New Jersey Administrative Code › Title 8 - HEALTH › Chapter 39 - STANDARDS FOR LICENSURE OF LONG-TERM CARE FACILITIES › Subchapter 5 - MANDATORY ACCESS TO CARE › Section 8:39-5.1 - Mandatory policies and procedures for access to care

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The facility shall
				comply with applicable Federal, State, and local laws, rules, and
				regulations.
(b) There shall be no
				discrimination against any resident or group of residents based on method of
				payment.
(c) The facility shall meet all
				currently applicable conditions attached to any certificate of need that has been
				granted to it.
(d) If a facility has
				reason to believe, based on a resident's behavior, that the resident poses a danger
				to himself or herself or others, and that the facility is not capable of providing
				proper care to the resident, then an evaluation should be performed and documented
				in accordance with the Guidelines for Inappropriate Behavior and Resident to
				Resident Abuse in Appendix B, incorporated herein by reference.
(e) The facility shall make available to indigent
				individuals at least five percent of its beds or, if the facility is licensed for
				100 or more beds, at least 10 percent of its beds. For purposes of this section, an
				individual is "indigent" if he or she is an applicant for admission or a current
				resident of the facility, and if he or she would otherwise meet the eligibility
				requirements of Medicaid reimbursement or county or municipal financial assistance
				for nursing home care.
CASE NOTES
Former N.J.A.C. 8:30-14.4(a), which required nursing homes to make
				  available "a reasonable number of their beds to indigent persons" as a condition of
				  licensure under
				  26:2H-5,
				  26:2H-8, and
				  26:2H-12, did not exceed the power
				  given to the State under
				  26:2H-1 et seq.; the argument that the
				  State was attempting to regulate the quantity of health care services, rather than
				  the quality of health care services was rejected because the acute shortage of
				  nursing home beds for indigent persons was a public health concern, and the
				  regulations were not arbitrary or unreasonable. In re Health Care Admin. Board, 83
				  N.J. 67, 415 A.2d 1147, 1980 N.J. LEXIS 1365 (1980), writ of certiorari denied by
				  449 U.S. 944, 101 S. Ct. 342, 66 L. Ed. 2d 208, 1980 U.S. LEXIS 3668, 49 U.S.L.W.
				  3331 (1980).
Former N.J.A.C. 8:30-14.4(a), which required nursing homes to make
				  available "a reasonable number of their beds to indigent persons" as a condition of
				  licensure under
				  26:2H-5, did not constitute a taking
				  without just compensation under N.J. Const. art. I, para. 20 because the regulation
				  served a valid public purpose and the nursing home was given a right to
				  administrative and judicial review of any allotment of beds. In re Health Care
				  Admin. Board, 83 N.J. 67, 415 A.2d 1147, 1980 N.J. LEXIS 1365 (1980), writ of
				  certiorari denied by 449 U.S. 944, 101 S. Ct. 342, 66 L. Ed. 2d 208, 1980 U.S. LEXIS
				  3668, 49 U.S.L.W. 3331 (1980).
Former N.J.A.C. 8:30-14.4(a), which required nursing homes to make
				  available "a reasonable number of their beds to indigent persons" as a condition of
				  licensure under
				  26:2H-5, did not violate the equal
				  protection rights of private facilities because the private facilities were involved
				  in a quasi-public activity and were therefore subject to extensive regulation in the
				  public interest; the classification was not suspect and did not implicate a
				  fundamental right and the nursing home's obligation to serve the public interest was
				  rationally related to the regulations. In re Health Care Admin. Board, 83 N.J. 67,
				  415 A.2d 1147, 1980 N.J. LEXIS 1365 (1980), writ of certiorari denied by 449 U.S.
				  944, 101 S. Ct. 342, 66 L. Ed. 2d 208, 1980 U.S. LEXIS 3668, 49 U.S.L.W. 3331
				  (1980).
Former N.J.A.C. 8:30-14.4(a), which required nursing homes to make
				  available "a reasonable number of their beds to indigent persons" as a condition of
				  licensure under
				  26:2H-5, did not conflict with the
				  federal Medicaid statute,
				  42 U.S.C. §
										1396 et seq.; there was no factual evidence
				  presented to support the claim that the reimbursement rates set in the program
				  violated the federal rates or that compelled participation in the state program
				  violated the voluntary nature of the federal program, constituting an unjust taking,
				  because there was no requirement in the regulations that a facility seek
				  reimbursement from Medicaid. In re Health Care Admin. Board, 83 N.J. 67, 415 A.2d
				  1147, 1980 N.J. LEXIS 1365 (1980), writ of certiorari denied by 449 U.S. 944, 101 S.
				  Ct. 342, 66 L. Ed. 2d 208, 1980 U.S. LEXIS 3668, 49 U.S.L.W. 3331 (1980).