New Jersey Administrative Code › Title 17 - TREASURY - GENERAL › Chapter 41 - OFFICE OF THE OMBUDSPERSON FOR THE INSTITUTIONALIZED ELDERLY PRACTICE AND PROCEDURE RULES › Subchapter 1 - GENERAL PROVISIONS › Section 17:41-1.2 - 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:
"Abuse" means the willful infliction of physical pain,
				  injury, or mental anguish; unreasonable confinement; or the willful deprivation
				  of services that are necessary to maintain a resident's physical and mental
				  health. "Abuse" shall also mean imposing treatment upon a resident who has the
				  capacity to make healthcare decisions, after the resident has made a voluntary
				  and informed choice regarding such treatment. "Abuse" shall also mean providing
				  to a resident treatment that is not medically indicated. However, no resident
				  shall be deemed to be abused for the sole reason that he or she is being
				  furnished non-medical remedial treatment by spiritual means through prayer
				  alone, in accordance with a recognized religious method of healing, in lieu of
				  medical treatment, if it is shown through the Office's review that the resident
				  subscribes to such religious method of healing. "Abuse" also shall not mean the
				  withholding or withdrawal of life-sustaining treatment in accordance with the
				  provisions of N.J.A.C. 17:41-2.
An "act" of any facility, government agency, or managed care
				  organization shall be deemed to include any failure or refusal to act by such
				  facility or government agency.
"Administrator" means any person who is charged with the
				  general administration or supervision of a facility, whether or not such person
				  has an ownership interest in such facility, and whether or not such person's
				  functions and duties are shared with one or more other persons.
"Caregiver" or "caretaker" means a person employed or
				  contracted to provide care or services to an elderly person, and includes, but
				  is not limited to, family, friends, the staff of a facility, managed care
				  organization representative, and managed care organization care
				  managers.
"Exploitation" means the act or process of using a person or
				  his or her resources for another person's profit or advantage without legal
				  entitlement to do so.
"Facility" means any facility or program, health care
				  institution, or institution, whether public or private, offering health or
				  health-related services for the institutionalized elderly, and which is subject
				  to licensing, regulation, visitation, inspection, supervision, or funding by
				  any government agency. Facilities include, but are not limited to, nursing
				  homes, intermediate care facilities, assisted living facilities, residences,
				  and programs, residential healthcare facilities, comprehensive personal care
				  homes, special hospitals, comprehensive rehabilitation hospitals and separately
				  licensed comprehensive rehabilitation units within general acute care
				  hospitals, long-term acute care hospitals, veterans' hospitals, psychiatric
				  hospitals, social day care centers for the elderly, adult medical day care
				  centers, adult family care homes, developmental centers, the independent living
				  section of continuing care retirement communities, and class "C" and "D"
				  boarding homes. "Facility" shall not mean a correctional facility or an acute
				  care medical center.
"Government agency" means any department, division, office,
				  bureau, board, commission, authority, or any other agency or instrumentality
				  created by the State or to which the State is a party, or by any county or
				  municipality, which is responsible for the licensing, regulation, visitation,
				  inspection, or supervision of facilities, or which provides services to
				  patients, residents, or clients of facilities.
"Institutionalized elderly," "elderly," or "elderly person"
				  means any person 60 years of age or older, who is a patient, resident, or
				  client of any facility or program.
"Managed care organization" means an entity that has, or is
				  seeking to qualify for, a comprehensive risk contract, and that is:
1. A Federally qualified HMO that meets the advance
				  directives requirements of 42 CFR Part 489 Subpart I; or
2. Any public or private entity that meets the advance
				  directives requirements and is determined to also meet the following
				  conditions:
i. Makes the services it provides to its Medicaid enrollees
				  as accessible (in terms of timeliness, amount, duration, and scope) as those
				  services are to other Medicaid recipients within the area served by the entity;
				  and
ii. Meets the solvency standards of
42 CFR 438.116
.
"Neglect" means failure to perform one's duties according to
				  an accepted professional standard.
"Office" means the Office of the Ombudsperson for the
				  Institutionalized Elderly.
"Office Program" refers to statutory or other activities
				  operating under the auspices and with the approval of the Ombudsperson. Office
				  Programs shall include, but are not limited to: Investigation and Advocacy in
				  response to Complaints Program; The Volunteer Advocate Program; Oversight of
				  the Regional Long-Term Care Ethics Program; The I Choose Home NJ/Money Follows
				  the Person Program; and Outreach/Education Program.
"Resident" means any elderly person who is receiving
				  treatment or care in any facility in all its aspects, including, but not
				  limited to, admission, retention, confinement, commitment, period of residence,
				  transfer, discharge, and any instances directly related to such status. For
				  purposes of this chapter, the term "resident" shall also include an elderly
				  patient or client who is receiving treatment or care in any facility or
				  program.
"State Program Coordinator" means an individual qualified to
				  administer and supervise the Volunteer Advocate Program throughout the entire
				  State of New Jersey, and who is capable and willing to promote the Program's
				  philosophy throughout the community being served.
"Volunteer Advocate" means an individual trained and
				  certified by the Office to make regular weekly visits to assigned long-term
				  care facilities. Volunteer Advocates receive training and are subject to
				  criminal background checks. A Volunteer Advocate may exercise, but need not be
				  limited to, such functions as visitation, consultation, problem solving,
				  eliciting complaints, and generally serving as an advocate on behalf of the
				  institutionalized elderly.
"Volunteer Advocate Program" is the means by which the
				  Ombudsperson promotes and ensures community contact with residents of long-term
				  care facilities, expands the outreach of the Office, enhances the Office's
				  ability to protect residents' rights, and ensures quality of
				  care.