New Jersey Administrative Code › Title 8 - HEALTH › Chapter 85 - LONG-TERM CARE SERVICES › Subchapter 2 - NURSING FACILITY SERVICES › Section 8:85-2.2 - Delivery of nursing services

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The NF shall provide
				24-hour nursing services in accordance with the Department's minimum licensing
				standards set forth by the Standards for Licensure of Long-Term Care Facilities,
				N.J.A.C. 8:39, incorporated herein by reference, employing the service-specific case
				mix system to classify recipients with similar care requirements and resource
				utilization. The NF shall provide nursing services by registered professional
				nurses, licensed practical nurses and nurses aides based on the total number of
				residents multiplied by 2.5 hours per day; plus the total number of residents
				receiving each of the following services, as more fully described at (f) below:
1.
Wound care
0.75 hour per day
2.
Tube feeding
1.00 hour per day
3.
Oxygen therapy
0.75 hour per day
4.
Tracheostomy
1.25 hours per day
5.
Intravenous therapy
1.50 hours per
						  day
6.
Respiratory services
1.25 hours per
						  day
7.
Head trauma stimulation; and
1.50 hours
						  per day
advanced neuromuscular or
orthopedic care
(b) The
				NF level of nursing care means services provided to Medicaid beneficiaries who are
				chronically or sub-acutely ill and require care for these entities, disease sequela
				or related deficits.
(c) The NF level of
				nursing care shall incorporate the principles of nursing process, which consists of
				ongoing assessment of the beneficiary's health status for the purpose of planning,
				implementing and evaluating the individual's response to treatment.
1. In his or her capacity as coordinator of the
				interdisciplinary team, the registered professional nurse, who has primary
				responsibility for the beneficiary, shall perform, beginning on the day of
				admission, a comprehensive assessment of the beneficiary to provide, communicate and
				record within the MDS: baseline data of physiological and psychological status;
				definition of functional strengths and limitations; and determination of current and
				potential health care needs and service requirements.
i. In addition to clinical observations and
				hands-on examination of the Medicaid beneficiary, the licensed nurse shall review
				the HSDP and any available transfer records. The assessment data shall be
				coordinated by the registered professional nurse with oral or written communication
				and assessments derived from other members of the interdisciplinary team and shall
				be consistent with the medical plan of treatment. The initial comprehensive
				assessment (MDS) shall be completed no later than 14 days after admission and on an
				annual basis thereafter. If there is a significant change in the beneficiary's
				status, the NF shall complete a full comprehensive assessment involving the MDS. The
				registered professional nurse shall analyze the data and utilize the resident
				assessment protocols (RAPs), or other screening tools as provided by the CMS RAI for
				completing the comprehensive assessment, to focus problem identification, structure
				the review of assessment information and develop an interdisciplinary care plan that
				documents specific interventions unique to the individual, which define service
				requirements and facilitate the plan of treatment.