
				include patients with stroke; congenital anomaly; major multiple trauma;
				polyarthritis, including rheumatoid arthritis; neurological disorder, including
				multiple sclerosis, motor neuron disease, polyneuropathy, muscular dystrophy, and
				Parkinson's disease; traumatic or nontraumatic brain injury; spinal cord injury;
				amputation; joint replacement; fracture of the femur, including hip fracture; and
				burns.
ii. Criteria for inpatient
				rehabilitation hospital care shall include the following:
(1) The need for close medical supervision by a
				physician with specialized training or experience in rehabilitation;
(2) The need for 24-hour per day rehabilitation
				nursing;
(3) The need for a relatively
				intense level of rehabilitation services;
(4) The need for a multidisciplinary team approach
				to the delivery of the program;
(5) The
				need for a coordinated program of care;
(6) The expectation of significant practical
				improvement in a reasonable period of time; and
(7) The establishment of realistic goals of
				self-care or independence in activities of daily living.
6. In order to admit a patient
				described at (a)5 above, the hospital-based subacute care unit shall:
i. Forward information pertaining to the
				clinically stable patient to either a licensed comprehensive rehabilitation hospital
				or an acute care hospital which has licensed comprehensive rehabilitation
				beds;
ii. Receive a favorable
				recommendation from either the licensed comprehensive rehabilitation hospital or the
				acute care hospital which has licensed comprehensive rehabilitation beds;
iii. Receive a written concurring recommendation
				regarding the patient's admission from the case manager at the acute care hospital;
				and
iv. Receive a recommendation to
				admit from the patient's attending physician.