New Jersey Administrative Code › Title 5 - COMMUNITY AFFAIRS › Chapter 27A - STANDARDS FOR LICENSURE OF RESIDENTIAL HEALTH CARE FACILITIES NOT LOCATED WITH, AND OPERATED BY, LICENSED HEALTH CARE FACILITIES › Subchapter 4 - GENERAL REQUIREMENTS › Section 5:27A-4.16 - Policies and procedures for advance directives

Current through Register Vol. 56, No. 14, July 15, 2024
(a) For purposes of this
				chapter, "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,
				26:2H-53 et seq. An advance directive
				may include a proxy directive, and instruction directive, or both.
(b) The facility shall develop and implement
				procedures to ensure that there is a routine inquiry made of each adult resident,
				upon admission to the facility and at other appropriate times, concerning the
				existence and location of an advance directive. If the resident is incapable of
				responding to this inquiry, the facility shall have procedures to request the
				information from the resident's family or, in the absence of a family member,
				another individual with personal knowledge of the resident. The procedures shall
				assure that the resident or family's response to this inquiry shall be documented in
				the resident's record. Such procedures shall also define the role of facility
				admissions, nursing, social service and other staff, as well as the responsibilities
				of the attending physician.
(c) The
				facility shall develop and implement procedures to promptly request and take
				reasonable steps to obtain a copy of currently executed advance directives from all
				residents. These shall be entered into the resident's record when
				received.
(d) The facility shall have
				procedures to provide each adult resident upon admission and, where the resident is
				unable to respond, the family or other representative of the resident, with a
				written statement of his or her rights under New Jersey law to make decisions
				concerning the right to refuse medical care and the right to formulate an advance
				directive. Appropriate information and materials on advance directives and the
				institution's written policies and procedures concerning implementation of such
				rights shall also be provided. Such written information shall also be made available
				in any language which is spoken, as a primary language, by more than 10 percent of
				the population served by the facility.
(e) The facility shall develop and implement
				procedures for referral of residents requesting assistance in executing an advance
				directive or additional information to either staff or community resource persons
				that can promptly advise and/or assist the resident.
(f) The facility shall develop and implement
				policies to address application of the facility's procedures for advance directives
				to residents who are experiencing an urgent life-threatening situation.
(g) A resident shall be transferred to another
				health care facility only for a valid medical reason, in order to comply with other
				applicable laws or Department rules, to comply with clearly expressed and documented
				resident choice, or in conformance with the New Jersey Advance Directives for Health
				Care Act in the instance of private, religiously affiliated health care institutions
				who establish policies defining circumstances in which they will decline to
				participate in the implementation of advance directives. Such institutions shall
				provide notice of their policies to residents or their families or health care
				representatives prior to or upon admission. A timely and respectful transfer of the
				individual to another institution which shall implement the resident's advance
				directive shall be effected. The facility's inability to care for the resident shall
				be considered a valid medical reason. The sending facility shall receive approval
				from a physician and the receiving health care facility before transferring the
				resident.
(h) At least one education
				training program each year shall be held for all administrative staff and employees
				providing resident supervision and/or personal care on the rights and
				responsibilities of staff under the New Jersey Advance Directives for Health Care
				Act, 26:2H-53 et seq., and internal facility
				policies and procedures which implement this law.